Why Does My Family Trigger My Anxiety?


Key Takeaways

  • Setting boundaries with your family can help manage anxiety.
  • Anxiety can be hereditary, so you might have learned anxious behaviors from family members.
  • Seeking therapy can help you understand and handle your family-induced anxiety better.

Ever wonder why your family can trigger your anxiety like nobody else, even when otherwise your anxiety might feel under control? Listen, we get it.

Having your family trigger your anxiety is a very common problem. Read on to learn more about anxiety triggers, how your family might be triggering your anxiety, and how to cope with family when anxiety rears its ugly head.

Understanding Anxiety Triggers

There are lots of things that can easily trigger anxiety, especially when family is involved. 

“It’s common for people to feel triggered or on edge around family members when there are expectations of what people should do, say, think, or feel,” explains Yolanda Renteria, LMFT. “People’s anxiety is often triggered when they’re afraid of making mistakes, making people upset, or disappointing family members.”

Your anxiety might be triggered if you feel like your family has unreasonable or unfair expectations of you—for example, if they don’t approve of your job or your significant other—or if their political opinions differ from yours.

Even small things can be anxiety triggers. If you know that a certain aunt is always going to ask you why you aren’t married yet, or if a sibling is definitely going to try to compare the two of you like they always do, that can stir up old and deep-seated anxiety.

Family Dynamics and Anxiety

“Family dynamics” refers to how members of a family relate to and interact with each other. Every family has their own unique dynamics. 

“Family dynamics can have a direct and significant impact on a person’s anxiety,” explains Ivy Kwong, LMFT. “Rigid roles and expectations, poor communication styles, high conflict, ongoing or historic abuse, financial stressors, enmeshment, and cultural and societal pressures in a family can all impact someone’s levels of anxiety.” 

If some of these dynamics feel emotionally upsetting or painful, that can lead to anxiety. 

Rigid roles and expectations, poor communication styles, high conflict, ongoing or historic abuse, financial stressors, enmeshment, and cultural and societal pressures in a family can all impact someone’s levels of anxiety.

Unfair Expectations

Maybe your mother always comes to you after a fight or disagreement with your father, expecting you to act as a go-between—that expectation of having to be the mediator can be anxiety-inducing. Or maybe, as the middle child, you feel as though you constantly have to prove yourself and your worth to your parents and siblings—this can also cause anxiety.

Poor Communication

Communication is key. “Poor communication in a family including frequent criticism, lack of emotional support, or unclear expectations can create a stressful environment and lead to misunderstandings and conflicts that increase anxiety,” says Kwong. 

Cultural and Societal Values

“Strong cultural values and societal pressures can define family dynamics and expectations,” explains Kwong. “Cultural and societal values and expectations about gender roles, family duty, and honor, and how success is defined can impose stress and contribute to anxiety, especially if individuals feel they may be punished, unloved, or ostracized for not meeting certain expectations.”

Unconscious Dynamics

Often, these dynamics are unconscious—most people might not realize how their family functions emotionally unless they really take the time and effort to examine patterns of behavior or talk about it in therapy. This means that, often, family members can unknowingly trigger your anxiety. 

“In certain family dynamics there can be unspoken roles that different members are expected to play such as the caregiver, peacemaker, or hero,” explains Kwong. “When unrealistic or excessive expectations are put on an individual like the need to be perfect or to sacrifice their needs and feelings for those of others, this can result in increased stress and anxiety.”

Genetic Predisposition and Anxiety

Anxiety can be hereditary, especially if you experience anxiety symptoms at a young age. So if someone or multiple people in your family have anxiety, it’s likely that you might inherit that trait.

“Individuals with a family history of anxiety may inherit a heightened sensitivity to stressors, making them more prone to anxiety in response to environmental triggers,” explains Kwong. “Research has also shown that if a close family member such as a parent or sibling has an anxiety disorder, an individual is at higher risk of developing anxiety which may be due to environmental or genetic factors, or a combination of both.”

If there is a family history of anxiety, it’s also very likely that, as a family, certain coping mechanisms or reactions to anxiety symptoms have been developed over the years that you are likely to have learned.

This behavior functions kind of like osmosis—being surrounded by anxiety can teach you how to react to your own anxiety, for better or for worse.

For example: “If a parent exhibits anxious behaviors like hypervigilance, excessive worrying, and avoidance, a child may learn to respond in a similar manner,” says Kwong. “These patterns may be observed, internalized, and adopted from parent to child, from one generation to the next, unless and until there is work done to address and heal the root of the anxiety.”

