Using Self-Help Anxiety (SAM) App: Initial Thoughts

I downloaded the Self-Help Anxiety Management (henceforth, SAM) app to my phone several weeks back with the intention of giving it a trial run. Today I got quite anxious and after knitting part of a scarf, walking three miles, trying to meditate, and taking a nap, all with zero success in stress-reduction, I remembered it. This is Day 1 of the test–I’ll write more well-rounded analysis in 7-10 days, when I’ve used it over time.  If you’re interested in testing alongside, this is the iOS link and here’s one for Android. 

—

Before: Yes, hi, this is anxious.

Before: Welp, even more anxious than I realized.

Thought 1: Wow, Kate, you are anxious a lot.

Thought 2: Wait, this seems to actually be helping quite a bit.

Cursory Look at the Best SAM Stuff:

-An anxiety tracker (data entry part pictured on left). I paired this with Annoyster (Apple/Android alternative), to pester me to chart anxiety at random intervals throughout the day. Goal: Getting a better picture than either charting when I’m calm enough to remember or charting when I’m anxious enough to open the app.

-The relaxation techniques appear to be gamified: though I haven’t levelled up yet, it appears that after using a relaxation techinque over time, you can “level up” to unlock tougher tools (Perhaps meditating or doing breathing exercises for longer periods of time? Will check back in next writeup.)

-Anxiety Toolbox: when you find activities in the app that are particularly helpful, you move them in here. I’m excited about this part for two reasons
-It indicates that the designers recognize that coping techniques vary widely. What works for me may leave you bored and still anxious.
-When the toolbox fills up, I won’t have to sift through all the activities on the main page to find what I want. Also, if I can make going from anxious to trying coping mechanisms quickly, it increases the likelihood that I’ll do that instead of getting wrapped up in a loop of self-defeating thoughts.

After: Anxious, but manageably so.

After: Anxious, but manageably so. Time invested to get to this point: 10 minutes.

-A little thing that just made me happy: in one of the calming techniques, guided breathing, you can adjust the inhale/exhale times. Attention to detail like this matters. I breathe quite shallowly, and likely wouldn’t have found the exercise practical without customization. Of course, if the app didn’t allow for this, I could have just done focused breathing exercises on my own….and been much less likely to make it a habit.

The Downsides:

-It’s not very intuitive. I had to read the directions and fiddle around with buttons for each screen. I strongly recommend playing with the app during a non-anxious time before putting it to use.

-There’s some sort of social network aspect where you can set up an account. I have no idea what the value of this is.

-All of the references, numbers to call, and resources are for the UK. (The app was developed by a university in Wales.

-I’m not sure how all the pieces of the menu fit together. Sure, it’s great that there’s a place for me to list things that make me anxious, and I like having coping techniques, but how can I use them most effectively? Not a lot of advice is offered. If this was the first app I’d tried or the first attempt I’d made to manage anxiety, I think I might be less enthused.

First thoughts: I like this! It’s the first app I’ve recommended to friends, and the first that I’ve seen immediate results from. It’s free, it’s made by people in the field, and worst case, I’ll have more data about my mood over time that I can use.

Links for downloading it yourself: Android, iOS

Disclaimer: I’m not a therapist. Definitely consult yours, and SAM and my advice aren’t alternatives to medical care. 

 

[Repost] On Running Out of Feelings, and What to Do Next

[This is a repost from when I was co-blogging with Ashley. It seemed appropriate, as I’m feeling a wee numb myself, and with school starting and winter coming, this seems to be a shared feeling.]

Hello, internet.
This is where I come to spill my secrets, right?

Sometime between last week and this one, I went numb–ran out of feelings. I think it was somewhere after the third friend in forty-eight hours contacted me with questions about leaving abusive relationships, between finals and Steubenville and painful anniversaries and suddenly having a living situation that went from Absolutely Planned to Horrifyingly Tenuous. Oh, and it’s my last day of therapy this week.*

And that’s the simple stuff.

Add in friends who need a Social Kate who smiles and has opinions and wit and does not resemble a posed block of wood. Sprinkle in academics, and taking a quarter off to work at a small agency that expects a lot from me.  Roll it all in the stress of attending a competitive university where everyone Accomplishes Things that can be itemized on a resume–things that don’t contain scary words like atheist…and feeling anything outside Ron Weasley’s teaspoon involved too much work.

