[HN Gopher] Anxious brains redirect emotion regulation
___________________________________________________________________
Anxious brains redirect emotion regulation
Author : conse_lad
Score : 442 points
Date : 2023-08-21 03:04 UTC (19 hours ago)
(HTM) web link (www.nature.com)
(TXT) w3m dump (www.nature.com)
| fud101 wrote:
| so we should be avoiding avoiding?
| NayamAmarshe wrote:
| Basically, yes.
| [deleted]
| Tistron wrote:
| The language of this is challenging for me to read and
| understand. Is there any clarity on whether high anxiety leads to
| this different routing, or whether there has been some event in
| the past leading to this routing which then leads to high
| anxiety? And is there any indication whether exposure to feared
| situations will lessen anxiety after this difference in routing
| is in place?
| psychphysic wrote:
| According to the paper avoidance begets avoidance.
|
| Avoidance and success in anxiety inducing situations both lead
| to relief. Most of us have plenty of experience of both leading
| to balanced future responses.
| abarkasxa wrote:
| have agoraphobia pretty bad. I've spent so much time trying to
| work on exposure, but then I'll have a huge panic attack, I don't
| have access to my frontal cortex to reason through it, during
| this time I'm feeling the immensity of the universe, I feel
| electricity running through my body, at the end of it all when I
| get somewhere "safe" I'm not able to think straight or sleep well
| for months. So yeah the impulse to avoid those feelings is pretty
| strong. I'll push myself once again in the future but the risk
| reward ratio is pretty bad. Thanks brain wiring!
| jaynetics wrote:
| Not a psychologist, but you might need to build exposure more
| slowly, and maybe check for other issues (such as generalized
| anxiety disorder, avoidant personality disorder, hypochondria)
| because a panic attack should not take months to recover from.
| nick__m wrote:
| find someone who prescribe propranolol, it makes exposure
| therapy a lot easier and the result are more durable.
|
| here's some reference:
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4820039/
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4818733/ ...
| throwing_away wrote:
| > Agoraphobia involves fearing and avoiding places or
| situations that might cause panic and feelings of being
| trapped, helpless or embarrassed. You may fear an actual or
| upcoming situation. For example, you may fear using public
| transportation, being in open or enclosed spaces, standing in
| line, or being in a crowd.
|
| Wait, do I have agoraphobia now?
|
| I thought we were still supposed to be avoiding indoor spaces
| and crowds on account of the highly infectious disease
| propagating the globe.
|
| We're supposed to be comfortable sharing air with others again?
| dag11 wrote:
| I wouldn't say avoiding others during a pandemic is
| agoraphobia, it's a rational response. But after a society
| has largely resumed dense public activities, it's only
| possibly a phobia if you've formed a personal preference to
| partake based on your own risk/reward tolerance yet find
| yourself anxious to do so.
| soulofmischief wrote:
| > We're supposed to be comfortable sharing air with others
| again?
|
| No, I think we need to go all the way and ban cars from inner
| city areas and replace them with zorbs.
|
| https://www.zorbs.us/
| petesergeant wrote:
| The Claire Weekes stuff is pretty old but very very good, worth
| looking up
| yosito wrote:
| Extreme agoraphobia probably requires more than just simple
| exposure to improve. I'd recommend working with a therapist.
| But one thing I am curious about: during exposure, you don't
| have access to your frontal cortex, that makes sense. But after
| exposure, do you spend any time reflecting, and reminding
| yourself that nothing bad actually happened to you? It might be
| that exercising your frontal cortex afterward could help you
| learn to cope with the situation in the future. At least,
| that's what I've done with social anxiety and it seems to help.
| DoreenMichele wrote:
| If you suffer from serious anxiety, I highly recommend you work
| on any health issues you have. Low blood sugar in particular is
| known to promote anxiety by increasing the amount of adrenaline
| in your system.
|
| I used to suffer a lot of anxiety. Getting physically healthier
| helped mitigate that enormously.
|
| Proviso: n=1, "anecdata" and the usual dismissals that random
| internet strangers desperately try to apply as if I somehow
| misrepresented myself and claimed it was from a large scale
| study.
| [deleted]
| dathinab wrote:
| There is nothing to dismiss
|
| health issues can both directly and indirectly make your
| psychological issues worse (or even be the direct cause of it)
|
| and also the other way around
|
| I think many of the "dismissal" (assuming non troll) comments
| come from with health issues people being feed up with getting
| the force feed the same advice they long time now every time
| their health comes up without the person giving their advice
| understanding their health issues. (e.g. not you because you
| just wrote what helped you in a neutral way).
|
| For example some absurd examples I have seen repeatedly:
|
| - a person with serve enough clinical depression to just be a
| step away from getting suicidal getting told "just do sports it
| will help" for the thousands time in a situation where they
| frequently have issues to even eat because their brain just
| stopped caring about being hungry
|
| - or a person with motion sickness from certain games being
| again and again told the same set of well known and years ago
| tried advice, potentially combined with "you must never try VR"
| even through they did try VR and depending on the title it's
| not an issue as long as movement in VR is done through motion
| tracking
|
| - or a person which had to stop their masters degree because of
| sever depression and anxiety being told "oh it's you could have
| done the masters because I was able to do so" when that other
| person just had a mild depressive phase due to overwork
|
| - or people which had Vitamin-D deficit (which is really good
| at making other health issues worse) now insisting that every
| time they meat a "sick" person they should take Vitamin D
| supplements because sure their trauma induced psychological
| issues are just a Vitamin D deficiency.
|
| Just to be clear I appreciate your your post, this is not
| trying to dismiss it in any way. In different to many of the
| examples I listed you bothered to formulate it neutral in a
| "this helped me, fixing health issues can help, here is why it
| helped me if you thing this could apply to you why not try it"
| way instead of a "this helped me so it 'must' help you too
| way". Through the line between both formulation is thin, and
| not seldom a matter of tone which is often lost in writing.
| yosito wrote:
| Not to mention that physical activity itself can be a great,
| immediate remedy for anxiety. A daily run does a whole lot for
| calming my anxiety.
| moffkalast wrote:
| Ah yes the age old solution to anxiety, eating a shit ton of
| sugar.
| DoreenMichele wrote:
| Eating sugar is the absolute worst thing you can do if you
| have functional hypoglycemia.
| Cthulhu_ wrote:
| Eat regularly, do physical exercise, go to bed at the same
| time, etc etc. All good advice of course, but when you're in
| that situation they're not easy. It takes self-discipline.
| DoreenMichele wrote:
| Also: Not necessarily the best means to work on your health.
| Sometimes you need dietary changes or to ferret out an
| unrecognized allergy -- allergy being another thing that
| promotes adrenaline -- and/or other changes to figure out
| what went wrong and how to walk it back.
| ajani wrote:
| This is just tedious. The electro-chemical map of the brain that
| is built and used to study it, is so primitive.
|
| Almost certainly, "the brain" tunes itself to its environment and
| inner states from a preformed inner structure through evolution.
| A lot of what is in the brain, is not actually to be found in the
| brain, or by studying it materially. The "formwork" that formed
| it, is lost in evolutionary time.
|
| Unfortunately there is no way to impute the formwork from the
| form, like say it would be possible to (mostly accurately) impute
| what formwork created a square column or cast a piece of iron.
|
| "The brain" is not in any way shaped like a physical object, and
| the formwork that formed it is infinitely complex.
| ajani wrote:
| When a vortex forms in a pool of water, it is formed by the
| complex interplay of water, the pond made up of earth, rock,
| plants, its undulations perturbing the water, the wind etc.
|
| The vortex appears and vanishes as conditions change. But is
| the vortex, the water? Is the water no longer water once the
| vortex dissipates?
|
| Is the vortex the same as any physical object? Or it's a form
| taken up by water?
|
| What if the brain is just the form. And what if the water is
| itself just a river fed by ocean currents millions of miles
| away?
|
| Standing by the river, you only experience the form, not the
| formwork, the substrate, or even the shaping force in time.
|
| I may have made this a worse explanation... hard to tell.
| meesterdude wrote:
| > "The brain" is not in any way shaped like a physical object
|
| Our brains are physical object, and the connections it is
| composed of are also physical.
| dboreham wrote:
| Don't understand the downvotes because I get exactly what
| you're saying -- it's like poking around in the data for an LLM
| and expecting to find a written language algorithm. Taking
| things further -- I think it's unlikely that much of the
| brain's operating software came via DNA. It's mostly machine
| learned from the environment and other humans. We call this
| child development.
| ajani wrote:
| > It's mostly machine learned from the environment and other
| humans. We call this child development.
|
| Yes, exactly. The software lies in humanity collectively. Not
| inside us, but in between us.
|
| Which is why it cannot lie entirely in the brain. At least
| not entirely in one brain.
|
| A new node born into the network, learns the network.
| Individual nodes perish, and new ones replace them. But the
| network doesn't go down. Or it hasn't yet.
|
| Much of conscious experience is the network. Isolation is
| painful because it deregulates the connection to the network.
|
| But even on the "hardware" side, there must be so many kinds
| of developments that must occur simultaneously. Some of it is
| as you say, environment based child development. Others that
| we may not quite be aware of, say patterns of neural firing,
| or growth patterns. Such developments probably get passed on
| in shape (DNA or X) to the next generation.
| otikik wrote:
| The brain is absolutely physical.
|
| > A lot of what is in the brain, is not actually to be found in
| the brain, or by studying it materially.
|
| You are talking about consciousness (and perhaps the non-
| conscious processing that the brain does as well). That is
| indeed a non-physical phenomenon, but it still has physical
| underpinnings.
|
| > The "formwork" that formed it, is lost in evolutionary time.
|
| You can't lose something that you never had in the first place
| :). It will take that as a figure of speech.
|
| The good news are: we _are_ very familiar with some things that
| "exist" but don't have a physical presence. On this forum,
| "software" is the most obvious one. "Math" is probably the
| second. There's many others, like all the emotions, entropy,
| and so forth. We can, to a certain degree, reverse-engineer
| some of these processes by looking at the physical imprint that
| they leave. It's true that we never get a full picture - the
| same way that just looking at the source code might not give
| you a good idea of how the RAM will look like when the program
| is executing. But it can give you _some_ insight. And then, if
| you are lucky, you may be able to fill in the gaps.