Regression and Family Triggers

Regression” means reverting to old patterns of thought and behavior when you’re with your family. This might mean that you start behaving and reacting to triggers like you did when you were younger rather than how you normally behave and react as an adult. This might also mean anxiety triggers from your childhood or a time when you interacted more with your family might return with a vengeance. 

Similarly, your family dynamics might regress as well. Your parents, for example, might treat you like a child rather than the independent adult that you are. They might try to relieve you of the responsibilities you face every day as a grown-up or dismiss your feelings or opinions that differentiate you from them. You also might start interacting with your siblings the way you used to when you were a child, which can result in fighting and jealousy.

Regression can trigger anxiety because it highlights the difference between your previous identity as a child and your current identity as an adult, and places these two identities in conflict.

It might bring up painful memories and associations that you haven’t had to face in years, which can also trigger anxiety.

Feeling regressed can also affect your decision-making when you’re with your family. “Regression can lead someone to make impulsive or immature decisions they later regret,” explains Renteria, “which is likely to reinforce existing dysfunctional family dynamics and increase regret later on.” 

So before you engage in an argument with your siblings or tell your parents to mind their own business, think about why you’re reacting that way and acknowledge that you might just be feeling triggered due to regression.

Coping Strategies for Dealing with Family Triggers

Luckily, there are many different coping strategies when it comes to dealing with family-induced anxiety.

Set Boundaries

One of the best things you can do for yourself when going into a family situation that might trigger anxiety is to set boundaries. But how?

“Start by deciding how often and for how long your body can tolerate interactions with family members with whom you feel anxiety and don’t agree to things outside of your comfort zone just to please others,” suggests Renteria. “Listen to your gut, learn to say no to things that feel uncomfortable, and limit how much time you spend around these family members.”

This might mean excusing yourself when your uncle starts ranting about politics, or giving a vague answer to the question “How’s your love life?” and quickly changing the subject. Decide what you can tolerate and what you can’t, and treat those decisions with respect.

Start by deciding how often and for how long your body can tolerate interactions with family members with whom you feel anxiety and don’t agree to things outside of your comfort zone just to please others.


YOLANDA RENTERIA, LPC

Honor Your Feelings

Renteria also recommends that you “practice tolerating people’s discomfort when you enforce your boundaries.” If someone disagrees with you or tries to push you past your comfort level, work on not immediately letting it slide just because it seems like the path of least resistance. Honor your feelings and allow yourself to extricate yourself from the situation.

If you can’t escape that situation—maybe you are staying with your parents or are at a family function that doesn’t allow for alone time—taking some deep breaths and going on an extra-long bathroom break can do wonders. Practice self-care by respecting your feelings and letting yourself off the hook for needing things from your family that they might not be able to provide.

Try “I” Statements

If you do feel as though you can address your anxiety with the family members that are triggering you, all the better. Try bringing the subject up gently, using plenty of “I” statements. You could say:

  • “It makes me feel bad when you say or do X.”
  • “I feel like you aren’t respecting my boundaries when you say or do X.”
  • “I want to be able to talk to you about X, but it feels difficult.”
  • “I need X from you right now.”

Your family might not know how you are feeling unless you tell them. This can be a great step towards mitigating your family-induced anxiety.

Seeking Professional Help

If you feel as though you cannot handle or improve your anxiety alone, you can always look for a therapist with whom you can address these concerns.

Talking in individual therapy about your anxiety triggers as they relate to your family can be especially helpful. A therapist can help you recognize your triggers and learn to react to them in a way that is healthy and emotionally appropriate.

Going into any interaction with your family armed with an understanding of what you need and what you are realistically going to get can pop that anxiety bubble and de-escalate the situation.

It might also be useful to engage in family therapy. Family therapy can help you learn to communicate effectively with any member of your family and identify personal and shared triggers that affect your interfamily relationships. Being able to address these issues directly with the help of a therapist as a skilled mediator can lead to insights and improvements that might not otherwise be possible.

However, bear in mind that your family members, especially the ones with whom you might have a more strained relationship, may not be open to family therapy or see the value in it. In spite of this, you can still work on your relationships and anxiety triggers in individual therapy.


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How to Cope With the Fear of Change

Key Takeaways

  • Journaling can help you understand your fears and shift them.
  • Meditation allows for self-reflection, helping you understand and appreciate what you need.
  • Setting goals can provide actionable steps toward positive change and reduce the fear of change.

