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DRUGS SHOULD BE AVOIDED IN STRESS BREAKDOWN
I think that drugs should be avoided in stress breakdown. However, if drugs are used in third stage stress breakdown, theoretically the best drugs to use would be small doses of the anti-psychotic drugs used to treat schizophrenic patients, and then these drugs should only be given for a short period of time. The drugs which might be useful, would be small doses of chlorpromazine (Largactil), thioridazine (Melleril), trifluoperazine (Stelazine) and haloperidol (Serenace). These drugs have side effects, and when used in non-psychotic disorders such as stress breakdown, should be used sparingly and for a strictly limited time.
I think that a person with third stage stress breakdown needs to be physically removed from the stressful situation, if possible. A holiday, or a rest in hospital with visitors restricted, is useful.
Whatever stage off stress breakdown a patient is experiencing, recovery is rapid once stress is relieved, the patient is rested, and has caught upon some sleep. This rapid recovery serves to differentiate cases of stress breakdown from other disorders, such as endogenous depression, the symptoms of which can sometimes resemble those of stress breakdown. The symptoms of endogenous depression will not settle down rapidly with rest, and this condition requires specific treatment.
*52/129/5*

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STRESS BREAKDOWN TREATMENT: USING DRUGS FOR STRESS-CAUSED ANXIETY SYMPTOMS
In our society, the use of sedative drugs to reduce feelings of anxiety due to stress breakdown has become a major health problem. Sickness and death due to the use and abuse of alcohol, our first sedative drug, wastes huge amounts of the gross national product every year and has been recognized as one of our society’s major problems. The use and abuse of prescribed drugs is also giving us cause for great concern; it is becoming more obvious that many doctors prescribing sedative drugs for people under stress are doing so without a clear understanding of the nature of the condition they are attempting to treat.
The drugs known as sedative drugs prevent the anxiety response from occurring when the nervous system is overloaded. They also interfere with the processing ability of the brain; therefore, while people may be relieved of anxiety from first stage stress breakdown by taking a sedative drug they will also be functioning less efficiently.
*47/129/5*



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HOW DO I KNOW IF I HAVE BDD? HAIR CONCERNS
Hair concerns are also very common. The most common worries focus on hair loss, thinning, or balding (a concern of one third of people who dislike their hair) and excessive facial or body hair (also present in one third of people with hair concerns). But hair obsessions may focus on virtually any aspect of the hair: it’s too curly, too straight, too full, not full enough, uneven, messy, or
dirty. James, a teacher, thought his hair “never looked right.” He feared that it was thinning and that other people laughed at him because he was going bald.
Each day he applied hair potions that cost him hundreds of dollars a month. Although his friends said his hair looked fine, he was so upset over it that he bought a thousand-dollar hairpiece. But this didn’t help. As he stated, “I was never satisfied; I still battled myself and wanted to get rid of it.” In fact, James was so unhappy with his hairpiece that he destroyed it in a fit of rage.
While men are more likely than women to worry about thinning hair,
women have this concern as well. One woman said her mother had very thin
hair, and she feared she would eventually look even worse than her mother,
becoming completely bald. It was hard to come in to see me because she feared
she became “balder and balder” with each visit.
Getting a haircut is usually a very distressing—even traumatic—event for people with hair concerns. “I’m terrified of getting my hair cut,” Jon told me. “Getting the right haircut is crucial. There’s very little stability in my life because of the BDD. How I feel and function depends on how I happen to look and the quality of my haircut.”
Hair concerns may also involve other body hair. Men may be preoccupied with supposedly uneven, light, or heavy beard growth. Men or women may think they have too much or too little body hair. Marie, an attractive 24-year-old nursing student, worried that she had “excessive” and “dark” hair on her nose and arms. She thought about her hair nearly “all day every day,” and she repeatedly looked at her arms, tweezed her hair at work, and, using special lights, checked her facial hair in mirrors for an hour a day. She tried to hide her hair with makeup, had electrolysis, wore long sleeves in the summer, and covered her face with her hands. Marie described her preoccupation as “severely upsetting,” saying that she felt “masculine” and “like a freak” whom no one would ever love.
*42/204/8*

