Tag Archives: Anxiety

Poornam: An Emotional Arc

For today’s art and creative writing summer workshop for elementary school kids, our lesson is titled ‘The Emotional Arc Of Storytelling’. Through the theme of roller coasters, my colleague, Pavani, and I plan to bring to light how good storytelling needs to have ups and downs, twists and turns, and loop-de-loops in the plot for a more complete experience. As I begin to chart my lesson plan, the innocent faces of some of the younger students in our class come to mind. Would they be able to grapple the concept of infusing emotion into their narration? Maybe, ‘Emotion’ is too strong of a word for them. Would it be easier to use the words ‘Feelings’ instead? 

Then doubt creeps into my ever curious mind. Are emotions and feelings synonymous?

As is the norm these days I google the difference between emotions and feelings and I find my answer in a study from Wake Forest University. 

Feelings arise in the conscious mind while emotions manifest in the subconscious mind. They are not interchangeable terms. Emotions are universal bodily sensations while feelings are personal interpretations of emotions. Love, hunger, pain are feelings while anger, happiness, and disgust are emotions. The article is complex and even before I finish reading the article, my mind sucks me into an ever turbulent black hole of questions. What then is depression? 

“Is it an emotion or is it a feeling – a personal interpretation of sadness, of unworthiness?

Depression is rampant now and the current state of our seemingly apocalyptic world with its chaos and uncertainty has only made sure it stays entrenched in our society. Naturally, another question pops up. When will all this end? Will life ever return to normal again?”

A ping on my phone brings me out of the everlasting loop of thought.

“We closed on the house! Finally!!!” texts my friend. 

“Congratulations!” I reply back, genuinely happy for her. She has worked hard to make this happen, managing two jobs and a family. She’s moving to a house bigger than the current one. Selfishly, my happiness stems not just from friendship but also from relief. People buying bigger homes, moving up the socio-economic ladder gives a semblance of returning normalcy to the present situation. Isn’t that what we all strive towards? Bigger dreams encompass an abundance of health, wealth, and happiness.

Six months ago, when the world began to shut down, fear prevailed. I was grateful to have a roof over my head, two square meals a day, and people I loved safe. I listened to spiritual greats every day and meditated without fail. Nothing else mattered. I was content to be alive with what little I had. From that gratitude stemmed the realization that I do not need much to be happy, that sitting in stillness and being in touch with that deeper part of myself makes my life complete.

Yet, here I am now, with the fear of the virus slowly dissolving. I have returned to my pre-pandemic definitions of success and happiness – a bigger home, vacations in exotic locales, and a great looking body. The lessons learned in the pandemic have been transient. Why else would SSR’s suicide shock me? And why else would a friend’s increased purchasing power make me happy? After all, in the interim, I had learned that material wealth and fame does not guarantee fulfillment. Yet, just as quickly as I have learned, I seem to have also forgotten that untainted joy stems from within. 

“Om Poornamadah, Om Poornamidam Purnat Purnamudachyate,

Purnasya Purnamadaya Purnamevavashishyate.”

(That (the source) is complete, this (creation) is complete as well. After completeness is taken away from completeness, only completeness remains. )

In essence, the divine source is within me and by my very nature, I AM COMPLETE. 

The phone rings.

“Hey, How’s the lesson plan coming along?” Pavani asks.

Ah – It’s time to get back to ‘The Emotional Arc of Storytelling’.

“Just starting, I’ll ping you once I’m done,” I say. 

As I go back to my lesson plan, Pavani’s words in the document bring a smile to my face – “Roller Coasters are a great metaphor for life. We go up, we go down, but we don’t have to crash. We can learn to enjoy the ride.”

In just a few moments I have, like a roller coaster, gone all around the twists and turns in my mind, from emotions and feelings to depression to joy and completion. I am yet unsure of whether depression is an emotion or a feeling or why it is so rampant and if life will ever return to the way it was before the pandemic. But, what I do know is – I do not need anyone or anything to complete me and knowing this is the anchor that will steady me during the turbulence. 

