Symptoms are not the same as a disorder

Feeling anxious, flat, irritable or overwhelmed are all symptoms that can appear in clinical conditions. They are also experiences every person has from time to time. Having a symptom does not mean we have a disorder. This is helpful to know whether it is you who is suffering, or if it is a loved one. We can quick to ‘pathologise’ a normal emotion. What I mean by that is, we take a normal emotion, sensation or thought and we attribute it to something being wrong with us, rather than recognising it as a natural response to what is happening in our lives at that moment in time.

Most of the time, these experiences are transient. They arise in response to what is happening in our lives, such as a stressful week, a difficult conversation, poor sleep or a disappointment, and they ease as circumstances change. This is our emotional system doing exactly what it is designed to do.

Having a hard day, or even a hard week, is not evidence that something is wrong with us. It is evidence that we are human.

When it may be something more

There are times when distress indicates something needs more attention. The difference usually lies in two areas.

1. It becomes fixed rather than fluctuating. Ordinary discomfort comes and goes. When distress stays in place for weeks or months, regardless of what is happening around us, it may reflect something more persistent.

2. It affects how we function across life domains. Everyday distress might make a particular situation harder for a while. When it begins to significantly affect our work, relationships, sleep, health and ability to look after ourselves, all at once, it is more likely to be clinical.

When both of these are present, it may be time to seek professional support. A psychologist can help us
understand what is happening and provide targeted support.

How our interpretation of discomfort adds to the load

Often, the discomfort itself is manageable. What makes it heavier is the meaning we attach to it.

In acceptance and commitment therapy (ACT), there is a useful distinction between clean and dirty discomfort. I have discussed this in a previous blog titled Clean vs Dirty Discomfort but essentially clean discomfort is the natural emotional response to a situation, such as nervousness before an important meeting while dirty discomfort is the extra layer we add when we react to that feeling, for example by thinking “Why am I like this?”, “I should be past this by now” or “This means something is really wrong.”

That second layer can turn a passing feeling into a much bigger problem. It can also lead us to avoid situations, constantly monitor ourselves or seek reassurance, all of which tend to keep distress going.

Measuring progress by how we respond

Many of us judge how we are going by checking in with our inner world. If our thoughts are quieter and our feelings calmer, we decide we are doing well. If anxiety or low mood shows up, we conclude we are going backwards, both in treatment and in life more generally.

The difficulty is that our inner world is not fully within our control. Thoughts and feelings shift with sleep,
stress, health, circumstances and many other factors. If our sense of progress depends on them, it will rise and fall with every change in mood.

A more useful measure is how we respond to what shows up.

Did we notice the anxious thought and still go to the meeting?
Did we feel low and still reach out to a friend?
Did a difficult feeling pass more quickly because we didn’t add to it?

These are signs of genuine progress, even on days that feel hard.

In ACT, this capacity is known as psychological flexibility. It is the ability to stay in contact with difficult thoughts and feelings while continuing to act in line with what matters to us. Building it is often what therapy is working towards, rather than the absence of discomfort or trying to get rid of discomfort.

Managing discomfort ourselves

Discomfort doesn’t need to be removed before we can live well. Often, the most helpful approach is to make room for it and keep going.

Expect discomfort as part of life. If we see distress as a normal visitor rather than a sign of failure, it becomes far less threatening. It doesn’t need to be welcome. It only needs to be allowed.

Notice the meaning we add. When we feel uncomfortable, it can help to separate the feeling itself from our conclusions about it. Feeling anxious before a meeting is one thing. Deciding it means we are going backwards is another. Often, it is the conclusion that weighs on us most.

Put the feeling in context. Before drawing conclusions, it can help to consider what else is going on. Have we been sleeping poorly, under extra pressure or dealing with a change? Distress often makes sense once we look at the circumstances around it.x

Keep doing what matters. We can feel uncomfortable and still go to work, see friends, exercise or attend to our responsibilities. Acting in line with our values, rather than waiting for discomfort to pass, helps feelings settle naturally and builds confidence in our ability to cope.

Give it time. Many feelings ease on their own when we stop trying to fix them. Allowing a feeling to run its course, without monitoring it closely, is often the quickest way through.

When to reach out

If your distress has stayed fixed for several weeks, or it is affecting several areas of your life at once, speaking with a psychologist may help. Reaching out at that point isn’t an overreaction. It is a sensible response to something that has moved beyond everyday discomfort.

If you are ever feeling unsafe or thinking about harming yourself, please contact Lifeline on 13 11 14 or call 000 in an emergency.

If you’re based in Brisbane, iFlexis Psychology offers appointments at Hamilton or Fortitude Valley, or via telehealth.