098 -Differential Diagnosis: What Causes That Symptom
Counselor Toolbox

 
 
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Happiness Isn’t
Brain Surgery:
Understanding Symptoms
Presented by: Dr. Dawn-Elise Snipes
Executive Director, AllCEUs

Counseling continuing education can be earned for this presentation at https://www.allceus.com/member/cart/index/product/id/570/c/

Objectives
~    Identify the common symptoms for anxiety and depression-based disorders
~    Learn how a positive change in one area or symptom can have positive effects on all symptoms or areas.
~    Explore
~    The function of each of those symptoms
~    The potential causes of each of those symptoms
~    Interventions for each of those symptoms

Review
~    Everything you feel, sense, think and do is caused by communication between your nerves with the help of chemical messengers called neurotransmitters.
~    “Higher order” thinking is able to over-ride sensory input and tell us there is a threat when none exists, or that there isn’t a threat when there really is.
~    Think of your brain as a computer processor.  It simply does what it is told, based on the information that it has.

What are symptoms
~    Symptoms are your physical and emotional reactions to a threat.
~    Symptoms are designed to protect you.
~    They are not bad or good. They just are.
~    Instead of trying to make the symptom go away, it may help to:
~    Understand the function of them
~    Identify alternate, more helpful, ways to deal with the threat
Lack of Pleasure
~    Form/Symptom
~    Lack of pleasure in most things, most days for a period of at least 2 weeks.
~    Cause
~    Neurochemical imbalance (insufficient dopamine, norepinephrine?) caused by:
~    Lack of sleep
~    Excessive stress
~    Drug or medication use
~    Hormone imbalances including thyroid problems
Lack of Pleasure
~    Function
~    This is your body's way of
~    Signaling that there may be a problem
~    Conserving excitatory neurotransmitters for a “real” crisis
~    Forcing you to address it.  After all, nobody wants to be depressed for very long.
~    How You Cope
~    Think back over a few times when you have been depressed, even if it was just for a few hours.
~    What did you do to help yourself feel better?
~    What makes the depression/lack of pleasure worse?
~    What can you do to prevent triggering your depression/lack of pleasure?

Lack of Pleasure
~    Simple-ish Interventions
~    Don’t expect exhilaration, but try to do some things that make you mildly happy.
~    Get plenty of quality sleep.  You need to stabilize your circadian (sleep-wake-eat) rhythms.
~    Improve your nutrition.  You can search online for “nutrition for depression.”
~    Think back to when you didn’t feel this way.
~    What was different?
~    What changed that started you feeling depressed
~    Remember that depression is a natural part of the grief process and also very normal after a trauma.  Be compassionate

Eating Behaviors
~    Form
~    Eating too much or loss of appetite
~    Cause
~    Imbalance in the brain chemicals that help you feel motivated to eat, such a norepinepherine and serotonin.
~    There are three primary causes of over-eating:
~    Your body needing the building blocks
~    Low serotonin
~    Your circadian rhythms are out of whack
~    Habit/self soothing
Eating Behaviors
~    Function
~    When nutritional building blocks aren't there, the body goes into overdrive trying to rebalance the system.  This means it needs more raw materials to make the brain chemicals; therefore, you may crave certain foods.
~    Disruption in your circadian rhythms. When you sleep at all hours of the day, or don't sleep at all, your brain does not get the normal ebb and flow of serotonin (among other chemicals) which leads to an imbalance in neurotransmitters.
~    Self-soothing.  Certain foods actually raise the levels of pleasure chemicals in your body (although not for long).
Eating Behaviors
~    How You Cope
~    In the past when you have just not had an appetite or have been eating to self-soothe, how did you deal with it?
~    How can you make sure you are eating a generally healthy diet, and making sure that your body has the building blocks it needs?
~    What can you do to ensure you are eating due to hunger and not distress?
~    What foods do you generally eat to self-soothe?
~    What can you do to prevent non-hunger eating?
~    What can you do besides eating to distract yourself from your distress or self-soothe?

Eating Behaviors
~    Some simple-ish interventions
~    Stop consuming caffeine at least 8 hours before bed.
~    Drink enough water (even if it is sparkling water or Powerade).
~    Have 3 colors on your plate at every meal.
~    Eat foods you enjoy, but in moderation
~    Use a plate.  Don’t eat out of the bag
~    Get enough sleep so you are not eating to stay awake.
~    Take a multivitamin. (I take mine after dinner, so it doesn’t upset my stomach)
~    Experiment with essential oils.  Some will increase appetite.  Some will decrease stress and cravings.
~    If you just cannot stomach eating, explore a meal replacement like Ensure.  This should not be done for a long period, but as a stop-gap, it usually is fine. Ask your doctor.

Sleeping Behaviors
~    Form
~    Sleeping too much or having insomnia
~    Cause
~    Sleeping too much can indicate poor quality sleep due to:
~    Stress
~    Poor sleep habits (exhaustion)
~    Pain
~    Hormone or neurochemical imbalances (apathy)
~    Allergies
~    Poor nutrition
Sleeping Behaviors
~    Cause
~    Insomnia can indicate:
~    An inability to relax
~    Pain making it difficult to  sleep
~    Insufficient serotonin/melatonin (also implicated in depression)
~    Function
~    When you are not getting enough sleep, you cannot recharge as efficiently.
Sleeping Behaviors
~    How You Cope
~    Identify why you aren’t sleeping well, and rule out the easy things.
~    Create a good sleep routine that involves the same two or three activities.
~    Reduce or eliminate caffeine at least 6 hours before bed.
~    Identify & address anything waking you up in the night.
~    Dogs
~    Coughing/allergies
~    Snoring spouse
~    Sleep apnea

Sleeping Behaviors
~    Simple-Ish Interventions
~    Get a physical to rule out any medical issues especially
~    Thyroid and other hormone imbalances
~    Chronic pain
~    Keep a notepad by your bed to write down things you need to remember instead of tossing them around in your head all night.
~    Use progressive muscle relaxation, to help your body relax.
~    Develop a stress management and relaxation plan.

