It’s not uncommon and it calls for action, not shame. Depression, anxiety, mania, stress, substances – sometimes we live on the edge. And it comes at a cost. How to survive a depression or anxiety crisis? Let’s talk…
Embrace your suffering and be worthy of it. What you expect from life is irrelevant. It’s what life expects from you that matters.
Beneath your conscious awareness, a dangerous amount of biological and environmental fuel accumulated.
Then came the igniting trigger, and you blew. It was crisis time and you believed there was no way out.
Be prepared
Does that hit home? Maybe you’re up to your neck in it right now. Lord knows I’ve been there a time or ten.
Fact is, we know blowups can sneak up on us anytime. Yet, all too often we aren’t prepared with coping strategies and techniques to pull us through.
We can’t be caught off guard like that.
How to survive a depression or anxiety crisis
“I was totally unprepared for this. And I have no idea what to do. Help…”
Between personal experience and my ER psych days, I’ve gathered a lengthy list of in the moment crisis interventions – some of which I still use to maintain balance.
I’m going to share 17 of them, but first…
If the tips don’t work for you, don’t think twice about reaching out to your mental health provider. If you don’t have one or if you’re having thoughts of harm to self or others dial 988 in the US. For those living elsewhere visit this incredibly helpful directory.
Let’s get busy…
17 Chipur tipurs
When the perception ofa crisis strikes…
STOP! Ground yourself and be confident in knowing your world comes to an end only by choice.
Accept what’s happening and the factors driving it – no fighting. And accept that taking hits is a part of being human. It’s okay.
Turn to the intervention plan you either have or will have after reading this.
Stay in the moment. If you start thinking down the road, you’re not going to like what you see.
Connect with your spiritual power source and maintain communication – pray, meditate. In addition to asking for help, listen.
In all things, maintain a spirit of forward motion. Even if it’s inches at a time, you’re on your way.
If you’ve been through it before, here you are. Obviously, you aren’t going down.
Understand there’s a good chance that what you’re feeling and how you’re behaving are being generated by cognitive distortions. Don’t blindly trust your thoughts.
Allow your reaction and response to evolve. If you force them, things will turn uglier.
Realize who you are, not what. And there’s no better time to learn the distinction.
Consider the circumstances as the best possible learning and growth opportunity, and make it your business to do just that.
Take what’s happening within the context of your life’s meaning. And if you don’t have one, get after it.
Embrace your suffering and be worthy of it. What you expect from life is irrelevant. It’s what life expects from you that matters.
In addition to your spiritual power source, reach out to a trusted loved one, friend, spiritual advisor, or mental health pro.
This may well be a life-defining moment. Step up, and make it happen.
Keep telling yourself there’s no shame in what you’re experiencing.
Never give up on hope. It never quit on you.
Now, you may be thinking that’s way too much to ponder when all hell’s breaking loose. But if you review the list several times – a part of being prepared – you’ll be amazed how much falls into place when the chips are down.
And why not favorite the article or print it? Perhaps it can be part of your plan.
So it begins
Those of us trying to manage mood and anxiety challenges live on the edge. And we pay for it. Explosions are going to happen – that’s just the way it is.
If we accept that, we don’t have to be a helpless and hopeless victim. What we can be is prepared. And so begins surviving a crisis.
Maybe a few more Chipur mood and anxiety info and inspiration articles will come in handy. Take your pick.
Would you bare your soul to a robot or bond with a chatbot? How ‘bout trusting a machine learning diagnosis? Artificial intelligence and mental health: fantastic things are happening. Here’s the latest…
…a Vanderbilt University Medical Center study revealed that machine learning predicted whether a person will take their life with 80% accuracy.
The Age of Artificial Intelligence is upon us. And if it’s managed responsibly it can be marvelous.
There are an abundance of artificial intelligence applications up and running, and emotional and mental health is on the list.
Here’s the latest…
Background
“AI In Mental Health: Opportunities And Challenges In Developing Intelligent Digital Therapies,” written by Bernard Marr, appeared on Forbes recently.
Mr. Marr is a world-renowned business and tech futurist and influencer, as well as a best-selling author.
We’re going to rely upon his hard work and knowledge to get us where we need to go.
Let’s roll…
Definitions
Before we get to the goods, we need to handle some key definitions…
Artificial intelligence
A field of science concerned with building computers and machines that can reason, learn, and act in a way that would normally require the intelligence of humans or that involves data whose scale exceeds what humans can analyze.
Algorithm
A well-defined, in sequence computational technique that accepts a value or a collection of values as input and produces the output(s) needed to solve a problem.