|
| The bad news: this is the most imbricated and complex piece of
| "code" that the humanity has ever faced. Our brains might
| simply not be capable of understanding their own complexity by
| themselves. Most of us have a "cache" of 7 items, after all.
| Barely good enough to swing to the next tree branch.
|
| But then again some good news: the complexity is definitely
| _not_ infinite- just very big. And we keep improving our tools.
| The same way some of them expand the limits of what we can
| physically do with our bodies, some of them expand what we can
| mentally do with our brains. Wether or not that will be enough
| for us to understand ourselves, to a certain definition of
| "understand", is still up in the air as far as I'm concerned.
| I'm agnostic about it.
| ajani wrote:
| "The brain" is made up of matter, yes.
|
| "The brain" is not physical like columns or iron. Those are
| simple objects. The kind physics likes to deal with. Things
| that are easily measured to describe its properties
| quantitatively and the relations of these properties as a
| placeholder for qualitative aspects (equations). Physics
| can't deal with the brain. No equation can be written.
|
| If a bud's seeds were to sprout in place, instead of in the
| ground, you would have every single ancestor plant in a very
| long chain. Every brain is the result of this kind of
| structure. A mother buds and sprouts a new human. If the
| umbilical cords remain attached, we have a very similar kind
| of long chain of human brains. Not like any other physical
| object.
|
| Physics is inadequate at studying "the brain". So, "the
| brain" is not a physical object.
| otikik wrote:
| > Physics can't deal with the brain. No equation can be
| written.
|
| There are many many many physics simulations out there that
| cannot be "written with an equation". Climate Modelling,
| for example. You cannot write a single equation to model
| all that. You need a big complex piece of software, made of
| many equations, a lot of hardware, and a lot of processing
| time. Any of those was simply inconceivable mere decades
| ago.
|
| It's possible that it's as you say, and the brain is
| inscrutable if we attack the problem from the physics point
| of view alone.
|
| I think that you _may_ be right. With what we have now. But
| decades from now? I 'm not so sure.
| ajani wrote:
| All climate models are based on mathematical physics
| models. I don't know the specifics, so I asked chatGPT
| and here is what it said:
|
| '''
|
| Climate modeling is a multifaceted field rooted in
| physics that relies on a complex set of equations to
| describe various atmospheric, oceanic, and terrestrial
| processes. Here's an overview of the key equations that
| form the foundation of climate models:
|
| Navier-Stokes Equations: Governing the flow of fluids
| like the atmosphere and oceans, these equations capture
| how the velocity of a fluid changes over time.
|
| Radiative Transfer Equations: Essential for understanding
| how sunlight and other forms of radiation interact with
| the atmosphere, including scattering, absorption, and
| emission.
|
| Energy Balance Models: These equations describe the
| balance between incoming solar energy and outgoing heat,
| fundamental for capturing the planet's energy dynamics.
|
| Equations of State: Linking density, pressure, and
| temperature, these equations are critical for
| understanding the behavior of the atmosphere and ocean.
|
| Continuity Equations: Representing the conservation of
| mass in the atmosphere and oceans.
|
| Moist Processes Equations: Capturing phase changes
| between water vapor, liquid water, and ice, along with
| latent heat exchange.
|
| Boundary Layer Equations: Describing the complex dynamics
| near Earth's surface where the atmosphere interacts with
| the land or ocean.
|
| Chemical and Aerosol Equations: Governing the reactions
| and interactions between different chemical species and
| particles, which can affect both weather and climate.
|
| Sea Ice and Glacial Equations: Modeling the flow and
| melting of ice, essential for understanding the
| cryosphere.
|
| These equations are solved numerically using computer
| algorithms, often over a grid representing the Earth's
| surface and atmosphere. Together, they form an
| interconnected system that allows scientists to simulate
| and analyze the climate system's behavior. This intricate
| mathematical framework underscores how the study of
| climate is fundamentally rooted in mathematical and
| physical principles.
|
| '''
|
| There are no such equations for the brain.
| [deleted]
| otikik wrote:
| Well you should have asked ChatGPT directly then:
|
| In the context of human behavior, consciousness and
| neurology, what are the mathematical equations that are
| relevant in order to model how a human brain works?
| Please highlight any equation that involves Physics in
| particular
|
| ChatGPT:
|
| Modeling the human brain is an extremely complex task,
| and it involves various levels of abstraction and
| different mathematical and computational approaches.
| While there are no specific equations that fully capture
| the intricacies of the brain's function, several
| mathematical and physics-related principles can be
| applied at different levels of analysis. Here are some
| relevant equations and concepts:
|
| Neuron Modeling:
|
| Hodgkin-Huxley Equations: These equations describe the
| behavior of ion channels in neuron membranes and are
| fundamental to understanding how neurons generate action
| potentials. Integrate-and-Fire Models: Simpler models
| like the Leaky Integrate-and-Fire model can describe the
| basic firing behavior of neurons using differential
| equations. Neural Networks:
|
| Backpropagation:
|
| This is a fundamental algorithm for training artificial
| neural networks. It involves the chain rule from calculus
| to update weights during training. Activation Functions:
| Functions like the sigmoid, ReLU (Rectified Linear Unit),
| and softmax are used to model the activation of neurons
| in artificial neural networks. Synaptic Plasticity:
|
| Hebbian Learning:
|
| Often described as "cells that fire together wire
| together," it's a principle used to model how synaptic
| connections strengthen or weaken based on correlated
| firing patterns.
|
| Diffusion Equations:
|
| Fick's Law of Diffusion: Relevant for modeling the
| diffusion of neurotransmitters across synapses.
| Information Theory:
|
| Shannon's Information Theory:
|
| While not an equation per se, concepts like entropy and
| mutual information are used to quantify information flow
| and coding in neural systems.
|
| Quantum Mechanics:
|
| While not directly related to classical neuroscience,
| there's ongoing research into whether quantum effects
| play a role in brain function. This would involve quantum
| mechanics equations such as the Schrodinger equation and
| the equations describing quantum states. Connectome
| Modeling:
|
| Graph Theory:
|
| Modeling the brain as a network involves concepts from
| graph theory, like adjacency matrices and graph
| algorithms. While not a direct physics equation, it's
| relevant for understanding brain connectivity. Functional
| Imaging:
|
| Techniques like Functional Magnetic Resonance Imaging
| (fMRI) rely on physics equations related to magnetism and
| nuclear magnetic resonance to measure brain activity
| indirectly. Biomechanics:
|
| Equations from mechanics can be used to model the
| physical properties of the brain, like deformation during
| injury or the propagation of mechanical waves in brain
| tissue.
|
| Electroencephalography (EEG):
|
| Maxwell's Equations: EEG measures electrical potentials
| on the scalp, and the interpretation of these signals
| relies on Maxwell's equations describing the behavior of
| electric fields. It's important to note that modeling the
| human brain is still an active area of research, and
| there's no single mathematical framework that fully
| explains all aspects of brain function. Instead, a multi-
| disciplinary approach is used, combining mathematics,
| physics, biology, and computer science to gain a better
| understanding of the brain's complexity at various
| scales, from individual neurons to large-scale brain
| networks.
| ajani wrote:
| > While there are no specific equations that fully
| capture the intricacies of the brain's function..
|
| That.
| bloopernova wrote:
| Fascinating study.
|
| For those who didn't read any of it: anxious people's brains use
| a different area when regulating emotions. Unfortunately the
| connection to this area may be more easily saturated during high
| emotional states.
|
| So, over stressed/anxious brains appear to have a different
| routing setup than everyone else. Very interesting find!
| dathinab wrote:
| I'm not surprised tbh.
|
| This fits very well with what you can see in anxious people,
| especially when combined with depression.
|
| Through I guess the meat of the paper is in all the subtle
| biological details they found, which I just honestly do not
| understand at all.
| bytefactory wrote:
| I'm hoping this will lead to more effective medical or non-
| medical interventions. Seems like major progress in our
| understanding.
| nyanpasu64 wrote:
| In my reading:
|
| > Unfortunately the connection to (*the usual area = FPl,
| that's a L not an i) may be more easily saturated during high
| emotional states.
|
| I do wonder if the FPl is overactive and needs to be slowed
| down like the article suggests (which _hurts_ behavior in non-
| anxious people), or if the amygdala is jamming the FPl with
| excessive signalling (and needs to be slowed down).
| bloopernova wrote:
| Yeah, I was thinking about the treatment possibilities while
| reading. My wife has very high anxiety, which cannabis
| edibles mitigates pretty well, so I wonder if the pot is
| affecting those areas.
| sergioisidoro wrote:
| I wonder if this shift of processing areas is behind the the
| "detachment" or "depersonalisation" (feeling like you're in
| autopilot, or not being you) that seems to be a common response
| to high anxiety.
| dboreham wrote:
| My understanding of this is illuminated by (stay with me here...)
| blockchains.
|
| Most blockchains use a kind of time-traveling/holographic data
| structure where a given tree root can be used to lookup state
| values in a big trie, for some block in the past. Different root,
| potentially different value for the state you're interested in.
|
| The brain seems to be operating a similar data structure where
| the answer to your query depends on some sort of "neural net
| root" value. This value seems to come from primitive structures
| (HPA?) and depends on basic things like fight/flight
| anxious/relaxed.
|
| The upshot is that people can believe/think/know different things
| depending on their current emotional state.
| rcbdev wrote:
| I doubt this is what they meant by "disrupting healthcare with
| blockchain"
| rejectfinite wrote:
| I just want benzos and lay in bed and watch Netflix all my life
| pleeeease please please its my dream life
| ericfrazier wrote:
| Dealing with stuff is dumb. Thank you, non_fpi secondary system,
| the round file of my brain.