The fear of change, or metathesiophobia, is a phobia that causes people to avoid changing their circumstances due to being extremely afraid of the unknown. It is sometimes associated with the fear of moving, also known as tropophobia. 

The fear of change can make it challenging to pursue your goals or make changes in your life. A little fear of change is normal—it tends to be hardwired into our brains. But excessive fear and anxiety can be a sign of a deeper problem.

Why Do Have a Fear of Change?

Human beings are naturally wired to fear change for several reasons. However, a fear of change may be more intense when the change is not within a person’s control. Verywell reached out to clinical psychologist Carla Marie Manly, PhD, to discuss why change is so scary.

Carla Marie Manly, PhD

When we choose to create a change, such as moving to a new home or shifting jobs, we feel more in control of the outcome. If the change is brought about by forces outside of our control, whether a boss, a pandemic or an accident, we feel disempowered.

— Carla Marie Manly, PhD

In instances of metathesiophobia, that disempowerment leads to strong resistance and a refusal to change solely out of the uncertainty that comes along with fearing the unknown.

Humans Are Wired to Fear Change

Historically, the fear of change is evolutionary and dates back to ancestral times. “From an atavistic [aka ancient] perspective, our brains are hardwired to prefer routine and consistency,” Manly explains. “Our ancestors preferred constancy as they inherently knew that change often brought a lack of safety.”

For example, our ancestors needed to move around to search for food, water, and shelter to survive. Staying in a location where these essential resources had been depleted out of fear could ultimately lead to starvation, dehydration, or death of the pack.

From a mental health perspective, things are no different in today’s world. Manly notes that our mental well-being tends to fare best when we have structure and routine in our everyday lives.

Manly continues, “When life feels predictable, we experience less stress and anxiety because we know what to expect. When life doesn’t feel predictable, and we are uncertain about what might be around the next corner, we feel stressed and anxious.”

Developing a sense of clarity about what might happen next when we pursue changes in our lives can help alleviate the fear of change.

How to Tell If You Have a Fear of Change

Although being scared of the unknown is common among most people, having a phobia presents more extreme symptoms that may manifest physically, emotionally, or mentally and disrupt your life.

How can you recognize if you have a fear of change? There are many distinct characteristics of the fear of change that someone might experience in their everyday life. Some of these signs include:

  • You feel stuck or unhappy in a situation yet avoid creating positive change
  • You stay in a failing relationship despite wanting to leave
  • You do not strive for an ideal career when you are miserable in your current one
  • You have extreme anxiety over what is going to happen in your future
  • You have an inability to accept life changes that are within or outside of your control
  • You refuse to stray from an everyday routine because you’re uncertain of what will happen if you don’t stick to it
  • You reject invitations to events, celebrations, family, or friends homes
  • You frequently feel nauseous or have indigestion when you think about change
  • You experience heart palpitations when you think about change
  • You find yourself shaking, sweating, or trembling at the thought of a life change

Fear of change may also be related to a fear of failure, success, loss, self-doubt, or upsetting others.

When Your Fear of Change Becomes Destructive

In essence, there are two types of fear: constructive fear and destructive fear.

Carla Marie Manly, PhD

Constructive fear alerts us to an actual threat [and] keeps us safe from danger. Destructive fear alerts us to a non-existent threat. There is no actual threat, but our minds tell us there is.

— Carla Marie Manly, PhD

Depending on the severity of a person’s fear of change, it may become destructive.

If destructive fear of the unknown is left unmanaged, potential complications may include:

How to Cope With the Fear of Change

If your fear of change is less severe, there are ways to cope that you can pursue every day to overcome this phobia:

Journal

Journaling can help you better understand your fears to shift them. Manly says that when we journal freely and without judgment, we enable our minds to unload and potentially understand what could hold us back.

Meditate

Meditation can also be a helpful tool when you are trying to overcome the fear of change. Manly reminds us that the more we turn inward to self-reflect, the more we come to understand and appreciate who we are and what we need.

When we set aside time for self-reflection each day, she says that we can become attuned to what we really want and need in life, which can help us welcome change a bit easier.

Create a Vision Board

Compile photographs, magazine clippings, and print images or art from the internet to create a board full of things that you would like to manifest into reality.

Manly says that creating vision boards gives our creative side a chance to imagine a different future. This process of imagining new possibilities for what our life can look like on the other side of change can be cathartic and support us in bringing those goals to reality.

Talk With Friends and Family

Discuss your fears with a trusted friend or family member. They may share a similar fear and offer tips on how to cope from personal experience. Otherwise, expressing your fears can help to alleviate shame, stress, or anxiety and make you feel less alone.

