The missing link: ADHD and depression

People with ADHD are some of the most spontaneous, free-spirited, fun-loving people God created. And yet they struggle with depression. Even though depression is often a comorbid (co-occurring) condition, it just doesn’t make sense: joyful AND depressed? Yet ADDitude Magazine states that depression is often a secondary disorder among adults with ADHD; they’re 2.7 percent more likely to struggle with it than the general population.

So, what causes this lack of joy? I’ve identified a sequential process that often occurs in people with comorbid ADHD and depression.

Biology

First and foremost, neurotransmitters have a huge role in the way depression plays out in people with ADHD. According to Healthline, people with ADHD show lower levels of dopamine––the neurotransmitter responsible for feelings of pleasure and reward. Minds with low levels of dopamine become the perfect hub for depression.

If malaise or depression of any kind becomes a problem, talk to your doctor or a psychiatrist about getting an antidepressant prescription. Taking medication isn’t the end of the world; rather, it can actually improve your world as the medicine prevents the reuptake of norepinephrine, which regulates the flight-or-fight response (responsible for anxiety) or serotonin (responsible for mood regulation). Overall, this medication can drastically improve your mood and quality of life.

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A helpful infographic on how neurotransmitters interact.

People-pleasing

I’m currently writing my next book (tentative title Attacking Atelophobia: pushing past perfectionism) and have researched the connection between performance anxiety and people-pleasing. ADHDers are often people-pleasers because they mess things up a lot. Unintentionally. And those who don’t understand the condition won’t forgive them. They just write these mistakes off as carelessness and discount any hard work. Actually, this pushback creates a strong drive in adults with ADHD, which can lead to perfectionism.

ADHD often comes with memory lapses, forgetfulness, or inattentive. Now, this isn’t entirely forgetfulness; I like to think of it as selective memory. I’ll often remember a part of something, but not the entire thing. That often gets me in trouble at work. Dr. Jeffrey Bernstein calls this phenomenon “honest lies.” People with ADHD will often justify their behavior to avoid disappointing people, even if they messed up, because they honestly didn’t try to disappoint the person; it just happened. As a result, the other person will often think the person with ADHD is lying. However, the person with ADHD is just being honest. For instance, I’ll often tell people, I didn’t realize I was doing that wrong! And they’ll reply with, why didn’t you ask questions?! And therein lies the never-ending cycle. The person without ADHD doesn’t understand me, and I can’t make them understand, so I revert to people-pleasing.

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You can’t control whether or not people like you.

Depression often stems from people-pleasing because people with ADHD overcompensate for their mistakes due to rejection-sensitive dysphoria. Dysphoria means “hard to bear.” So, the term basically means you have difficulty bearing rejection.

WebMD lists the following signs of RSD:

  • Easily embarrassed
  • Anger/emotional outbursts when someone hurts you
  • Low self-esteem
  • Unattainable high standards for self
  • Avoidance of social situations and withdrawal from other people
  • Fear of failing to meet others’ expectations
  • Thoughts of self-harm

Even this list screams depression! 

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This is what RSD feels like.

Do you see the neverending trap yet? People with ADHD become so disappointed with themselves that they try harder, which can cause anxiety over doing things wrong and lead to more mistakes, which results in more disappointment…It will never stop, and it’s something we have to cope with.

Emotional hypersensitivity

Do people constantly tell you that you’re overly sensitive?

Since most people with ADHD are Highly Sensitive Persons (HSPs), they often feel extreme emotions. The highs are very high, and the lows are very low. Therefore, joy turns into exuberance, and sadness turns into depression. RSD is actually probably the result of emotional hypersensitivity: criticism doesn’t just become a suggestion––it’s a truth about someone’s identity.

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The problem of intense feelings and depression.

Now, don’t write this off as a curse. It’s a blessing in disguise! Friends might often come to you for advice because they know you’re empathetic or are an active listener. Other people don’t have that skill. However, it can seem like a burden when you feel others’ emotions on top of your own.

The main thing is recognizing when emotions control your life. If you can remain conscious of when negative emotions take over your brain, the risk of depression decreases. I often journal my negative thoughts to avoid depressive states.

Shame

A never-ending road of people-pleasing often bends into shame because the person with ADHD feels something deeply wrong with themselves. Other people constantly point out their flaws, so they think something must be wrong with them. However, it’s not true. You are who God created you as. ADHD is inescapable; you can find ways to manage things, but ultimately, you can’t change your biological wiring.

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Here’s a great definition of shame.

Constantly thinking about how bad of a person you are or how often you mess up results in a nearly inescapable shame trap that takes a lot of therapy to retreat from. Trust me, I’ve been through therapy four times due to shame. I used to think something was wrong with me because it seemed like a) I always screwed things up and b) people always pointed out my flaws. However, I eventually discovered that I often made more mistakes when I internalized this shame. Plus, ADHD comes with some benefits, such as hyperfocus. Everyone has their weaknesses, and ADHD just may happen to be yours. Don’t let other people slap a shame label on your forehead because it could cause significant mental health issues.

Suicidal thoughts

This is usually the last resort for people with both ADHD and depression. They already have a predisposition to a lack of happiness. They can’t please people. Emotions overwhelm their overstimulated mind. They fall into a self-hatred cycle because they remain powerless as shame controls their life. Taking all this into account, depression and ADHD can certainly lead to suicide, according to ADHD in Adults. The impulsivity that comes with ADHD can also influence this decision.

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You have a purpose! Don’t give in to suicide.

Breaking the link

How can those of us with ADHD escape from co-occurring depression? First, we must find some way to compensate for the dopamine deficit––whether that’s through medication or tremendous self-care. Second, we have to remain aware of emotions. Yes, it’s okay to feel, but don’t let those feelings spiral out of control. Third, we need to overcome shame by talking to a friend, family member, pastor, or therapist. Lastly, we need to see the value in our identity and condition. Although ADHD comes with negative aspects, it also has some positives that often shine in personalities, such as being highly observant.

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Wisdom from one of the best swimmers!

 

Highly Sensitive People and Hypoglycemia

I knew something was wrong with me when I started feeling sleepy throughout the day. But I slept 7-8 hours! My mind protested. Nevertheless, I battled constant fatigue for the last three months, and I asked myself, what in the world is wrong with my body?! It eventually worsened to the point where I stopped swimming for an entire week last month: on top of school and working four jobs, I was exhausted. I actually almost fell asleep in class a couple of weeks ago because I was zoning in-and-out of consciousness. I knew I had to sacrifice something, so swimming it was. Yes, it’s my stress-reliever, but I had at least enough energy to make it through the day.