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TREATMENT OF STRESS BREAKDOWN: STOICISM VERSUS CHRISTIANITY IN VULNERABILITY TO OVERLOAD
The philosophy which demands that we be prepared for all eventualities well in advance so we can bear them with dignity and restraint is that of the ‘Stoic’ philosophers of the Roman Empire. This stoic philosophy, far from dying out with the ancient Romans, seems to be alive and well and flourishing as an integral part of modern Western culture. Large numbers of people seem to regard as culturally normal, a question such as:
‘What will I do next Thursday if nobody cooperates and everything goes wrong?’ The only answer I can reasonably give (and people literally do ask me questions such as this), is, ‘Panic, I suppose; perhaps burst into tears.’
The best-known spokesman for Stoic philosophy was Seneca, one-time tutor to the young Emperor Nero. Nero later forced Seneca to suicide. In his Letters From a Stoic, Seneca advises his friend:
Let the personality be made ready to face everything; let it be made to realize that it has come to terrain on which thunder and lightning play terrain on which
‘Grief and vengeful Care have set their couch,
And pallid Sickness dwells, and drear Old Age.’ This is the company in which you must live out your days. Escape them you cannot, scorn them you can. And scorn them you will, if by constant reflection you have anticipated future happenings . . . We must see to it that nothing takes us by surprise . . . this habit of continual reflection will ensure that no form of adversity finds you a complete beginner.
Christian philosophy, on the other hand, offers quite the opposite advice.
This is why I tell you: do not be worried about the food and drink you need to stay alive, or about clothes for your body After all, isn’t life worth more than food? And isn’t the body worth more than clothes? Look at the birds flying around: they do not plant seeds, gather a harvest, and put it in barns: your Father in heaven takes care of them! Aren’t you worth much more than birds? Which one of you can live a few more years by worrying about it? . . . Your Father in heaven knows that you need all these things. Instead, be concerned above everything else with his Kingdom and with what he requires, and he will provide you with all these other things. So do not worry about tomorrow; it will have enough worries of its own. There is no need to add to the troubles each day brings.
There are no prizes for guessing which of the two approaches would be better for preventing overload leading to stress breakdown. The problem, however, is the person caught in the middle, who perhaps is afraid to trust God enough to leave the future to him to worry about, but who believes enough in Christianity to be saddled with a list of do’s and don’ts which merely further overload the nervous system.
*42/129/5*



