Releasing Anger Anxiety and Depression | Counselor Education Tools

Good morning, everybody, and welcome to this episode of Integrative Behavioral Health Care. I'm your host, Dr. Donnelly 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 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. 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 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 ofthe mill depression, your clinical depression, and the 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 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. You know, all of the things that we talk about that happen, we. 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 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, effort. So if you want to learn more about that, you can watch one of the videos on acceptance and commitment therapy. 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 are 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 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 part of the fight or fleet? Anxiety is the flee 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 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 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. 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 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 some wind at your back. Again, it takes energy to stay angry, 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 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. 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, 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, 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. 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. 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. Your choice. When you feel distress, 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. That's telling you that something may not be right and you need 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. 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 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 depressed, getting dressed when 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, 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 and get evaluated for, 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, 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 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 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 Calgon, take me away. And you could see this woman just soaking down into her tub and taking this deep breath 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? 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 or hoping to learn about new skills that you can use to help you de stress when you get 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 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 feel vulnerable. It makes total sense. And even the primitive parts of our brain back in that amygdala 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? Sometimes, if we can catch these things early, before irritation turns into rage, and 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? 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 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 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 everybody at admission. When you are experiencing distress or 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? And, and that gave people the option or the ability to state when they were clear headed and able to think about the options, 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 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 with people who are rude, for example, and going through and identifying the things that trigger 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 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. 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 whenever, whenever you encounter those situations, you don't automatically feel powerless. You know 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 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, ident. Feeling them, identifying them, accepting them non judgmentally. That's always helpful. That's your brain trying to communicate to you, holding onto them and nurturing them for hours on end without doing anything about them. That can sometimes be unhelpful. 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 we talked about this, you know, a 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 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. 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, 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 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 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 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 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. 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 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. One of my toward 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 walk is a better toward option. Cuz 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? 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? 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. Okay, so you 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 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, depression, just in case, that's not doing you any good because continuing 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. So make a choice. Yeah, 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 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 proactively doing these activities that you enjoy, it's going to downregulate that HPA axis because you're helping, you know, 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 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. Sorry. So they reflect you having more power in that situation 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 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 different techniques that you can use. One that I Like is when I'm feeling 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 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 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 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. 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. Sort of thinking about it that way, but feeling it come in and energize your body. 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. 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, 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 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 flows going back to that area. But you can envision the 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 body. You 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 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 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 my arm's broken isn't going to make it heal any faster. So, okay, my arm's broken. Got it. I'm going to 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 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 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 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 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. 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 of endorsed 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 handball basically for a little while. 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 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 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 going to 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 arise, I'm going to remind myself I already done it. 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 turned up smile and open hands, 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 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 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 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, then that's probably an away behavior. We can engage with others who are going to, as we say in addiction, co sign 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. Providing support, providing validation, providing empathy 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 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 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 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 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 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 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 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? 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 present this is part of that ongoing six Weeks to a Happier, Healthier you 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 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 is, you know, the non tactful way to say it. Support groups are not created equally, but 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 comes down to when you interact with this person who 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.