https://www.youtube.com/watch?v=6mKFQbdKh_0
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Good morning everybody and welcome to this episode of integrative behavioral health care i’m your host dr dawn elise snipes today we are talking about one of the affective aspects of integrative behavioral health we’re talking about releasing anger in all its forms and
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anxiety and depression so what are we really talking about well when i say anger in all of its forms what i’m talking about is obviously anger hatred irritation resentment guilt which is anger at yourself for something jealousy which is anger at somebody else for something that they have
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envy which is similar to jealousy just kind of a different word and grief grief remember is also going to be talked about over in depression because when we go through the grieving process we go through denial anger bargaining depression and acceptance not necessarily in that order when
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i’m talking about anxiety i’m talking about the various forms from just general stress to worry fear panic and depression is obviously you’ve got your quote run-of-the-mill depression your clinical depression and the
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depression that comes along with grief so we’re talking about all of these dysphoric feelings when we hold on to dysphoria it keeps our hpa axis revved it’s kind of like training with a bungee cord you are trying to get away from it but the the dysphoric feelings are like this little
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guy back here that is just holding you back it’s taking your energy and you’re trying to get away but you’re just kind of stuck physically when that happens it drains our energy it can alter our sleep quality because we are on high alert it can increase inflammation it reduces immunity
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you know all of the things that we talk about that happen when that hpa axis stays activated for too long affectively when we’re dysphoric a lot of times we don’t have just one simple dysphoric emotion if we have depression we may also have guilt and anger and resentment on top
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of it so affectively when we are feeling unhappy there are often a lot of associated emotions in acceptance and commitment therapy hayes talks about that as dirty discomfort so if you want to learn more about that you can watch one of the videos on acceptance and commitment therapy
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i digress cognitively when we are in hpa axis overdrive we are not going to think as clearly or as flexibly because we are in fight-or-flight mode we kind of have tunnel vision going on so it’ll be easier once we release this dysphoria to think you know more broadly to think more
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flexibly we’ll have more energy in our environment and more energy to devote to our relationships when we are not nurturing the unpleasant feelings which will improve our relationships and hopefully improve our environment so let’s talk about some of these things anger remember is your fight
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part of the fight or flee anxiety is the flea part of fight or flee and depression is the forget about it part of fight or flee anxiety and anger are responses to perceived threats remember when you feel anxious when you feel angry it doesn’t necessarily mean there is a threat in this context
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at this point in time it means there might be and you need to use that energy that your body is freed up for you to check it out to make sure that you’re safe to make sure that there is no threat depression indicates a state of helplessness and hopelessness which can be a response to
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an ongoing threat with no hope of resolution if you are exposed to something and you know you just can’t seem to escape it it can you can feel depressed you can feel hopeless and helpless depression can also occur as a result of grief over the loss of something or someone important
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you know that is again a sense of hopelessness and helplessness you’re not going to be able to get that person or thing back so you may go through a grieving period of depression where you lament not having that thing in your life but it also is an opportunity to reflect on the things that are
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important in your life and redirect your energy towards some of those things to be to nurture them while they are still there so sometimes depression can serve a motivating focus to help you kind of get um some wind at your back again it takes energy to stay angry
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anxious or depressed and to complain and to blame so we want to figure out what’s a better way to use that energy you have to make a choice and you notice that is italicized bolded and underlined you have to make a choice to use your energy to improve the next moment and you may not
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have very much energy you may only have a sliver of energy or an ounce or a drop or however you want to categorize it but that energy that you do have you have to make a choice how to use it when i talk about dysphoria a lot of times i use a dog poop analogy
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we have a lot of dogs in our house so it makes sense to me but i can be sitting at the table or sitting on the living room in the living room and start smelling dog poop and that is kind of like my hpa axis telling me that there might be a threat because you know
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i get angry when i start to smell that i’m like oh who did what where now it doesn’t necessarily mean that there is dog poop somewhere in the house one of my dogs could have just passed gas and they do that very well thank you very much but i have a choice at this point
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i can sit on the sofa and get angry about the fact that a dog may have pooped somewhere in the house and it’s stinking up my house and it’s making me angry that it’s stinking up my house and i can complain about it but is that going to do anything to resolve the smell no
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a better use of my energy is probably to get up and look around to see is it dog poop or did somebody just pass gas because that helps me figure out you know whether there’s a problem or it’s it’s something else that may be fleeting
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your choice when you feel distressed you feel anxious you feel angry you feel depressed for some reason all right notice that acknowledge that accept it non-judgmentally that’s your body telling you to do something it’s telling you that something may not be right and you need