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TREATMENT OF STRESS BREAKDOWN: ANXIETY AND UNNECESSARY STRESSES
Treatment of stage one symptoms – anxiety
The most effective treatment for anxiety due to overload of the nervous system is not to overload the nervous system. The simple advice is: ‘Take it easy, don’t take on more responsibility than you can handle.’ This simple advice, however, is usually the most difficult to follow, because of three factors:
1. People are so adaptable that we tend to accept more and more load and responsibility up to a point where we begin to fail. We often simply don’t know how much is too much.
2. As much as we’d like to, we may not be able to avoid the stress and responsibilities which are thrust upon us.
3. We always experience some anxiety whenever we have to perform a new task which is unfamiliar to us. We recognize this as normal and accept that some anxiety is unavoidable in acquiring new skills. We therefore become used to ignoring anxiety and fail to notice when it is a signal of overload.
Identifying unnecessary stresses
The first thing to do to avoid needless stress is to identify the unnecessary loads we place on ourselves.
The most easily identifiable unnecessary stresses, I believe, are those we impose on ourselves by demanding guarantees of adequate performance. For example, a person undertaking a particular task, and who is concerned with getting ready in advance for the possibility of not being able to complete the task satisfactorily, has possibly quadrupled the load on the nervous system.
I commonly find that people suffering from stress-breakdown symptoms have often used up too much of their nervous system’s processing capacity by demanding from themselves answers to various unanswerable questions about the planned outcome of the tasks they face.
Had they concentrated on the task in hand, they would have perhaps been able to complete it without experiencing anxiety. The overload is often not from the task they have to do, but from trying to service all the unnecessary guarantees they have demanded from themselves. We often find ourselves demanding answers to unanswerable questions about our performance, such as:
• How can I be perfectly sure?
• How do I know I’ll be able to cope if…?
• What will they think if I fail?
• What will I do if…?
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TOWARDS GOOD SLEEP: RELAXATION AND MEDITATION
The onset of normal sleep is a drowsy, relaxed state, a state of peaceful letting go. It should be a state that we drift into naturally, yet in this busy, stressed age, many people have simply lost the art of relaxation, and have to relearn it.
Watching television, going to the cinema, socializing and other off-duty activities all have their place, but they are not really relaxing.
True relaxation involves switching off the active right brain, and also the part of the nervous system that gears us up for action. It reverses the process of building up tension by bringing into play the parasympathetic nervous system, which counteracts the effects of stress, and helps to strengthen the immune system. Regular relaxation can actually alter body chemistry, and deep states can help the brain to produce endorphins, hormones that have been called ‘the body’s own morphine’, which have the effects of lifting the mood and relieving pain.
Meditation has many similar effects. Though relaxation is aimed chiefly at the body, and meditation at the mind and spirit, both slow down and rebalance the body-mind system. Many people who meditate regularly find they need less sleep than before, because during their meditation periods they are giving their systems deep rest. Both meditation and relaxation require us, and also enable us, to let go of worry and tension and focus on the present moment.
Some people are quite scared of letting go; they feel they must hang on and stay in control. This is partly because many of us have been brought up with the idea that ‘doing nothing’ is a waste of precious time, possibly even sinful; partly because of a not always conscious fear that something terrible will happen if we let go. The most vivid example of this I ever saw was on a plane journey with a friend who was scared of flying: she sat rigid in her seat clutching the armrests, and I suddenly realized that she was actually trying to hold the plane up.
Letting go is a normal part of life’s rhythm; hanging on to control builds up physical tensions which go to bed with you. A tense mind is less able to solve problems than a relaxed one: if you learn to relax you will find that it will not make you less efficient, but better able to cope, and with more control over your waking and sleeping patterns.
In 1985 a small study was carried out by the Sleep Laboratory at Leeds University, with a group of airline pilots. Pilots have such irregular hours and routines that they often have to take sleeping pills to get their rest, a far from ideal situation. Ten pilots were taught a mixture of muscle relaxation and mental meditational techniques, which enabled them to get to sleep whenever they needed to, in unusual environments, even on long taxi-rides. Eight months later, seven of them were still using these techniques; of the remaining three, one had been practising his own form of meditation before the study.
Most people in these tense days could benefit from regular relaxation or meditation. Build it into your day: give yourself a space to practise for 20 minutes at least once a day.
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SOME COMMON SLEEPING PROBLEMS WITH CHILDREN
The screaming baby
A screaming baby can be exhausting for both parents and child. There may be a number of reasons for it, and it is a good idea to check that there is nothing physically wrong.
In the first few months a very common cause is colic. It is said that nothing can be done about this, and parents find themselves walking up and down during the night holding the baby until it quietens. However, colic can be helped by some natural medicines, as can other causes of screaming. (See the section of natural therapies towards the end of this chapter.) Gently stroking a small baby’s feet is also very soothing and calming.
The colicky stage is a risk area for establishing a pattern of ‘ baby cries — mother comes running’. While it needs comforting at this time, once the colic is over is the time to get it into the habit of sleeping without expecting parents to be in constant attendance.
The overtired child
Some small children need more sleep than their parents realize; if your child is fractious, particularly at bedtime, it could be overtired. Remember, toddlers don’t know what the time is, and it’s up to you to tell them firmly that it’s bedtime.
Try putting the child to bed earlier; you will soon find out if they benefit from more sleep. But if you do experiment with different bedtimes, give the experiments time to work, so that the child has a chance to adapt to the new routine. A major cause of disturbed sleep patterns in children is inconsistency on the parents’ part.
The child who needs less sleep
As children get older, they are sometimes packed off to bed long before they’re ready for sleep, because the parents want the evening to themselves. It is confusing for them and their body clocks to be told it is time to sleep when they don’t feel sleepy, and they may raise strong objections.
It’s best to be honest with them about your own needs. Rather than engaging in a battle, let them play or read in bed until they are ready for sleep. (As a child sent to bed before I was sleepy, I used to read for hours under the bedclothes, to the detriment of my eyesight.) If you trust your child, he or she will go to sleep when they need to. They are less likely to if it becomes a major issue.
Demanding attention in the night
Some children have the parent-debilitating habit of waking in the night and demanding attention. This could be because bad habits have been set up in babyhood when an over-anxious mother has looked in at the slightest sound. Or it could be because they feel they’re not getting enough of her attention during the day. But so long as they are getting all the daytime love they need, they could be testing how far they have you on a string.
Providing there is nothing genuinely wrong with them, the standard advice is to leave them to cry, but many parents feel uncomfortable about this. There is a difference, however, in the sound of a child crying simply to get attention, and the cry of a child who is genuinely afraid or unhappy. It may be necessary to show the child you are there, but also let it know what your limits are, kindly but firmly. Leave the child with plenty of toys to play with if it does waken in the night. Again, you could create a system of rewards, or perhaps a star-chart, for undisturbed nights.
Sleepwalking
Sleepwalking is quite common in children and adolescents, and normally tails off in the late teens. It usually occurs in the deep stages of sleep and the child is not aware of it. It may be a sign of minor unresolved anxiety, but if it happens regularly there could be a deeper emotional cause. If occurrences coincide with particular incidents or some anxiety affecting the child or the whole family, the child may be in need of reassurance.
Otherwise, don’t worry the child by making too much of it. He or she will normally return to bed spontaneously; don’t waken them. But do make sure there’s no danger of the child falling out of windows or otherwise getting hurt.
Nightmares
Most small children go through a phase of having nightmares, usually around the ages of three or four, coinciding with a phase in their development when they are more anxious in general, and perhaps scared of the dark. If the child remembers the nightmare next day, he or she may perhaps be frightened of going to sleep.
Unless they occur very often, nightmares don’t necessarily mean that the child is emotionally disturbed; they can be triggered by a television programme or the sight of a fierce dog in the park, for instance. All the same, it’s important to respect the child’s fears, and listen to anything they want to tell you about their dream.
Make the child feel as secure as possible, and let them know that you are there if needed. They may like to have a nightlight; you can also appoint a favourite toy as a guardian. Some parents have helped children to lose their fear of nightmares by getting them to draw pictures of them and making a game of it — for example, drawing a dream monster and then putting a red nose on it. If a child suffers regularly from nightmares, there may be some deeper cause, and you should talk to your GP about it.
Night terrors
Night terrors occur most often in small children, though adults can experience them too. When they happen the child suddenly sits up in bed, staring into space and screaming in apparent terror. Although these episodes can be very frightening for parents the child usually doesn’t remember them. They occur during the deep stages of sleep and are not related to dreams or nightmares. Stay with the child and comfort it until it falls asleep again.
Night terrors may be caused by the child going to bed feeling angry or distressed, and again, if they are frequent, the child may be reacting to some deeper worry or family problem about which it needs reassurance.
*41/169/2*