Confession: I had blood sugar crashes back in my gastritis days––and that’s understandable, considering how little I ate. Even something like a scoop of ice cream would make me sleepy. Now that I’m healthier, I thought I was done with that. However, after a conversation with my mom a couple of weeks ago, I discovered I wasn’t. I’m not diabetic, but I truly am hypoglycemic. I denied it for a month, but after some research, I knew.

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How I feel during blood sugar crashes.

Obviously, chronic fatigue was a huge factor––I actually started only eating breakfast most of the week last month because I felt better if I didn’t eat lunch or dinner––actually, that got me in trouble later on. Anyways, I later noticed that I’d have horrible migraines. Ones that made me nauseous, stifled my concentration/memory, and made me isolate all day because I needed a completely quiet space. Pain relievers didn’t help, and I drink plenty of water, so I was stumped.

Later on, I found out that migraines are actually a symptom of hypogylcemia, according to Verywell Health.

Guess what? Those headaches come with a dull throbbing that turns into pulsating throbs. Bingo. I knew that was it.

You know the term hangry? That’s usually the colloquial term for low blood sugar. Headaches are the body’s way of saying, I’m dying! I need sugar for energy! The brain suffers when glucose levels drop, according to Vanquish Headache Relief. Irregular meals can trigger these headaches, but blood sugar also drops from eating high-carb meals, dieting, and even not eating enough protein (I’m guilty on that one).

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Hangry=hypoglycemic

So, since I’m a non-competitive athlete, guess who started eating a bunch of carbs this spring? Yep, me. It wasn’t a huge issue before since I actually practiced a hypo-friendly habit––eating five smaller meals a day. Due to my busy schedule, I never had time for real meals, so I just snacked throughout the day.

Summer camp food did not help things. I don’t really eat beef or pork, and the chicken isn’t the best, so I mainly ate beans, cheese, and peanut butter for my protein. However, you need quite a bit of these for an adequate source of protein. Plus, I often just grabbed what was there––pasta, rice, bread, you name it. This didn’t help anything. I didn’t sleep well at all this summer, which didn’t help, but eating a bunch of carbs to compensate for my swimming also didn’t help. My body needed protein and fat for stable blood sugar levels, so I suffered blood sugar crashes without enough protein. At the time, I thought I was just sleep-deprived––and perhaps I was––but I also had repeated low blood sugar episodes. Yikes.

But wait…I’m not diabetic. I wondered, why is this happening to me? Upon further research, I discovered that Highly Sensitive Persons (HSPs) actually have sensitive blood sugar levels because they have sensory processing sensitivity. That’s basically a fancy way of saying we overreact to ordinary stimuli: food, noise, social time, even feelings. Therefore, things hit our bloodstream much quicker than the average person. It’s also why many HSPs (including me) are sensitive to many medications (I take children’s doses!), food additives, and even too much of one food group: gluten, dairy, you name it. I personally can eat gluten, but I have to limit my dairy intake.

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The mind of an HSP.

Thankfully, I know what to do now. I need to “graze” throughout the day on high-fat, high-protein snacks, eat more complex carbs (brown rice, quinoa, whole-wheat bread), and drink tons of protein shakes because, as a busy college student, I hardly make meat for myself. I can’t really eat “normal” meals, and that’s okay––I just have to let people know beforehand. Most dietitians will recommend a Paleo diet, which is high in healthy fats and proteins. This prevents the quick release of insulin that leads to blood sugar crashes.

So, I am now a Paleo person. Not willingly, but I know it’s for the best. No, it doesn’t mean I can’t have sweets or white bread. It just means I can’t have a lot of it and can’t eat those things too often. I even have to watch how sweet I make my lattes at work (thankfully, I actually like mine less sweet). Caramel macchiatos are a no for me. Vanilla lattes with two pumps are a yes. Because I swim a lot, I need tons of calories, but I make up for it with protein bars and trail mix. Adapting is difficult since I often just want to grab something quick (Top Ramen, my college friends…), but I know my well-being comes before convenience. I suggest the same for any of my HSP or blood sugar sensitive readers.

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Exercise and autoimmune illnesses

When my doctor told me I couldn’t swim anymore in January 2017, I was crushed. I told him, “No. I have to,” and he said, “You can’t keep losing weight. You won’t get better until you gain more weight.” So I obeyed.

However, swimming was my stress reliever, so it’s no surprise I had panic attacks every-other-day during midterm season in March that semester. When my doctor first told me I couldn’t work out, I thought I literally couldn’t exercise at all. Actually, I kept losing weight after I stopped swimming because I lost muscle mass and I walked around campus/ at work all the time. So, although I did technically exercise, I didn’t receive the benefits because I was also stressed at the same time (e.g. at work or walking around campus after working on a difficult project).

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I love swimming, but I had to stop for a while so my body could heal.

Why exercise is important

Dear readers, I know you’ve probably heard a ton about exercise making people happy, but I’ll lay out why even light exercise helps. According to the Better Health Channel, exercise helps with sleep, mood, negative thought patterns that result from mental illnesses, builds community during partner workouts, boosts self-esteem and self-confidence, and helps people avoid addictive behaviors.  Remember how Elle Woods from Legally Blonde said “Exercise increases endorphins?” We want endorphins not only because they help with mood, but they also help regulate the immune system, according to Mark’s Daily Apple. Also, exercise can add extra pounds, via muscle weight, for those who need to gain weight.

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Get at least a little bit of exercise each day.

The dilemma

Exercising with an autoimmune condition proves difficult because too much may result in worse pain and symptoms. High-impact or cardio exercise can especially aggravate the condition. Plus, many people with autoimmune conditions are underweight, so losing more weight is an issue. So, what do you do? Do you avoid exercise entirely, or just fight through the pain? The answer: compromise. Find light activities: low-speed swimming, yoga, stretching, walking around the park, hiking easy trails, doing house chores, walking up and down stairs, and biking on level streets.

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Stretching is a great form of physical activity.