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to check it out all right so what do we do once we figure out what’s going on we need to make sure we’re safe you know look around make sure you’re safe if not do what you need to do to get safe but then choose your energy for how to improve the next moment
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it could be to use your distress tolerance skills it could be to take a shower and get dressed when people are grieving or depressed sometimes get taking a shower and getting dressed is a monumental task but if you can at least do that that day i remember when my kids were young
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and i had postpartum depression with both of them but a lot worse with my son just getting up and taking a shower and getting depre getting dressed was seemed like a monumental task some mornings but i felt a lot better after i did it partly because i got up and got out of bed
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but partly because when i forced myself to do that i was helping to reset those circadian rhythms you may use your energy to make a doctor’s appointment if you are feeling clinically depressed or you just can’t seem to shake that anxiety maybe what you need to do is see a doctor
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and get evaluated for any physiological causes of what’s going on or you know maybe you want to consider a short course of medicine that’s an a a reasonable choice you may choose to call a friend or to pray sometimes screaming into a pillow when you’re angry can help and that may seem juvenile
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but let’s think about it we know that when we breathe in hold and breathe out when we slow our breathing down it actually triggers the relaxation response well when you scream into a pillow what are you doing you’re taking a big breath in you’re holding it for a second and then you are exhaling
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and it’s really slow so yes you’re screaming but you’re also slowing your breathing which can help release some of that tension and start triggering the rest and digest you can also practice deep breathing and maybe even add in a little aromatherapy take in that
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breath that soothing smell back when i was very young there was a a commercial for calgon bath bath beads or bubbles or whatever it was and their their slogan was uh calgon take me away and you could see this woman just soaking down into her tub and taking this deep breath
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and letting all the stress go so aromatherapy can have a place deep breathing we know has a place but it’s up to you to figure out what is the best way to use my energy now you can ask yourself how is what i’m doing right now helping me to improve the next moment
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and i would ask you right now how is what you’re doing right now helping to improve the next moment you know maybe you’re learning by watching this you’re learning about uh or hoping to learn about new skills that you can use to help you de-stress when you get
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anxious or maybe you’re hoping to find something that you can use right now i don’t know what can you do as soon as this broadcast is over to improve the next moment even if you’re having a great day what can you do to make it even better what can you do to continually use your energy to
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work towards that rich and meaningful life that’s filled with happiness that you hope to have feeling threatened or hopeless so angry anxious or depressed represents a state of powerlessness we don’t like to feel powerless because that makes us
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feel vulnerable it makes total sense and even the primitive parts of our brain back in that amygdala says says i don’t like this i don’t want to keep feeling this way all right that is reasonable what are your early warning signs of anger anxiety and depression
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sometimes if we can catch these things early before irritation turns into rage it’s easier to check it out improve the next moment and reverse course what can you do so when you notice these signs you can de-escalate what helps you when you start getting angry what helps you de-escalate
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is it going on a walk is it taking some deep breaths what works for you keep a list of these things because when you’re in that moment when you’re in that zone you’re not going to be thinking broadly about okay what are my options you want the distress to stop so it’s nice to
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have a little list right there by your computer on your mobile device wherever that can help you out along with this when you start feeling angry anxious depressed what can others do to accommodate or help you sometimes it just means getting out of your way and leaving you
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alone so you can have a minute to yourself some people really just need some me time other people need a hug some people want someone to talk to what is it that other people can do for you when i worked in community mental health that was one of the questions that we would ask
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everybody at admission when you are experiencing distress what things are most helpful for us to do and what things do you absolutely not want us to do what things are most not helpful um and and that gave people the option or the ability to state
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when they were clear-headed and able to think about the options um what would be most helpful and give us a clue about what might actually make the matters make matters worse another thing that you can do before we release it we’ve got to figure out what causes it and
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what to do about it so another thing that you can do is identify what are your triggers in general what things generally make you angry you know i get irritable um with people who are rude for example um and going through and identifying the things that trigger
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your emotions you know i get depressed when i see an animal or a person that’s suffering so i know that’s one of my things once you identify these situations that are general triggers for you identify what aspects of the situation you have power over what can
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you do to feel empowered in this situation with animals you know i can’t rescue every animal i’ve had to accept that but i can engage in animal rescue i can engage in animal advocacy so in terms of my depression about animals who are suffering that’s something that i have power over
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i don’t have power over you know backyard breeders and other things so thinking about each of your general triggers identifying what aspects you have power over will help you so whenev whenever you encounter those situations you don’t automatically feel powerless you know