So I just started feeling numb.

It’s awful. I hate it and I go round and round between being irritated at not feeling anything, and getting angry about it…and then giving up because even anger feels muted and exhausting. It’s not terribly unusual–when you run out of emotional energy, that’s how it goes. It sucks, and I know I’m not the only one who gets this. So here’s how I minimize suckage. (The technical term, ya know.)

Lists

An idea stolen from someone–either the indomitable Captain Awkward or Keely. Each day gets two lists. List One: everything I have to accomplish that day in order to prevent the week from crashing and burning, and nothing more. Anything else you accomplish goes on List Two.

List Two starts out empty, and you have no obligation to fill it. It can be empty at the end of the day, and you will still have survived and accomplished important things and can sleep easily. If there is anything on List Two, you get to feel proud of it. You have gone above and beyond. Congratulations! Well done, you.

Excuses ahead of time are your friend.

Because the socially appropriate answer to a concerned “How are you feeling?” is almost never “My brain is being awful and I can’t feel anything and also everything fell apart last week.”, stock phrases are your friend. Among my favorites:

I haven’t been sleeping quite right, thanks for asking!
Because this is true even if it means you’ve been sleeping constantly and your brain feels like fuzz.

Oh, you know, long week. [Tired smile.]
Where a “long week” is defined as any set of days where life was hard and not worth explaining.

I’m a little out of it right now. It’s probably [related thing that may or may not explain your actual problems.]
Poor finals. I’m constantly blaming them–this is my most used phrase. I actually rarely find exams overwhelming, but they’re a fabulous explanation for why I’ve developed the habits of your average hermit crab.

Sorry, I have a touch of a stomachache.
People with stomachaches tend to get all silent and huddle in the corner of any given gathering, trying to force their gastric juices to cooperate. I don’t particularly advocate lying, but if this gets you out of an nosy stranger’s headlights, I approve.

This terrible clip art is not the Feelings Police

This terrible clip art is not the Feelings Police

Numb is okay.
There are no Feelings Police. They will not come find you and lecture you into submission for not possessing the correct emotional range. Feeling numb is weird and uncomfortable and unpleasant, but it goes away and you can survive it. Give yourself permission to feel as bad as  you do, to nap as long as you need to, and to feel a little hollow.

Be greedy.

And along with that, be greedy. Will taking day off to paint your nails and consume only popcorn make you feel better? Do it. Will skipping that party to play videogames in your room feel better than pretending to feel social? You suddenly have new plans for the evening. Within the limits of your wallet and abilities, do whatever seems as though it could improve your day.

Hide in groups.
The thing about large groups of people is that you can get lost in them. Everyone else will jump about and make noise and try to figure out how to split the check when Susan ate half of the onion rings that Johnny ordered, David and Sarah split an entree, and Jacob only brought large bills.  And you can just sit there. Let everyone else have wild, sweeping feelings. There’s less pressure to say interesting things when everyone else is being exciting. You can tune out, drop in for the occasional murmur of agreement, and still be holding up your little corner of being social.

Update: Puzzles
Stephanie explains.

—-

So there it is. Ideally, these will work this time around, and I’ll kick the fuzzy-brain feels sometime before the end of my spring break.  What do you do?

* NU requires that I take the coming quarter off from classes to work Monday-Thursday, from 9-5. Therapy is only available Monday-Thursday, from 9-5. I’m sure there’s a witty name for the choice between skipping my lunch hour to get therapy and not having therapy for an eating disorder, but right now I can’t manage to find it.

Some Thoughts for The Therapist I’ll Be (Part 1)

I’m looking at grad school [gasps, slams laptop closed], and thinking about careers and plans and futures. (Adulting! It’s scary shit.) Which means lots of reflecting on what I’ve learned and heard about the good and awful things therapists can do. So, some notes, some things I want the future Therapist Kate to remember:

1. I will talk process.

Get an email from a potential client? Those are scary to send. Like, preventatively terrifying. And years from now, I will remember how hard it was to press ‘send’ this year. And then I will respond, right away. Even if it’s that I can’t help, that I’m not taking new clients, I will respond. Because it’s even scarier to have pressed send and never hear back.