Vidya Murlidhar is an essayist and children’s book author from Charlotte, NC. Her work has been published in Chicken Soup for the Soul, Mothers Always Write, Grown & Flown, India Currents, and other places.  

Finding the Silver Lining: Stories of Strength and Struggle

As the global COVID-19 crisis has continued well beyond initial predictions and precautions, the response of the community at large, especially across the Indian diaspora, has been startling. Some have embraced the changes, calling for society to adapt and accept the circumstances as “the new normal”; others have lamented the lockdown as a pestilence to be endured. For many in the Indian community on a global level, questions and concerns about when the global pandemic will end remain unanswered.

However, some have managed to find a platform to voice their stories during these difficult days, especially through a younger audience. This has shed light on the experiences of many who have previously have encountered limited responses from peers and the wider community.

We the Young, a positive, youth-driven Indian media platform, has responded to the COVID-19 crisis by assisting young people to find the silver lining during the uncertainty of these times. As an online portal, the virtual community has developed a safe space that welcomes the voices of youth to share their story and find inspiration from others’ shared experiences. Many Indian youth have been able to voice their personal outlook on life from a mental health perspective as a way to engage with young people across the internet.

As a way to facilitate this further, this initiative also collaborates with mental health experts, advocates, and those with lived experiences to engage and explore approaches to coping with various mental health issues through their weekly initiative, the Mental Health Dost.

Udita was one such youngster who found it difficult to keep her emotions in check early on, especially when it came to her relationship. Diagnosed with clinical depression and borderline personality disorder, she found it hard to handle the pressures life threw her way, and she wished to end it all. A random Google search led her to get connected to a helpline, where she found herself pouring out her emotions to the person on the other end of the line; who gave her both the assurance and hope that she was looking for. Now with professional intervention, Udita has found help and is coping with her mental health issues. “For me, now, Udita says, “it’s one day at a time”. 

Many young people just like Udita have began to share their stories as part of the Instagram live series, #DearZindagi; which, with the help of We the Young, has been turned into a mini-documentary series which has been promoted online and has received thousands of views and responses from young people with shared experiences who also are empowered and able to share their voice as a result.

As We the Young continues its campaign to engage others, including through their social media campaign, #InItTogether, as well as their weekly live sessions with artists and advocates who share their tips during isolation, and the blog online which is updated regularly – the story continues. The voice of youth has continued to empower others to do the same, and as the platform continues to impact others, many more youngsters are inspired to join this growing community.

Commenting on the need of the hour, Charit Jaggi, the founder of We The Young said, “We need to create more platforms and safe spaces for people to come and share their vulnerabilities and problems..so many of us are battling with loneliness, anxiety, and depression alone. No one deserves to suffer alone. There is an urgent need for us to come together as a generation, right now more than ever.”

For young people across the global Indian diaspora, strength in solidarity is the best way forward.

Joseph Kolapudi is a young writer, currently serving as Editor-in-Chief for ProvokeWoke, a youth-driven, online platform. He also contributes to several print and online publications. He has been recognized as a Global Shaper by the World Economic Forum for his work locally and internationally. 

Nexts Steps to Reduce Anxiety

Are you feeling anxious during these troubled and difficult COVID times? Anxiety starts to affect our mental and physical status. We worry about our families, friends, and ourselves. What if something happens, what next? Fear, and anxiety, come from thinking of the future.

Maslow’s hierarchy of needs is a motivational theory in psychology comprising a five-tier model of human needs. In the traditional Maslow pyramid, we see that the basic physiological ( food, water, warmth, rest) and safety needs ( security, safety) are not met for many of us. Many have lost their jobs, do not have a roof over their heads, or even food to eat. This causes immense anxiety, frustration, anger, and fear. However, even for those whose primary needs are met, there is still a tremendous amount of anxiety. To help understand and cope with this feeling in these unusual times I have redefined the upper part of the pyramid.

In these uneasy COVID times, it is necessary to ease our minds. What are our emotional needs during a difficult time like this? Here is a simple diagram that helps explain it. During this time it is good to go within us.