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that okay there are some things that i can do in this situation that can help me feel empowered in what ways is holding on to your anxiety anger or depression helpful to you and yes it can be helpful we hold on to it for a reason a lot of people hold on to their anxiety
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because they’re afraid if they let it go then they won’t be alert to threats that are going on so examining you know what is motivating you to hold on to these feelings and in what ways is holding on to those dysphoric emotions unhelpful now remember i said at the beginning
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ident feeling them identifying them accepting them non-judgmentally that’s always helpful that’s your brain trying to communicate to you holding on to them and nurturing them for hours on end without doing anything about them that can sometimes be unhelpful
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what are you afraid will happen if you let go of your anxiety anger and depression is that belief accurate is the belief that if i let go of my anger at this person they will hurt me again is that belief accurate well and and we talked about this you know a
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couple weeks ago when we talked about anger not necessarily forgiveness just means letting go of that anger just means you are choosing not to give them a steady dose of your energy all the time it doesn’t mean you’re forgetting what they did it doesn’t mean you’re not learning
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from what they did it doesn’t mean that you’re not protecting yourself from them it means that you’re choosing not to invest that emotional energy over there you’re choosing to save that for your rich and meaningful life and those relationships that are important
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once you’ve identified what you’re afraid will happen what can you do to address those fears to keep yourself safe the next thing you can do is make three lists identify you know one for anxious
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one for angry and one for depressed identify what you currently are anxious about what you currently are angry about what you currently are depressed about once you have it down on paper you can start dealing with it you know get it out there so you can see it and then you can
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start crossing them off your list as you deal with them for each one of those situations ask yourself become mindfully aware what are the facts about this issue in this context at this time am i safe if not what can i do to get safe safety is always the first priority how does
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this situation remind me of a past time when i felt powerless and what is similar and different in this situation you may be in a relationship this it often comes up in relationships you’ve been in bad relationships in the past you’re in a relationship now and you start feeling
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abandonment anxiety you start feeling anxious well okay am i safe from abandonment right now am i safe in my person if not what can i control to get safe you can’t control whether that other person comes or goes but what can you do to make sure that you’re safe from harm how does
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this remind me of that past relationship when i felt powerless okay you know maybe that your significant other is engaging in similar behaviors all right so what’s similar and different in this situation well one big thing is it’s a different significant other so we do want to consider that
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and asking yourself you know do i know that for a fact for a fact that this person’s behaviors and the way they’re acting mean the same thing that that other person’s behaviors meant and the chances are probably not so it’s important to look at that transference
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and not hold people and situations in the present hostage for something that happened in the past be informed by the past but judge the present on its own merits what part of this situation do i have control over what are my toward options so let’s stay with abandonment anxiety for right now
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one of my tour options might be talking to my significant other and telling them how i’m feeling and why or asking them about what’s going on maybe another toward option is to call my best friend and run it by her see what her take is on it because she’s more objective maybe going on a
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walk is a better tour option because sitting there stewing over it isn’t doing me any good you see where i’m going here figuring out what part what parts of the situation do i have control over how can i improve the next moment how can i keep myself safe and improve the next moment
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and then finally what is the probability that if i do what i can to improve the situation that there will still be a terrible outcome you know what’s the probability that if i talk to my significant other that i am going to find out that they are getting ready to abandon me
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what’s the probability that that’s going to happen what’s the probability that if i use my energy proactively that the worst case scenario is going to play out most of the time the probability of the worst case scenario is pretty small
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okay so you’ve figured out what you are angry anxious or depressed about you’ve started identifying ways you can improve the next moment to deal with it once you have done all that you can you have this residual feeling of anxiety or dysphoria sometimes or tension
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sometimes a situation can can’t be completely resolved right now you have to have patience and during that time when you’re have quote having patience stewing on or continuing to hold on to that anxiety or anger or depression just in case that’s not doing you any good because continuing
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to be anxious isn’t solving the problem so once you’re safe you’ve done what you can to improve the next moment it’s important to trigger that relaxation response continuing to stay revved is only going to impair your health your energy your happiness and maybe your relationships
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so make a choice i’ve identified the problem i’ve done what i can now i’m going to make a choice to use my energy in a more positive way and you can use the acronym cats if you want contributions if you engage in contributory activities to help others maybe you go help help your neighbor do