2. I will continue to update and talk process in every step of the way.

Going to need a week to figure out my schedule? I’ll make sure to check in and update.

3. I will ask everyone pronouns and then use preferred ones in all notes and files.

Because really. This is just a habit worth developing.

4. I will have multiple avenues of contact.

Making my first therapy appointment involved no less than two websites for health services, three google searches, and one very very scary phone call. (Apologies to everyone who thought Moaning Myrtle briefly occupied the third floor bathroom that day. I didn’t have anywhere else to call from.) Then, to do intake? Another phone call. This time, a long one, conducted from my room. I had a roommate. Not to mention, this just about sums up my feelings about phones.

Email is easy! Email means clients can revise and edit and make sure they’re clearly stating what I need. They can write down lists and then give accurate pictures of their symptoms. I will have multiple ways to be contacted, because the barrier to entry shouldn’t be calling me. (Happy ending: my new counseling center takes–nay, encourages–scheduling via email.)

5. I will remember that I can’t help everyone. 

This is the stray cat principle. As nice as it would be to rescue every feline with big eyes and soft fur, you have a house, apartment, or commune of finite and inchangeable size. You know this. So which cats do you adopt? The ones who get along with your life. The ones who you think won’t tear all the drapes up every night and leave you stressed and angry and neglectful of other cats.

In the same way, I will remember that it’s both unethical and downright harmful to take on clients who have issues you’ve no experience in. It’s not acceptable to take on so many clients that I let them slip through the cracks. That I owe it to my clients to take care of myself, to make recommendations and decline and refer when I think I’m not the best practitioner.

Ideas? Put them in the comments!

Pages Updated: Brain Self Help & Decompressing

Just some housekeeping here!

I’ve added more resources to the Brain Self-Help tab at the top of the page. Links are intended to provide resources for when you cannot access therapy, want to try something on your own time, or just find that therapy isn’t helping in the ways you want it to. The Anxiety and Depression sections have been combined (because most of the resources applied to both) and a number of books and applications have been added.

Need to decompress? That page has also been expanded, with about eight new fiddly or calming things to do when you really just need to shut your brain up for a few.

Have ideas for either page? Please, please, please comment below. 

[Mental Health Hack] Cooler Heads Prevail

Note 1: I’m baaaaack! (I hear this carries more weight when you don’t have to say it every time you write a post.)

Note 2:  An obvious but important disclaimer: I am not a doctor, therapist, or the delightful mishmash of the two, a psychiatrist. I am but a lowly psych-student-sometimes-social-services-intern blogger. Calibrate appropriately, consult doctors when necessary, and full steam cautiously ahead. 

Welcome to Mental Health Hacks, a when-the-hell-ever-ly feature on making your life easier, brainwise. Each post will be short, science-based ideas for life hacks for the neuro-typical and atypical. Your mileage may vary! Your topic suggestions are encouraged!

—–

I mean, you can totally panic if you want to. But here’s something that might help you panic more effectively.

Around the time I started having troubles with [sub-clinical] levels of anxiety, I noticed something weird. When I got anxious (and very occasionally, before I realized I was high-anxiety), I would feel too warm. WAY too warm. Not sweaty, not that the room was too warm, just a slow burning under my skin. The nearest comparison I could give is the shame-heat of feeling humiliation or embarrassment.

In retrospect (or maybe just in confirmation bias), I can recall being scared or stressed as a child and feeling that slow flare. When I felt too warm, it was hard to concentrate on the task at hand, resulting in a frustrating loop of “Too warm, can’t think! But if I can’t think, I can’t finish this project!”…resulting in STRESS SPIRALS. Not fun.

As it turns out, this is quite common. The theory (annoyingly, all behind paywalls) is that stress-motivated vasoconstriction–when blood vessels contract–is to blame. Despite sounding a wee terrifying, the vascular contraction isn’t terribly dangerous in small amounts. Similar results can be achieved by caffeine. Scientists argue, each with pet data, whether the reaction is found in people with panic disorder and not in those with generalized anxiety disorder or the reverse.

But! Everybody seems to agree that in some subset of people, being anxious means feeling uncomfortably warm, and that sometimes the sensation of heat precedes the emotional aspect.  (With fascinating anecdata about severe anxiety leading to a phobia of blushing.)