Let’s look at this diagram. We need to accept this situation as it is. It may not be what we anticipated or wanted, but with Acceptance, it will be easier to deal with the situation, rather than fight against it. 

Routine is a sequence of actions regularly followed. In these times it would be beneficial to create a healthy routine. Pick things that you have control over and make them an integral part of your routine.  When new things show up that are not in your control, let them go, and don’t let it affect your routine. In this process of not being able to be always in control of happenings, anger, and frustration arise, which need to be slowly released. 

Would you like to connect with others? We have been asked to social distance. The effects of this have brought about sadness and a feeling of loneliness. Even though you are social distancing, you can nurture your relationships with emotional Connections. Go on, pick up the phone, and speak with a friend, text, or use social media. Share your feelings and know that you are still connected even though you are physically apart. This is not forever.

The world has slowed down so that you can discover yourself. Think about taking a pause and figuring out what is the new normal.  When you Reset, what you thought meant something important to you may have changed. What seemed normal no longer seems useful to you. 

For many of us, it is hard to concentrate on our emotional needs when we are filled with anxiety and fear.  Use these next steps to reduce your anxiety first so that you can take care of yourself and the needs within.

  1. Reduce watching and listening to negative news.
  2. Enjoy family time with a feeling of gratitude. I understand it is difficult at times being under the same roof. Cooking, cleaning, teaching kids (homeschooling), video conference meetings, loud music, dogs barking. Once this is over you will realize that this was an opportune time to bond with each other. So make it happen now.
  3. Be in the present. Anxiety, worries, and fear come from thinking of what will happen in the future. Just live for the moment as life is precious and should not be taken for granted. 
  4. I find yoga, meditation, and most of all a good night’s sleep valuable to calm my mind.  Many apps and sites offer meditation sequences. 
  5. Practice gratitude. Gratitude for being you, for having the smallest of things. Gratitude for the frontline workers, researchers and so much more. 
  6. Exercise helps release your feel-good chemicals. If you are allowed to and it is safe then, walk, run, cycle with 6-foot social distancing in a non-crowded area while wearing a mask. Come home and wash your hands. 
  7. It is time to take on a new hobby, or even learn a new language. All the things you always wanted to do but didn’t have time for. 
  8. Charity is giving. Giving makes you have a feeling of purpose and control. Donate to an organization, assist the elderly, support those who need your help. 

I keep asking myself what is troubling me. Is it the fear of my fragile life, that my loved ones or I am locked down at home? So many things keep flitting through my mind causing anxiety, but the best approach is to look at what I have and be thankful. Be in the moment. 

Geetanjali Arunkumar is a writer, artist, life coach. She is the author of ‘You Are the Cake’.

Keeping Young Adults Safe During The Pandemic

Last month, after California Gov. Gavin Newsom ordered most of the state’s residents to stay home, I found myself under virtual house arrest with an uncomfortably large number of Gen Zers.

Somehow I had accumulated four of my children’s friends over the preceding months. I suppose some parents more hard-nosed than I would have sent them packing, but I didn’t have the heart — especially in the case of my daughter’s college roommate, who couldn’t get back to her family in Vietnam.

So, I had to convince six bored and frustrated 18- to 21-year-olds that, yes, they too could catch the coronavirus ― that they needed to stop meeting their friends, wipe down everything they brought into the house and wash their hands more frequently than they had ever imagined.

The first two weeks were nerve-wracking. I cringed every time I heard the front door open or close, and when any of the kids returned home, I grilled them remorselessly.

The day after a house meeting in which I laid down the law, I found my son, Oliver, 21, inside his cramped music studio in the back of the house with a kid I’d never seen before. And that night, I saw one of our extra-familial housemates in a car parked out front, sharing a mind-altering substance with a young man who used to visit in the pre-pandemic era.

If I’ve been neurotically vigilant, it’s because the stakes are high: I’ve got asthma and Oliver has rheumatoid arthritis, making us potentially more vulnerable to the ravages of the virus.

But even as I play the role of enforcer, I recognize that these kids are as anxious and worried as I am.