| rejectfinite wrote:
| I have 0 motivation. I havent cleaned in 2-3 years. I sit in
| trash next to my PC. lol Atleast I have you guys
| judiisis wrote:
| how to get over this and get over tendency to avoid? Please
| someone help I am struggling and procrastinating and destroying
| my life
| SentinelLdnma wrote:
| Wish I could give you an npm package for that, but best I can
| do is a process: [0] keep a log / journal [1] make a change [2]
| observe the result [3] iterate
|
| [0] is to raise awareness and detect cause and effect. Keep it
| minimalist. I once went overboard with a whole spreadsheet.
| Plain text turned out better. What to track? Inputs (food,
| media, activities) and outputs (physical and psychological
| state). [1] Try eating better, exercise, changing media
| exposure, time outside. If you go down the supplement rabbit
| hole, start with simple things like magnesium. Attach new,
| better habits to your existing routine. [2] Watch out for
| delayed reactions. For instance, what I ate 48 hours ago has
| significance. [3] while(true)
|
| Random bonus: if there is something that negatively affects
| you, seek out its polar positive opposite. I'm very easy
| bothered by sounds. Leaf blowers shall die. But this also means
| sounds have a strong positive leverage on my mental state:
| https://youtu.be/gKdFbdrk-58
| rob_galvan wrote:
| I relate to this. Also that excessive caffeine exacerbates my
| anxiety and makes avoidance more likely.
| rejectfinite wrote:
| But I need that!
| NayamAmarshe wrote:
| It's always fear, isn't it?
|
| We're afraid to approach people, afraid to ask for help, afraid
| that someone might react in the worst possible way or something
| really bad might happen.
|
| But obviously, it never happens the way we imagine. Reality is
| 100% of the time, different from our imagination and yet, many of
| us still fail to remember that.
|
| Every good opportunity that I ever got, was from me coming out of
| my comfort zone and avoiding to avoid situations.
|
| It's important to remember, anxiety is a useful defense
| mechanism, but not 99% of the time.
| voisin wrote:
| "I've lived through some terrible things in my life, some of
| which actually happened." - Mark Twain
| Obscurity4340 wrote:
| I've weirdly noticed a type of analagous mechanism in
| relation to anxiety where I castastrophize or engage in
| worst-outcome thinking and when things inevitably turn out
| ok, the relief from the incongruity has a somewhat "euphoric"
| and calming effect. I feel like it might be somewhat
| maladaptive and "addictive"
| j33zusjuice wrote:
| Does this all feel familiar?
|
| https://youtu.be/_tpB-B8BXk0
|
| I don't know if it's always this way, but I create
| emergencies and catastrophes because I otherwise have no
| motivation to do anything. My back has to be against the
| wall to get me to act. It's been a lifelong issue, I've
| tried to kill myself several times because of it, and I
| learned it was ADHD in the last month. 100% of my issues
| are explained by this. I never would have guessed.
| Cthulhu_ wrote:
| Definitely sounds like not a good thing, even though it
| ties in with pithy sayings like "expect the worst but hope
| for the best" or "Don't get your hopes up and you'll never
| be disappointed".
| LouisSayers wrote:
| I remember reading something similar about people who
| survived bombings in London during the war.
|
| Apparently many of the survivors were quite content as they
| had somehow survived the destruction.
| Obscurity4340 wrote:
| I think "meaning" plays a huge role and when you can get
| yourself to buy into a productive/growth mindset-type
| narrative, it does seem to help immunize against trauma
| or at the very least, to help integrate it to the point
| the negative effect is attenuated
| lolinder wrote:
| This was first attributed to Mark Twain in a Singapore
| newspaper 13 years after his death, so was probably not
| actually said by him. It looks like it's just one of those
| things people say:
|
| https://quoteinvestigator.com/2013/10/04/never-happened/
| xyzelement wrote:
| Spot on. This hit me a few weeks ago when I was considering a
| long workout class ln Peloton. I was hesitant to hit the start
| button because it was late, I was tired, etc. Then I realized
| that it was genuinely harder to hit play than to actually do
| the class.
|
| Literally I've done thousands of workouts and have never
| regretted one, yet every time there's this negotiation to not
| do it. I am connecting that to your "reality is different 100%
| of the time" point.
| scruple wrote:
| It's sort of a meme but I experience this pretty frequently
| with running. I've been a distance runner for over 30 years
| now but when I have a long run and I wake up and I'm just not
| feeling it, I will stare at my running shoes with pure hatred
| for a while before finding the courage to lace up and move.
| It's always the right decision, I always feel incredible once
| I get going, but it's sometimes very hard to summon the
| motivation at the onset.
| jh00ker wrote:
| This book by David Burns [1] taught me that ACTION comes
| first, AND THEN motivation arrives. If you lay there and wait
| to be motivated, it will never happen. Specifically:
|
| 1. Action
|
| 2. Results
|
| 3. Motivation
|
| 4. Repeat!
|
| Anti-pattern:
|
| 1. Motivation
|
| 2. Action
|
| 3. Results
|
| 4. Does not work
|
| When I notice myself using self-talk like "ugh, I just don't
| feel like it" I thing of A-R-M and it helps.
|
| 1: https://amzn.to/3shnZlg
| lynx23 wrote:
| I am assuing this is in the context of some kind of mental
| health issue? Because this reads and feels backwards to me.
| Maybe it is a recipe for people without motivation, and
| that is fine. But I, for one, am mostly driven by
| motivation. I dont do things just because they are written
| on a list, or because someone told me it is supposedly
| good. I do things because I am intrinsically motivated to
| do so, or not. Just performing an action in hope of
| positive affirmation to boost motivation feels like the
| algorithm to drive a robot, not a human.
| Cthulhu_ wrote:
| It's not necessarily a "mental health issue", it's just
| fairly common procrastination.
|
| Also, there's motivation and there's (self-) discipline.
| You get up in the morning or do things either because you
| feel like it, or because you have to. Of course it feels
| better if you feel like it (you're motivated), but if
| you're not motivated then discipline has to take over.
| loveiswork wrote:
| > I am assuing this is in the context of some kind of
| mental health issue?
|
| Yes, if you are already 'self-actualized', you don't need
| to be thinking about behavior modification frameworks,
| your behaviors are already serving you.
|
| Some people have circumstances and long-lived reactions
| and behaviors for those circumstances that make it very
| difficult to change course, even if they have a real
| desire to. This 'disconnectedness' between lived
| experience and personal goals and values can lead to a
| lot of anguish. In those cases, following a framework,
| even though it can feel 'weird', can lead to the positive
| sparks required for change.
| NayamAmarshe wrote:
| Some days you have to find motivation and some days
| motivation finds you.
|
| Either way, it's because of your actions.
| m463 wrote:
| I'm assuming the above affiliate link is the book Feeling
| Good: The New Mood Therapy by Dr. David Burns
|
| https://www.amazon.com/Feeling-Good-New-Mood-
| Therapy/dp/0380...
| HKH2 wrote:
| > This book by David Burns [1] taught me that ACTION comes
| first, AND THEN motivation arrives.
|
| Existence precedes essence?
| johnchristopher wrote:
| > Anti-pattern:
|
| >
|
| > 1. Motivation
|
| > 2. Action
|
| > 3. Results
|
| > 4. Does not work
|
| Action and discipline (the habit of doing the same action)
| beat motivation everytime. And yet you will find people on
| HN that will fight to death that motivation is enough or
| that motivation is the moving force of discipline. Up to
| redefining words if needed. I think it's because of the
| warped guilt trip of the saying "you didn't do it/achieve
| it because you weren't motivated enough" and the
| "entrepreneuship" spirit of the audience who needs to
| believe that they can succeed no matter what and motivation
| is the main factor because it's something fuzzy enough they
| can say they had it or hadn't when they fail/succeed and
| ignore the hard unpleasant things like hard work, luck,
| skills, talent, etc.
| 0xcde4c3db wrote:
| I think a big part of the difficulty here is that
| "motivation" is a very broad term, and people often mix
| up different aspects of it (both intentionally and
| unintentionally). It pretty much covers the "full stack"
| of goal-oriented behavior: everything from the
| neurological factors that balance action vs. inaction
| generally to the most abstract meta-goals toward which
| actions are ultimately directed. When people say they
| "lack motivation", the experience they're describing
| might involve any mixture of deficiency in the biological
| foundations of attention and behavior, lack of
| identifiable goals, or lack of belief/understanding in
| the connections between actions and goals. An aphorism
| like "discipline beats motivation" can't possibly come
| close to engaging that full spectrum, so even if there's
| value in the underlying idea, there will probably always
| be people who feel that someone saying it is
| misunderstanding or ignoring their difficulties.
|
| Furthermore, I think what people are sometimes
| confronting when they discuss motivation is personal
| belief in markedly different goals than society promotes.
| In such cases they're not really expressing a lack of
| motivation generally, but rather frustration with a
| disconnect between the goals they actually believe in and
| the goals that they've been told to pursue (typically
| with according extrinsic reward/punishment). Telling such
| people that they just need to develop discipline is
| probably about as useful as telling atheists that they
| just need to go to church.
| prawn wrote:
| Always comes back to uncertainty. The things we avoid have
| somewhat unpredictable outcomes. Fear of calling someone: who
| will answer, will they resent the interruption. Fear of
| submitting work: is it what they wanted, is it good enough.
| Avoiding starting a creative job for a client: am I taking the
| right tack, am I wasting my time?
| imartin2k wrote:
| Yes most of human behavior is about fear - just that we mostly
| aren't aware of it. Almost everything is a coping strategy for
| fear - some constructive, others destructive. Some people end
| up with more of the constructive ones, others with more of the
| destructive ones. The way to have some control over this is
| mindfulness, to practice being aware of the fear whenever it
| comes, and then of the habitual response. And then to practice
| responding differently if one doesn't find one's habitual
| response constructive.
| dotnet00 wrote:
| At the same time, as someone very prone to this kind of
| behavior, with siblings with similar issues to talk to, we've
| all found that few attempts at helping are more frustrating
| than being told "just remember that you don't need to be
| anxious". The entire point is that in the moment that just
| doesn't work. It's kind of like telling a person with ADHD to
| just pay attention.
