While anger is not commonly a symptom that is associated with anxiety, there is evidence to suggest that when a person has an anxiety disorder, the rate and intensity of their anger can increase. Within this blog, we will explore the relationship that can exist between anxiety and anger. We will also highlight the help and support that is currently available at Priory Group for people who are experiencing such emotional distress. Anxiety and anger: what is the relationship? Anxiety and anger can become connected in a number of different ways: Anxiety activates people’s fight or flight instinct When somebody has an anxiety disorder, they will often feel intense fear towards possible threats and dangers. For someone with a social anxiety disorder, this could be crowds or social events, whereas for someone with a general anxiety disorder, their fear could be towards a broad range of potential scenarios such as losing their job, damaging their friendships or getting into accidents. These thoughts cause people with anxiety to experience symptoms such as an increased heartbeat, shortness of breath and nausea. This is because thinking about the possible dangers activates their fight or flight instinct. While some people ‘take flight’ when they feel anxious and stay away from possible dangers, others find that their fight response is activated. This can result in them becoming angry. This typically happens when the person feels trapped or is struggling to comprehend and express how they are feeling. People can often feel angry towards their anxiety disorder People with anxiety can become frustrated and angry about the impact that their disorder is having on their life. Typically, they will direct this anger at themselves. Irritability is a symptom of anxiety When a person is experiencing anxiety, they will often be more irritable than usual. It is a common symptom of the disorder. With their body and mind overwhelmed with worry, the person can feel stressed and depleted of energy. This can make it difficult for them to shrug off or ignore things as they normally would be able to do. In turn, this can cause them to become more irritable and anger quicker. People can feel anxious about their anger When someone becomes angry when they feel anxious, it can leave them feeling guilty, ashamed and embarrassed afterwards. This can cause the person to fear becoming angry in the future. In turn, they may bottle up their anger around others as they worry about being judged, damaging relationships or hurting other people’s feelings. Tips for dealing with anxiety and anger If you have been struggling with anxiety and anger, it may be useful for you to introduce a few practical coping strategies into your daily life to help you improve how you’ve been feeling: Take a few minutes for yourself: if something is making you feel stressed, anxious or uncomfortable, remove yourself from that environment if you can. Find a quiet space and give yourself time for your stress responses to reduce. You may want to try some deep breathing - take in a slow deep breath through your nose for four seconds. Imagine filling your lungs from the bottom right to the top, making them as full of air as possible. Hold the breath for another count of three, and then exhale gently through your mouth for another count of six Exercise outdoors – doing something that requires a lot of energy like running or cycling can help. When you exercise, you focus on your body, which gives you little time to concentrate on or mull over any anxious or angry thoughts. Moving and being outdoors are also well-known mood boosters. They stimulate the release of neurotransmitters including endorphins, oxytocin and serotonin, which can leave us feeling more positive Write down your thoughts – whether you have a physical diary or keep notes on your phone, writing can be a good way to release any anxious or angry thoughts. The act of writing or typing these thoughts can feel as though they are flowing from your mind onto the paper or phone, helping to create some distance between you and them Look after your wellbeing – give yourself the time to recharge your batteries and keep yourself well. When you’re feeling drained and have little energy, this can have a detrimental impact on your mood and mental health. Remember that you deserve to look after yourself and that doing so is incredibly important for your body and mind. Sleep well, eat right and do the things that you enjoy in life Treatment for both anxiety and anger If you are experiencing both anger and anxiety, and find that it is starting to impact heavily on your life, you may want to think about accessing professional treatment. Taking steps to address and manage both of these emotions can help you to start improving to how you currently feel. At Priory Group, when you first visit us, you will meet with a consultant psychiatrist, who will work with you to determine the best treatment plan for your requirements. This could include: Weekly therapy sessions – it may be recommended that you come to your local Priory Wellbeing Centre or sign up to our online therapy service Priory Connect for weekly sessions with one of our therapists. Your therapist will help you to determine the thoughts that have been leaving you feeling anxious and angry, and will work with you to address these thoughts and beliefs so that they have less of an impact on you going forward A programme of day or half-day sessions – if it is felt that you would benefit from more intensive treatment, it may be recommended that you come to Priory for a series of day or half -day sessions. Depending on your consultant psychiatrist’s recommendations, your programme could include one-to-one or group therapy sessions, counselling, anger management sessions, family or couples therapy and mindfulness sessions Residential treatment – if your consultant psychiatrist believes that it would be best for you to receive a more structured form of treatment, they may suggest a stay at one of our hospitals. Here, you will receive 24-hour support and ongoing monitoring of your condition. You will also receive a plan that includes therapy sessions alongside wellbeing sessions, including yoga, meditation and mindfulness