My daughter, Caroline, 18, is filled with sadness and despair, feelings she had largely overcome after going away to college last fall. She recently started doing telephone sessions with her old therapist. Oliver has begun therapy — remotely, for now ― after dismissing it as pointless for the past several years.

A study released this month by Mental Health America, an advocacy and direct service organization in Alexandria, Virginia, shows that people under age 25 are the most severely affected by a rise in anxiety and depression linked to social isolation and the fear of contracting COVID-19.

That is not surprising, even though the virus has proved far deadlier for seniors. Mental health problems were already rising sharply among teens and young adults before the pandemic. Now their futures are on hold, they can’t be with their friends, their college campuses are shuttered, their jobs are evaporating — and a scary virus makes some wonder if they even want those jobs.

Paul Gionfriddo, Mental Health America’s CEO, says parents should be attentive even to subtle changes in their kids’ behavior or routine. “Understand that the first symptoms are not usually external ones,” Gionfriddo says. “Maybe their sleep patterns change, or they’re eating less, or maybe they are distracted.”

If your teens or young adults are in distress, they can screen themselves for anxiety or depression by visiting www.mhascreening.org. They will get a customized result along with resources that include reading material, videos and referrals to treatment or online communities.

The Child Mind Institute (www.childmind.org or 212-308-3118) offers a range of resources, including counseling sessions by phone. If your young person needs emotional support, or just to vent to an empathetic peer, they can call a “warmline.” For a list of numbers by state, check www.warmline.org.

Caroline’s case is probably typical of college kids. She moved back home from San Francisco last month after her university urged students to leave the dorms. Her stuff is stranded up there, and we have no idea when we’ll be able to reclaim it. Meanwhile, she has been planning to share an off-campus apartment starting in August with four of her friends from the dorm. We can get attractive terms if we sign the lease by April 30 ― but what if school doesn’t reopen in the fall?

For Oliver, who’s been living with me all along, the big challenges are a lack of autonomy, a need for money and cabin fever. Those stressors got the best of him recently, and he started doing sorties for a food delivery service. Of course, it makes me crazy with worry every time he goes out, and when he returns home I’m in his face: “Did you wear a mask and gloves? Did you keep your distance? Wash your hands!”

But what can I do, short of chaining him to the water heater? And if going out — and getting some cash in his pocket ― makes him feel better, that can’t be all bad (unless he catches the virus).

If your kid dares to work outside the house, and you dare let him, several industries are hiring — particularly grocery stores, pharmacies and home delivery and food services. Child care for parents who have to work is also in demand, so your fearless teen might want to ask around the neighborhood.

Volunteering ― again, if they dare — is another good way for young people to feel independent and useful. In every community, there are vulnerable seniors who need somebody to shop for them or deliver meals to their homes. You can use www.nextdoor.com, a local networking app, to find out if any neighbors need help.

Food banks are in great need of volunteers right now. To find a food bank near you, go to www.feedingamerica.org. Blood donations are also needed. Older teens and young adults can arrange to donate by contacting the American Red Cross (www.redcross.org). For a list of creative ways to help, check out Youth Service America (www.ysa.org).

While the kids are inside the house, which in my case is still most of the time, put them to work. “Anxiety loves idle time, and when we don’t have a lot to do, our brain starts thinking the worst thoughts,” says Yesenia Marroquin, a psychologist at Children’s Hospital of Philadelphia.

I’ve harnessed the able bodies of my young charges for household chores. A few weekends ago, I decreed a spring cleaning. They organized themselves with surprising alacrity to weed the backyard, sweep and mop the floors, clean the stove and haul out volumes of trash.

Considering the circumstances, the house is looking pretty darn good these days.

This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

Looking for the Good Within

Breathe, and take a moment to think about how you truly feel in these uncontrollable times. We all feel some level of anxiety, some more than others. How we manage and handle this anxiety will impact both us and those around us. 

There is COVID-19 news everywhere we turn and we feel like a pressure cooker at home, lonely, anxious and ready to explode. Some of us feel lost and unable to control things for us and our loved ones. What feels overnight, we have been confined to our homes with or without family members.

