Anxiety disorders are very common, which affect about 40 million adults in United States with age 18 years and above which accounts for 18% of the population. Though anxiety disorder is a treatable condition, only thirty percent of the people suffering receive treatment. Anxiety disorders occurs due to a number of complex factors like genes, personality, life events and brain chemistry. People who suffer from anxiety disorder also suffer from depression and vica versa. Approximately half of the patient diagnosed with depression also have anxiety disorder. Women are more likely to be affected than men. Generalized anxiety disorder affects 3.1% of the population and panic disorder affects 2.7 % of the population. Social anxiety disorder accounts for 6.8 % of the population and is equally present in men and women and usually begins at around 13 years of age. 8.7% of the people have specific phobias. And OCD accounts for 1% of the population. Many people suffering from anxiety disorder may also be suffering from some other disorder or physical illness at the same time which makes their recovery difficult.
Burnout syndrome: The term burnout was coined by an American psychologist Herbert Freudenberger in 1970s. At that time, he used this term to describe the consequences of excessive stress and ideals that were very high experienced by mainly helping professionals like doctors and nurses who have to sacrifice a lot including themselves for the welfare of other people. They would feel exhausted, restless and were unable to cope with the stress they were experiencing. But now a days this term is not only limited to them but includes anyone ranging from celebrities to overworked employees to homemakers. Despite this condition becoming so widely experienced, there is no clear definition for it which makes its diagnosis difficult. There are three main symptoms of Burnout syndrome:
There is no well-defined method to diagnose this syndrome but a questionnaire is mostly used namely Maslach Burnout inventory (MBI).
The three psychological symptoms of stress are
Boredom – Repetitive work as in the office or household work can become a major source of boredom in some people. Due to lack of change and variety, their mind does not feel stimulated and the boredom and fatigue sets in. It results in underperformance, loss of concentration and increased accidents.
Tension – Little tension is useful and necessary as it keeps us alert and motivated to increase our performance. But constant tension is a very common psychological symptom of stress. It can occur due to difficult relationship or excessive competition.
Anxiety – It occurs when the person feels that he is not capable of dealing with the potential problems he is facing. Potential problem because the problem may or may not be there but the patient feels these problems to be real. Mostly people deal with such anxiety with prior preparation, mental or physical. But the thoughts of the anxious patient becomes more concentrated on what could go wrong and they find it difficult to ignore and these problems begin to grow in their mind
And the three physical symptoms of stress are
Stress recovery is a unique experience for every individual because the reason of stress is unique for each individual and the reaction to stress is also unique. Therefore there is single formula which will solve the problem for everyone and here the assistance of a counsellor is enhanced.
The first stage of recovery from stress is known as the emergency stage or the outcry stage. During this stage, the response of the patient to anything around them is intense and their anxiety level is extremely high. In this stage the fight or flight response kicks in. The patient arrives in the emergency either during the traumatic experience or may be due to something that triggers the stress. This stage will last as long as there is imminent danger to the patient. The patient has intense feeling of fear, hopelessness and helplessness. The physical symptoms are very high blood pressure, rapid breathing and a pounding heart.
The treatment would involve learning how to cope with anxiety and panic attacks. It involves learning breathing techniques, relaxation exercises, supportive and effective self-talk. Some lifestyle changes including diet and exercise are very important. The counsellor can help the patient to understand how the patient has developed this anxiety condition which help the patient to work a way out of this cycle of anxiety because it helps them to make sense of their problem and points to the areas of their emotional vulnerability that triggered their anxiety in the first place. In case of phobias, the counsellor can help the patient to learn some desensitizing techniques to avoid the patterns for their stress. The counsellor can educate the patient about the symptoms of stress, how they have come about, what happens in the brain during the period of stress and how counselling will help them and support their natural healing process.
A major step a client can take to recognize his own self-worth is acceptance of the true strengths and weakness. It is very hard for some people to accept themselves especially the weakness. It is like a glass with a tiny crack, when the client makes mistakes or faces some stressful situation, the glass breaks into pieces and so does his self-acceptance. Self-acceptance is a skill that can be nurtured. There are twelve ways in which self-acceptance can be cultivated:
Setting an intention to shift the paradigm from the game of shame, doubt and blame to allowance and acceptance
Celebrating your strengths
Surrounding oneself with the people who are optimistic and will help you to grow and accept yourself
Creating a support system.