The downside

Despite the benefits of exercise, any kind of gym workout can cause flareups for autoimmune sufferers, according to the Paleo Mom. This is because the body releases cortisol––the stress hormone––which can overwhelm the immune system. This is why avoiding high-impact activities is important. Don’t engage in the following: SPIN classes, cardio kickboxing, hip-hop dance, speed or distance running, HIIT training, Crossfix, P90x, speed swimming, or anything similar. If you’re unsure about what activity works for you, talk to your PCP.

Another hazard to remain aware of is nausea/acid reflux. For instance, I suffered from gastritis and GERD, so I often had acid reflux or stomach cramps if I pushed myself too hard. I’ve been distance training during my swim sessions because I’m a lifeguard, but I can still get acid reflux if I overdo it, so I end my workout early if I feel an onset. Know what the tendencies are for your specific autoimmune condition and adapt accordingly.

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The correlation between exercise and cortisol levels.

Staying healthy

Even if you’re careful, it’s also important to set boundaries because, as someone with an autoimmune disease, your body is already weak. Many people with chronic illnesses resource the spoon theory, which states that people with autoimmune diseases only have so much energy to expend. The spoons in this theory represent units of energy––once a person’s spoons are gone, they have no energy left.

Keep that image in mind as you plan out daily activities. Think about how many spoons you realistically have for the day, and know how much time you can allocate to each activity. Of course, spend a reasonable time on exercise, but keep it under 45 minutes. 30 minutes is probably a good amount to start with, and you can increase or decrease workouts by 10-15 minutes depending on your energy level.

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How many spoons do you have?

In addition, think about the frequency of your workouts. Do you exercise every day, three times a week, five times a week, or every day? I would definitely not recommend every day––set aside at least one rest day so your body can recuperate. Furthermore, if you’re underweight or at a borderline-healthy weight, don’t exercise too often so you can maintain your weight. As with the time, you can also go back-and-forth between how often you work out, but listen to your body and know when enough is enough. You’ll have more energy some days, and less on others. Don’t beat yourself up for shortcomings: instead, enjoy the time you have and try your best. Stressing out will only make things worse, and you won’t receive the same benefits from exercising with a clear mind.

Muscle soreness may also become an issue for those who already experience joint or muscle pain and fatigue. In this case, I recommend stretching or yoga, which will help ease both.

All in all, just make sure your body moves frequently throughout the day, even if that just includes getting up from your chair and stretching every 30 minutes, going grocery shopping, or taking an evening stroll.

 

 

 

Three grades of panic attacks: three movie characters

People flip out when I say the words “panic attack,” but I want them to know that lately, they really have nothing to be afraid of. My panic attacks lately are minor––equivalent to anxiety attacks––but I still categorize them as panic attacks due to the way they’re triggered and because I always hyperventilate just a little bit during these moments.

Anyways, as I’ve navigated Panic Disorder over the last two years, I’ve discovered that not all panic attacks are created equal. I’ve had panic attacks that have lasted 10 minutes (e.g. all the ones I’ve had this past year), I’ve had some where I cried so hard I couldn’t breathe and felt dizzy––yet still calmed down relatively quickly––and I’ve had ones that have lasted an hour (the ones that sent me to the ER back in Feb./Mar. 2017). Although I still struggle with panic disorder, it’s pretty mild––I was panic attack free from February-May and only had one panic attack each month in June and July. None no far this month, which is good news.

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Something to keep in mind with those who struggle with anxiety: fears often appear real in their mind.

So, with this in mind, here are the three categories I’ve adopted for panic attacks and their characteristics:

  1. Mild: crying with a low level of hyperventilating (may or may not hold head in hands to avoid feeling shame), muscle tension/shakiness, running off emotions but still able to understand others’ words, does not lose touch with reality, some verbal communication, possible mild headaches from stress; recovers within 15 minutes. This is the most common level for people who have gone through therapy and is the stage my panic attacks fall into.
  2. Moderate: Hyperventilating becomes more severe and person starts having difficulty breathing, lightheadedness, immediate onset of muscle weakness, very tense muscles, can somewhat process what others are saying, possibly unable to speak, high levels of fear, starts becoming uncharacteristically angry, heart starts racing, nausea, cold sweats; recovers in less than 30 minutes. This is the most common level for people who have tried anxiety-management strategies, but don’t quite know how to use them yet.
  3. Severe: Worthy of sending someone to the ER. Vertigo (the person can barely walk), very tight chest/ inability to breathe (for the most part) due to tightness in throat, starts losing touch with reality/ feels like they’re losing control or going insane, no communication at all with anyone nearby, often repeats one phrase (“I can’t breathe,” or “help” are were common for me), heart races very quickly, wants to literally flee their environment and may resist help, possible self-harm behaviors. This is often the severity for those with PTSD, those with severe PD/agoraphobia (fear of being in places or situations that induce anxiety), and those with newly-discovered anxiety disorders. 

Reading about them is one thing, but what if we watched some movie clips with some of your favorite characters?

Mild: Elsa from Frozen

Elsa has anxiety? Why, yes––she often says, “Conceal, don’t feel, don’t let them know.” Feeling is what triggers her fears, as with any anxiety disorder. Those with an untrained eye would just think she’s really hurt––and while that’s true, those with the trained eye know exactly what she struggles with. Elsa acts pretty normal before Anna gets there, but the anxiety comes after Anna mentions what happened in Arendelle, Elsa starts holding her head, can still listen to Anna yet is still concentrating on her fear, has a bit of panic in her eyes, and starts to focus on her emotions that just upgraded in intensity. She’s not at the point of crying yet, but she seems to have mild hyperventilating from her fear and inability to control the situation. As you can see, she’s still functional, but her fears are starting to get the best of her.

Moderate: Jessie from Toy Story 2

Those who don’t have anxiety may just think Jessie is overreacting to a bad memory. While that’s true, I think she’s experiencing a moderate panic attack. She’s hyperventilating to the point where it looks like she can’t breathe (she’s holding her hand over her chest, which is a pretty good sign), her heart is most likely racing, she gets antsy and shakes people, is teary-eyed, and her eyes scream “fear.” Also, it seems like she’s not really listening to Woody or Stinky Pete because she’s stuck in that memory of being inside a box (perfectly understandable, though).