| romphl wrote:
| This 100%. But the only time where I do have the courage to
| step out of that comfort zone is when I have that don't-give-a-
| shit attitude usually triggered by a specific life situation
| for e.g divorce made me not give a shit about being self-
| conscious about going to the gym or I'm pretty bad at asking
| people for help but had to approach someone at immigration to
| get help with my passport in front of everyone there.
|
| I wish it comes easy like with the people I know for e.g no
| worries or issues at all with questioning a contractor
| regarding the price of remodelling a kitchen, sending back
| dishes due to some quality issues..etc
| matejn wrote:
| This reminds me of Seneca's letter on groundless fears. "We
| suffer more often in imagination than in reality." [1]
|
| [1]:
| https://en.wikisource.org/wiki/Moral_letters_to_Lucilius/Let...
| alexo67 wrote:
| The thing is, if you really know it's just a fear, it's much
| easier to name it and overcome it. I know from myself that the
| worst thing that can be is anxiety of unknown origin.
| mindwok wrote:
| As an anxious person with people-pleasing tendencies, something
| I've been trying to focus on is reframing the situation and
| removing fear entirely. For me, fundamentally the fear of
| social interactions comes from the fear I'm going to do
| something wrong, that person will react badly, and I'll feel
| bad about myself. I've realised this entire calculus is broken,
| because you feel good or bad based on people's reactions which
| is something you cannot control.
|
| Instead, I'm trying to focus on feeling good or bad based on my
| intentions, and seeing people's reactions as merely a feedback
| loop to better align my actions with my intentions. It has been
| difficult but I think it is slowly working.
| Cthulhu_ wrote:
| But your actions may have good intentions but still end up
| getting a bad reaction. Think codependency; you may have good
| intentions dealing with the other person's bad behaviour, but
| you're still encouraging the bad behaviour that way, and you
| may still resent your own actions despite your good
| intentions.
| mindwok wrote:
| That's the idea though, if your intentions are sound but
| you're not getting the reactions you expect, then you need
| to re-evaluate how you're acting. The important part is not
| to beat yourself up about it - bad reactions are just a way
| for you to learn and correct your actions, fundamentally
| you are still the person you think you think you are.
| lazide wrote:
| They key thing here is that what you're describing can be
| interpreted several ways.
|
| One could be maladaptive (long term) and is the easy
| approach (or may be necessary to survive short term) -
| 'oh, I need to be _nicer_ or _give more_ ', or 'oh, I
| need to manipulate them or make them be okay with this'
| which is the codependent approach.
|
| The other is to step back, realize perhaps you're already
| giving too much, and it's time to leave (safely) or deal
| with more blowback at the moment to set a boundary even
| at the risk of real problems.
|
| That takes courage and a wider view, exactly what is hard
| to do when in these situations though.
| afarviral wrote:
| I've been doing this too, but saying to myself "you are off
| the hook altogether" with the reasoning that the harm from
| not attempting something is just so much worse than any
| typical consequence from saying or doing something dumb in
| the moment, to the point it needn't even be a consideration.
| But I like this approach of focussing on intention, to
| rationalize it.
| NayamAmarshe wrote:
| > Instead, I'm trying to focus on feeling good or bad based
| on my intentions, and seeing people's reactions as merely a
| feedback loop to better align my actions with my intentions.
|
| This is the way. People might disagree, but I've noticed that
| our intentions really do influence the outcomes because our
| intentions affect the way we approach problems (Kinda like
| Wave function collapse). My world is a mere reflection of who
| I really am, what I really think and what I meditate upon.
| mindwok wrote:
| Yes, I completely agree. Instead of being upset with
| outcomes (like how people react to me in interactions),
| there's three things I've been trying to instead focus on:
| Am I at peace with my core values? Do my intentions align
| with those values? And finally, do my actions align with
| those intentions. If something bad has happened, and those
| three questions are a 'yes', then you have no reason to
| feel bad because you've been completely true to yourself
| and this occurence is something outside your control. If
| it's a 'no', then you probably need to do some reflection
| and figure out where in that chain something is going
| wrong.
| nyanpasu64 wrote:
| If you say something unpleasant to a boss or someone else
| with the power to hurt you in life, even if it is aligned
| with your values (like enforcing boundaries or refusing
| unethical tasks), you may get fired, lose your income and
| destabilize your future safety, and have every reason to
| feel bad about your situation.
| frereubu wrote:
| Epictetus would add that you need to act in accordance
| with "nature", by which he meant the world as it is,
| including human behaviour, not as we want it to be. In
| this case "nature" would include the behaviour of the
| boss and you can act accordingly, knowing that if you
| challenge them you may suffer repercussions.
| mindwok wrote:
| I see your point but I'd argue that if you feel bad about
| this it means your core value is actually financial
| stability over sticking to your principles at any cost,
| and in that case your actions and intentions didn't align
| with what you truly value.
| lazide wrote:
| Easy to say when you aren't homeless or at risk of being
| made homeless.
|
| For some folks, unfortunately, lying at times is a
| necessary survival mechanism.
| mindwok wrote:
| I'm not disagreeing with you at all. If you value
| financial stability over taking a stand about things you
| might disagree with, then lying for survival is aligned
| with your values. Using the ideas I described above, this
| would be completely acceptable for the person doing that.
| mpol wrote:
| Still you might think, I did the best I could.
| isykt wrote:
| >I've realised this entire calculus is broken, because you
| feel good or bad based on people's reactions which is
| something you cannot control.
|
| Yes. A thousand times this. It has taken me years to create a
| situational intuition around this. Another thing that I have
| had to learn is that _people aren't thinking about you nearly
| as much as you think they are._ Like, take whatever amount of
| time that you think someone is thinking about you in any
| social situation, and divide that by 10. That's still more
| than they are thinking about you.
| hackerlight wrote:
| Anxiety is maladapted for the modern world. Everyday situations
| in our ancestral past were legitimately dangerous so in that
| context it paid to be excessively cautious.
| Obscurity4340 wrote:
| Its honestly getting to that point though, and, depending on
| the robustness of your support network and economic
| situation, it can actually get that bad or worse.
| clnq wrote:
| Yes, but we are one proverbial red button away from nuclear
| hell on Earth no ancestor could have prepared for, where a
| lot of anxiety will translate into a lot of lives being
| saved. So we're not too far from being adapted to the modern
| world.
|
| It's just that temporarily things are going well - there are
| no famines, no lawlessness, and no wars. As soon as we return
| to chaos even a bit, all those thrifty genes and anxious
| genes won't be so maladaptive.
|
| There doesn't even need to be a world-ending scenario. Just
| go live outside an urban center, among wild animals, and all
| these genes will help you.
| sgregnt wrote:
| > "Reality is 100% of the time, different from our imagination"
| A bit of a hyperbole: 100%? So never ever we can predict
| reality? I think, if we focus on the core details, we are
| better than always wrong, perhaps even much better.
| NayamAmarshe wrote:
| That's what I meant. Even if you imagine a scenario you can
| successfully predict (a cashier handing you your change, for
| example), how it plays out in experience is always different.
|
| Anxiety causes you to imagine how a scenario would play out,
| in detail. Flashes of things going wrong, something breaking
| apart and all the terrible things that a horror movie
| director could imagine.
| [deleted]
| JumpinJack_Cash wrote:
| > > afraid that someone might react in the worst possible way
| or something really bad might happen.
|
| That type of anxiety is easily beaten, the one where the worry
| is that 'not the best thing ever happens' is much harder to
| beat
|
| Kinda like 'if you ain't first you're last mentality' and
| opportunity cost type thing
| madaxe_again wrote:
| A little anxiety is a good thing. It's the nagging feeling that
| maybe you should complete that pre-flight checklist.
|
| I forecast a lot of doom, but try to bother only with the dooms
| I can prevent or mitigate. This is useful for going "I should
| replace that pipe before it bursts" or "I should fill up on gas
| here as it's 300km to the next station".
|
| Where it goes wrong is doom we either cannot control at all, or
| cannot control without inflicting greater dooms - what someone
| else might think, whether the sun will rise tomorrow.
|
| I feel we are trained (thanks, marketing. Thanks, social
| animals) to sensitise ourselves to a great many fears, most of
| which are beyond our control, and it does us little good.
|
| Case in point: a little over a week ago I was having apoplectic
| paroxysms over the amount of stuff I have to do at home before
| winter - foundations to dig, brush to clear, firewood to
| gather. Then, a forest fire ripped through our land, which was
| somewhere in my mind as "definitely one day, probably not
| today, don't sweat it, but have a plan". The former anxiety I
| was letting grow out of all proportion - so fucking what if I
| don't dig foundations this year? No deck. Boo hoo.
|
| The latter, if I'm honest, occasionally kept me up at night,
| and occasionally hovered around the edge of my field of
| imaginary view, like a particularly irritating fly, but after I
| would reassure myself that we had go-bags packed, that we had
| the ability to run without hesitation, it would subside. It's
| that whole agency thing - being able to take what actions you
| can to alleviate an anxiety. If there's no meaningful action to
| be taken, it's a useless anxiety, best forgotten.
|
| If anything, more positives have emerged than negatives - the
| fire service fixed our road, which we'd been begging the
| council to do for years, the flammable brush is cleared, and we
| discovered we have a great many friends.
|
| Sometimes it takes the manifestation of one of our anxieties to
| remind us what is and what isn't worth worrying about. Watching
| a friend or family die also has the desired effect - but
| unfortunately from experience, it isn't permanent, and we (I
| mean I) seem to need a slap in the face from time to time to
| remind us what matters.
| protoman3000 wrote:
| Window of tolerance.
| impulser_ wrote:
| So from my understanding. Anxious people are so anxious that they
| overload the part of the brain that typical deals with anxiety so
| the brain routes it to another part of the brain to deal with it
| and that part of the brain isn't what you want dealing with it so
| it cause problems.
|
| So the key is too limit overloading the part of the brain that
| deals with anxiety, which probably means doing things you are
| fearing to do so that you no longer fear doing it.