As it is said that,” You can’t calm the storm… so stop trying. What you can do is calm yourself. The storm will pass.” We need to gather ourselves and stay calm for ourselves but also our elderly, our children and the immune-compromised. 

What can I say to help you in this time of need? What if we tried to change your thought process by changing your frame of mind? Can we try to change the story you are telling yourself? At this time, tell yourself that the Universe is giving the world a chance to reset itself by slowing down, for you to look at life from a different perspective and reconsider our ways. Sometimes taking time to do nothing brings everything in perspective.

We realize that we are deeply interconnected with human interaction that we have taken for granted. Becoming aware of what we had and being grateful for the smallest of things we have now, will help us move forward. You are alive and breathing if you are reading this and we need to feel the warmth of gratitude. You may like to place a ‘gratitude jar’ in your home and let everyone put in a slip for expressing what they are grateful for. You will realize that there are chaos and difficulty in the real world, but you are still able to find things that you are thankful for in this present moment. Writing and reading these slips of gratitude will help change your thought process to look for the good! As I mention in my book, ‘You Are the Cake’, “The simple daily act of gratitude can lower our stress levels and ground us for a healthier and happier life… Be in the moment and feel how fortunate you are in so many ways. Count your blessings.” Read these slips of gratitude and over time your mind will automatically look for the good. 

Send out your positive vibes to others and those suffering. But in all this do not lose focus that you must practice self-care and compassion. You have time now to spare, so sit down and be steadfast and reduce your anxiety. Don’t give all your attention to the external world. Look for the good within. How do you do this and reduce stress? Meditation, Visualization Tapping are different ways of achieving this (you can find more information in my book, You Are the Cake). At this time of need, I have made the kindle version available at virtually no cost to everyone.

Here is a short Metta or loving-kindness meditation and visualization we can use to reduce our fears and send out positive vibes to the world. 

  1. Sit in a comfortable position, close your eyes.
  2. Breathe in and out regulating the breath. 
  3. Visualize yourself, your family, your loved ones, the community and the people of the world one by one.  
  4. Say this in your mind with a feeling of compassion.

May I and the others be happy, safe and well. 

May there be peace, wellness, and love. 

All is okay 

  1.  Continue breathing with calmness in every breath. 
  2.  Close your eyes and picture that you are gathering all your negative stressful thoughts. Visualize yourself taking a broom and sweeping up all the negativity. Picture it being put into a bag and thrown away. Let go of this stress and move forward towards looking for the good. 
  3. Visualize yourself calm, well and happy. Breathe, be grateful and open your eyes gently. Let that smile linger on your face and in your heart. 
  4.  Feel the stillness deep inside and keep some energy and balance within.

Mental and social isolation can get to one. I suggest that you connect with your friends and family via phone, video conferencing, emails or so many more ways. I can video-chat, participate in group calls or multiplayer social games with my friends. This laughter and connection make me feel good and centered.   

Listen to the fact that we need to shelter-in-place to provide safety and flatten the curve of this deadly outbreak. To those who can offer help to the elderly via shopping or other errands, please reach out safely. You can donate to the families of the first responders, our heroes or the homeless. Donate blood at the Red Cross. Some people are printing 3D face masks for the responders, others sewing masks. Do whatever you can to help this hurting world. Working on a hobby will keep you focused and fulfilled. I enjoy painting and trying to sing, but when I do then everyone leaves the room!

We can take turns becoming a balm for each other. Let’s not worry about being perfect or getting it all right. Know that you are doing the best you can. 

Reduce your stress, be in the moment and be grateful for the smallest of things. Stress makes you believe that everything needs to happen right now while faith assures you that everything will happen at the right and perfect time. Have faith and move towards looking for the good. 

Geetanjali Arunkumar is the author of ‘You Are the Cake’ and a wellness coach. 

Corona Casts Dark Shadow Over Mental Health

Dr. Madhu Bhatia, a psychiatrist in Washington D.C., finished setting up her home office a few days ago, two weeks after the Metro area began to sit up and take notice of COVID 19.

