am I losing my mind?

by Sally Burningham

Everybody goes through periods when they're unhappy, down, anxious, panicky or terribly stressed. Most of the time, these episodes pass, but they are extremely unpleasant while they last. You might even question your own sanity during these times.

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Here we look at some of the bad feelings you might have, what might cause them and how to deal with them.

Sometimes these distressing feelings go on for far longer than expected and come to dominate life. If this is happening to you or someone you know, it's important to get help. There are links in this feature to ways of doing this and to more in-depth information.

sounds familiar?

'I worry all the time. I often find that my heart begins to race, I start to breathe faster, my palms sweat, my muscles tense and my stomach fills with butterflies. I don't know what to do. Am I losing my mind?'

this could be general anxiety

You're in good company – the UK Office of National Statistics estimates that 3.1% of the population (that's more than 1.8 million people!) experience general anxiety at any one time.

Your reactions are the same ones that our primitive ancestors needed to fight or flee when confronted with danger. Fortunately we no longer have to face fearsome beasts on a daily basis, but the sensations remain and can occur at the most inappropriate times.

You may feel powerless in anxiety's grip, but there is quite a lot you can do to help yourself:

• get information If you are worried and anxious about anything in particular, don't hide your head in the sand. Find out as much as you can about the problem and then look for solutions. Most of the things we worry about turn out to be not nearly as bad as they seemed inside our heads!
• challenge negative thoughts If you find yourself constantly running yourself down inside your head, make it a deliberate policy to say 'Stop!' and find a more positive thought to replace the negative one. For example, if you mentally moan, 'I'll be made redundant and never get another job,' tell yourself instead that 'Being made redundant could send me on my way to an even better job!' You may not believe it at first, but it will have a positive effect on you. If you find this difficult to do on your own, you could also try 'cognitive behaviour therapy'. Check it out in our feature on cognitive behaviour therapy.
• relax Even a simple technique can help a lot. Try '7 to 11' breathing: breathe in to a count of 7, and breathe out to a count of 11. And when you breathe in, be sure that your abdomen fills with air.
• exercise Physical activity will use up the adrenalin produced by your body that causes the unpleasant sensations of anxiety. It can also make your brain produce endorphins – natural 'feel good' chemicals.
• the 'worry half-hour' If you usually worry all the time, force yourself to stop and only allow yourself to do it for a set 30 minutes a day. If worries creep into your mind at other times, write them down so that you can deal with them during your dedicated worry half-hour.

For more information check out our feature on anxiety. You can also check out the stress section, where you will find don't panic with its 10 top stressbusting tips, and more advice on how you can remove the stress in your life that can lead to anxiety.

If your symptoms have been going on for some time you should talk them through with your GP who may be able to recommend some treatment.

sounds familiar?

'Out of the blue, when I was on my way to work, I had difficulty breathing, I became dizzy, my heart beat incredibly strongly and I had chest pains. I began to sweat and shake, I felt as if I was choking and, most of all, I was very, very afraid. I don't know what to do. Am I losing my mind?'

that was probably a panic attack

Panic attacks are an explosion of anxiety, which can be very frightening and can have many causes. The suggestions above for general anxiety may help you to prevent an attack or, if one does occur, might help you to cope better.

People who have panic attacks are often afraid that they're having a heart attack or are going to die. So a visit to your GP is a good idea – finding out that nothing is physically wrong with you, that you are not about to die, can be a great relief.

Remember: panic attacks are frightening, but they will not harm you. It is fear of them that allows the disorder to continue.

For more information on panic attacks and how to deal with them, check out our feature on panic attacks.

sounds familiar?

'Every time I have to speak to a group of people, even only three or four, I completely fall apart. My hands get clammy and shake, I feel my throat tighten and my mind goes blank or is flooded by terrifying thoughts. It's really beginning to hurt me at work. I don't know what to do. Am I losing my mind?'

you may have a type of social phobia

This kind of phobia or 'stage fright' is the fear of situations where you might be exposed to the negative opinions of others. Because you are very anxious about what other people think, your performance is likely to suffer, which simply reinforces your fear – and so the cycle continues. This can happen not only when doing public speaking and other formal performances but also when just generally socialising. For more information check out our feature on phobias.