|
| I could be wrong, but that my understanding of it.
| psychphysic wrote:
| More accurately multiple parts of the brain are activated when
| considering anxious situations.
|
| In anxious people the FPI is unable to override the avoidance
| behaviours.
|
| The key is not to limit overload you don't have much choice
| there, it's to use other mechanisms to make your seek exposure
| and not continue avoidance.
|
| CBT is all about teaching those skills the paper mentions TMS.
| xboxnolifes wrote:
| > So the key is too limit overloading the part of the brain
| that deals with anxiety, which probably means doing things you
| are fearing to do so that you no longer fear doing it.
|
| Which is pretty much the go-to advise for a lot of people with
| anxiety as far as I'm aware.
| bluepizza wrote:
| As a life long anxiety sufferer, I identify with your
| interpretation.
|
| My anxiety devolves into panic attacks if I try to deal with it
| consciously - self talk, rumination, avoidance. But it goes
| into a dormant state when I don't engage with it consciously
| and just let it be.
| DrThunder wrote:
| Yeah I had a couple rough years with panic attacks, high
| anxiety state (always been anxious but not to that level).
| What you start to realize is that you are actually scared of
| the anxiety itself, not the situations so much. So, you sort
| of get caught in loop of being scared of your own emotions.
| The treatment is simple, but takes work and a lot of habit
| forming through time... but essentially you just stop
| thinking of the anxiety as an emotion you shouldn't have or
| should fear.
|
| Like you said, just let it be and stop caring about it.
| Anxiety can be a good thing, it's a normal emotion. Any
| attempt to stop it or control it will end in disaster. Let
| your body/mind do it's thing. Emotions are fleeting and they
| will always come and go. Over time you sort "re-wire" your
| brain to stop panicking every-time it feels a fleeting
| anxious feeling.
| barrenko wrote:
| So in a way anxiety prevents learning a.k.a moving past
| "undesired" behaviours.
| lazide wrote:
| It's a maladaptive response, yes.
| lr4444lr wrote:
| You're assuming the region in question will undergo
| desensitization rather than reinforcement learning. That may or
| may not be the case.
| otikik wrote:
| > doing things you are fearing to do so that you no longer fear
| doing it.
|
| Careful with that assumption. I can see it completely
| backfiring. Doing the thing repeatedly can end up _increasing_
| the anxiety. If this route is taken, then "the thing" must be
| introduced very gradually and from a place of security.
|
| As an example, for an arachnophobe, it would starting with
| something like "draw a dot. Draw a line coming out of the dot.
| Keep drawing lines up until 8. Pay attention to your anxiety
| levels and remind yourself that this is not a real spider, only
| a drawing. You are in control, you are safe". Then progressing
| to pictures of cartoon spiders, then the first picture of the
| most cute realistic spider that one can find, and so forth. It
| would be a process that takes months and it's not guaranteed to
| work. For example, a realistic depiction of a spider might be
| too much to handle even with a gradual approach.
|
| On the other hand, if you tell that person "Close your eyes and
| open your hand. There, I put a tarantula in your hand, you see,
| it's innocuous!" that person is going to be scared of spiders
| for life.
|
| I'm exaggerating, but hopefully it sends the point across.
| Aeolun wrote:
| Actually seeing a tarantula made them a lot less scary. Hard
| to be afraid of something so fluffy.
| anon373839 wrote:
| This isn't quite accurate.
|
| Graded exposure can be a more manageable way to get to the
| end result (fear extinction), but reminding yourself that the
| threat isn't real is a fear-neutralizing behavior that will
| limit the effectiveness of the treatment. The point of
| exposure therapy is to feel the fear and to do nothing about
| it other than let the feeling (eventually) climax and
| dissipate. (In fact, "lean in harder" can be even better than
| "do nothing".)
|
| [Edit: I want to emphasize this point for others who may find
| this post: if you are doing exposure work or you're
| supporting someone who is, please don't reassure
| yourself/them that the exposure isn't dangerous. At best it
| undermines the treatment; at worst it reinforces the fear.
| When you violate your anxiety by facing a feared situation or
| idea, it will and should feel like you are doing something
| bad and dangerous.]
|
| Second, graded exposure isn't always necessary - flooding
| (direct exposure to the high level fear situation) works too,
| and can work a lot faster.
|
| But I think most people with anxiety disorders have a number
| of fears not just a single isolated phobia - and they're
| connected in a network of sorts. It's often helpful for the
| person to experience success in extinguishing a low-moderate
| grade fear first, to grok the process and build confidence to
| approach their worst fears successfully.
| hoseja wrote:
| Only I will remain.
| eliasmacpherson wrote:
| > doing things
|
| I believe this is done in supervised fashion in Exposure and
| Response Prevention, and also CBT. Some say ERP violates the
| Hippocratic Oath part about 'do no harm'.
|
| I found the mockery of it in GTA SA quite entertaining [1]. In
| my own experience, it's probably best to talk to a therapist
| before forcing yourself into doing things you are fearing.
|
| [1] https://gta.fandom.com/wiki/Inversion_Therapy
| guerrilla wrote:
| It violates the Hippocratic oath as much as cutting somone
| open for surgery does. That is to say, it doesn't at all.
| esperent wrote:
| Physiatrists and psychologists don't take the Hippocratic
| oath in most cases. I don't think it's even that common for
| doctors to take it - definitely not in it's original "do no
| harm" form.
| _def wrote:
| Im also responding to the "do the things you fear" bit: I
| _think_ you are right. As to why this works for some and
| worsens it for others, I think that depends on _how_ you
| approach this.
|
| In my experience these confrontational situations need to
| strike a certain place between "too easy" and "too hard". It
| hardly helps to throw people into situations they can't handle
| again and again. A more gradual approach via small wins is the
| way to go IMHO, with a focus on avoiding the learned avoidance
| patterns, heh. There's also the aspect of the perception: one
| needs to be able to accept small victories and see them as the
| improvement that they are.
|
| But all of this is way easier said than done, especially if you
| have to deal with it all by yourself.
|
| So while I think that you are technically right, I think it's
| easy to misunderstand for people as "just toughen up" (not
| implying that's what you meant, but there is this to many
| people unknown middle part of it that I wrote about).
| lazide wrote:
| IMO, the 'just toughen up' advice is people kind of giving
| up.
|
| It's not _wrong_ per-se - just useless. If they could do
| that, they wouldn't be in the situation! Like telling someone
| with PTSD to 'just calm down', or someone with an eating
| disorder to 'eat normally'. If they could, they wouldn't have
| the problem!
| jjallen wrote:
| What if there are things we are fearing to do but shouldn't be
| doing also?
| lionkor wrote:
| Then usually you shouldnt have a need to do them, and if you
| feel like you do, that might be the problem to address.
| weird-eye-issue wrote:
| Fear and anxiety are very different
| nottrobin wrote:
| How so?
| poszlem wrote:
| Fear is an immediate, emotional response to a known or
| definite threat.
|
| Anxiety is a more prolonged emotion that arises from an
| anticipated or potential threat or a situation that's
| uncertain. Unlike fear, the source of anxiety might not
| be real or immediate.
| anon373839 wrote:
| Fear is a response to a _perceived_ threat. For example,
| in a panic attack you fear dying, but you are in no more
| danger than anyone else.
|
| Anxiety is a kind of fuzzy term because it encompasses an
| overall pattern and cycle as well as the associated
| feelings. But a useful distinction is that anxiety is
| driven by avoidance of fear of some uncertainty, and
| exposure and acclimation to that fear (without avoidance)
| is what extinguishes the anxiety.
|
| Avoidance can take almost any form, but common examples
| include worry and rumination, procrastination, compulsive
| rituals like hand-washing or internet research, self-
| medicating, and superstitious behaviors. And of course,
| literal avoidance.
| lr4444lr wrote:
| I think this splits hairs. Yes, fear means "perceived"
| threat. You could be acculturated to handling venomous
| snakes, but that doesn't male the average modern society
| dweller pathologically fearful of the same snakes.
| Anxiety is about the distorted _anticipation_ of a
| threat. E.g., the snake handler has been doing this his
| whole life, but after seeing his brother accidentally
| step on one, get bitten, and die, he starts fearing that
| every one of his future interactions with snakes will be
| so likely to entail that outcome that he refuses to touch
| them anymore, and can 't avoid a panic attack if he's in
| the room with one, despite all his past skill.
| anon373839 wrote:
| I was responding to a suggestion that fear occurs when
| the trigger is a "real" threat. But of course, the
| feeling is the same regardless of whether the hazard is
| real.
|
| Also, since I've already been accused of hair-splitting,
| I might as well point out:
|
| > can't avoid a panic attack
|
| There's no need to avoid a panic attack. In fact, trying
| to avoid a panic attack feeds the panic.
| lloeki wrote:
| From my experience, the way I'd describe it is:
|
| - fear is transient, you feel it in the moment and then
| it goes away. You can then remember "boy I was scared"
| and feel the memory of fear but not fear itself. You can
| project and imagine a situation where you'd be scared.
|
| - anxiety is a persistent state of stressful anguish.
| There are peaks and troughs. During peaks it can be
| overwhelming and look like, trigger, or mix with fear.
| During troughs anxiety is still there somewhere deep, it
| merely takes a backseat to other emotions. In every
| moment it biases every process your mind undertakes.
| moffkalast wrote:
| > anxiety so the brain routes it to another part of the brain
| to deal with it
|
| In a sense, anxiety is like a malignant cancer? That explains a
| lot.
| yosito wrote:
| If your interpretation is correct, it seems that there could be
| some truth to the old wisdom of (gradually and willingly)
| facing our fears in order to develop more courage.
| amelius wrote:
| > So the key is too limit overloading the part of the brain
| that deals with anxiety, which probably means doing things you
| are fearing to do so that you no longer fear doing it.
|
| I gave this advice in the past, but I know people with social
| anxiety disorder for whom this approach does not work.
