Anxiety, worry and pulmonary hypertension
In a special article for Emphasis, trainee clinical psychologist Dr Gregg Rawlings challenges some common misconceptions about mental health and PH.
T
he term anxiety is used to describe a range of types of thinking processes, emotions, feelings and physical sensation. Anxiety is also commonly associated with particular types of coping behaviours. Challenging misunderstandings about anxiety is important as this can actually help reduce experiences associated with anxiety. Misunderstandings about common forms of distress associated with long-term conditions such as pulmonary hypertension can also cause stigma, and prevent people from talking to others and seeking help.
“I am the only one experiencing problems with my anxiety”
Many people experience anxiety to a level that significantly impacts on their quality of life. In England, six out of 100 people will experience anxiety to such a level that they may benefit from seeing a mental health professional, such as a psychologist or counsellor. In pulmonary hypertension however, up to 50 out of 100 people experience clinical levels of anxiety. Given the nature of pulmonary hypertension, experiencing worrying thoughts and feelings of nervousness is to some extent to be expected. So the take home message here is you’re not alone in experiencing anxiety!
“Anxiety is the same as worrying”
It is true that worrying thoughts are a common characteristic of anxiety; however, in anxiety that has become a problem, levels of worry can become all-consuming and typically trigger other reactions or ‘symptoms’. For example, it’s not uncommon for people to also experience palpitations, tightness in the chest, fatigue, dizziness, distressing emotions, sickness and difficulty breathing. As you may have already noticed, there can be an overlap between symptoms of anxiety and symptoms of PH. For this reason and more, anxiety in pulmonary hypertension is particularly important to address. Please do seek support if you are experiencing the reactions described above and they are negatively affecting your quality of life.
WINTER 2020 emphasis 50
“It is just my pulmonary hypertension that is the problem, not my anxiety”
Pulmonary hypertension does of course have a considerable impact on those living with the condition. As already stated, this can also increase the likelihood of experiencing difficulties with anxiety. The good news is that some relatively simple techniques can help with reducing anxiety. See page 22 for more information.
“It can be embarrassing talking to people about my anxiety”
Although as a society we have come a long way in being more open to talking about distress, unfortunately, mental health difficulties can still be stigmatised. This can make people feel uncomfortable and experience distressing emotions when talking about their mental or psychological health and wellbeing. Like most things, this can become easier with practice and time, and the benefits of discussing your anxiety do outweigh the negatives.
“People who have anxiety are weak or crazy”
Holding these beliefs tend to be linked to the stigmatisation of mental health conditions, which influences how people view themselves. In fact, it takes a lot of strength and courage to acknowledge, be open to discussing, and learn strategies to cope with anxiety. In addition, as already discussed, experiencing some feelings of anxiety from time to time is pretty much normal when living with a long-term condition like pulmonary hypertension.
“I just need to snap out of it”
Unfortunately, it is not as simple as just ‘snapping out of it’ or ‘stopping thinking about it’. To help illustrate this point, I want you not to think of a pink elephant… I bet you thought of a pink elephant. This shows us the more we