Set Micro and Macro Goals

Once you understand where your fear of change comes from, you can then set attainable goals in an effort to take actionable steps toward positive change.

According to Manly, fears tend to subside when we embrace a can-do attitude, take things one step at a time, and move toward them slowly, mindfully, and in conscientious ways.

Avoid Avoidance

Avoiding necessary changes due to fear can lead to a build-up of stress and lead to harmful situations or circumstances. Oftentimes, fear of the unknown can be more anxiety-provoking than it’s worth in the end.

Rather than looking at what could happen in a negative light (e.g. as an enemy, or focusing on what could go wrong), Manly suggests reframing change as an invitation for a world of new possibilities to arise instead.

She has witnessed positive change occur with her clients where people who finally took steps to move forward ultimately wondered why they didn’t make changes sooner.

Treatment for a Fear of Change

Intense fear of change can lead to more extreme symptoms that can interfere with your daily life, including how you navigate socializing, working, and maintaining relationships. In some cases, these symptoms may be diagnosed as a specific phobia.

However, it is possible to overcome this fear with the proper treatment, such as therapy or relaxation strategies. Medication may also be beneficial in times when holistic measures fail to provide relief.

Get Help Now

We’ve tried, tested, and written unbiased reviews of the best online therapy programs including Talkspace, BetterHelp, and ReGain. Find out which option is the best for you.

When to Seek Help for a Fear of Change

At what point should someone seek help to alleviate their fear of change? Some signs that you should seek professional assistance include:

  • Excessive fear and anxiety
  • Avoidance behaviors that make it challenging for you to do things like go to school, work, or maintain relationships
  • Changes in appetite or sleep patterns
  • Feelings of hopelessness
  • Lack of motivation
  • Loss of interest in activities you used to enjoy

If such symptoms have lasted for two weeks or longer and make it difficult to function in your daily life, you should talk to your doctor or therapist.

If you feel chronically stuck, depressed, or anxious, Manly says that it is important to reach out for professional help. She notes that trained professionals can be helpful by objectively pointing out self-limiting mindsets and supporting you in healthy life changes.

Morgan Mandriota

By Morgan Mandriota

Morgan Mandriota is a writer, the founder of Highly Untamed, and an expert writer at Verywell Mind.


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How to Overcome Panic-Related Procrastination

Key Takeaways

  • Anxiety can lead to procrastination by fueling perfectionism, overwhelm, and low self-esteem.
  • Break big tasks into smaller, manageable steps to make progress and feel less anxious.
  • Don’t wait for the perfect moment to start a task; just begin to make progress.

Procrastination can be a common problem for many people with anxiety-related conditions, including panic disorder. There are numerous symptoms of panic disorder and common anxious personality traits that can contribute to procrastination.

The problem with using procrastination to avoid the things that are making you anxious is that it makes anxiety worse in the long run. Instead of waiting until the last minute and adding even more stress to your life, finding ways to deal with anxiety and overcome the urge to procrastinate is a more effective response.

This article explores some obstacles that may hinder your progress toward your goals and responsibilities. Read through them and consider if you are allowing these potential roadblocks to lead to procrastination.

How Anxiety Causes Procrastination

Anxiety can lead to procrastination for a number of different reasons. Some of these include:

Perfectionism

Having an anxiety disorder puts one at risk of perfectionism. While it might seem like this perfectionism is a positive attribute, having such high standards can increase the risk of procrastination. Perfectionism can cause you to:

  • Feel defeated when things don’t turn out exactly how you wanted them
  • Put off tasks because you know you don’t have the time or energy to do them to your standards
  • Engage in poor reasoning and self-talk, including the use of “should” statements (“I should complete this task perfectly or not at all.”)
  • Experience self-criticism that derails your efforts to achieve your goals

Perfectionism can also lead to procrastination, as you need everything to line up perfectly before you feel ready to work on a particular task. You may always be waiting for the “perfect time” to start working on a goal.

Worry

Worrying can also prevent you from accomplishing your tasks and goals. Sometimes, our worry about the end results will keep us from completing certain responsibilities.

For example, you may put off going through your bills out of worry about whether you will be able to pay them. Perhaps you have been putting off certain self-care activities or talking to your doctor about panic disorder because you are nervous about the outcome of these tasks.

Feeling Overwhelmed

When faced with a large task, it is easy to feel discouraged by the amount of work ahead. Procrastination can be a sign that you simply don’t know where to begin. You may even feel paralyzed by the daunting amount of tasks ahead of you. Putting things off may temporarily make you feel better, but in the long run, it will most likely add more stress and anxiety to your life.