Try some of the suggestions for general anxiety given above. Cognitive behaviour therapy may also be worth trying. You could learn how to face your fear through 'graded practice.' First, ask yourself:

• What type of setting makes me feel particularly anxious?
• What sort of audience or subject matter disturbs me the most?
• What makes it easier or harder for me to cope?

Using the information you've gathered from this, draw up a plan of graded exposure to the situation that frightens you, from the least frightening to the most. For instance, you might find talking informally to one or two people a bit daunting but something you think you can manage. Use anything that might help you (for example, prepare a list of topics beforehand) and try to learn from the experience. Carry out this exercise until you can do it confidently and without anxiety. Then move on to the next level – say, giving a brief formal talk to three people.

You can have as many levels as you need – just remember to take everything slowly and only proceed to the next level when you are satisfied that you are no longer afraid of the one you are on. Your final level should be what you most fear. You might find that you need professional help to carry this out (see box finding a therapist).

If your anxiety symptoms are quite severe – and the occasion is particularly important – you might ask your GP one of the beta-blocker medications. These drugs can help to reduce of some of the physical symptoms of anxiety, such as slowing the heart, calming breathing and reducing muscle tremor.

sounds familiar?

'I feel very low all the time. Nothing gives me pleasure any more – certainly not food since I've virtually lost my appetite. I can't sleep the night through and I'm usually tired during the day. I don't know what to do. Am I losing my mind?'

it sounds as if you could be depressed

Sometimes this occurs as the result of something bad that has happened to a person – loss of a job, bereavement, a major disappointment in a relationship, an extremely stressful home or work life. At other times, it is just something that is 'turned on' inside, seemingly for no reason.

When you're depressed, your mind focuses on negative thoughts – 'I'm unlovable', 'I'm no good', 'I can't get out of this situation.' If you've had these thoughts for long enough, you can find yourself interpreting even the slightest downturn in life as being your own fault because you are 'unlovable' or 'inferior' or have no control. The future seems unchangeable – and very, very bleak.

Most of the time, depression will last a little while and then you will start to come out of it, taking an interest in the things around you and seeing a future that is a little more promising. However, sometimes depression goes on for much longer and is a lot more extreme than a bout of feeling low and you will need professional help.

Read our feature on depression for more information on what is sometimes called 'clinical depression.'

Whichever type of depression you may have, there are a lot of things you can do to help yourself climb out of the emotional chasm it creates – see our feature on self-help strategies for some good tips.

help and info

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organisations

To find a suitably qualified psychologist in your area contact:

The British Psychological Society (BPS)
St Andrews House
48 Princess Road East
Leicester LE1 7DR
Tel: 0116 254 9568 (office)
E-mail: enquiry@bps.org.uk
Website: www.bps.org.uk/index.cfm
The BPS is the representative body for psychologists and psychology in the UK. Their website has a 'Find a Psychologist' facility where you can search for a psychologist in your local area.

To find a suitably qualified counsellor psychotherapist in your area contact:

British Association of Counselling and Psychotherapy
35-37 Albert Street
Rugby CV21 2SG
Tel: 0870 443 5252 (Mon-Fri 8.45am-5pm)
E-mail: bacp@bacp.co.uk
Website: www.bacp.co.uk
BACP can provide you with a list of private counsellors in your area, plus information on counselling and choosing a counsellor. Please telephone or send an SAE to the above address. Alternatively, you can search for a counsellor at the website which, along with an online directory of counsellors, contains details about membership, training and an extensive publications list.

British Confederation of Psychotherapists (BCP)
Senior Administrator
West Hill House
6 Swains Lane
London N6 6QS
Telephone: 020 7267 3626
E-mail: mail@bcp.org.uk
Website: www.bcp.org.uk
The BCP now has a register of Psychotherapists available online.

United Kingdom Council for Psychotherapy (UKCP)
167-169 Great Portland Street
London W1W 5PF
Tel: 020 7436 3002
E-mail: ukcp@psychotherapy.org.uk
Website: www.psychotherapy.org.uk
Umbrella group for over 5000 practitioners all registered through member organisations. Will provide lists of registered psychotherapists free of charge; the database can be searched by local area or other criteria such as wheelchair access or language.