Machine learning
A branch of artificial intelligence and computer science that focuses on the use of data and algorithms to imitate the way humans learn, gradually improving its accuracy.
Chatbot
A computer program that simulates human conversation to solve problems and answer questions. Modern chatbots use technologies, such as artificial intelligence and machine learning.
Artificial intelligence and mental health: Applications
I’m guessing you’ve been exposed to the artificial intelligence (AI) hype. Have you ever wondered if AI could somehow come to your emotional and mental rescue? Maybe you’ve had visions of healing similar to our featured image.
Let’s see if we can get you some answers…
Artificial intelligence therapists
Chatbots are on the rise and they’re offering advice, symptom coping assistance, and a communication conduit during treatment.
And catch this, they can pick up on keywords during a conversation that can trigger a referral and direct contact with a human emotional and mental health (EMH) professional.
Marr offers Woebot as an example of a therapeutic chatbot. It gets to know the user’s personality and adapts to it. And it can even talk the user through quite a few therapies and exercises frequently used to manage a variety of conditions.
Marr goes on to mention the chatbot, Tess. It offers free 24/7 on demand emotional support and can be used to help with anxiety and panic attacks in the moment.
Wearables
Wearables up the AI treatment ante. They don’t wait around for action on the users part. Since they’re worn, and their sensors are constantly interpreting body signals, they give an immediate heads up if something merits a look-see.
Marr uses Biobeat as an example. Sleeping patterns, physical activity, variations in heart rate and rhythm – they’re all tracked and used to assess the user’s mood and cognitive state.
The data is compared with aggregated and anonymized data from other users to provide warnings when intervention may be necessary.
Diagnosing and predicting outcomes
AI, specifically machine learning, can be used to analyze a user’s medical and behavioral data, voice recordings collected from phone calls to intervention services, and more to flag warning signs of problems before they progress to an acute stage.
For instance, Marr mentions a review of studies conducted by IBM and the University of California. The review found that where AI was used to parse various data sources, machine learning could predict and classify mental health problems – including suicidal thoughts, depression, and schizophrenia – with “high accuracy.”
“Come on, Bill, it all sounds too good to be true. What’s the catch?”
Taking things to the extreme, a Vanderbilt University Medical Center study revealed that machine learning predicted whether a person will take their life with 80% accuracy.
And research is currently being conducted at the Alan Turing Institute that’s examining ways of using large-scale datasets from individuals who have not shown symptoms of EMH issues to predict who is likely to develop them during their lifetimes.
And if that isn’t enough, AI has been used to predict cases where patients are more likely to respond to cognitive behavioral therapy (CBT), therefore being less likely to require meds.
Improving patient outcomes
If you’ve wrestled with an EMH disorder, nobody has to tell you that sticking to a treatment regimen can be challenging.
AI can be used to predict when the user is likely to slip into non-compliance and either issue reminders or alert their healthcare providers to enable manual interventions.
Personalized treatments
Research is underway involving leveraging AI to create personalized treatments for a number of mental health conditions. It’s been used to monitor symptoms and reactions to treatment to provide insights that can be used to adjust individual treatment plans.
And how ‘bout this? A University of California, Davis study focused on creating personalized treatment plans for children suffering from schizophrenia based on computer vision analysis of brain images.
Artificial intelligence and mental health: Challenges
Let’s wrap things up by talking about work that needs to be done.
Okay, you may be saying to yourself, “Come on, Bill, it all sounds too good to be true. What’s the catch?” Well, not really “catches,” but there are challenges that are being addressed.
Marr talks about AI bias. He’s referring to inaccuracies or imbalances in the datasets used to train algorithms that could perpetuate unreliable predictions or social prejudice.
For instance, when it’s known that EMH issues are more likely to go undiagnosed among ethnic groups with poorer access to healthcare, algorithms that rely on this data may also be less accurate at diagnosing those issues.
And then there’s the fact that diagnosing EMH issues often requires more subjective judgment on the part of clinicians compared to diagnosing physical conditions.
Are you on board?
Quick note before we say goodbye. Lots in the works regarding AI and psychotropic medications – recommendations, prescribing, and development.
Well, that’ll do it. Man, I broke a sweat writing this one – so much information, so much learning. And a big thank you to Bernard Marr, by the way.
How do you feel about it?
The Age of Artificial Intelligence has begun. And emotional and mental health is along for the ride. The big question is, are you on board?