| ddmf wrote:
| I have social anxiety and pushing myself to get out there
| leads to massive fatigue which makes me not want to go out
| and do that again, it can lead to a vicious cycle.
| yard2010 wrote:
| Exposure Therapy is a great method to deal with this in my
| humble experience, it has to be set up with sensible
| realistic boundaries though, and maybe start small, like
| doing an imagination ET, or taking medication to overcome
| the initial anxiety.
|
| Reframing this as a challenge with concrete goals rather
| than a problem helps too.
|
| I'm no expert though, and I advise you to talk to a
| professional that can help with this.
|
| Don't forget that this is not a problem but just another
| part of you, and love yourself :)
| antman wrote:
| Has two parts: Meeting with people, interacting with people.
| One step at a time, a couple of people, for a specific
| timeframe.
| lazide wrote:
| The issue comes when/if the people trigger real issues -
| like fear of being manipulated , or safety concerns.
|
| Right now mental health is a huge problem overall in
| society, and therapists and Psychiatrists are no except to
| the rule unfortunately.
|
| It's gotten _very_ predatory out there.
| giantg2 wrote:
| "Anxious individuals consistently fail in controlling emotional
| behavior, leading to excessive avoidance, a trait that prevents
| learning through exposure."
|
| Sounds a lot like burn out in ny experience.
| coder-3 wrote:
| No, burnout is too much exposure to certain stressors
| FailMore wrote:
| The authors/others interested in anxiety, may be interested in
| the paper: Dreaming Is the Inverse of Anxious Mind-Wandering:
|
| https://psyarxiv.com/k6trz
|
| Written by me and discussed on HN here:
|
| https://news.ycombinator.com/item?id=19143590
|
| There is a coherent argument to be made that the problem of
| misplaced anxiety is so prevalent/fundamental to the species,
| that dreaming is a built in mechanism for diagnosing it.
|
| A summary of the paper is:
|
| Anxious states involve: The default mode ("imagination") network,
| high levels of the fight-or-flight neurotransmitter
| norepinephrine, and an active amygdala.
|
| REM dreaming states involve: The default mode ("imagination")
| network, extremely low levels of the fight-or-flight
| neurotransmitter norepinephrine (80% below base levels), and
| (surprisingly) an inactive amygdala.
|
| The content of dreams can be viewed as inverse anxious mind
| wandering, where situations we find ourselves in actually
| encourage confrontational behaviour, however we are able to
| observe our avoidant behaviour with clarity that is not so
| present in waking life. (This also indicates that anxious
| structures are not really associated to the neurological state,
| as in we still seem to follow our anxious patterns even when
| norepinephrine levels are low, implying that the structures that
| represent them in our brain are not affected by different levels
| of norepinephrine/must exist outside of something so variable.)
| byteknight wrote:
| In my head, what this says is that the brain is a muscle that
| will use pathways and otherwise more used areas, more frequently.
|
| Seems logical when I think about it that way.
| protoman3000 wrote:
| It's a great study. I would welcome if they did the same
| experiment and analysis on groups of people who had an anxiety
| disorder diagnosed and got healed, preferrably with CBT or other
| non-pharmacological methods alone, and a healthy population. It
| would be interesting to see the effects of therapy on this
| mechanism and whether an higher excitable FPI stays activated in
| the healed cohort or it's exitability is less, or the amygdala
| activation is again the root of all of this. It's notable that
| some healthy individuals had high FPI excitability but were not
| anxious.
| riazrizvi wrote:
| So, heightened anxiety triggers alternate emotional regulation,
| with traits like pro-avoidance behavior.
|
| To me this is not necessarily dysfunctional. It may also go hand-
| in-hand with motivating heightened deliberation. I can see how
| one can fall into regressive patterns like distracting ourselves
| away from critical path actions, especially if a particular
| person only uses one of two strategies, 1) try going on as before
| or 2) try forgetting we need to go this way.
|
| I take a more neutral approach on the finding and don't yet
| assume this is something that is best medicated out of. They show
| that _even mild emotional challenges can saturate FPl neural
| range_ , which to me is simply a greater sensitivity that can be
| easily overloaded (like when you put the voltmeter on a more
| sensitive setting). Exposure Therapy is a methodical, deliberate,
| routine heavy strategy. ET doesn't simply get us to re-engage, it
| gets us to re-engage with new and different behavior, which may
| be essential to success.
| psychphysic wrote:
| The paper suggests rTMS to disrupt the disruptive activities.
|
| The emotional challenge in this study was that you had a
| joystick and sometimes you pulled that joystick towards you
| when you saw an unhappy face. That's what was paralysing
| emotional challenge was for highly anxious people. Meaning it's
| unlikely their PFl could have any control in real life
| scenarios. It's important to note that in both anxious and non-
| anxious people the PFl was highly excitable. It's the pattern
| of its activity that makes a difference.
|
| Cognition is hard work and the truth is you can't reason about
| your entire life and expect much success. Like driving a car as
| a learner your whole life, I remember the first driving lesson
| I had, I couldn't even focus with the radio on. Imagine if
| every time you got in you had less intuition about how to
| drive.
|
| Think of the absence of fpi as a lack of intuition you get once
| you learn to drive.
|
| CBT +/- an SSRI for 6months is a small price to pay to regain
| intuition.
| fellowmartian wrote:
| One potential problem with this approach is that a person
| might not actually fear driving a car but dying in general,
| and this fear spills over into all parts of life. I don't
| think you can CBT your way out of it.
| psychphysic wrote:
| I think that's just the type of problem CBT practitioners
| love to work on.
| fellowmartian wrote:
| I think it's a "if all you have is a hammer" situation.
| In my experience and from talking to different therapists
| CBT is ill-equipped to deal with existential problems
| because it doesn't embrace them or helps patients learn
| from them. Existential therapy or other forms of
| psychoanalysis is better suited, in my opinion.
| kenjackson wrote:
| I agree with your take on CBT and existential problems
| (although CBT is incredible for many other types of
| issues). Do you have more details on therapies that are
| useful for existential types of problems?
| xtiansimon wrote:
| > "Like driving a car as a learner your whole life, I
| remember the first driving lesson I had, I couldn't even
| focus with the radio on."
|
| This reminded me of starting to ride a motorcycle (again) in
| 2021. Lots of anxiety and stress.
|
| Two years later I'm not as stressed. But, each near-accident
| I've had was following not paying attention.
|
| Thinking about this on a ride over the weekend, I mused about
| solo-jet fighter pilots and Olympians. I recalled breathing
| exercises are supposed to help.
|
| Reading the abstract, I'm reminded of awkward social
| situations and inexperience in primary school. I'm thinking
| the biggest lesson was trying, and realizing failure is not
| life threatening. But it didn't stop me from developing some
| bad habits for cheating on tests, and waiting until the last
| 48 hours to write my papers.
|
| I think getting a job at 16 helped a lot. It was at a comic
| book shop. I held that job for seven years.
| elwell wrote:
| > realizing failure is not life threatening
|
| That doesn't hold true when it comes to riding a motorcycle
| though. Maybe the fear is warranted.
| OkayPhysicist wrote:
| "Fear is the mind killer". Focus spent worrying about the
| potential consequences of failure is focus not spent on
| avoiding failure altogether.
| jancsika wrote:
| > "Fear is the mind killer".
|
| I wonder if anyone has ever done a cross-check of the
| "fearlessness" lit authors for signs of toxoplasmosis.
| OkayPhysicist wrote:
| It's a Dune quote.
| huimang wrote:
| Failure in this case ranges from life-altering
| disabilities or death outright. The emotional toll on
| your friends and family. The waste of medical resources
| on you.
|
| Yeah, people should have a healthy amount of fear for
| needlessly dangerous things.
| OkayPhysicist wrote:
| The time for thinking about that is before you get on a
| bike. Once you're going down the highway, fretting about
| what-ifs does not help you.
| chaostheory wrote:
| Hence, the warranted fear. It's not a "failed response"
| in that case
| Aeglaecia wrote:
| [flagged]
| psychphysic wrote:
| Eh? I don't understand what you're saying.
| [deleted]
| Aeglaecia wrote:
| journey not the destination
| kdmccormick wrote:
| > institutionalized gaslighting
|
| Quite an accusation. Have you done CBT?
| Aeolun wrote:
| I can sort of see how you get there?
|
| "I know you are afraid of walking through a crowd of
| people, but think of how many people do that every day.
| Think of all those times when you were 15 when you did it
| without any problem."
|
| E.g. your problem isn't real, it's all in your mind.
| Which of course it is, that's kind of the point :)
| jplusequalt wrote:
| From the outside, it's easy to dismiss an anxious
| individuals fears as nothing more than thoughts in their
| head that are (sometimes, but not always) completely
| removed from reality. But from the perspective of the
| anxious person whose sympathetic nervous system is
| causing elevated heart rates, shaky sweaty hands and
| feet, heart palpitations and chest pain, pressure
| headaches, and brain fog, the problem may seem a tad bit
| more serious than something that's "all in your mind".
|
| Look, I understand what you're trying to say, but as
| someone who deals with all of the physical symptoms of
| anxiety listed above and has been told by loved ones
| countless times "your problem isn't real, so just don't
| stress about it", it doesn't help, and it's frankly
| infuriating to hear.
| kdmccormick wrote:
| Agreed, and I think GP mostly agrees with you too, their
| phrasing was just confusing.
|
| As a bipolar person I have come to semi-ironically
| embrace the "it's all in your mind" mindset, but with the
| understanding that literally EVERYTHING is in our minds,
| and there is no clean distinction between physical and
| mental symptoms. Mental and physical illness are one and
| the same, because our body feeds our brain and our brain
| runs our body.
|
| Simple example: a stomachache involves your brain
| noticing and reacting to something going on in your
| stomach. Is it your brain's fault for telling you your
| stomach is upset, or your stomach's fault for having the
| conditions to be upset, or your brain's fault for leading
| your stomach to have the conditions to be upset, or your
| stomach's fault for altering your brai chemistry so that
| it has the conditions to lead your stomach to.... etc,
| you can understand how fuzzy it all is.
