Summary of Informative Links Template
Definitions:
Source 1: Suicidality in patients with primary diagnosis of panic disorder: A single-rate meta-analysis and systematic review
SUMMARY
When PD is comorbid with other mental illnesses (anxiety, depression, substance abuse, personality disorder), the rate of lifetime suicide attempt increased by 50%
Suicide rates in patients with PD can be 2-3x higher, especially for women.
PD: Common anxiety disorder, characterised by recurrent and unexpected panic attacks.
Symptoms: urge of fear and distress, pounding heart, racing pulse, difficulty breathing, suicidal ideation and even attempt
Source 2: Why do I feel guilty when I relax?
SUMMARY
- You have an overactive or anxious mind
- Hard work is ingrained into our culture
- Your identity is linked to productivity
- The benefits of resting aren’t obvious
- You have trouble staying organized
How to overcome feelings of guilty when relaxing
- Stay in the present moment
- Make a to-do list
- Know that you’ll never finish your to-do list
- Remember the benefits of relaxation
- Limit social media use
Source 3: What is suicidal ideation?
SUMMARY
Treatment: Safety planning, psychotherapy, medication, ongoing support. I pulled this source because it offered many helplines and support services that I would like to include in the response somehow.
Source 4: Panic attacks and panic disorder
SUMMARY
Panic attack: causes sudden, temporary feelings of fear and strong physical reactions in response to ordinary, nonthreatening situations
The main difference is that certain stressors often trigger anxiety attacks, whereas panic attacks can happen unexpectedly and suddenly
Panic disorder: Anxiety disorder that involves multiple unexpected panic attacks; Usually happen without warning and arent due to another mental health or physical condition
Symptoms
- Chest pain
- Difficulty breathing
- Trembling or shaking
- Racing heart
- Sweating
- Nausea
- May feel intense terror and choking sensation
- Chills
- Tingling or numbness
- Sweating
- Fear of losing control
- Derealization or depersonalization
Treatments
- Cognitive behavioral theraoy
- Exposure therapy
- Medications/Antidepressants/Anti anxiety meds
Source 5: Can anxiety cause chest pain?
SUMMARY
During an anxiety attack, your brain sends a rush of the stress hormones, adrenaline and cortisol, throughout your body, causing heart rate and BP to rise. This may cause pain or tightness in your chest. Hyperventilation can also cause stress on the intercostal muscles of the chest wall
Managing anxiety chest pain
- Use relaxation techniques
- Eat healthy
- Limit caffeine
- Exercise daily
Other treatment options
- Cognitive behavioral therapy
- Antidepressants
- Anxiolytics
- Benzodiazepines
- Beta blockers
Chest pain from a panic attack: use breathing techniques
OVERALL CONCLUSIONS:
Dear Feelingsuffocatedandconfused,
Reaching out for help, as you've done by writing this letter, is a sign of strength. Seeking out support doesn't mean that anything is "wrong" with you; rather, it's a way to explore new strategies for reducing your stress, minimizing your physical symptoms, and changing the way you see and talk with yourself. There are many strategies you may take to begin to address your concerns, so keep on reading to learn more about them.
Note: We should address the suicidal ideations here immediately and get right into talking about how to manage these thoughts and where to seek help.
You noted that the next stress reduction workshop isn't until next semester; you might check to see if the workshop is offered through your campus' health promotion or education office (often associated with the campus health services). Seeking out the professionals who work in such an office may meet your needs — they may be able to provide the same information to you in a one-on-one setting, rather than at a workshop. They may also have some of the information available online. You may also find it helpful to see if workshops on focus or time management are available on campus. This type of workshop may provide new information or strategies on how to stay focused, and how to better manage your time in order to prioritize everyday needs such as eating and sleeping. This may help to reduce the stress and anxiety you feel over your schoolwork. In addition to the workshops and walk-in appointments, you can find out what type of stress relief activities they may have happening on campus.
Note: This can be a lot more condensed. I think we can just briefly talk about exploring other resources on campus, but really focus on ones that are for mental health emergencies. We want to emphasize resources that are available in a crisis for this person so that their panic, anxiety, or stress can be eased in the moment.