Energy
~    Form
~    Lack of energy and/or fatigue.
~    Cause
~    Insufficient or excessive sleep
~    Lack of motivation and reward
~    Lack of movement
~    Fear of failure or rejection
~    Poor nutrition
~    Function
~    The body is devoting scarce resources to rebuilding and functioning.

Energy
~    How you cope
~    What (besides caffeine) helps you get energy?
~    What drains your energy?
~    When you have felt lethargic in the past, how did you help yourself feel better?

Energy
~    Simple-ish Interventions
~    Get up and move around. Try doing 15.
~    Increase the motivating chemicals by having some successes.
~    Get an accountability buddy.
~    Identify any fear or depressive thoughts that may be dampening your motivation, and think the opposite.
~    How do you get energy/motivation when you don’t have any?
~    How do you get started on a task when you don’t want to?

Agitation or Slowing
~    Form
~    Being sped up (agitation) or slowed down during the day.
~    Cause
~    High levels of anxiety
~    Stimulants
~    Unstable blood sugar/poor nutrition
~    Poor sleep
~    Function
~    When you are sped up, your body is likely detecting a threat (real or chemically induced).
~    If you are slowed down you are likely “out of gas”

Agitation or Slowing
~    How You Cope
~    When you feel driven and/or anxious, how have you been able to get it under control?
~    What can you do to be kind to yourself?

Concentration
~    Form
~    Trouble concentrating and/or making decisions
~    Cause
~    Neurotransmitter, hormone or blood sugar imbalances caused by lack of sleep, poor nutrition, excess stress
~    Feelings of helplessness causing you to second guess yourself
~    Function
~    Energy conservation. If your body is struggling to just keep going, it is not going to divert energy to higher order thought processes unless they have a direct impact on your survival.

Concentration
~    How You Cope
~    What helps you focus (small chunks, working in the morning..)
~    Simple-ish Interventions
~    How can you be kind to yourself?  Like Stephen Covey says, sometimes you need to take a break and “sharpen the saw.”
~    Make sure you are eating a healthfully and frequently to keep your blood sugar stable and give your body the building blocks to make your neurotransmitters.
~    Make sure you are hydrated.
~    Get adequate, quality sleep
~    Take a powernap after lunch.  Research shows that a nap after lunch increases “focus chemicals” up to 200%

Hopelessness & Helplessness
~    Form
~    A sense of hopelessness or helplessness     “I can’t go on like this.”  “Nothing seems to ever work.”
~    Cause
~    When your brain chemicals are out of whack it impacts mood and motivation. Causes include:
~    Poor nutrition
~    Lack of quality sleep
~    Negative thinking patterns keeping you stuck
~    Chronic pain
Hopelessness & Helplessness
~    Function
~    This is simply a signal that something is wrong.  You need help.
~    How You Cope
~    What helps you feel empowered?
~    What are you hopeful about?
~    What are your goals?
~    What are three things you can do today to start making things better?
~    What are three things that have gone well in the recent past?

Hopelessness
~    Simple-ish Interventions
~    Identify things that give you hope or make you happy and do one of those each day
~    Identify what you DO have control over
~    Watch a video or read a book that makes you laugh
~    Get adequate sleep (Are you sensing a trend here??)
~    Drink at least 8 glasses of water and eat a relatively healthy diet
~    Talk with a friend and create a plan to get un-stuck

Excessive Worry & Fear
~    Form
~    Excessive worry or fear
~    Cause
~    Neurotransmitter imbalance
~    Negative thinking patterns
~    Effects of drugs (even OTC or caffeine)
~    Physical issues (especially heart or thyroid)
~    Function
~    Fight or flight is a basic survival reaction.  For some reason the body is perceiving a threat when none is there.
Worry & Fear
~    How you cope
~    What are your distress tolerance skills
~    What makes your worry/anxiety worse? Better?
~    Simple-ish Interventions
~    Understanding that fear is a protective reaction is the first step.
~    The next is to identify what you are afraid of and why that is scary.
~    Minimize stimulants which intensify anxiety reactions.
~    Learn your stress/worry/fear triggers and identify ways you have dealt with them, or could deal with them.

Hypervigilance
~    Form
~    Hypervigilance—being easily startled
~    Cause
~    Excessive worry or fear
~    Stimulant overuse
~    Function
~    To keep you on high alert for the perceived threat
~    How You Cope
~    What do you do to help yourself feel safe
~    At home
~    At work
~    In public

Hypervigilance
~    Simple-ish Interventions
~    Avoid being startled
~    Create a “safe” environment (Feng Shui)
~    Avoid stimulants

Racing Thoughts
~    Form
~    Racing Thoughts
~    Cause
~    When you are upset, the brain wants to find out how to stop it.
~    Function
~    You will often run through things in your head that are causing you stress.  Until you can identify the threat, it is like playing pin the tail on the donkey.
~    Simple-ish Interventions
~    Write everything down on a piece of paper or a whiteboard.
~    Avoid taking on anything extra that you will need to balance.
Summary
~    Every symptom has a function
~    Each symptom is usually caused by a neurotransmitter imbalanced due to:
~    Poor nutrition
~    Poor sleep
~    Negative thinking styles
~    Excessive stress
~    Thyroid/hormone issues
~    Cardiovascular issues
~    Addiction
~    Recovery involves identifying the function and:
~    Eliminate the problem
~    Find a healthier alternative