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yard work or go volunteer somewhere that may get your mind off of it that also promotes serotonin dopamine and oxytocin release activities to distract yourself and increase positive emotions that also is going to increase your serotonin and your dopamine and when you’re
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proactively doing these activities that you enjoy it’s going to down regulate that hpa axis because you’re helping as serotonin and dopamine go up cortisol is going to go down thought restructuring embracing the good with the bad trying to focus on the positives you know any of those cognitive
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behavioral tools that you want to try to use those are things that you can do when those unpleasant thoughts start to resurface again you can try to restructure those thoughts so they are more powerful so they were that sorry so they reflect you having more power in that situation
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instead of reflecting a sense of hopelessness and helplessness and s stands for sensation immersion we’ve talked in other videos about how aromatherapy massage just walking outside and feeling the sun beat on your face for a minute not for too terribly long can help release serotonin
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and dopamine and endorphins exercising can also help release those so you start using your energy to promote those positive neurotransmitters and start feeling better start improving your energy deep breathing and guided imagery can also be helpful now these there are a lot of
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different techniques that you can use one that i like is when i’m feeling uh anxiety or anger when i inhale you know and it’s the deep breathing inhale for eight hold exhale for eight when i inhale i envision the air coming into my body
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being this brilliant blue color i love blue so blue and it’s calming and it’s cooling i hold it for a second as as i exhale that blue has turned to red it’s absorbed all of the anger and anxiety and as i exhale i envision that air coming out being red and taking all of the
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hot emotions with it when i’m depressed i do the same thing but instead as i inhale i inhale yellow yellow is cheerful to me sometimes it’s purple but we’ll stick with yellow for this as i inhale i inhale yellow and when i exhale i’m exhaling all of the blackness all of the darkness that
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i’m feeling and you know you need to do it a few times but it can be helpful it occupies your mind and it also slows your breathing slows your heart rate and triggers that rest and digest when you’re inhaling remember feel the power and positive energy pulsing through your body
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when i do it i inhale i feel that blue coming in and almost like it’s joining with my blood and going through all of my veins and arteries and scouring for anger and anxiety to absorb it um sort of thinking about it that way but feeling it come in and energize your body
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you can use progressive muscular relaxation and i have a video on that on the youtube channel there are other people that have progressive muscular relaxation videos but the big thing to remember with progressive muscular relaxation is to focus on two things
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noticing being able to actually relax your muscles and feeling that tension and energy move out of your body so i like to start from the head and move down and every time i tense and then i release i imagine the enter the energy and the distress being pushed out
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being pushed further down kind of like when i’m power washing the sidewalk and then it goes out my fingertips and out my toes eventually so with progressive muscular relaxation you start we’ll start at the top start at your head as you
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inhale you tense your scalp muscles you hold that for a second you notice what it feels like tense and then you actually relax and you feel those muscles relax when you feel those muscles relax what’s happening actually is the blood flow is going back to that area but you can envision the
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blood coming in and grabbing the tension and moving it out of your scalp and you do that for every muscle group all the way down to your toes when you tense hold your breath notice what that tension feels like as you exhale say in your head relax and feel the tension moving out of your
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body can also try to release some of this the distress with what i call positive power mantras breathe in hold it for a second and then as you exhale say your mantra a few i am strong i am courageous i can get through this or i am loved i have people who
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will help me god loves me i am safe loved and protected or i choose to be calm and at peace you can write your own positive power mantra but basically you are trying to reassure and nurture yourself just like a loving parent would have done to help you
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feel calmer and relaxed even if the adversity is not completely resolved you can try turning your focus instead of focusing on the problem turning your attention saying okay the problem exists but i’m going to shelve it you know sitting here focusing on the fact that
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my arm’s broken isn’t going to make it heal any faster so okay my arm’s broken got it i’m gonna focus on these other things over here that are that i’m grateful for you can also do a mindfulness activity and really focus on the present moment and when you start feeling that
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anxiety or depression creeping back in again check make sure you’re safe as long as you’re safe and you’ve done everything you can identify the positive things that you notice right now with guided imagery you can go to your happy place and i have a couple different guided imagery
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meditations on the youtube channel but it just helps you to sort of transport yourself in your mind to a place where you can completely relax you can also visualize yourself becoming happy in the moment imagine okay i’m not feeling great right now i’m going to visualize what’s the next thing
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i’m going to do to start feeling happier visualize you know the next 10 15 minutes and see yourself doing things or see yourself getting happier some people like to journal about it get it out on paper and then give it to the universe you know once it’s there you don’t have to worry
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about forgetting about it you write it down and you can give it to the universe some people prefer to give it to god their higher power whomever but once you get it out then you can put it in a box and choose to revisit it then you have a choice about all right i’m going to leave that there