Speaking of taking care of everyday needs, taking the time to prioritize taking care of yourself and your body can help manage your everyday stressors (although it may feel like a challenge to do so). This includes eating a balanced diet, getting enough quality sleep, and being physically active. You may want to check your school fitness center to see if they have any class offerings that appeal to you, such as yoga, spinning, or aerobics. If that's not your thing, you can try exercises such as a body scan or progressive muscle relaxation to help ease some of the stress you're feeling. Whatever you do, remember, the time you take to invest in your well-being is time well spent.
Note: I’m not sure how I feel about this paragraph. I personally don’t find it helpful to point these things out to someone who is in a crisis. Instead, I think we should just link at the end one of the questions that I remember updating about stress management techniques, rather than listing them out here. And I think we should focus on how to help this person short-term during their crisis rather than long term, because to them it may seem like they are only able to focus on just getting through those few minutes during their panic attack. If we bombard them with a bunch of things to do for the future to take care of themselves, it may overwhelm them or cause them more panic.
If you’re not ready to talk with a mental health professional, perhaps you can start by visiting your health care provider to address your physical symptoms. They can talk with you and ask questions to better understand what you're experiencing. Based on the information gathered, they can make appropriate recommendations and they may be able to provide you some more information. If it's necessary, they may recommend other tests to see if there are any other reasons that could cause you to feel this way. Their recommendations may also include seeing a mental health professional and identifying options for short- or long-term care. If you choose to see one at the suggestion of your medical provider, you can start by asking for a one-session consultation to determine if that person is someone with whom you feel comfortable and safe. If, after the initial meeting, you believe that you might not get the help you need, you can ask your health care provider for another referral. They may also be able to provide some other background information or check to see if there are other causes that may make you feel this way.
Note: This paragraph is too long and can be condensed into one sentence—the first one. (If you are able to, speak with a health care provider or mental health professional.) I can add treatment options (therapy and medications) from source 3, 4, and 5 here.
All of this being said, some of these strategies may not be enough to help relief you of the stress and anxiety that you're experiencing. You mentioned not wanting to see a psychiatrist. Would you be open to seeing another type of mental health professional? There are many different kinds that aren't a psychiatrist that could still provide some guidance and help you with your concerns. Based on the concerns you've expressed, you may find it helpful to talk with someone about how you're feeling. You can read Types of therapists in the Go Ask Alice! Emotional Health archives to learn more about the types of mental health professionals that are out there and if any may be a good fit for you. If you're not comfortable speaking with a one-on-one visit format, you may want to look into whether or not your school offers support groups for students experiencing stress and anxiety around school. You certainly aren't alone in experiencing these kinds of feelings, and they may have resources for you to talk to other students about that they're experiencing and what strategies work for them to manage them.
Note: The linked question is not up-to-date with the GAA! Standards, so I will have to remove it. Maybe I can include more leading questions here to help this person uncover why they may not want to go to a psychiatrist? Or not, because it may seem like I’m really pushing them to go.
No matter what your next step might be, finding some relief and strategies to mitigate stress moving forward is definitely worth taking the time to tackle.
Overall notes: Overall, I agree that this question fails to address what this person is going through. Understandable, because it’s a very difficult question. To be honest, I also don’t entirely know what to think about this question or write for this person. They need professional help and I can’t seem to think of an answer that I think will help them.
Here’s what I think the structure of the response should look like:
The first paragraph needs to do something to reduce the panic. The first few sentences about reaching out and praising them for seeking support are good. I think after that we need to get into talking about the panic that they are feeling and how understanding how difficult it can be to complete work while in the constant state of panic, anxiety, and stress. Then we talk about their suicidal ideations (SI), what those might look like (having passive thoughts of suicide) and what can be done about that. Hotlines, 24/7 crisis centers, anything that offers something urgent. After we address the urgent items (panic attack, SI), then we can start getting into other stuff. I think next we should have them think about why they don’t want or cannot see a psychiatrist (Financial reasons? Cultural reasons? ) by asking them leading questions. Then we can offer perks of going to a mental health professional, therapist, etc (treatment, therapy, medication) that can help them. Finally, we can go into why other resources (on-campus resources, linking other GAA! Stress management questions). We will review why they feel guilty when they relax towards the end before linking these resources, so that hopefully by the time the reach the end of this response they are feeling less panic and were able to use any hotlines or urgent resources they needed to.
Notes on research:
- Plenty of research on mental health topics, but difficult for me to decide what I specifically wanted to pull for this question.