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RELAXATION TECHNIQUES, BIOFEEDBACK FOR STRESS BREAKDOWN TREATMENT: POSSIBILITY TO FURTHER STRESS BREAKDOWN
Some of the relaxation exercise and biofeedback methods have as an underlying theory that feelings of tension under stress are a sign that the sufferer is physically unfit. The inference is that stress should not cause anxiety symptoms in a person whose body is physically fit from regular exercise, and who has his feelings under control.
I reject this concept. It must always be remembered that anxiety response to stress is a normal alarm mechanism. Abnormal physiological states can lead to anxiety symptoms when the person is trying to deal with what might be otherwise a normal stress load. I fear that some people giving advice about stress management seem to believe that anxiety under excess stress can be reduced by their methods.
The promise of some relaxation techniques and biofeedback methods, that they can dismantle the alarm reaction which warns us when we begin to overload the nervous system, seems at best ineffective, and at the worst, possibly harmful.
I believe that abuse and disrespect for ourselves is part of the human condition, and I tend to view the proposed use of techniques which would free us from the penalty of overloading our nervous systems, as just another example of the human behaviour which tends to make us vulnerable to stress breakdown in the first place. The promise that modern biofeedback methods are able to combat stress, in my view, just leads people to think they can cheat the system, and get more and more work out of their over-stressed nervous systems without paying any price. In fact, attitudes such as these are the classical preconditions for progressing from stage one stress breakdown to stage two and stage three. I tend to see therefore, some of these stress management programmes as potentially capable of producing serious stress breakdown, if they are used in ignorance of the real function of the anxiety response as a warning signal of overload.
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COPING WITH INSOMNIA: A HEALTHY ENVIRONMENT
As has already been mentioned, your bedroom should be associated with sleep, and not with other activities. It should also be warm and welcoming, with a peaceful and healthy atmosphere; some bedrooms, as will be seen the next section, can actually damage your health.
Colours
Colours have an influence not only on our visual sense but on our nervous system; they radiate at different wavelengths, some of which are stimulating, and some calming. Calming colours for bedrooms are soft blues and greens, pastel pinks and peaches; neutral colours like beige and cream are also appropriate. Avoid vivid colours, particularly in a child’s bedroom, where they might seem cheerful but can be over-stimulating.
The bed
Your bed should obviously be comfortable, ideally with a firm but not over-hard mattress. People’s tastes in mattresses vary, and if you’re happy with a squashy one, that’s fine. But soft mattresses are not good for your back in the long run.
It’s best to sleep with a single pillow, which keeps your neck at a natural angle. A stiff neck is often greatly improved when two or three pillows are replaced with a single one. (It’s been suggested, incidentally, that if you sleep badly in strange houses, taking a familiar pillow with you will provide the link with home that will allow sleep to come.) Some people find hop- or herb-filled pillows help them to sleep; you can get them at herbalists like Culpeper’s. Sniff before buying to make sure you like the smell.
Fresh, clean air
Fresh air is important, provided it doesn’t make the room too cold. If you don’t like sleeping with an open window, consider getting an ioniser. Ionisers replace in the atmosphere negative ions, electrically charged molecules which are found in abundance in mountain air and around waterfalls, and which keep the air healthy and clean.
Crystals
Crystals are getting very popular these days as aids to healing, meditation, and clearing the atmosphere. Rose quartz and amethyst are both suitable stones for sleep; keep one by your bedside. When you buy a crystal, it should be thoroughly cleansed before you use it, since crystals absorb energies from the atmosphere around them. Soak it for several hours in a bowl of salt water, rinse it under the cold tap, don’t wipe it with a cloth but place it to dry on a sunny window sill.
*43/169/2*

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TREATMENT OF STAGE TWO STRESS BREAKDOWN SYMPTOMS
The symptoms of stage two stress breakdown: loss of emotional control and failure of self-motivation indicate an urgent need for rest and sleep.
The cause of the symptoms of stage two is the run-down of the body’s inhibitory reserve, just like an automobile battery which has run flat. The body’s reserves will therefore need to be regenerated. The treatment for second stage stress breakdown symptoms will require emphasis on relief of stress, rest, extra sleep and adequate nutrition. Sleep is the most important factor in the speed of regeneration of the body’s inhibitory reserve.
The person suffering from stage two stress breakdown can be thought of as a person experiencing a functional health crisis. The proper course of action in treating someone with second stage stress breakdown, should be:
1. The person needs to be rescued from the stressful situation by someone who can step in and arrange for the over-stressed person to be relieved of responsibilities. In most cases, the rescuer role is performed by the family doctor, who has the authority to issue sickness certificates, as well as to influence his patient to rest.
2. The patient should go to bed, hopefully to sleep. Meals should be regular, and problems and relatives should be kept away from the over-stressed person.
3. Drugs should be avoided for two reasons. Firstly, the patient has already demonstrated loss 0f emotional control, hence the diagnosis of second stage, people suffering from stage two stress breakdown might be more likely to take impulsive mini-overdoses, and secondly, the over-stimulation of the cerebral cortex, which results from the body’s reaction to sedative drugs, would be theoretically likely to provoke stage three stress breakdown symptoms.
*50/129/5*