For help with depression or anxiety:

Depression Alliance
35 Westminster Bridge Road
London SE1 7JB
Telephone: 0845 123 23 20
E-mail: information@depressionalliance.org
Website: www.depressionalliance.org
National network of self-help groups for people experiencing depression. Offers a quarterly newsletter, national pen friend scheme and correspondence service with advice, guidance, support and fellowship to people experiencing depression, and their carers. Produces booklets and leaflets on various aspects of depression.

First Steps to Freedom
1 Taylor Close
Kenilworth CV8 2LW
Helpline: 0845 120 2916 (every day 10am-10pm)
Info: 01926 864473
E-mail: info@first-steps.org
Website: www.first-steps.org
A confidential helpline for people suffering from general anxiety, panic attacks, phobias, obsessive compulsive disorder, anorexia and bulimia, and their carers. Offers counselling, listening, advice, support and information.

Mind (National Association for Mental Health)
15-19 Broadway
London E15 4BQ
Tel: 020 8519 2122
Mind Infoline: 0845 766 0163 (Mon-Fri 9.15am-4.15pm)
E-mail: contact@mind.org.uk
Website: www.mind.org.uk
Campaigns for better mental health services in England and Wales, through its national office, regional offices and network of over 200 local branches, some of which also provide services. Publishes a range of helpful books and leaflets. Contact them for details of your nearest local group and for more information.

National Phobics Society
Zion CRC
339 Stretford Road
Hulme
Manchester M15 4ZY
Helpline (members only): 0870 7700 456 (Mon-Fri 10am-4pm)
E-mail: nationalphobic@btconnect.com
Website: www.phobics-society.org.uk
A membership-only organisation, run by sufferers and ex-sufferers of anxiety disorders, that provides support and advice to people affected by phobias and anxiety disorders. Offers one-to-one therapy (with home visits for those who are housebound through agoraphobia etc.) including CBT, clinical hypnotherapy and counselling.

SANE
1st Floor
Cityside House
40 Adler Street
London E1 1EE
SANELINE: 0845 767 8000 (every day 12pm-2am)
E-mail: london@sane.org.uk (admin queries only)
Website: www.sane.org.uk
SANELINE is a national mental health helpline providing information and support for people with mental health problems, and those who support them. They can provide information on illnesses and symptoms, local and national mental health services, medication, treatments and therapies.

websites

Anxiety Disorder Education Program
www.nimh.nih.gov/publicat/anxiety.cfm
Has information about panic attacks, phobias and other anxiety disorders and treatments, plus links and contacts. Part of US National Institutes of Health website.

Mental Help Net
www.mhnet.org
Website offering information on a wide range of mental health topics.

NetDoctor – Generalised Anxiety Disorder (GAD)
NetDoctor Women's Health Anxiety Feature
A NetDoctor article that looks at generalised anxiety disorder (GAD) – when worrying becomes an illness.

Social Anxiety UK
www.social-anxiety.org.uk
Information and support for sufferers of social anxiety (SA) and related problems. Features chatrooms and details of local meetings across the UK.

The Royal College of Psychiatrists – Anxiety and Phobias
www.rcpsych.ac.uk/.../anxietyphobias/anxietyphobias.aspx
Factsheet including symptoms, causes and where to get help.

reading

Anxiety, Phobias and Panic Attacks: Your questions answered by Elaine Sheehan (Vega Books, 2002)
Information and advice on types of anxiety, treatments available, including self-help strategies, and what to expect.
Get this book

Living with Mental Illness: A book for relatives and friends by Elizabeth Kuipers and Paul Bebbington
Provides explanations and practical advice on matters such as coping day to day and in a crisis.
Get this book

Overcoming Social Anxiety: A self-help guide using cognitive behavioural techniques by Gillian Butler (Constable Robinson, 1999)
The author explains what social anxiety is, and how to overcome these feelings and build confidence. Includes techniques for overcoming conditions such as panic attacks, depression, anxiety and addictions.
Get this book

The Anxiety and Phobia Workbook by Edmund Bourne (New Harbinger Publications, 2001)
Provides proven techniques for confronting and overcoming a wide variety of phobias, fears, and anxieties.
Get this book

(July 2001, resources updated December 2004)