“I’ve already seen an uptick in anxiety among my patients,” she says, “and now, more than ever, I need to stay in touch. I’m expecting an increase in cases, and more Post Traumatic Stress Disorder (PTSD) type symptoms.”

“This is the first time I’m practicing telepsychiatry on this scale,” she adds wryly. “It’s going to be a new experience for me and many of my colleagues – but it may be the future, for a long time.”
The suddenness and speed of COVID19’s onslaught has sent our health care and our social systems into shock. Equally important, (but in danger of being underplayed as all our attention focuses on the battle with the virus), it has been a massive, invisible shock to our collective psyche.

As we live this in real time, health professionals all over the world are getting more concerned about the long-term emotional fallout from the pandemic. The complete cessation of normal activity in lockdown, a constant ticker tape of rising numbers of those infected and dying on TV, and economic insecurity associated with the shutdown is the perfect formula for creating a sense of suppressed panic and helplessness, which, in turn, is a perfect breeding ground for anxiety disorders and depression.

We can look to China, which was ahead of the curve, for the trajectory of anxiety and anxiety related disorders. Early studies on the effect of the pandemic indicate an enormous, lingering impact on mental health. In the first few weeks of the lock down in China, there was mostly worry about contracting the virus and the safety of loved ones. As more time passed in quarantine, financial strain and more stress with family relations piled onto the general worry for safety.

In an ITV report, Dr. Peng Kaiping, the head of Psychology at Tsinghua University in Hubei province (where the epicenter, Wuhan is located), says they are now increasingly seeing symptoms of PTSD among the population.

“It’s important to remember,” says Dr. Bhatia, “that even something as innocuous as more enforced time at home with the family can become a source of great anxiety, if it isn’t handled correctly. There can be something like too much togetherness. Time has to be managed carefully, especially in families which already have underlying stresses in relationships.”
She advises setting up strict daily routines, especially if there are children at home.

“Children need the security a routine provides. However, they also need social interaction with their peers and a sudden cessation of contact with friends creates anxiety. If they are young, set up facetime playdates for them.”

“For teenagers, try to give each individual enough time on their own and permission to retreat into their own space if they want to, but designate a family time where you come together, especially for meals. Make that a pandemic free space, where things like homework or activities are discussed and optimism about the future is restored.”

“South Asian families are often not very good at expressing their feelings, and there is a sense of shame, specifically in the older generation, in admitting that they are fearful. This is a time when parents should reassure their children (and sometimes their own parents), that it’s important to talk frankly about one’s fears and be supportive of each other.”

Therapists and providers are increasingly adapting their practices to technology to get their message out.

Pallavi Surana, a resident of Herndon, Virginia, and a meditation therapist, has guided a group meditation session every Friday for the past 10 years.

With Virginia’s COVID restrictions, she has now taken it to Facetime (the group dials in from home and meditates together) and increased its frequency to an hour every day.

“Daily Meditation is more important than ever during this crisis,” she says. “We are locked in at home, with our fight or flight responses highly aroused. Calming our minds has an enormous impact on our immune systems, and doing it collectively is even more beneficial. Even a short 20-minute session has an impact.”

Alice Walton in a recent Forbes article suggested important ways to preserve sanity and maintain optimism during these trying times.

Gratitude is a therapeutic emotion. Take time to be grateful for family and friends, and for all the things which are working for you in life. In a Harvard health study, it was found that writing down even 5 things you were grateful for, just once a week, had an enormous positive effect on emotional well-being.

Exercise and meditate daily. Treat these activities as necessary, medicinal doses of stress relief and give them priority. There are several online sites offering free exercise routines and meditation. Mindfulness based stress reduction (MBSR), developed by Jon Kabat Zinnat at UMass, has been shown, through many studies, to be very effective. Several organizations now offer this online. Meditation is a proven stress buster and is especially good for our immune systems.