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EFFECT OF STRESS BREAKDOWN ON THE SEXUAL RELATIONSHIP
One of the early symptoms of stage three breakdown is an inability to tolerate high levels of sensory stimulation. Previously enjoyable stimulation can become disagreeable and actually uncomfortable. Sexual stimulation, likewise, can become disagreeable.
In this stage of stress breakdown, men and women, particularly women, who previously enjoyed an active sex life, can be turned off sex for no reason apparent to either partner. The real reason is, of course, simply that the nervous system cannot tolerate high levels of stimulation. However, it is rare that couples have the insight to accept this as an explanation and leave it at that. If they did, there would be less unhappiness arising as a result of what these couples usually wrongly see as a failure of their sexual relationship.
Some women who are accustomed, at times, to having sexual intercourse with their husbands without orgasm, may be satisfied, when they are suffering from stress breakdown symptoms, with the warmth of close contact without orgasm. ‘I just don’t want to be bothered with feeling anything’, she says. Unfortunately, this turning off sex may be misinterpreted, usually by both of them.
There are always enough unresolved difficulties between husband and wife in any marriage which can be used to explain why one or both of them seem to have lost interest in each other sexually. Pressed for an explanation for the current lack of sexual interest, wife or husband might bring up one of their old, unresolved conflicts as a reason. The other partner might erroneously believe, then, that it is necessary to solve this particular problem in order to restore the former sexually-satisfying status quo. When this problem seems to be irresolvable, he or she may feel deceived or humiliated, hurt and rejected.
In our society, where it is culturally acceptable or normal for women to lose interest in sexual activity at times in their lives, a relatively young man who begins to lose interest in sexual relationships with his wife is usually suspected of having another woman, or of being mentally ill. It is often the wrong assumptions and misinterpretations in this situation which lead to trouble. Take, for example, the case where a couple was both experiencing stage three symptoms, behaving in unusual ways, responding strangely. He turns off sex, she thinks he has another woman (he hasn’t); she decides to behave in a way entirely inappropriate for her and goes out and picks up a casual lover. Such an out-of-character change in behaviour is not uncommon in third stage breakdown.
The marriage might then fail, not on the basis of the primary lack of sexual interest, but because of the unfortunate responses which might result.
*60/129/5*

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STRESS AND MARRIAGE BREAKDOWN: BLAMING MARRIAGE ITSELF FOR MARRIAGE BREAKDOWN
I think our society these days is inclined to see marriage itself as a cause of problems in marriage. For example, it is not uncommon to hear people blame their marriage for the deterioration in their sexual relationship: ‘I think I just got bored with the same old routine, Doctor!’ Likewise, people may blame their communication problems on ‘becoming bored with the same person’, or ‘We just grew apart.’
Therefore, people who blame the marriage for some of their relationship difficulties tend to see trial separation as an answer. Similarly, some people see divorce as an answer to problems of personal self-acceptance and personal worth. The tendency to think this way reflects primarily the philosophy of our post-war Western democracies, described ably by Paul Vitz as ’selfism’.
Vitz contends that what our culture has done in relation to its views on the rights and responsibilities of the individual self, is to take the Christian concept of the self – each person intimately loved by God, unique, with specific gifts and talents to be used for God’s service – and then take God out of the picture. Thus we are left with the concept of each individual as unique and important, each with a specific destiny to fulfill, but there is no God, and there is no evil. Therefore our society, once it did away with the concept of sin, was left without anything to explain why we, who begin life as beautiful, innocent children, can grow up to be selfish, greedy, power-hungry, dissatisfied adults.
The response of our society was predictable. We discovered new devils and new bad influences to explain why we human beings always seem to create problems in getting along with one another. I find that people now tend to blame marriage, commitment to love relationships in general, family influences and society, as prime causes of their own unhappiness.
I believe if I stood on the street, asking all the people who walked past, whether society has a good or a bad influence on the individual person, that a lot of the people answering would say it had a bad influence. Many of these people answering my question would be healthy and fit, protected by this same society against catching all sorts of diseases, fed, clothed and entertained by the very system which they think is the basis of a lot of our interpersonal difficulties.
Similarly, marriage as a concept has come in for a great deal of criticism in recent years, particularly from younger people, who tend to see the solution to their fears of rejection in not signing up for life in marriage, but instead negotiating limited contractual agreements, mainly for the sake of the orderly disposal of shared property once the relationship breaks down.
Therefore people experiencing stress breakdown symptoms and relationship problems, if they are to save their marriages, need to resist a general society tendency to drift into divorce. In this climate of peer-group pressure in favour of splitting up, it almost seems as if it takes more psychic energy to stay together and face problems than split up and start again.
However, the people who have opted for divorce often find that divorce hasn’t solved their problems, but in fact, magnified them. Ex-husbands don’t become ex-fathers, nor do ex-wives become ex-mothers of children whose big problems begin when parents become divorced. Often people, who find themselves divorced as the result of stress breakdown affecting the marriage, find that when they lose their ex-partner, they lose their best friend.
It might sound an unexpected thing to say, but I believe from my experience in psychiatry, that divorce solves the problems of very few people. Easy divorce is associated with an increasing number of people being raised in one-parent families, in real poverty. I believe that stress breakdown is a major reason for divorce in this country, and the majority of those divorces are unnecessary.
*55/129/5*