Depression comes in many different forms. The symptoms are wide-ranging and it can affect people in many ways. While most people recognise that depression can cause intense sadness, a lack of energy and anxiousness, there are a number of symptoms that people are less aware of. We recently ran a survey to find out people’s understanding of the different symptoms of depression. These were the results: The importance of recognising all symptoms of depression Depression not only affects how a person thinks and feels. The mental health condition can cause physical symptoms and can also impact on behaviour. When people know what to look for, it can help those with the mental health condition to get access to the right help and support faster. Dr Syed Omair Ahmed, a consultant psychiatrist at Priory Hospital Woodbourne, says: “When a person continues to live with depression unknowingly and without accessing the right treatment, it can cause their depression symptoms to worsen and serious health issues can arise. “It can lead to physical health issues including malnutrition, obesity, heart disease and diabetes. If a person turns to alcohol or drugs in an attempt to alleviate their symptoms, this can cause further issues. People can also develop cognitive decline and suicide risk also increases with severe depression. Psychotic symptoms can also develop. “Family life can become adversely affected, and relationships break down. Some people also engage in reckless behaviour which can get them in trouble with the law.” Understanding the lesser known symptoms of depression Dr Ahmed has put together information on the lesser known symptoms of depression and why they can happen: Finding it difficult to make decisions - depression can decrease certain areas of the brain in volume and disrupt normal ‘electrical connections’. This can cause a person’s focus and concentration to diminish, making it difficult for them to make decisions. Depression also leads to sleep disruption and lethargy. This lack of energy can affect a person’s ability to make decisions Changes in appetite or weight - depression can change our metabolic systems, which can lead to an increased or decreased appetite. As people with depression can have lower energy levels, they may also be less motivated to prepare food. On the other hand, some people may ‘comfort’ eat as a coping mechanism Having difficulties in your home, work or family life – a loss of sleep caused by depression can cause some people to become irritable, which can affect those they are close to. A person may also withdraw from others, which can impact relationships. Problems with focus and concentration may also cause work performance to decline, and lead to a demotion or job loss. If a person resorts to self-medicating with alcohol or drugs, this can again exacerbate difficulties at the home, work or within the family Low sex drive - people with depression can experience a loss of desire and experience delayed orgasm. A person’s sexual arousal depends on their ability to experience pleasure. If this is missing due to depression, this can lower their sex drive. Low energy levels and low self-esteem also contribute to this picture Feeling guilt-ridden - people with depression struggle to achieve perspective on negative life events. This can make them feel wholly responsible for negative things that happen, making them feel guilty Moving or speaking more slowly than usual – the slowing of both thought processes and physical movements is a well-established symptom of severe depression. Partly due to decreased energy levels, it is also known that certain chemical and structural changes in the brain can cause this Unexplained aches and pains - people with depression often experience various body ailments including pain. While quite often, there will be no underlying physical cause, the pain and distress is very real. In depression, as emotions are not processed properly, people tend to focus on the physical symptoms they experience rather than underlying emotional problems Changes to your menstrual cycle - during a depressive phase, a hormone called cortisol rises. This sends messages to the brain and the reproductive system, delaying or ceasing ovulation, leading to a delayed or absent period Constipation - if a person’s appetite is adversely affected, and their dietary intake is quite poor, they will lack essential nutrients and fibre. This can lead to bowel disturbances including constipation. Low fluid intake can also worsen constipation. Low serotonin levels in depression have also been shown to slow gut movements What to do if you think you’re suffering from depression If you are concerned that you may be suffering from depression, speak to friends or family, as they will be an invaluable source of support. Also, book an appointment to visit your GP, who will be able to provide you with a diagnosis and a treatment programme to follow. This may include psychological therapy, medication or a referral to a specialist mental health service like Priory Group. If you are worried that you may have depression, you can also come directly to Priory Group. One of our consultant psychiatrists will be able to assess your symptoms, provide you with a diagnosis and recommend the best form of depression treatment for you to receive at one of our hospitals or wellbeing centres. This could include: Weekly counselling or talking therapy sessions – accessing therapy, especially CBT, can often be useful for people with depression. These sessions can help you to determine the thoughts and feelings that are fuelling your depression, and help you to work on moving beyond them so that they less of a hold on you Day sessions at one of our hospitals and wellbeing centres – a form of treatment that is slightly more intensive than weekly therapy, attending day or half-day sessions at one of our hospitals and wellbeing centres will see you taking part in a programme that includes both group and one-to-one therapy as well as wellbeing and mindfulness sessions Residential hospital stays – for people with severe depression, your consultant psychiatrist may recommend a more intensive form of treatment, which can include a stay in one of our hospitals. During this time, you will receive 24 hour care and support and take part in a structured programme that includes both therapy and wellbeing sessions Medication – if appropriate, your consultant psychiatrist will be able to prescribe medication alongside therapeutic support At our North London hospital, we are also able to provide rapid acting programme in depression (RAPID) by triple chronotherapy, where wake and bright light therapy is used to help alleviate depression symptoms. This can be used alongside medication and other psychological therapies. Repetitive transcranial magnetic stimulation (rTMS) is also available at our Harley Street Wellbeing Centre. This uses electro-magnetic fields to stimulate areas of the brain associated with mood control and is typically used to help people with treatment-resistant depression.