3. Katniss from the Hunger Games: Catching Fire

Katniss is so strong, right? Well, maybe not. She’s human, and she’s having devastating flashbacks that draw her into a place of severe panic. If you don’t believe me, just skip halfway through this video and watch the clip. You’ll see what I mean. Anyways, after she shoots the guy with her arrow, Katniss literally starts losing touch with reality because of a flashback. She literally can’t listen to those who try to calm her down because she’s just that panicked. She’s clearly hyperventilating and distressed, and she’s not communicating in any way. If this were real life, she’d probably run away from Gale at that point, or Gale would take her to the ER.

So, as you can see, some panic attacks really aren’t that bad. Most people with PD or PTSD will use that term as a synonym for a general “anxiety attack,” but it’s often that people with Social Anxiety Disorder, GAD, or OCD will use those because their disorders work slightly differently.  All in all, panic attacks are characterized by the feeling of panic in some way, whether that’s mild, moderate, or severe.

Demystifying anxiety

I write this blog for one of two reasons: 1. To help others with mental/physical illnesses understand more about their condition(s) and 2. To help those who don’t know much about mental/physical illnesses, or for those who wish to help someone they know with a specific condition. This post falls in the latter category––I want to break anxiety down into simpler terms for those who don’t struggle with it and are willing to understand more about it.

Myths vs. facts

First, we’re all socialized to believe certain things, and mental illness is no exception, according to Psychology Today. Due to your own life experiences or things other people have said, you probably have some misconceptions (negative stigma) about anxiety.

Here’s an infographic from the ADAA with myths and corrections. Feel free to put this on your phone or print it out for future reference. Pay particular attention to the third one; I’ve had several people tell me that I can’t possibly handle high-stress situations due to my anxiety. They’re wrong, and this infographic contains the correct answer. Plus, dealing with stressful situations isn’t one of my triggers––unless we’re talking about academic assignments––because I have performance anxiety (which is actually minor now that I’ve worked through my fear of imperfection).

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What myths have you believed?

Also note the final myth here. I actually haven’t really had a problem with people being too encouraging; on the other hand, I’ve had people say things that are too harsh. You need to have a balanced response. Give some tough love, but in a respectful way. An example of this is, “I get you’re feeling upset about making mistakes at work, but have you told your manager ways they can help you?” As the previous answer states, you DO need to face your fears and stop avoiding situations that make you fearful. Personally, I take a step forward and back in this area––I don’t avoid people or situations that make me anxious, but sometimes I do have minor panic attacks if I still feel like I’m not doing something well enough or am not “good enough” for someone.

Now that you’ve taken a look at some of these truths vs. myths, let’s look at what goes on in the mind of someone with anxiety.

The anxiety cycle

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A basic example of an anxiety cycle.

This isn’t the most comprehensive diagram, but it will suffice. My therapist often gave me a diagram just like this, but blank, so I could fill in my own thoughts, triggers, feelings, and behaviors. As you can see, the majority of anxiety and panic attacks start with a trigger (AKA a fear), which leads to a thought, then intense feelings, and behaviors that result from those thoughts and feelings. Most people have what’s called “the critic” in their head, according to Anne-Marie Hearne. This is a voice that tells you everything that’s wrong with you as a person––your flaws and insecurities. I’ve been working on shutting mine off throughout this year.

As I filled out this diagram with my third therapist last fall, I realized that you can often change this cycle around. Let’s look at my performance anxiety as an example.

  1. Thought: I always screw things up.  Feeling: I feel like a failure.  Behavior: Staying silent when someone tries to comfort me.
  2.  Feeling: I feel upset because I messed something up again.  Thought: I’ll never do anything right.  Behavior: retreating to my room and feeling down about myself.
  3.  Behavior: Beating myself up for a mistake I made.  Thought:  Will I ever make anyone happy?  Feeling: I’m worthless.
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This is a great infographic about physical signs of anxiety!

Clearly, this cycle has nuances, so if you can identify someone’s thoughts, feelings, or behaviors, you can probably get to the root of their anxiety. Try asking some of these questions if you’re unsure about how to help someone, according to WebMD.

  • How often do you feel this way/ how many times have you gone through something like this?
  • What happened that made you feel this way?
  • What did you think would happen?

You can also say some of things things from Health Central.

  • Your fears are understandable (so, validating their emotions).
  • I am here to support you.
  • How can I help you?
  • Everything will get better––you can get through this, it’s okay.
  • What strategies help best when you feel anxious? (This can also help them resource their anxiety-management strategies if they’re not actively using them).
  • We can get through this together.

Looking at the responses above, the best things you can do are A) provide support B) stay with the person and C) offer solidarity. There are definitely some things you want to avoid (check out the post I previously wrote about that here), but I’ll revisit some of them.

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So accurate. Not even an understatement.

Things to AVOID doing:

  • Invalidating their feelings. Regardless of whether or not you agree with the person’s feelings, they need your support. Since anxiety happens when someone’s flight or fight system isn’t working properly, their emotions are heightened during anxiety/panic attacks. Therefore, invalidating their emotions will only make them defensive and feel like you’re not listening. I understand many people think they’re helping by saying things like, “You really need to get over your fears,” but wait until after the person calms down. This way, their rational thinking returns, and they most likely won’t be on guard.
  • Trying to make them talk too soon. Anxiety and panic attacks come with many physical symptoms, according to Health Guide: shortness of breath, hyperventilating, irritability, difficulty concentrating, feelings of dread, dizziness, muscle tension, headaches, sweating, and a pounding heart. Clearly, they’re a bit unstable at this point. Trying to make someone talk when they’re experiencing these things doesn’t really work because they can’t speak very well; it’s difficult to understand someone when they’re blubbering and hyperventilating. Wait until they feel better––it usually only takes probably about 10 minutes or so. It’ll feel like a long time, but in the grand scheme of things, it’s not too long.
  • Attacking them I don’t really even need to explain this one. The moment you make someone feel ashamed about their anxiety, they won’t trust you, and they’ll stand up for themselves because they’re used to others being judgmental towards them. You may not personally struggle with it, or you may think they’re being irrational, but at least try to see things from their perspective if you really care about them. If nothing else, go find someone else who you think can really help them.

While I’m thinking about it, asking someone to write down or draw out their feelings during anxious moments will help tremendously! This way, you’re not frustrated about their lack of communication, and they don’t feel pressured to physically vocalize their feelings. It’s a win-win.

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A good example of writing out feelings.