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some people like they feel they need to revisit it periodically other people once they put it in that box it’s like okay i’ve done all i can do i’m going to put it on the shelf for right now try doing exercise or something cathartic to redirect that energy and promote the release
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of endorse endorphins cathartic means using that energy in a way that helps you feel a little bit better for example going out and taking a ball if you’re angry going out and taking a ball and throwing it as hard as you can against the wall playing um a handball basically
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for a little while um exercising can be good push-ups something is something else that you can do pretty easily without a lot of equipment the last suggestion i have is what i call fake it till you make it and i don’t mean ignore your feelings completely i don’t mean fail to take care
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of yourself acknowledge accept unconditionally make sure you’re safe and then choose remind yourself that as distressful thoughts arise that you’re safe you know maybe you’re waiting on test results from the doctor okay you know you’ve done everything you
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can you went to the doctor you got the test done now it’s a waiting game and stressing over those test results is just gonna make you irritable drain your energy impair your sleep so okay i’ve done everything i can to deal with this situation right now when distressful thoughts
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arise i’m gonna remind myself i already done it i’ve i have already done everything i can i’m safe and i am going to choose to commit my energy to other things that are important in my life in dialectical behavior therapy marsha linehan talks about um turned up smile and open hands
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just trying to be present in the moment when we adjust our non-verbals even if we’re all by ourself when we adjust our non-verbals it actually can help improve our mood dysphoric emotions serve a purpose to motivate you to do something
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to ensure that you’re safe and appreciate what you have in the present moment once you’re safe and you’ve done what you can to improve the next moment to address the situation actively triggering the relaxation response can help down regulate your hpa axis
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which can help improve your mood increase your energy and improve your health all right in terms of questions i’m looking at what we have going on right here it’s important to remember when you’re engaging in towards behaviors if one of
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those is seeking emotional support for someone from someone you know you want to make sure that what you’re engaging in is helpful and moving you toward your goal of a rich and meaningful life if all you’re doing is commiserating uh then that’s probably an away behavior
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we can engage with others who are going to as we say in addiction cosign on our bs and that’s not helpful so it is important to make sure that your relationships are pro pro social and proactive and promoting you towards your rich and meaningful life
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uh providing support providing validation providing empathy um and providing encouragement to take that next step forward toward what you think is important in terms of sharing this information with other people not everybody is ready willing
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or able to hear it people have to be at a level of readiness for change and i have several videos on the youtube channel that talk about stages of readiness for change and increasing motivation but until someone is motivated to start using their energy nothing that you say to them is probably
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going to land because they don’t want to hear it they’re not ready or open to any new ideas and there are a lot of reasons people may be in what we call the pre-contemplation stage of change and it’s important to be sensitive to that a lot of times people are in pre-contemplation either
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because they don’t realize there’s a problem or because they feel hopeless and powerless and it’s important to be sensitive to that that you know maybe they’ve tried to recover before whether it’s depression or anxiety or you know pain and it hasn’t
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stuck maybe it helped for a little while but it didn’t stick and they relapsed and that can cause people to be hesitant to start trying to change again so we do want to be sensitive to that and in that case it may be helpful to enlist you know a counselor or a spiritual guide to
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help you figure out what direction might be useful it’s not there’s nothing that i can do from you know just talking in generalities that can really help in any individual situation to get somebody to change people are going to change when they decide
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they’re ready to change all we can do is hope to bolster their motivation with motivational interviewing techniques or motivational enhancement techniques are there any other questions
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i really appreciate everybody taking time out to be with me i know for a lot of you you’re still on your holiday break so i appreciate you being here and enjoy having you guys um present this is part of that ongoing uh six weeks to a
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happier healthier use series so tomorrow we will be talking about cognitive tools in response to your question about avoiding people who are going through similar situations no support systems can be super important but it is whether you are engaging with people
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who are empathetic and encouraging and supportive of proactive positive forward movement or you are in the quagmire of a group of people who are who just want to sit around and complain uh is you know the non-tactful way to say it support groups are not created equally but
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some support groups are very helpful and i do encourage people to find support groups that do have helpful people in them and not everybody in a support group may may be helpful there may be certain people that are more proactive than others but ultimately it
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comes down to when you interact with this person do you feel understood validated supported and empowered or does it just reinforce your sense of helplessness and powerlessness have a great day everybody and i’ll see you tomorrow same time same station
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