If you aren’t into meditation, studies have shown that just calming your breathing – taking a few minutes a day to sit quietly and breathe deeply – can greatly reduce daily stress. Simple breathing exercises, like those taught in Yoga, (check out these top rated apps), are also great at soothing the mind and producing a sense of well-being.

Your daily exercise routine should be supplemented by “quality time” outdoors. The Japanese concept of “forest bathing,” which means spending as much time in nature as possible and mentally “bathing” in its beauty, is now backed by science. Being around greenery doesn’t just calm the mind – it has a proven effect on our immune system and lowers the levels of the stress hormone, cortisol. Consider positioning your home office where you have a view of the greenery outside.

And last, but not the least, connect to friends and family daily through whatever means available. Social isolation is like a punishment for our species, because we are wired with a strong need to interact. A recent article in the Washington Post by social scientist, Arthur C. Brooks, emphasizes the importance of social interactions which allow eye contact. Looking directly into a person’s eyes while talking releases oxytocin, the pleasure hormone, and is the most beneficial for our social needs. So, choose a medium like Skype or Zoom or Face Time where you can see your friend or family.

Stay safe, dear reader, and remember to hug your family often! Human touch is a proven therapy for anxiety.

Jyoti Minocha is an DC-based educator and writer who holds a Masters in Creative Writing from Johns Hopkins, and is working on a novel about the Partition.

Edited by Meera Kymal, contributing editor at India Currents.

Could You be Suffering from Anxiety?

Over the last two weeks, how often have you felt nervous, anxious or on edge? How often have you felt that you weren’t able to stop or control worrying?

If your answer to these questions is half or more than half the days, it’s possible that you may be troubled by, or contending with, some anxiety. These simple questions, as benign as they sound, are adapted from an anxiety screen (GAD-2) that should be administered to patients at each primary care physician visit. The purpose of this screen, far from labeling someone as mentally unwell or ascribing a diagnosis, is to identify patients who are possibly having trouble dealing with day-to-day stressors, life events, or are suffering from a mental illness and could be helped in feeling and functioning better through therapy.

As a nurse, and now a medical student, I have often encountered patients who are extremely apprehensive about labels: depressed, anxious, obsessive, manic. The stigma around these labels and fear of being labelled as someone who has mental illness limits patients’ answers to clinician questions. “No! I am not depressed”, “I don’t have those problems” or “I can deal with it”. This patient perspective often leads to the patient continuing to silently suffer with symptoms of anxiety: constant worry about work, poor sleep, irritability, difficulty focusing or concentrating or feeling fatigued. 

According to the National Institute of Health (NIH) more than 1/5th (19.1%) of the American population above the age of 18 has had some form of anxiety disorder in the past year. While research on the South Asian community is limited, the prevalence of anxiety in the South Asian community mirrors that of the general American population, 20.8% of South Asians meet criteria for having an incident of anxiety, substance abuse, or affective disorder in their lifetime. Importantly research specific to South Asians has identified that, as a group, they are less likely to seek and utilize mental health services and that stigma around mental illness in the community may be a reason for this phenomenon.

    Admitting to anxiety, worry, or feelings of dread is not a sign of weakness. Similar to having a fever, pain in your knee from arthritis, or trouble swallowing, anxiety is a real medical condition for which you should be able to seek and receive care and help. Treatment for anxiety starts with a visit to your doctor. In collaboration with your doctor, and based on screening questionnaires and conversations with him/her, you can chart a plan for yourself. Anxiety comes in many forms; Social anxiety, Generalized Anxiety Disorder, Panic Disorder, Post Traumatic Stress Disorder, and Obsessive-Compulsive Disorder. However, a plan of care for all of them can begin simply: a referral to Cognitive Behavioral Therapy with a qualified healthcare professional and/or picking from possible drugs that modulate the amount of neurotransmitters in your brain (aka SSRIs or SNRIs).

Kultaj Kaleka is a third-year medical student at Central Michigan University’s College of Medicine, and a student delegate to the AMA. He aspires to pursue Psychiatry. Prior to medical school, Mr. Kaleka worked as a registered nurse at Mt. Sinai Hospital.