Types of anxiety and triggers

Anxiety is not a cookie-cutter condition. Just like there are many varieties of cakes, there are also many varieties of anxiety. Most people think all anxiety is Generalized Anxiety Disorder (GAD), where people feel anxious about pretty much everything––and although GAD is common, a lot of anxiety sufferers only feel anxious when their specific fears are triggered.

Here are some different types (from the US Dept. of Health and Human Services):

  • Generalized Anxiety Disorder––characterized by chronic anxiety, even when there’s really no cause for it.
  • Panic Disorder (which I have)––characterized by repeated episodes of intense fear, accompanied by physical symptoms.
  • OCD––characterized by intense thoughts and/or repetitive behaviors (a compulsion to do or feel something).
  • Social Anxiety––overwhelming anxiety and excessive self-consciousness in social situations
  • PTSD––develops after exposure to a traumatic event.

So, you see, it’s hard to understand anxiety until you know about these different disorders. Someone could be anxious about the need to wash their hands all the time. Others may be afraid of talking to others and become mute. Some may feel anxious anywhere they go. Others may feel anxious when they’re in a situation that reminds them of the abuse they faced as a child (emotional or physical). Some may be anxious only when it comes to work or school performance (ergo, me). Everyone’s different.

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This quote is spot-on.

Ultimately, anything can become a trigger, but these are some common ones (from Healthline).

  1. Health issues
  2. Medications
  3. Caffeine (this may work differently for those who have ADHD, like me. It actually helps my anxiety).
  4. Skipping meals
  5. Negative thinking
  6. Financial concerns
  7. Parties/social events
  8. Conflict
  9. Public events or performances
  10. Personal triggers––traumatic events, songs, places, or anything that reminds you of a bad memory.

I personally can check off the following: health issues, skipping meals, negative thinking, finances, conflict, performance situations, and bad memories.

Here’s how those play out in my personal life.

When my gastritis/GERD were at their worst, I became incredibly anxious (with severe panic attacks every-other-day) because I was almost at the point where I needed to be fed with an IV tube because I literally couldn’t eat anything without being in tremendous pain.

I become anxious when I skip meals because I’m hypoglycemic, so I already need to eat something every couple of hours. If I don’t, I become incredibly tired and don’t have the energy I need to push through the day.

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How low blood sugar affects anxiety

I’m notorious for negative thinking, and this makes me anxious because those thoughts plague me all day. It’s like a mixtape in my head that never shuts off, and it makes me feel physically exhausted. That’s why it’s so important for me to process negative thoughts.

Regarding finances, this isn’t normally a trigger for me, but it can be because I’m often compelled to work over 30 hours a week to pay off my student loans.

I recently discovered that conflict is a MAJOR trigger for me. I generally don’t experience conflict because I’m an easygoing person, but I do occasionally. I recently went through a conflict, where I felt like I wasn’t being listened to and wasn’t given grace for my mistakes. Instead of dealing with it immediately, I decided to ignore it and hoped it would become better. That didn’t happen. Instead, I became frustrated and everything blew up in my face. Lesson learned: deal with the issue before you become frustrated and, in turn, make someone else feel frustrated toward you.

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I tend to overthink many things…

Performance is a bit different for me––I explained my triggers earlier, so I won’t rehash them here.

Lastly, personal triggers. Mine come from bad memories––specifically when I was bullied in high school and when I experienced several rejections from the campus newspaper and magazine in college, despite my professors telling me I was a talented writer. Due to these experiences, I often get flashbacks when people tell me I always make mistakes, hold my mistakes against me, or say that I’ll never be good enough to do “x thing.” It’s similar to PTSD, but not as severe.

Why people with anxiety feel emotions so intensely

It’s no surprise that mainly feelers struggle with anxiety. After all, if thoughts and emotions usually cause the physical manifestations, then it makes sense. Thinkers don’t generally struggle with it as much because they’re very rational and don’t rely on their emotions too often––strong emotions are generally uncomfortable for them. Feelers, on the other hand, trust their emotions and often physically feel them. Those who internalize these emotions: they’re called empaths.

Healthy Place provides an excellent definition of an empath:

Empaths are individuals who are unconsciously affected by other people’s moods, desires, thoughts, and energies. They can, literally, feel the emotions of others in their bodies and attempt to carry these emotions on their shoulders without ever being asked. It’s for this reason that there are often anxious empaths.

I literally feel other people’s emotions (which is why I can become upset with people who try to lie to me about their emotions, especially their emotions toward me) and, as a result, feel emotions very intensely. That’s how I developed gastritis: my body literally internalized stress to the point where I eroded my stomach and esophagus.

Anyways, I’m an INFJ––with 80 percent feeling––AND an empath. That’s a perfect combination for an anxiety disorder, unfortunately. So, because I feel things so intensely, any “overwhelming” feelings (grief, frustration, stress) impact me severely to the point where I can emotionally overload and shut down. After anxiety attacks, I often feel “numb” because I’m that spent. Also, I know exactly how other people feel about me just by taking in their tone of voice, facial expression, and body language. They don’t even have to say anything––I just know because I can feel it. Therefore, I hate it when people lie to me about the way they feel, especially if they have a problem with me.

So, taking this all into account, this is something to look for in those who struggle with anxiety. Find out what their Myers-Briggs is and if they’re an empath. Then you’ll understand why they feel the way they do and see that their problem isn’t really that big, but it seems big to them because of the emotions they’re feeling.

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Feelers, well, feel a lot.

Feeling-type personalities may also be Highly Sensitive People (HSPs), so they are very sensitive and dealing with unmanaged emotions wears them out. Although they can find ways to feel less sensitive, they’re still probably more sensitive than the average person, myself included. Therefore, if you think someone is overly sensitive, just work with them and try to find less-harmful words or phrases.

According to Managing Anxiety and Stress by James Archer, feelers often manage their anxiety best by talking about their feelings with others, feeling understood by others, and by expressing their feelings. This is especially important for HSPs, who can easily become overwhelmed if they bottle up pain or hard emotions inside them and then let them all out in frustration or anger. If you want to learn more about this from a Christian perspective, I suggest reading The Gifting of Highly Sensitive Burden Bearers .

On that note, I want you to know that being an HSP isn’t a bad thing––I believe God created these people to become counselors, psychologists, teachers, as well as fulfill other roles that require emotional sensitivity. However, left unmanaged, it can become destructive. I’ve become aware of this, but I’m also not perfect. I try not to overreact, but I will become upset if someone I trust/respect hurts me. All that to say, if you encounter an HSP, don’t chastise them for being sensitive. That’s discrediting who God created them as. What you can do is say, “Hey, I didn’t mean to offend you. I’m sorry. What’s another way I could say [fill in the blank] so your feelings don’t get hurt?”