Forgiving oneself and moving forward.
Not being too critical of oneself
Doing some charitable deeds
Realizing that acceptance is not giving up. It is just accepting that somethings are not under our control.
Being kind to oneself
The counsellor may refer a client to some other agency if
The client has other needs
The counsellor does not possess the specific skills required to deal with the client’s problem.
The client requires a more qualified and specialist assistance.
The counsellor knows that the client is beyond the professional basis.
The counsellor and the client are not able to establish a therapeutic relationship for some reason or the other.
The counsellor has some difficulty with the issue the client wants to discuss because they have some kind of personal meaning or it makes him uncomfortable.
No progress is being made
The client is behaving disruptively which might be harmful to the client and others.
The counsellor can use the cognitive behaviourial therapy to break the cycle of negative thinking. The counsellor can explain to the client that it is not the event that is responsible for the stress and depression he feels but it is the meaning that he attaches to them. The negative thinking blocks the client from seeing the things that he thinks does not fit with what he believes to be true. The counsellor can help the client to identify his problems and write it down on a paper and rank them based on the severity with which they affects them. This will help the client to identify the most significant problems and then counsellor can along with the client set a long term goal to deal with the major problems.
Self-talk includes the thoughts which may be random or have any meaning and purpose that run in the mind of an individual. The thoughts may be said silently in the mind or out loud in public. There is two types of self-talk, positive or negative. The positive self-talk helps the person to focus and keeps him motivated whereas the negative self-talk is pessimistic and critical. It demotivates the person and decreases his performance. They key to remember is that negative self-talk is going to happen but one should not focus on it and should focus on positive self-talk.
A client under stress may not admit to acknowledge that it is not that the problem/event which is causing the stress but it is his interpretation what is causing him the trouble. The client must be specifically asked as to what is causing him stress and why does he think that it is a stressful situation. There is often temptation in these people to blame external factors for their stress and their stressful behaviour. These clients lose control of themselves under stress and anxiety.
Negative thinking and dependency are very dangerous and damaging to a depressed client and should be discouraged. Pessimistic thinking takes the form of a cycle and it becomes very difficult for the client to break this cycle. Some depressed patient develop suicidal thinking which should be taken seriously and be dealt with prompt action. Dependency on other people, their approval can have a very damaging effect on the already depressed client. If the people around are not supportive and are critical of the client, it shatters the self-esteem of the client and the client feels no self-worth. Therefore, the client should be educated to become independent and confident
Facts and statistics, Anxiety and depression association of America
Depression: what is burnout syndrome, 2013, PubMed health, reviewed from https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072470/
Weber, A & Reinhard, A, 2000, Burnout syndrome: a disease of modern societies?, occupational medicine ,Vol. 50, Issue 7, Pg 512-517
Carthage, 9 Psychological symptoms of stress, reviewed from https://www.coachingpositiveperformance.com/9-psychological-symptoms-of-stress/
The stages of PTSD recovery, reviewed from https://ptsdtreatmenthelp.com/the-stages-of-ptsd-recovery/
Goodman,E , Stages of recovery, Anxiety disorder treatment and recovery, reviewed from https://anxietyrecovery.com/newsletters/stages-of-recovery/
Tartakovsky,M , Therapists spills: 12 ways to accept yourself, reviewed from https://psychcentral.com/lib/therapists-spill-12-ways-to-accept-yourself/00013976
Health psychology consultancy, counselling: when to refer clients, 2011, reviewed from https://healthpsychologyconsultancy.wordpress.com/2011/11/14/counselling-when-to-refer-clients/
5 occasions when you might refer client to another counsellor, reviewed from https://www.counsellingpracticematters.com/5-occasions-when-you-might-refer-clients-to-another-counsellor/
Jensen, J, self talk 101: Why you need to believe in yourself, reviewed from https://inspiyr.com/the-incredible-power-of-self-talk/
Negative thinking :cycle of depression, reviewed from https://www.online-therapy.com/depression/negative-thinking-cycle-of-depression
Self-talk, reviewed from https://www.eacgators.com/selftalk.pdf