| Aeolun wrote:
| Yeah, sorry. My comment was meant to agree, but
| illustrate that to people without anxiety (or disinclined
| to trust the medical establishment) CBT might come across
| as little different from "it's all in your head".
|
| I suffer from the same, and after CBT, it's actually kind
| of worse to hear "it isn't real, so don't worry", because
| I _know_ it (on the balance of probability) isn't real,
| but somehow that doesn't make me feel any better.
| kdmccormick wrote:
| EDIT: Sorry, I misunderstood your comment, I thought you
| were GGP saying that "it's all in your head" is better
| than CBT. Leaving my original response below.
|
| Sure, but someone with crippling anxiety could easily
| counter your with any of these:
|
| * I was assaulted when I was 17 so of course I could do
| things more easily when I was 15.
|
| * I feel physical symptoms of anxiety when I am around
| others so it's not just in my mind.
|
| * I am a fundamentally worse person than average and do
| not deserve to be around other people.
|
| * I don't care about what others can do, I would rather
| die than walk through a crowd.
|
| CBT tries to meet people where they are, acknowledge
| them, and then give them the tools to move in a healty
| direction. Kinda like this:
|
| "I know you are afraid of walking through a crowd of
| people. I want you to imagine walking through the crowd,
| and tell me what you think and feel.
|
| OK, so you feel physically ill, and you feel like there
| are bugs on your skin, and you imagine people around you
| are talking about you. Let's acknowledge that's how you
| feel.
|
| Now, let's look at this logically. Do you accept that
| it's unlikely that anyone is actually talking about you?
| Can you touch your skin, confirm there are no bugs? And,
| finally, do you understand that your nausea, whilst real,
| is likely a physical symptom of anxiety following from
| the other two things, so if we work on the anxiety then
| the nausea will subside too?
|
| Great. So we've acknowledged how you feel, and we've
| acknowledged that what you are feeling is driven by
| anxiety moreso than reality, and we agree that it's
| possible for you to overcome. It's OK if that doesn't
| immediately resolve your fear, but next time you are near
| a crowd, I want you to think about what we talked about
| before you decide to avoid the crowd."
|
| This is proven to be more likely to help people. If your
| smug "IT'S ALL IN YOUR HEAD" solution worked, then plenty
| of kids with mental issues would have been magically
| cured when their parents said that exact phrase to them.
| lanstin wrote:
| One's beliefs and feelings won't be rational but the
| overall functioning of your brain is mostly reasonable
| when you know enough about your self, your past, and your
| brain. The task of building a fulfilling life with the
| nervous system you actually have is not trivial but also
| not impossible.
| 121789 wrote:
| No not really. Gaslighting has an intent to deceive
| someone to pull them away from reality. CBT starts with
| the assumption by both people that the patient is away
| from reality and gives them tools to bring them closer.
| Gaslighting is like trying to convince a healthy person
| they're fat (and giving them an eating disorder in the
| process) while CBT is like giving a fat person practices
| to manage appetite.
| kdmccormick wrote:
| Well said.
| hunkiry wrote:
| I believe OP is trying to suggest that if you're well
| adjusted to the current world, you're the one who is
| deluded. And therefore, any method to change your
| perspective is forcing a delusion. Gas lighting.
|
| The fat person in your metaphor is actually fit,
| surrounded by unhealthy skinny people who have been
| convinced they are fit.
| yard2010 wrote:
| CBT is the gold standard solution for this kind of
| problems[0].
|
| [0] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5797481/
| Aeolun wrote:
| It's not really different from asking people to remember
| how things didn't go wrong in earlier situations though.
| It's weird how giving it a specific name and repeating it
| often enough in a variety of different ways makes it
| actually work.
| 0xcde4c3db wrote:
| As far as I can tell, CBT is the gold standard for
| psychotherapy in much the same way that agile is the gold
| standard for software development. There's compelling
| evidence that some implementations can be remarkably
| effective at least some of the time, and a vague
| consensus that it's good and proven. However, there's
| also widespread disagreement and confusion about what it
| means to actually do it, how to evaluate whether it's a
| poor fit as opposed to the practitioner or client "doing
| it wrong", and the extent to which it meaningfully
| outperforms other approaches across a variety of real-
| world situations.
| d4nt wrote:
| One of the first things that some reading on psychology
| gives you is the realisation that the "real self" is an
| illusion. You're a bundle of competing drives and
| narratives. Even you don't know why you do stuff most of
| the time, and you make up justifications after the fact. So
| if one way of looking at things makes you stay home and
| cry, while another leads to going out and making the world
| a better place, maybe training yourself to pick the latter
| interpretation is a good thing.
| smeej wrote:
| Interestingly, Internal Family Systems therapy, which
| applies techniques from family systems therapy to the
| internal world, treats this as a "both-and." You _do_
| have a core Self, but one of the primary things it does
| is lead and direct and serve as the primary attachment
| figure for all the other parts of you, which are
| conceptualized as individual, separate characters with
| their own history, needs, desires, wounds, and fears.
|
| I've found this to be an _immensely_ helpful way to work
| through my own struggles and maladaptive behaviors.
| Trying to get myself to do something challenging is more
| like leading a group, some of whom are gung ho and others
| who are terrified because something about it reminds them
| of something that went very badly for them back when we
| were younger.
|
| When it feels like some negative attitude is overriding
| the whole system, it's said that a part has "blended"
| with the Self, and the way forward is to help it unblend,
| to step back or aside so you, as the Self, can be in
| relationship _with_ it, can listen to it and understand
| it (which goes a long way in its own right), but then
| also help meet the need or protect from the scary thing.
| The part never has access to all the resources you do as
| the Self, and the part is often a young child trying to
| take on something that _should_ be overwhelming for a
| child.
|
| I have no idea whatsoever if this is the case, but it
| wouldn't surprise me to find that what's actually
| happening inside the brain in these cases is an energy
| shift away from, for example, this over-excited anxious
| part of the brain to one with more control and executive
| function. It might be a way of training the mind to
| direct the activation of the brain, not unlike training
| for any other sort of skill.
| chrbr wrote:
| Is there a commonly-recommended introductory text for
| IFS? I've always found it interesting, and it resonates
| with me, given my internal monologue(s).
| yasman wrote:
| No Bad Parts - Richard Schwartz
| Lalabadie wrote:
| Levi's Internal notes Family Systems is a good place to
| dive into. Be warned that it's broad but non-linear:
| https://integralguide.com/IFS
|
| Someone from Reddit also compiled this (well-ordered!)
| list of references: https://liveifs.notion.site/IFS-
| Books-Youtubes-etc-b1fb32e8f...
| fellowmartian wrote:
| I think it's the other way around, CBT and SSRIs is not the
| last resort but the first. These techniques can help
| acquire the basic life skills of operating in anxious
| situations, but they're a prosthesis.
|
| You can use this prosthesis to tackle the underlying deeper
| issues.
|
| But I do agree reliance on CBT and SSRIs as the be-all and
| end-all of therapy is bad and inhumane. They're the most
| commodifiable techniques, but they're Pavlovian and reduce
| human beings to machines you can train through a chat bot
| (really?).
| riazrizvi wrote:
| I think we might each be talking to different ends of the
| extreme here.
|
| > recruitment of FPl when controlling emotional behavior
| fails in patients with emotional disorders
|
| I won't comment on people who have emotional disorders, or
| who have operated in this modality for very long periods of
| time. I'm more interested in it as a transient mechanism in
| people without disorders.
| psychphysic wrote:
| Ah I'm not sure you can extend this study to high anxiety
| circumstances in otherwise non-anxious people.
|
| The executive functions that highly anxious people need to
| engage are precisely the functions that high stress levels
| disrupt.
|
| This is about low stress situations in anxious people.
|
| Not high stress situations in non-anxious people.
|
| It's not likely that we can extrapolate between the two.
| And it's likely under those scenarios a third or more
| mechanism comes into play (flight, fight, freeze).
|
| Not to mention the control were all men so we do need
| better sample for replication before we consider
| extrapolation.
| riazrizvi wrote:
| It's hard to say where the boundary of application lies,
| I believe. The paper is naturally concise, and
| experiments typically select potent examples to clarify
| the phenomena, economically. Without the authors'
| clarifying contextual anecdotes, I believe there is a lot
| of room to interpret.
| [deleted]
| isykt wrote:
| > I take a more neutral approach on the finding and don't yet
| assume this is something that is best medicated out of.
|
| Is it possible for an individual to do ET, or indeed other
| therapy in combination with medication, to study the change in
| this response? I tend to agree that we (collectively) should
| not look at these results and immediately look for a drug to
| change it; after all, that's how we arrive at a popular culture
| that thinks depression is a chemical imbalance (it's not), so
| it would be nice to be able to use these findings in
| conjunction with therapies that focus on a person's ability to
| change their own mind.
| Aurornis wrote:
| > To me this is not necessarily dysfunctional.
|
| If it wasn't dysfunctional, it wouldn't be a diagnosed with
| mental health condition to begin with.
|
| I think this is a concept that is getting lost in mainstream
| mental health discourse: There is a big difference between
| anxiety _the emotion_ and anxiety _the mental health disorder_.
| Similar story for depression and concentration struggles.
|
| It's normal to feel anxious at times. It's not healthy when
| anxiety becomes so dominant as to interfere with normal
| activities of life, manifesting as the type of pervasive
| avoidance behavior described in this study.
|
| This is becoming a huge problem among the young people I've
| mentored recently; They will go through phases where they
| become convinced, often by TikTok or Reddit, that they have
| ADHD, anxiety, and/or depression because they aren't perfect
| robots who do marathon study sessions with a smile every day. I
| feel like I'm always explaining to them that it's normal and
| healthy to feel _some_ discomfort as they learn and grow. It's
| not reasonable to expect everything in life to come easy. Of
| course, there are students who struggle with mental health
| issues as well, but the difference between someone struggling
| with lifelong ADHD and someone who just learned about ADHD
| through a serious of TikToks a few weeks ago and now thinks
| they have it is obvious when you've been working with them both
| for a long time.