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I decode people more often through nonverbal cues than what they actually say.

Bottom line

I get it; anxiety is a difficult territory to navigate. It’s frustrating for those who don’t personally deal with it, and it comes with lots of complications. However, once you finally understand how someone experiences anxiety and what their triggers are, everything will become more manageable.

Spend more time with that person and really get to know what makes them tick, whether that’s over coffee, just hanging out, or going on a walk together. You might be surprised at what you find out. Specifically ask them what their childhood was like, what their fears are, and significant events that have shaped their life. Knowing all this information will help you “decode” that person. In addition, ask them what their personality type is. I always try to figure out a person’s Myers-Briggs personality type because it helps me understand them better.

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Get to know someone by taking them out to coffee.

According to the ADAA, 18.1 percent of adults struggle with anxiety. In a room with 22 people, that’s approximately four. It breaks down differently between each disorder:

  • GAD: 3.1 percent, 6.8 million people.
  • PD: 2.7, 6 m.
  • Soc. AD: 6.8, 15 m.
  • OCD: 1, 2.2m.
  • PTSD: 3.5, 7.7
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It’s more common than you think.

Furthermore, chances are you’re a college student or know someone who is. Want to know how many college students struggle with anxiety disorders? 1 in 5, according to The Conversation. That’s 20 percent. Yikes. According to Time Magazine, a record number of college students are seeking counseling, and schools can’t keep up with the demand. So, I hope this post helps some of you understand what it is you’re feeling.

Taking these statistics into account, anxiety disorders are probably more common than you originally thought. I hope this post has opened your eyes to the breadth and depth of anxiety, but also given you some clarification. If you have any questions, feel free to ask away in the comments.

You are MORE: You’ve been remade

I’ve always been a big Tenth Avenue North fan, but I haven’t listened to one of their songs in a while––You are More––and, wow, I’m blown away by how much I identify with the girl in this song. Like the girl, I feel like I can’t hide my shame because it seems like that’s all people see. It doesn’t matter how kind, patient, hard-working, or loyal I am. The moment I mess up, or the moment I tell them I have an anxiety disorder, all I am is trash to them. They don’t want anything to do with damaged goods.

Just as the girl wonders, I constantly think about how I drifted away from the free-spirited person I once was. Until last month, the fear of being unloved also crippled me, to the point where I would think something was wrong with me as a person if I couldn’t please someone.

But…

I often forget who I really am––a child of Christ––and what was done for me. Because Christ has come, I don’t have to worry about my flaws. Through his power, I can do what he has equipped me to accomplish, and he can make a beauty out of my mess. As the song says, it’s about where our brokenness brings us to. Since I have Christ in me, I can forgive those who have made incorrect assumptions about me and still love them, even though it’s hard.

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This is such a beautiful reminder that we ARE because God IS. 

In addition, the girl in the song seems like she was a church kid because she “knows all the answers” and tries to believe what others have told her is true. Similarly, I know all I should care about is how God thinks of me––but God also created us for community, and it’s so difficult to live life with other people who only see a false version of you instead of your true self. Like this girl, I also have rehearsed several lines. When people ask me how I hold my life together, I often say, “Oh, I just trust that God has my back because he’s faithful.” And it’s not that I don’t believe it, but I have to hold a death grip on that truth when I’m going through difficult things because my mind tells me to just give up. Just like that girl, I often become too weak to stand back up when I fall.

I actually took a screenshot of the music video for this song, which features a chalkboard full of lies in the background. Here it is (watch the video for a closer look at all the phrases).

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Look at some of those words and phrases: How can I change? Shame. Does anyone care? OCD controls me. Why do I feel so lost? Can anyone hear me? No one notices me. It’s hard to forgive and forget. Suicide? Insecurities. Afraid of letting people down. Not good enough.

We are MORE than poor decisions. We are MORE than the mistakes we made––and that includes unintentional mistakes, which I make a lot of since I have ADHD. Since I’m so right-brained, I think about things in a very different way than most people, and I generally need something explained in a specific way for it to stick in my mind. Otherwise, I need reminders. Some people just don’t get that, and they don’t have the patience to deal with my stupidity––but I know God is still proud of my hard work. We’re MORE than the problems we create.

Friends, I know life is tough, and I don’t have all the answers. However, I hope you can find some encouragement in what I shared and within these lyrics.

Here are the lyrics:

There’s a girl in the corner with tear stains on her eyes
From the places she’s wandered and the shame she can’t hide
She says, “How did I get here? I’m not who I once was,
and I’m crippled by the fear that I’ve fallen too far to love.”

But don’t you know who you are
What has been done for you
Don’t you know who you are

You are more than the choices that you’ve made
You are more than the sum of your past mistakes
You are more than the problems you create
You’ve been remade

Well she tries to believe it that she’s been given new life
But she can’t shake the feeling that it’s not true tonight
She knows all the answers and she’s rehearsed all the lines
So she’ll try to do better but then she’s too weak to try

‘Cause this is not about what you’ve done
But what’s been done for you
This is not about where you’ve been
But where your brokenness brings you to
This is not about what you feel but what He felt to forgive you
And what He felt to make you new

Here’s why I (almost) gave up swimming for a month

You know that “If you really knew me” game? Anytime someone asks me for my answer, I always reply with, “I LOVE swimming.” That’s not even putting it lightly. Literally, I live and breathe water. I’m pretty much like Ariel (well, before she wanted fins, anyway). Or maybe a fish is a better comparison.

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This is a photo from the day my doctor let me go back to swimming last year!

Anyways, the last time I gave up swimming for an extended period of time was last year, from mid-February to mid-June, because my doctor told me I couldn’t lose more weight  (I was 92 pounds because I lost so much weight from gastritis).

However, ever since my doctor gave me the okay last summer, I’ve pretty much swum two hours a day because I missed swimming so much. I’m training for open water events, but swimming is also my stress and anxiety reliever. Plus, it helps calm my hyperactive mind down because I have ADHD.