Depression and insomnia are often interlinked but the connection between them can be complex. It is far from a simple cause-and-effect relationship: Depression can result in a person experiencing insomnia, as sleep problems are a common symptom of the mental health condition Insomnia can appear first, and then trigger and perpetuate depression as the lack of sleep impacts a person’s mood and anxiety levels Depression and insomnia can also be experienced as two simultaneous yet unrelated disorders Within this blog, we will look at the steps that you can take if you are currently experiencing both depression and insomnia. Addressing your depression and insomnia When dealing with both depression and insomnia, it is recommended that you seek professional support so that a specialist can review your symptoms and advise on the best steps forward. As a first port of call, you may want to visit your GP. They will either be able to provide you with treatment or refer to a specialist service such as Priory Group for further assessments and specialist treatment. You can also come directly to one of Priory Group’s hospitals or wellbeing centres to discuss your depression and insomnia with a consultant psychiatrist. They will be able to carry out a thorough assessment to determine the best form of treatment for you, which may include therapy and pharmacological treatment. CBT for depression and sleep disorders Cognitive behavioural therapy (CBT) is a practical, hands-on form of therapy that can be particularly useful for people suffering with depression and insomnia. CBT techniques for sleep disorders Cognitive behavioural therapy for insomnia (CBT-I) teaches you ways to change any thoughts and behaviours that are impacting your sleep. Sessions typically focus on the following areas: Stimulus control – re-associating your bedroom with sleep and sex. As part of this, you will be encouraged to move away from your bedroom if you can’t sleep at night and only return when you are sleepy again Sleep restriction – setting and sticking to rigid sleep and wake times, helping your body to fall back into a natural rhythm so that you have a better sleep pattern Cognitive restructuring – addressing thoughts and beliefs that are destructive to your sleep. For example, if you go to bed thinking “I will never go to sleep”, you are encouraged to replace this with “it’s normal to take some time to get to sleep”. CBT-I also teaches you how to relax and quieten your mind before bed to stop your thoughts from going into overdrive as soon as your head hits the pillow Sleep hygiene education – assessing aspects of your lifestyle and environment to see if improvements can be made to help you sleep better. This will include evaluating such things as your caffeine and alcohol intake, your bedtime routine as well as your sleep environment CBT techniques for depression When dealing with depression, you will often experience negative thoughts and beliefs about yourself, other people and the world around you. This can cause you to feel extremely sad, hopeless, ashamed and guilty. CBT sessions can help you to address and move past these destructive thoughts and beliefs in the following ways: You work to identify any destructive self-talk and automatic thoughts that you hold onto, which may include things like “I’m worthless”, “no one likes me” or “there’s no point” You learn how these thoughts and beliefs have been affecting how you feel and behave, and how they could impact you going forward You practise replacing these destructive thoughts and beliefs with ones that are more positive and productive, which could include “I have family and friends who care about my worth”, “I won’t give up” or “I have accomplished a lot” By learning how to identify, stop and swap destructive thoughts and beliefs through CBT, you can stop them from having such a negative influence on your mood as you go forward. Ways to help you manage your depression and insomnia We understand that living with depression and insomnia can be exhausting. When accessing professional support, there are also strategies that you can start to include in your day-to-day life to help you manage how you are feeling. These include: Keeping to a regular sleep/wake routine – when we stick to a sleep schedule, the routine helps our body to fall into a natural rhythm, where it comes to recognise times when we should be asleep and times when we should be up and about Exercising outdoors once a day – exercise can be a mood-lifter and also a good distraction from our thoughts and feelings. It can also be a good way to exert energy, so that you feel more tired in the evenings. Just make sure that you don’t exercise in the four hours before your bedtime as this can actually make it more difficult to sleep Avoiding afternoon naps – these can stop you from sleeping well in the night. If you feel like you need to take a nap, avoid sleeping for longer than 20 to 30 minutes Limiting the amount of caffeine and alcohol you consume – avoid alcohol and caffeine in the six hours before you go to bed, as it can impact on the quality of your sleep. Caffeine and alcohol can also cause spikes and dips in your mood and energy levels, so monitor the amount your consume Making the most of your support system – when you are dealing with depression and insomnia, reach out and talk to people who you trust and who care about you. You don’t have go through this alone. If you don’t feel comfortable speaking to close friends and family about it, you can also speak to a therapist or counsellor, or seek support from The Samaritans, who will always be there to listen when you are going through a difficult time