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TOWARDS GOOD SLEEP: LIVING IN THE PRESENT
Anxiety and sadness, anger and resentment, are always concerned with either past or future. If you are totally focused in the present moment you can’t be anxious. So try to take opportunities of living in the present as much as you can.
Put your full attention on whatever you are doing at the time when you’re doing it, whether it’s working, walking, or washing up. Let your thinking mind off the hook for a few minutes; pause and be aware of your physical body, of your feet on the ground, and your surroundings. If you are out walking, simply look at and experience the sights and sounds, without getting involved in a long train of thought. Gradually you will learn to switch off that over-busy mind and give it and you a rest.
Happiness, the opposite of anxiety and depression, is only ever found in the present moment. We look back with nostalgia, thinking ‘If only things had been different!’, or forward to achievements we believe will make us feel good; or we believe that someone else could make us happy, if only they would behave differently.
If you remember the real moments of happiness in your life you will know that they don’t really depend on other people or events, but on feeling good with yourself. Living in the present helps us to accept ourselves as we are, without judging ourselves by other people’s standards. It takes practice, and may not come easily at first, but it’s another habit that can be cultivated. And it’s a healing habit: one woman totally cured her depression by living in the present, giving up all regrets about the past and fears for the future.
It’s also a habit you can take to bed with you. Instead of worrying about whether or when you are going to get to sleep, simply be with yourself in the present moment, regretting nothing, expecting nothing, giving your body and mind permission to let go and rest.
*52/169/2*



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TREATMENT OF STRESS BREAKDOWN: STRESS WE CANNOT AVOID
We come now to the people who are suffering from stage one stress breakdown symptoms as a result of stress that they cannot possibly avoid. In this category I place the people whose occupations require them to accept long periods of stress when they may also be short of sleep and malnourished. Soldiers come into this category; so do the families caring for severely handicapped relatives and some mothers of newborn babies, if they are denied help from others. My advice to people suffering from stress-breakdown symptoms from unavoidable stress is:
• Are you really sure you can’t get any help at all? Are you really a coper who thinks it is a sign of weakness to ask for help?
• If you cannot avoid stress symptoms, at least don’t mistake them for symptoms of illness, and don’t make any wrong assumptions about the origins of your symptoms. For example, if you are bursting into tears at the thought of having to psych yourself up to do the shopping on your own, don’t load yourself up with guilt for being lazy.
• If you can’t avoid the big problems, at least get rid of as many of your other little problems as you can. It’s like jettisoning extra baggage to lighten the load if the ship is in danger of sinking. So if you can’t look after your sick baby and the other children as well, and keep the house clean, let as many non-essentials go as you can.
• Get as much sleep as possible, even if it’s just ‘forty winks’ now and then during the day. Don’t skip meals, and don’t do anything like deciding now is the time to go on a crash diet to lose weight. Don’t drink alcohol or ask the doctor for sedative drugs. Cut down on your tea and coffee intake.
• Decide to take a holiday when the stress is over, and do it. The holiday might be going to bed for a few days, or going away to recuperate and be pampered.
*43/129/5*

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TREATMENT OF STRESS BREAKDOWN: BRAIN RESPONSE TO SEDATION CAUSING WITHDRAWAL AGITATION
Sedative drugs include alcohol, chloral hydrate, barbiturates, and the benzodiazepine drugs such as diazepam (Valium), oxazepam (Serepax), nitrazepam (Mogadon), and the increasing number of drugs on the market whose generic names end in ‘azepam’. The effect of any of these drugs is mainly on the cerebral cortex, interfering with the inhibitory cell groups and the mechanisms which trigger the alarm or anxiety response. Some of us like to feel slightly sedated, relieved of our fears by the Dutch courage of alcohol and other sedative drugs.
However, while sedative drugs may make us momentarily feel good, the brain does not happily accept the sedative drug’s slowing-down effect on the brain cells in the cerebral cortex. In response, the reticular activating system reacts to the sedation by sending increased stimulatory impulses to the cerebral cortex.
As the sedation from the last dose of drug wears off, the person begins to experience a hangover, a feeling of touchy hypersensitive agitation, due to the over-stimulation by the reticular activating system. This vague over-stimulation of the brain, as a reaction to the last sedative dose, usually lasts four times as long as the sedation did. After that time, the brain is able to reduce the stimulation and the cells get back to normal function.
Thus, a person feels more anxious after a sedative drug wears off than he would have if he hadn’t taken the drug.
After the sedation wears off the mild agitation from the brain’s response to the drug feels very uncomfortable and the person seeks another dose to relieve the agitation resulting from the previous drug dose. The problem is that this agitation is additive; after taking multiple doses of the drug, the person will experience such a high degree of agitation on ceasing the drug, he or she may become fearful of not being able to relieve the agitation with another dose and drug dependence may result. The risk of sedative dependence is so high where a person is being treated for stress-breakdown symptoms that sedative drugs should only ever be given when the anxiety symptoms themselves have become the major cause for concern. For example, a person who reacted to stress-breakdown symptoms with a phobic avoidance reaction (such as agoraphobia) and became unable to leave the house for fear of experiencing anxiety, might be more disabled from being unable to leave the house from fear of anxiety than by drug dependence.
Sedative drugs, in order to bring the situation under control, might be justified in those circumstances. However, I believe that in the vast majority of cases of anxiety symptoms caused by stress overload, the use of sedative drugs cannot be justified.
*48/129/5*