What I’m about to write might shock those of you who know me well: I’ve nearly given up swimming for the last month––and here’s why. First, when I switched departments here at camp, it made me miss lifeguarding more. Second, in light of that painful situation, I realized I primarily sought peace in swimming. Yes, I did trust God for peace––but after swimming. I thought that slicing my arms through the water would always help me feel better.

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I miss lifeguarding, but I’m returning to the Biola pool again soon!

Before all the hard stuff I dealt with last month, I worked my way up to swimming two or three times a day––which isn’t bad if you’re an Olympic swimmer. Although I’ve been training for a while, I’m not one of them, and I’m working eight hours a day. I also haven’t slept well lately, so I’m even more tired than the average person.

Over the past month, I’ve swum probably two hours a week––a dramatic contrast. How has that affected my life?

It’s been hard, but it’s also been beneficial.

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This is how happy I’ve been lately! Stark contrast from earlier this summer. 

At first, I became anxious about the fact that I wasn’t swimming––I didn’t want to backtrack in my training, and I didn’t want to become anxious because I wasn’t swimming. After the second week, however, I noticed a change. I actually enjoyed my swim time instead of pushing through muscle fatigue. I started valuing downtime and rest more. If I didn’t feel like getting up to swim a certain day, I just slept later that morning. I made time for activities that bring me joy that aren’t physically tiring: painting and playing music. I made more time for friends instead of hogging it for my swimming time. Sadly, I would do that: put swimming before relationships.

If you’ve kept up with my writing, you know my three words for this year are rest, revitalization, and relationships. By giving up swimming, I realized I needed more emotional rest and time for relationships. Furthermore, I have grown as a person because I realized I need to trust God for peace instead of trying to find it myself.

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I’ve met some AMAZING people this summer!

Within the last week or so, my mind has felt quieter––which isn’t too common for an introvert with ADHD and anxiety. I’ve felt less anxious, and I’ve smiled! Literally, people in the dining hall and my coworkers constantly tell me that my smile brightens their day. I’ve finally found peace, and I’ll cling to it.

Will I return to the hard training regimen I’ve adopted for the past year? Yes and no. I’ll still swim every day, but I won’t push my limits. I’ll stick to a training schedule, but I won’t swim extra on hard days. Instead, I’ll pick up a journal, process by myself (see picture below) and with friends, and spend time with the Lord.

 

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Here’s a peace-building journal exercise I did last month.

It is PUBLISHED

Readers, my book is finally on the market! I’m so excited this day finally came, and I hope all of you grab a copy in some form––ebook, paperback, or hardcover. If you’re short on cash or prefer a digital version, good news. The ebook is only 3.99.

This book contains the story of the health journey I went through over the last two years––which is where this blog came out of––and how I overcame a few significant issues: stress, anxiety, depression, suicide, gastritis, GERD, and nutritional deficiencies (B12 and magnesium).

I hope this book inspires you and helps you overcome the physical or mental health crises you or a loved one are facing. Please share my book with everyone you know and review it after you have read it!

Click this link to find it on Amazon.

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It’s published! 

The final link: how ADHD causes anxiety

After working with three therapists and ending my sessions in December 2017, I thought I finally had my Panic Disorder all figured out. Turns out I was wrong––because I only discovered I had ADHD at the end of September, I didn’t really work through that with my therapists because my main focus was my Panic Disorder. Guess I should’ve brought that up because it would have made a difference. I recently wrote a post about how ADHD causes anxiety, but I’ll go a bit more in-depth here. I only discovered this connection about a couple of weeks ago, and I’m so glad I did because it has helped me feel tremendously more at peace.

So, how exactly does ADHD cause anxiety? Well, the problem with having ADHD is you will never. Ever. Ever…be perfect. No matter how hard you try. It’s because our minds are wired in a way that’s completely different from the majority of society. As a result, we’re highly innovative, insightful, and creative––but our weaknesses shadow those positive traits. According to Unpacking ADHD, people often say these things about those who suffer with it: we’re lazy, forgetful, need to try harder, or don’t care enough. Furthermore, Dr. Ferrari states that people also will often call us oversensitive, emotional, and say we often jump to conclusions too quickly.

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Is being sensitive really that bad?

Upon further research that stemmed from my intuition, I realized that the inattentive part of ADHD may actually result from being very right-brained, which means our left-brain functions are weaker than the average person. According to Simply Well Being, people with ADHD struggle with certain detail-oriented tasks (generally not those that require creativity, such as painting and playing music, but rather tasks like math), reflecting/analyzing/organizing, being consistent, and focusing on one thing instead of multiple things.  But that still probably doesn’t answer your question: why do people with ADHD excel more in “right-brained” functions?

It’s most likely due to a dopamine imbalance. Healthline reports that low levels of dopamine in the left region of the brain could be one of the causes of ADHD. If you’ve read my book or previous blog posts, you know that dopamine is responsible for working memory, information retention, pleasure, focus, motivation, energy, social interaction, and creativity.

As you can see, dopamine is responsible for a lot. That’s why it’s incredibly important to get medication if you think you have a dopamine imbalance––and remember to take it (silly me forgets a lot due to my ADHD). That’s one of the problems of having ADHD, actually: forgetting to take your meds. Other neurotransmitters––serotonin and norepinephrine––also overlap with dopamine and are responsible for similar functions, such as mood. Here’s a Venn diagram that displays the connection between these three.

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These neurotransmitters have slightly specific functions, but they all overlap at some point.

 

Anyways, how does this interact with anxiety? If you’re not sleeping well, not retaining information well, not feeling well and avoiding people because of it, and not remembering things well, that can result in a TON of performance anxiety (atelophobia). The more you forget things, have difficulty processing things, have a lack of energy, and feel like being alone all the time, the more you will become emotionally overwhelmed, exhausted, and feel like a failure.

Since people with ADHD are also incredibly sensitive empaths (Highly Sensitive People), we tend to catastrophize disagreements and others’ impressions of us. Someone simply not liking our personality turns into others not liking us, which creates anxiety about that conflict. Someone even saying “I’m disappointed in you” is earth-shattering, and that’s why it’s important to let supervisors know, ‘Hey, I’m highly sensitive. I know you might be harder on other employees, but I need to receive corrections with a softer tone so my emotions don’t go haywire.” I learned that lesson hard this summer after working with two leaders that were the exact opposite: very strong and not emotionally sensitive people, so they didn’t understand the burden I dealt with every day. However, I know that was partially my fault. I never let them know that I had a medical reason for having emotional breakdowns if I received too many corrections in a day. Now I know what to do for next time so I don’t have to switch departments at another job.