|
| > I take a more neutral approach on the finding and don't yet
| assume this is something that is best medicated out of.
|
| The study doesn't say that this is "best medicated out of". It
| specifically highlights exposure therapy as being effective in
| normalizing this in individuals who respond to it:
|
| > and exposure therapy has been shown to restore frontopolar
| function in those PTSD patients that benefit from treatment.
|
| I think this is another issue permeating pop culture discussion
| of mental health issues: The assumption that strong medications
| are the default response. Every medical professional I know
| prefers lifestyle interventions and therapy modalities to
| prescribing medications, but patients often arrive convinced
| that they _need_ medication. If the provider recommends therapy
| or lifestyle interventions they often get angry that at the
| perception that the provider is being dismissive or not taking
| their problem seriously.
| tacker2000 wrote:
| I also see that some of these types of people you mention
| wear this (imagined or not) ADHD "status" as some kind of
| badge of honor, so that they may feel superior to or more
| special than "normal" people. Weird times.
| firebirdn99 wrote:
| I think it's always been that way to some extent. There's
| some element of being human, where we seek empathy from
| others or pity if you will to a degree. I know I've done
| it, where I made justifications for something I have
| difficulty in.
|
| It's just now there's a lot more of it, where there is a
| lot more awareness of disabilities, and empathy rightfully
| but also means more people are inclined to maybe take the
| easy way out through diagnoses or taking medication to
| cover for some emotional issues. If there is no other way,
| then you should seek out meds,etc. But it is part of being
| human, to understand and overcome some difficulties through
| perseverance, resilience, or emotional work.
| agumonkey wrote:
| I agree, the term is stretched too thin. Same goes for
| shyness. There's a threshold.
| nonbirithm wrote:
| > They will go through phases where they become convinced,
| often by TikTok or Reddit, that they have ADHD, anxiety,
| and/or depression because they aren't perfect robots who do
| marathon study sessions with a smile every day.
|
| I was struggling to put a name to this phenomenon but I
| recently learned about the term "semantic contagion" as
| coined by Ian Hacking. There is an article I found
| interesting that speculates the rise of a rare disorder with
| the proliferation of the Internet in the 1990s.
|
| I think the idea that an influx of readily available
| information can confuse people with tempting theories or
| misinterpretation is more relevant than ever today.
|
| https://archive.is/OsvZ6
| BoxFour wrote:
| > The assumption that strong medications are the default
| response. Every medical professional I know prefers lifestyle
| interventions and therapy modalities to prescribing
| medications
|
| Moreover, these two aspects nearly always coincide: Every
| credible institution will require you to engage in therapy in
| tandem with commencing medication. Often, once your condition
| improves, the discourse shifts towards the possibility of
| gradually decreasing your medication (though this is
| obviously a conversation, not a mandate).
| DrThunder wrote:
| This is the wrong approach imo. Therapy, lifestyle changes,
| learning to cope with it without meds should always be the
| first line treatment. More and more, you see the approach
| of just handing out meds like candy with a small mention
| that you should also seek therapy AFTER you get the meds.
| You can go to a general doctor and they'll write you up a
| prescription for an SSRI with hardly and convincing at all,
| there is no requirement for therapy so I'm not sure where
| you're getting that from.
|
| The side effects of meds for anxiety issues are far too
| downplayed imo. Benzos, ssri's etc. all have very
| detrimental side effects and are very difficult to get off
| of.
| jplusequalt wrote:
| Preface: I'm speaking as someone who is diagnosed with
| OCD and generalized anxiety disorder, and I will be
| speaking about my experiences.
|
| When my mental health took a turn for the worse a few
| years ago, I was strongly encouraged by my therapist to
| start taking medication. I was admittedly skeptical upon
| hearing. I had never taken psychiatric medications before
| as I held many misconceptions of their side effects, and
| besides, I figured therapy was supposed to "fix me," so
| why should I need meds?
|
| When I inquired as to why they wanted me to become
| medicated, their response was that patients tend to only
| reach out for help AFTER their mental health becomes
| severe enough that "learning to cope without meds" is not
| an option. When a provider is faced with such a case,
| they are trained to treat it with as much aggression as
| reasonably possible in order to prevent the patient from
| becoming even more despondent. This means medication.
|
| From the perspective of the patient, it appears that
| they're being funneled into taking meds, but from the
| perspective of the provider they recognize the trajectory
| the patient is on, and suggest taking drastic actions
| before things get worse.
| BoxFour wrote:
| > there is no requirement for therapy
|
| As I mentioned before, reputable establishments typically
| mandate concurrent therapy, particularly when dealing
| with conditions like depression and anxiety. Your
| therapist and psychiatrist will often work together and
| share notes to better treat you. Reputable psychiatrists
| will often ask if you want to try therapy alone first:
| The good ones have no lack of patients, so it's not in
| their interest to even take you on immediately especially
| if you're not committed to getting better through
| therapeutic means.
|
| Sure: Just as you can unquestionably locate primary care
| physicians who readily prescribe large quantities of
| Vicodin, naturally, you can also come across
| psychiatrists and PCPs who readily prescribe SSRIs
| without much supervision.
| DrThunder wrote:
| "As I mentioned before, reputable establishments
| typically mandate concurrent therapy"
|
| But, this is objectively false. Are you trying to say a
| GD is not "reputable"? Like I said, you can go directly
| to a GD almost anywhere in this country and they will
| give you an SSRI with no requirement or mandate to get
| therapy at all. They will all mention it but there's
| nothing that requires you to attend therapy.
| BoxFour wrote:
| > are you trying to say a GD is not "reputable"?
|
| In the capacity of a psychiatrist? No, a primary care
| physician is not a trustworthy substitute for a
| psychiatrist. Mental health disorders should not be
| addressed by a PCP, even if they have the ability to
| prescribe you medication for it. You should seek
| treatment from mental health clinics that almost always
| have both psychiatrists and therapists on staff or work
| closely with other clinics that do.
|
| Furthermore, once more: Numerous primary care physicians
| excessively prescribed opioids like candy. Acquiring a
| medical license does not automatically equate to being
| reputable in all fields.
| jyrkesh wrote:
| I've shared my experience in being diagnosed as ADHD as an
| adult already[1][2], but in this context, the net is that I
| fought even the concept of going on any kind of medication
| for a long time. I wanted to go hard on lifestyle
| interventions and all kinds of different "tricks" for working
| around my constant reshifting to different priorities.
|
| Ironically, while I love my therapist still, my psych has
| been an absolute pill pusher. I've routinely told her that
| I'm not interested in _also_ being prescribed Xanax because
| I'm having some anxiety after a long, shitty breakup. That
| discomfort is part of the human experience. But she is SO
| eager to throw more Rx at me...it's been kind of eye opening
| how easy it could be to abuse prescription meds.
|
| [1]: https://news.ycombinator.com/item?id=33806988
|
| [2]: https://news.ycombinator.com/item?id=33807050
| tukantje wrote:
| So can we fix it?
| psychphysic wrote:
| Avoid avoidance.
|
| This is a study on the structural appearance of anxiety driven
| behaviours.
|
| Treatment remains the same, CBT +/- SSRI which facilitates
| relearning behaviours via Dopamine actions.
|
| Paper speculates TMS might be used to disrupt some brain
| regions.
| dathinab wrote:
| yesn't
|
| the results of this study can, in combination with other
| studies over time, potentially, lead to better treatment
| methods. Weather that's better assistant medication, better
| ways to apply treatments or a better understanding of some of
| the unusual treatment methods.
|
| But what is described in the paper seems to me to be a
| fundamental mechanism of the brain to cope with anxiety
| overload. And that we can't fix, because it isn't really
| broken. I mean compare it to a bit far fetched example: Water
| spill ways. Especially on a larger scale they always come with
| drawbacks and you can't fix that. What you can change is stuff
| like how you wire up the spill way (e.g. when and which gates
| opens when) or e.g. how likely they need to be engaged (by
| upstream changing things), or how well you (as a city) cope
| with whatever drawbacks the specific water spill way has. For
| all of this properly understanding the underlying mechanics is
| important. And this is what the paper is about, properly
| understanding the mechanics so that we can provide better
| treatment.
| petesergeant wrote:
| If you suffer from anxiety, and haven't tried any of the
| following yet, worth giving a go: escitalopram (with medical
| supervision, also 10mg did nothing for me, 20mg was life
| changing), ingesting silexan / lavendar oil, L-Theanine with your
| coffee, less coffee, less alcohol, propanalol (see a dr) instead
| of benzos for break-through anxiety, ashwagandha.
| jassyr wrote:
| I second escitalopram. 10mg changed my life.
| mrguyorama wrote:
| It's really a roll of the dice. My mother was scared of me
| getting on Escitalopram because it gave her panic attacks but
| it was literally a silver bullet from me. 10mg a day turns me
| from a broken brain to a mostly normal human brain. It's such
| a lightswitch effect that sometimes I wonder if I'm
| overselling it to myself, and then I forget to get my
| prescription refilled for a couple days and I can feel that
| anxiety creeping back in from the edges, trying to make it's
| insidious way back into my life, and then I remember why I
| take it.
|
| My understanding is that each SSRI type med has a roughly 30%
| chance of working for you, though the odds are slightly
| connected for SSRIs that are similar.
|
| If only the ADHD was as easy.
| rejectfinite wrote:
| >L-Theanine
|
| This with caffeine is amazing!
|
| *Its whats in green tea that gives the calming effect
| riazrizvi wrote:
| I personally have tried and agree with L-Theanine to reduce
| coffee anxiety without killing its alertness power, and anxiety
| certainly spikes a day after a night out drinking. But I think
| we are missing here the most important levers; 1) a steady
| regimen of well-scheduled exercises and injury-preventing
| recovery work, 2) a well-scheduled nutritionally balanced diet
| free of inflammatory products. Julia Ross's The Mood Cure goes
| into specifics for the latter, for example sufficient
| L-Tryptophan is important for a feeling of well-being. I think
| scheduling is key because stress increases with energy
| unpredictability.
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