Addicted to social media, amped up depression and anxiety – you browsed for help. And, bingo, you found an article on the fear of missing out. Now it’s on to causes and remedies…
’Life’s greatest joys are often found in the simplest of moments shared with people who truly know and love us.’
You see an image of friends having a good time together and it begins to sink in that you’re not part of the fun.
Continuing to stare at the screen, you’re falling into what psychiatrist Dr. Rashmi Parmar calls the “sticky trap” of the fear of missing out: FOMO.
Background
We started a two-part series last week on the fear of missing out. Most all of the content comes from the Psychiatric Times article “Understanding the fear of missing out,” written by Dr. Parmar.
Quick definition of FOMO: a pervasive apprehension that others might be having rewarding experiences from which one is absent.
FOMO is most often associated with social media; however, it’s not an exclusive arrangement.
Much more on FOMO in part one. Now to causes and remedies…
What causes the fear of missing out?
Like most everything we talk about, the bottom-line cause of FOMO is unknown. Yep, we’re dealing with the brain. That means we’ll be turning to risk factors and theory for some answers.
Risk factors
Let’s see: low self-esteem, loneliness, fear of social exclusion, anxiety, depression, risky behaviors, problematic smart phone use, fear of negative and positive evaluation, lower sense of having social needs met, general feeling of dissatisfaction with life.
They’re all risk factors for FOMO. Gender and age don’t appear to be in the equation.
Theories
Way down deep in our minds, what could be generating or contributing to FOMO? Dr. Parmar shares three interesting theories. See what you think…
Self-determination: Suggests that we’re motivated by three innate psychological needs: competence, autonomy, and relatedness. When they’re met, our self-motivation and mental health thrive. When they aren’t, our motivation and sense of well-being head south.
Too many choices: Having tons of options is great, at least until we start obsessing over whether we made the right choice. Did our selection make us miss out on something else? Psychologist Barry Schwartz: “Learning to choose is hard. Learning to choose well is harder. And learning to choose well in a world of unlimited possibilities is harder still – perhaps too hard.”
Cybernetic process model: Cybernetics is about control and communication. For any given situation, our brains are constantly sizing up options and comparing them to our goals or expectations. When the dots don’t connect, we may feel uncomfortable. FOMO can distort this process and make it harder to accurately evaluate the current situation. We may end up pursuing lesser and unhealthier priorities, instead of those that are necessary for our personal goals. When that happens, nothing matches up, we’re buried in doubt, and we end up following everyone else.
“Pervasive” isn’t in the definition for nothing. FOMO runs deep.
How do you manage the fear of missing out?
“Yes, I have FOMO. I accept it. Now I gotta’ make some changes.”
Okay, we’ve come to the conclusion that we’re dealing with FOMO. Can’t pop a pill, so what are we going to do about it?
Before we get to the goods, here’s a quick splash of reality. Be it FOMO or any other emotional or mental condition, nothing will ever change without acceptance.
Why would it if we don’t buy-in to what ails us?
Now to Dr. Parmar’s advice…
Set a daily limit for social media time. One study indicated that limiting social media to 30 minutes a day significantly reduced FOMO and anxiety, and increased overall well-being.
Hit snooze. If images and accompanying content are pushing your buttons, pause or remove social media apps for a while.
Tidy up your feed every so often. Review who and what you follow, asking yourself how they make you feel. If it’s not so hot, let them go.
Engage with friends in person. It may not be easy at first, but nobody has to tell you that social media will never replace the warmth and spontaneity of human contact.
Get to know your FOMO and what triggers it. Confront your insecurities, accept them, and adapt.
What’s important to you? Use the answers to establish life goals.
Do your best to keep your emotions from determining your behavior.
Keep a journal to identify and examine unhelpful feelings.
Remind yourself that even if people are always smiling, you never know what challenges they’re experiencing.
Actively organize activities that make you happy with the people you enjoy. Why wait for an invitation?
Make it a point to recognize and appreciate JOMO – the joy of missing out. Focus on contentment and satisfaction with who you are. Other actions include adopting a JOMO approach by focusing on contentment and satisfaction with who you are.
Practice gratitude to shift the focus from what you don’t have to what you do.
Practice mindfulness daily through meditation, yoga, or breathing exercises. It’ll keep you grounded in the present moment.
Find joy in the simple things in life.
Adopt a practical and problem-solving approach to FOMO. Be prepared by coming up with strategies to deal with challenging situations.
If you’re living with FOMO, can you make them work for you? How ‘bout some of your own?
From Dr. Parmar
Happiness does not come from comparing ourselves, chasing perceived expectations, or even feeling superior to others. It is not the quantity but the quality of experiences that matters. Life’s greatest joys are often found in the simplest of moments shared with people who truly know and love us.