Actually, there’s a medical term for this: rejection-sensitive dysphoria. Here’s a quote about what that feels like from an ADDitude Magazine article:

“I’m always tense. I can never relax. I can’t just sit there and watch a TV program with the rest of the family. I can’t turn my brain and body off to go to sleep at night. Because I’m sensitive to my perception that other people disapprove of me, I am fearful in personal interactions.”

According to the article, a fear of failure is catastrophic for people with this condition––and that’s why we take corrections at work so personally. We’re just super sensitive, and that’s how God created us. However, some leaders won’t budge. They’ll just say, “Oh, that’s my management style. I’m not going to change it for you.” If you hear that, just do me a favor and quit that job. It’s not worth the misery. I even challenged a leader on this issue, and I wasn’t afraid to do so. I don’t usually challenge authority, but I felt like I wasn’t being listened to, so I spoke up. Don’t let people put you down for having feelings.

The best bosses and leaders I’ve ever worked with get to know each member of their team individually and cater their leadership style towards them. This is also known as “self-awareness,” or the ability to understand how your actions affect those on your team, according to Catering Institute. No, they won’t change it for people who can adapt to it, but for those who can’t, they’ll take a slightly different approach.  That’s how you know you have a leader who cares. Some of the professors I’ve had at Biola use that approach as well, so I know it’s not a task too difficult to ask for. Working with leaders who aren’t self-aware makes me super anxious because I’m always worried about impressing them, but they’re never impressed with me anyways because I’m a failure in their eyes, so it creates this incredibly violent cycle that only ends with self-hatred or self-harm. That’s why it’s important to find a safe work environment: so you don’t harm your emotional and physical health in the process.

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Found this nice infographic about self-awareness that can help leaders improve upon that trait.

Now, taking this all into account, it seems that the majority of the ADHD/anxiety relationship comes from an overcompensation of imperfections. We don’t think logically, but we understand figurative meanings and can read between the lines exceptionally. We’re flexible people and adapt many approaches for the same task. We’re profoundly intuitive and creative. Our mysteriousness stumps so many people that they become frustrated with us, and we internalize their response towards us, unfortunately.

In addition, anxiety can also result from conflict with people due to our highly sensitive nature. We’re so empathetic that we take facial expressions, body language, and tone of voice into account when we converse with someone, which is how we know how they feel about us. I’ve had people tell me point-blank, “No, of course I like you,” but all these non-verbal cues scream, “I’m only putting up with you because I have to.”

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The definition of an empath in five points.

I hope all the information I presented here helps you in some way, whether you’re primarily inattentive, hyperactive, or a combined-presence type (which is me). Hopefully, this knowledge will help you work through anxiety and live a healthier life.

Psalm 34: learning to give up control

Throughout my college years at Biola––even during my first semester as a grad student  at Talbot this spring––I’ve struggled with a fear of losing control, which is one of my anxiety triggers I’m still working through. Thankfully, I just got over my fear of never measuring up (atelophobia), which actually came from my ADHD. Regardless, I’m also still working through my third and final trigger: conflict. I get anxious when other people don’t like me––for no apparent fault of my own––and still dislike me when I try to make things right. I guess that just goes to show that you also can’t control other people. Anyways, I’ve been reading through Psalm 34 in my morning devotional time, and it’s really spoken to me because it reminds us about how God is in control, even when difficult things happen in our lives.

Fear the Lord, you his holy people,
for those who fear him lack nothing.

-Psalm 34:9

Depending on your theological view, this verse could apply only to traditional Israel, or also to the church today. I believe in the latter and feel that, since Jesus’ inaugurated kingdom includes Gentile believers (those who are not Jews), we are still God’s holy people. The psalmist reminds us that God is our provider and gives us everything we need. He is ultimately in control over everything and knows what’s best for us, even when we think we know what’s best. That’s a difficult statement to swallow at times, but the more you realize this, the easier trusting God becomes.

Turn from evil and do good;
seek peace and pursue it.

-Psalm 34:14

It’s unclear what evil specifically refers to here, but I’ll relate this to my fear of interpersonal conflicts. It’s so easy to lash out at people who hurt us, especially when they make incorrect assumptions about us, but we are called to be peacemakers. Even if someone deserves revenge or a snippy response for the ways they hurt us, we should try to make amends. Even if we forgive someone, however, they may not reciprocate––but as long as you seek peace, you have done your part and can walk away knowing that you cannot control their response or behavior.

The righteous cry out, and the Lord hears them;
he delivers them from all their troubles.
The Lord is close to the brokenhearted
and saves those who are crushed in spirit.

-Psalm 34:17-18

These two verses are the ones I’ve read over continually this past week. Just as God delivered the Israelites from trouble––especially in the book of Judges––he still rescues us from disasters today if we find refuge in him and recognize that his hand is over us. Now, this peace may not come immediately because we live in a world with evil, but peace will eventually come. God also doesn’t always act immediately because we would abuse his trust, so patience is key here. Having patience is the opposite of needing to have control: it’s knowing that you have to wait for things to work out instead of forcing them to work out.

Secondly, God knows how we feel. His son endured many of the same sufferings we did––including a small feeling of loss of control when he died on the cross as he recited part of Psalm 22 (” My God, why have you forsaken me?”). He is a good Father and is by our side, even when we feel deserted. Remembering this helps me feel better about not having control because I can have confidence that I can find God’s peace if I do not let chaos control my life.

The Lord will rescue his servants;
no one who takes refuge in him will be condemned.

-Psalm 34:22

Lastly, God is there for us when we face situations beyond our control. I recently dealt with a ministry situation where I disagreed with someone, and I felt like my character was attacked. For a while, I wondered if something was wrong with me, but after talking to other trusted leaders, I realized that I received condemnation for reasons beyond my control. I couldn’t control what the other person thought, but I could control my response. So, I forgave that person and realized that God had my back. At first, I panicked because I thought I was losing sight of myself, but then I understood that the less I dwelled on the situation, the more I felt at peace. The more I stopped living in the past or future, the more contentment I experienced.

Learning how to refrain from controlling every last aspect of our lives is difficult for anyone with anxiety––especially those of us who are perfectionists. It takes time, patience, and effort, but peace will come eventually because the light always overcomes the darkness.