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Other names: Fludac, Rapiflux, Sarafem

TOWARDS GOOD SLEEP: IT’S NEVER TOO LATE
Older people are often depressed simply because they feel lonely and useless. Family and friends move away or die, and it can feel as though nobody cares. But that may just be because nobody knows you’re there. You may have to make the first move, but do make it. Old age in itself doesn’t have to mean mental deterioration. Make sure that you have a regular routine, giving yourself proper meals and whatever exercise you can.
You may be entitled to rights that you don’t know about, like getting a telephone installed; contact your town hall and find out about your entitlements. Even if your body is slowing down, look for outside activities that can provide company and mental stimulation. Some local authorities operate ‘Adopt a Granny’ schemes, which have given a new lease of life to many elderly women who find themselves wanted members of a family again. Lots of families would appreciate baby-sitting services. Your local social services department or health visitor may be able to let you know of local groups that you can join.
It’s never too late for further education. Many older people get a great deal of stimulation — and company — from adult education classes. There is also The University of the Third Age, which has a number of branches countrywide.
*51/169/2*



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WHY BDD IS UNDERDIAGNOSED – ADDITIONAL CLUES: DEPRESSION, SOCIAL ANXIETY, AND OTHER SYMPTOMS – SOCIAL PHOBIA
Certain other disorders also commonly co-occur with BDD and may be a clue to its presence. One of these is social phobia (also known as social anxiety disorder), an excessive fear of social or performance situations due to a fear of doing something embarrassing or humiliating. Another is obsessive compulsive disorder (OCD), characterized by obsessions (intrusive, recurrent, unwanted thoughts that are difficult to dismiss despite their disturbing nature) and compulsions (repetitive behaviors that are intended to reduce the anxiety caused by obsessions). A high percentage of people with BDD have had problems with alcohol or drugs. The only study I know of that’s assessed how common BDD is in this group was the Minnesota inpatient study I mentioned earlier. This study found that a surorisinelv hieh percentage—26%—of inpatients with a substance ue disorder (drugs and alkohol) also had BDD.
So it’s important to ask people with these disorders whether they have symptoms of BDD. It’s important to inquire, because BDD sufferers may be too embarrassed and ashamed to volunteer their symptoms. In the depression study and the substance abuse study I just described, not a single person revealed his or her BDD symptoms to their doctor or therapist until specifically asked about them, reflecting BDD’s often secretive nature.
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STRESS AND MARRIAGE BREAKDOWN: THE LOVE RELATIONSHIP THAT FORMS THE BASIS OF MARRIAGE
One of the noticeable features of our society in recent years is the high divorce rate and the increasing number of one-parent families. I believe that stress breakdown is responsible for the failure of many of these marriages. In many cases, seemingly rock-solid marriages fail to withstand the effects of excessive stress, even where the stress was external to the relationship.
Of course, divorce and separation operate in our society as potent stressors, and are actually contributing towards causing stress breakdown.
The love relationship which forms the basis of marriage needs to be strong enough to withstand stresses and strains on the relationship in order for a marriage to last. Let us look first at some aspects of married love.
While we recognize that marriages between people who hold widely differing moral, cultural and political beliefs are not likely to last, nevertheless we are aware that love relationships are built partly on differences in personality. In stress breakdown these differences can become, instead of a basis for mutual attraction, the expressed reasons for seeking separation and divorce.
We tend to fall in love with people who have some of the qualities we lack, and the children that result from that union have the advantage of both sets of qualities. If this were not so, if instead we married people who were just like ourselves, we would soon lose that great variety of personalities and talents which are required to run a complex, co-operative society.
The tough, cruel people would beget tough, cruel kids, and the soft-hearted, weak people would beget soft-hearted weak kids. It would not be long before the cruel, tough ones would destroy the others, leaving us to try to run our country with a uniform batch of Nazi clones. Luckily we tend to be attracted not to opposites, but to people who have qualities we lack.
A moment’s reflection on the happily married couples we all know will reveal that this statement is generally true. Strong, mannish women seem to be happily married to round-shouldered ‘Walter Mitty’ types, who love their wives dearly. The tough, rugby second-row forward who seems to lack any trace of femininity in his make-up, usually seems to be, in my experience, married to a woman who seems to have very little in the way of masculinity in her make-up. I have been observing people for many years, and it always appeared to me that both husband and wife together seem to form a sort of basic unit. There seems to be in each person a kind of appetite, or longing, for some person who will provide in the relationship the qualities that each of them lack.
This isn’t to say that this mutual satisfaction is totally complete. The unit, the ‘one flesh’ (as described in the Bible) which results from that love relationship, may be only partly satisfying to both, but nevertheless, the concept of the two partners in a married relationship forming a basic unity is generally valid and real.
Therefore, in a situation where ‘both husband and wife are suffering from stress breakdown symptoms tending to interfere with their ability to accommodate the personality differences between them, the very basis of their love relationship can be threatened. Third stage stress breakdown produces an inability to tolerate previously tolerated differences.
*53/129/5*