Nice, doc. Thank you.
Acceptance and action
Very few of us like the feeling of missing out. But when not liking turns into fear, it’s time to take a long hard look.
And if FOMO is staring back at us, acceptance and action are the only remedies.
You noticed on Facebook that two of your friends are taking a trip together. “Wait, why am I missing out on the fun?” And now you’re hooked on monitoring plans – that don’t include you.
And, bam, we begin to spend hours on platforms comparing, keeping score, and confirming our deepest insecurities.
Very few of us like the feeling of missing out.
But when not liking turns into fear, it’s time to take a long hard look.
Background
Came across a fascinating article on Psychiatric Times. “Understanding the Fear of Missing Out” was written by psychiatrist Dr. Rashmi Parmar.
I really didn’t know much about the condition and how troubling it can be. After boning up, I knew I had to bring it to you.
Dr. Parmar provided a wealth of quality information, primarily within the context of social media.
We’re going to do a two-parter. We’ll handle what the fear of missing out is in this piece. And we’ll talk about cause and what to do about it in part two.
The vast majority of what you’re about to read comes from Dr. Parmar’s work.
“Understanding the Fear of Missing Out”
Dr. Parmar doesn’t pull any punches coming out of the gate. She observes that social media feeds our need to live our lives through others. Of course, we have plenty of them at our fingertips, 24/7.
Hours can fly by as we stare at the screen, becoming all the more vulnerable to what Parmar calls the “sticky trap” of fear of missing out: FOMO.
By the way, FOMO is often associated with social media; however, it isn’t an exclusive arrangement.
Subtle beginnings
Parmar points out that FOMO is subtle in the beginning. Aw, seeing an image of friends enjoying time together or the “perfect” family taking a dream vacation. But what’s beginning to sink in is we’re not part of the picture – the fun. We may even believe we’ve been excluded.
And, bam, we begin to spend hours on platforms comparing, keeping score, and confirming our deepest insecurities.
Definition and characteristics
The term “fear of missing out” was coined in 2004, as image-based platforms opened the door to people’s lives.
It was defined in 2013 as a “pervasive apprehension that others might be having rewarding experiences from which one is absent.”
FOMO is associated with lack of sleep, reduced life competency, emotional tension, negatively affected physical well-being, anxiety, and a lack of emotional control.
It can be felt as a single episode, long-term disposition, or overall state of mind. Ultimately, it can lead to a deep sense of social inferiority, loneliness, or rage.
Touches upon our vulnerabilities
“I’m not getting any likes – nothing. Guess that kind of makes me a loser.”
FOMO touches upon many of our vulnerabilities.
For instance, in adolescents with social anxiety, not having to go face-to-face on platforms, such as Instagram and Snapchat, makes it easier to satisfy unmet social needs.
Thing is, though, it sidesteps the hard and valuable work of talking to people in person – with unedited and unfiltered versions of reality – for personal validation.
Much of that validation comes from attracting likes and engagement. When it doesn’t happen, it can spark frustration and rage, leading to a distorted sense of self and reward.
The social media snare
It’s hard to fathom that we experience struggles when all we see are images of perfect bliss. Social media influencers are all over that with stylized content geared to build audiences, sell products, and keep us coming back.
According to Dr. Parmar, FOMO is a big reason people choose to follow influencers. Fact is, we don’t want to miss out. And social media platform administrators know it.
Really, we’re dealing with addiction dynamics. And cross-sectional studies indicate a strong correlation between internet addiction and mood, anxiety, and attention-deficit/hyperactivity disorders.
The Instagram leak
Dr. Parmar shares that Instagram has long been accused of knowingly stoking the flames of FOMO. Their own internal research found that 66% of girls and 40% of boys have been confronted with negative social comparisons on the platform.
She goes on to report that In a 2021 leak, former employee and whistleblower Frances Haugen revealed that company officials knew of the app’s danger to teens but did nothing to address it – even after researchers offered suggestions.
Due to a subsequent investigation, Instagram’s parent company Meta (formerly Facebook) temporarily put on hold plans to launch Instagram Kids, an app directed at users aged 13 years and younger.
What?
As of this writing, the app isn’t available. However, Meta continues to launch parental supervision tools and privacy features. Many experts question their effectiveness and Meta’s intent.
For example, kids need to opt in if they want their parents to supervise their accounts. That allows parents to set time limits, track time, and see who their children are following and who’s following them.