Okay, so then what?

Reducing the immediate internal inferno can give you the space needed to deal with people and situations. It’s nigh on impossible to respond peacefully and reasonably when EVERYTHING IS HOT AND AWFUL. So–we make it less hot and awful. Additionally, brains are not so great at determining cause and effect with emotions. There’s a high probability that just feeling less heated can reduce your net anxiety.

[PAUSE: Stick a pencil or pen between your teeth. I promise this is relevant.]

Things I’ve found to work:

-A cool or cold washcloth/paper towel/anything on the back of the neck. This also eases dizziness, which usually comes knocking when I’m anxious.

-A fan or cool breeze pointed at my face (good) or back (better).

-Fanning myself with whatever’s closest at hand. This one sounds particularly obvious, but has the added advantage of giving you a way to avoid eye contact.

I’ve also heard that standing with a freezer or fridge door open (or walking into one, if you’re in food service) can help. My experience is that airflow trumps the air’s temperature, but whatever tips your cow.*

*This is why I love the Midwest.

[#FtBCon] Skepticism & The DSM Notes

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DSM-IV and Me: It’s complicated.

Tonight at 6:00pm Central (that is, right now), I’m giving a talk about skepticism and the DSM: the Diagnostic and Statistical Manual of Mental Disorders.

This is the link to watch. 

Summary:
Multiple personalities? Personality disorders? The Diagnostic and Statistical Manual (DSM) contains a list of all recognized mental illnesses. How valid is it? Kate will look at the best and worst mental health diagnoses and talk about what makes for useful skepticism when it comes to mental health.

My goals:

-How the DSM gets the diagnoses

-Should we throw it out?

-What diagnoses are particularly good? Which ones are particularly bad? Why?

–Overdiagnoses. Let’s talk about it. 

-What does the future of diagnosing mental illness look like? (In which Kate makes wild speculation and expects to be wrong.)

-Taking lots of questions. 

—- A Long List of Resources and Elaboration on Things I Mention —-

Reliabilty vs. Validity. I touched on the difference, but there’s also different kinds of each! Learn more here.

Changes to the DSM? Take a look at the whole list via the DSM5 website.

I talked about the 1973 change that removed homosexuality from its classification as a mental disorder. For more information here’s a transcript of an interview with some of the psychiatrists in the American Psychiatric Association (APA) who made it happen. Includes Nixon masks and a secret group called the GayPA.
Part 1
Part 2

Schizophrenia: more info on symptoms and causes here.

Eating disorders–a comprehensive collection of research.
DSM5 updates [pdf]

Depression
–Prevalence
–Biomarkers research

Personality disorders: the DSM5 alternate hybrid model [pdf]
Obligatory Marsha Linehan fangirling

[Will update with more post-talk!] 

IMPORTANT: I won’t be able to check comments here! Ask your questions in the chatroom, etc.

 

 

#FtBCon: I’m Doing Things!

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I’m going to be speaking in this weekend at FtBCon. Since I’m mainly prepping for my panel and talk, I’ll leave the summaries here. Video will be livestreaming on YouTube and available immediately after.

Panel: Supporting Freethinkers With Mental Illness
11 pm Central Time on Friday (tonight)

“Have you tried yoga?” “You just need to pray harder.” “You should try this herbal supplement.” People with mental illnesses get advice like this all the time. Although it’s not particularly helpful to anyone, with skeptics and atheists it’s especially misguided. What should we say to freethinkers dealing with mental illness? How do we support them in an evidence-based way? How can we use skepticism and critical thinking to reduce the stigma of mental illness? How can we improve access to treatment that actually works?

Other Panelists: Olivia James, Brendan Murphy, Miri Mogilevsky,

Talk: Skepticism and the DSM
6-7pm Central Time on Saturday

Multiple personalities? Personality disorders? The Diagnostic and Statistical Manual (DSM) contains a list of all recognized mental illnesses. How valid is it? Kate will look at the best and worst mental health diagnoses and talk about what makes for useful skepticism when it comes to mental health.

This will be a one-hour talk–though I’ll absolutely set time aside for questions. It’s a topic I’m very excited about–if you have aspects you want to hear about, by all means, leave them in the comments.