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Other names: Endep

WHY BDD IS UNDERDIAGNOSED: NOSE CONCERS AND OTHER SYMPTOMS
Nose concerns are also very common. About 60% of people with nose concerns worry that their nose is too large. More than a quarter worry it’s bumpy or misshapen. Less commonly—sometimes after nose surgery—they think it’s too small. One woman thought her nose was “bumpy and swollen”; a middle-aged man thought his was “puffy.” People with nose concerns are especially likely to have surgery—often repeated surgeries. One woman I treated first thought her nose was too large, and then, after surgery, felt it was too small. A college student first believed his nose was too long, but then, after surgery, thought his nostrils were too wide.
I once had an interesting conversation with a psychiatrist from Japan who was familiar with BDD. He was surprised to learn that I’d found that people in the U.S. usually worry that the nose is too large; in his experience, in Japan the concern is often that the nose is too small. In addition, he said that concerns with hair loss are uncommon in Japan. These observations raise the interesting question of whether cultural factors may influence the exact worry that people have.
BDD can also involve larger body areas. Many men are preoccupied with their overall body build, thinking they look too small or inadequately muscular. This form of BDD is called “muscle dvsmorphia.” Thev may wear many layers of clothing to enhance their size, excessively lift weights, or use potentially dangerous anabolic steroids to bulk up. Others—often women—are concerned that they’re too large or overweight. Of the people in my studies, 22% were excessively concerned with their weight.
*43/204/8*



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COPING WITH INSOMNIA: GEOPATHIC STRESS
I used to think that ley lines, the lines of electromagnetic energy running through the earth, were of strictly academic or hippy interest — until I experienced for myself the effects of sleeping over a stressed energy line.
Energy radiated upward from the earth is normally positive, but it can be distorted by underground water currents, mineral deposits, electric pylons and geological fractures, which cause the earth’s electrical fields to radiate at unnaturally high frequencies. These distortions, called geopathic stress, can cause severe problems to anyone living, and particularly sleeping, over them.
The effects of geopathic stress include insomnia, depression, stress, respiratory problems and depletion of the immune system. It has been found to have a strong relationship with the development of cancer and other serious illnesses like Multiple Sclerosis: sometimes you come across a house in which whoever lives there develops a serious illness. Geopathic stress can also be the reason why some people never feel really well, while others don’t recover from illness, whatever treatments they try.
In West Germany the problem is considered important enough for the government to have funded in 1987 a 400,000 DM research project to investigate the claim that cancer can be caused or exacerbated by living in an area of geopathic stress. And according to research in both Germany and Britain, there appears to be an important link between geopathic stress and cot death, the theory being that it weakens babies by affecting their immune system.
Geopathic stress may not actually cause cancer, depression and so on; what it appears to do is to trigger an illness towards which the person is already prone, or to magnify minor feelings of anxiety or depression. In my own case it is possible that the stress was caused by a re-routing of local water pipes, since I slept in the same room for many years before developing the symptoms of geopathic stress. I was recovering extremely slowly from a back problem, and at the same time found myself waking in the morning with extremely unpleasant and powerful sensations of anxiety, depression, and general horribleness. I had no way of knowing that what was probably a mild attack of self-doubt had been magnified a hundredfold, and began to wonder whether I was a candidate for psychiatry.
The cause was eventually pinpointed by a homoeopathic doctor whose wife confirmed the presence of geopathic stress through dowsing — for which I am eternally grateful. What was really convincing was that once the stress had been dealt with, I returned within a day or two, (and with enormous relief) to a normal state of mind. The experience has convinced me that geopathic stress is a very real and serious factor in our health, particularly in view of its possible connection with cot death.
It is hard to say how widespread this problem is. Dr Julian Kenyon, Director of the Centre for the Study of Complementary Medicine in Southampton, originally trained in orthodox medicine and now specializing in acupuncture, homoeopathy and research into the human energy fields, told me that geopathic stress is common enough to be considered seriously in insomniacs who don’t respond to the normal methods.
Using a Vegatest (a diagnostic machine used by some doctors and natural practitioners) he finds that about 15-20 per cent of his patients suffer from geopathic stress; as he says, they are a highly selective population, but could still represent quite a lot of people.
The presence of geopathic stress is obviously of great importance to our physical and emotional health, and that of babies and children. How can you tell it’s there?
*45/169/2*