But how ‘bout this? In an effort to “balance teen safety and autonomy” parents can’t see message content. What?
Humans have sought relationships with deities from the beginning of time. Makes you wonder if we’re wired for it. Have you ever heard of the “God Spot?” Do we really have one? Let’s take a look…
Dr. Ferguson wants to pursue ways in which the findings can assist in understanding the role of spirituality and compassion in clinical treatment.
Poking around for content ideas last week, it jumped out of the screen: The “God Spot.”
If you were traipsing around the online psych world and saw it, what would be your reaction?
Well, I was hooked and had to learn more. And after jumping from article to article, I found what I was looking for…
“Researchers Identify Brain Circuit for Spirituality”
Brigham and Women’s Hospital posted a Research Brief entitled “Researchers Identify Brain Circuit for Spirituality,” dated July 1, 2021. It announced the results of a study completed by their Center for Brain Circuit Therapeutics.
A neural circuit for spirituality and religiosity derived from patients with brain lesions appeared in the June 29, 2021 edition of Biological Psychiatry. The study team leads were Michael Ferguson, PhD and Michael D. Fox, MD, PhD.
Background
The Brief begins by pointing out that more than 80% of people around the world consider themselves religious or spiritual. Curious thing is, research on the neuroscience of spirituality and religiosity has been sparse.
It goes on to state that the functional neuroimaging used in previous studies rendered a spotty and often inconsistent picture of spirituality. However, the new and advanced approach to mapping spirituality and religiosity used in their study delivered on the mark and fascinating results.
The bottom-line
Speaking of those results, here’s the gist. Dr. Ferguson, Dr. Fox, and team used lesion network mapping to identify a specific brain circuit that serves as a neural underlay for spirituality and religiosity.
Dr. Ferguson…
Our results suggest that spirituality and religiosity are rooted in fundamental, neurobiological dynamics and deeply woven into our neuro-fabric. We were astonished to find that this brain circuit for spirituality is centered in one of the most evolutionarily preserved structures in the brain.
Are you wondering what the structure is? Hang in there.
How did they do that?
So how did the team come up with the goods? They used data from another study in which 88 patients completed the Temperament and Character Inventory (TCI) before and after brain tumor resection – occurring in various places throughout the brain.
The TCIs spiritual acceptance subscale is a validated measure of spirituality and religiosity.
Interesting: 30 patients reported a decrease in spiritual belief, 29 reported an increase, and 29 reported no change.
The periaqueductal gray
Periaqueductal gray
Makes sense that the brain lesions in patients with changes in spiritual belief would be mapped. And when they were, the brain circuit for spirituality was found to be centered in the periaqueductal gray (PAG).
The PAG is a column of cells that stretches 14 millimeters/.5 inches in the midbrain portion of the brainstem. You can see its approximate location in the image.
The PAG plays a major role in pain modulation, fear conditioning, defensive behaviors, altruistic behaviors, and unconditional love. Given its size, think about how incredible that is.
Is the PAG the “God Spot?” If you want it to be, sure. All I know is the discovery is huge.
Are there other players?
Key brain structures
The brain circuit for spirituality may be centered in the PAG, but are there other players?
Of particular note, a 2012 University of Missouri-Columbia study suggested the frontal-parietal brain circuit (located in the cerebrum) is related to spiritual-religious experiences.
The authors went on to speculate that “selflessness,” associated with decreased right parietal lobe functioning, is the primary neuropsychological foundation for spiritual transcendence – having less focus on self, which makes one more capable of focusing on things beyond.
Keep in mind, the PAG (located in the midbrain) is anatomically connected to the prefrontal cortex, our executive functioning center, and other brain structures. And though certain parts of the brain may play a dominant role, they all work together to facilitate spiritual experiences.
What’s next?
The study may be completed, but the Brigham and Women’s team isn’t finished.
They want to see if they can replicate the study results across a variety of spiritual and religious backgrounds.
And how ‘bout this? Dr. Ferguson wants to pursue ways in which the findings can assist in understanding the role of spirituality and compassion in clinical treatment.
Dr. Ferguson…
Only recently have medicine and spirituality been fractionated from one another. There seems to be this perennial union between healing and spirituality across cultures and civilizations.
I’m interested in the degree to which our understanding of brain circuits could help craft scientifically grounded, clinically-translatable questions about how healing and spirituality can co-inform each other.
Please keep up the good work.
A “God Spot?”
Humans have sought and embraced relationships with deities from the beginning of time. And 80% of us consider ourselves to be religious or spiritual. It really does make the case for common wiring.
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