Fear and Low Self-Esteem

Sometimes, we are held back by our own negative beliefs and overpowering fears. People with anxiety disorders are often prone to poor self-esteem and can find it difficult to overcome negative thinking patterns.

Self-doubt and fear can make you feel you will fail to reach your goals. For example, you may jump to conclusions, believing you lack the skills needed to accomplish your goals. You may avoid getting started to avoid the disappointment you would feel if you did fail to meet your goals.

Dealing With Perfectionism

Fortunately, there are strategies you can use to help deal with worry and perfectionism that contribute to procrastination:

  • Don’t wait for perfection: When you are dealing with anxiety, you might find yourself putting off tasks until you feel like you have all of the tools, information, or time to do them perfectly. By waiting for everything to be in order, you are actually putting off any progress and giving in to procrastination.
  • Notice your worries and perfectionist tendencies: To begin to move past these issues, start thinking about how worry and perfectionism may be holding you back.
  • Get comfortable with making mistakes: Give yourself permission to make some mistakes. Assess if perfection is necessary and even possible. Most people experience disappointments and failures along the way to success.
  • Tackle tasks instead of worrying about them: It can be helpful just to get started on a stressful task rather than continue to worry about it.
  • Break tasks down into smaller chunks. If a task seems overwhelming and that keeps you from getting started, break it down into smaller, more doable steps that help you make progress a little at the time.

The more we put things off, the more anxious we become about them. Think about what tasks you have been avoiding and begin to take action to complete them. You may be surprised by how much less anxious you will feel when steadily chipping away and progressing toward achieving your goals and responsibilities.

Coping When You’re Overwhelmed

At times when you feel overwhelmed and uncertain of where to begin, just start somewhere.

Pick out one small thing that you can complete to accomplish your larger goal. It may be helpful to list the many small steps that will lead to accomplishing a greater task.

In order to get started:

  • Look at the big picture
  • Examine all of the steps that are involved in completing the task
  • Make a list of steps and the order in which they must be completed
  • Estimate how long each step will take
  • Set a timer and work on the project for a specific period of time
  • Write them down and track your progress

Goals often become much more manageable when you break them down into smaller parts.

Overcoming Fear

To overcome your personal fears or negative self-concepts, begin to assess whether you really lack the skill set needed to complete a specific task.

To get started, ask yourself these questions:

  • Can you learn and develop these necessary skills on your own?
  • Is there a way you can delegate your tasks?
  • Do you know anyone you can recruit to help out?
  • Is it possible to hire someone to assist with getting the job done?

For example, let’s say you want to do more physical exercise, but fear and self-consciousness keep you from going to the gym. Is it possible to ask a trusted friend to go with you? Does the gym offer a guide or trainer to help you become more efficient in using the equipment? Or maybe you would be more comfortable exercising at home.

When fear and low self-esteem are leading to procrastination, try to push past negative thinking and find creative ways to accomplish your goals.

Press Play for Advice On Dealing With Procrastination

Hosted by therapist Amy Morin, LCSW, this episode of The Verywell Mind Podcast shares ways to stop procrastinating. Click below to listen now.

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Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Kelly J. Your best life: Perfectionism–the bane of happiness. Clin Orthop Relat Res. 2015;473(10):3108-3111. doi:10.1007%2Fs11999-015-4279-9

  2. De Palo V, Monacis L, Miceli S, Sinatra M, Di Nuovo S. Decisional procrastination in academic settings: The role of metacognitions and learning strategies. Front Psychol. 2017;8:973. doi:10.3389%2Ffpsyg.2017.00973

  3. Henriksen I, Ranøyen I, Indredavik M, Stenseng F. The role of self-esteem in the development of psychiatric problems: A three-year prospective study in a clinical sample of adolescents. Child Adolesc Psychiatry Ment Health. 2017;11:68. doi:10.1186%2Fs13034-017-0207-y

Katharina Star

By Katharina Star, PhD

Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. 


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Religious Delusions in Bipolar Disorder


Key Takeaways

  • Religious delusions are false beliefs with religious content that differ from accepted cultural beliefs.
  • Increased focus on religion can happen in bipolar disorder and isn’t always a sign of delusion.
  • Religious beliefs can help improve outcomes, but religious delusions can worsen the illness.

Religious delusions are a type of delusion with religious content. Although there are no clear guidelines to differentiate normal religious beliefs from pathological ones, a belief is generally only considered delusional if it is idiosyncratic, grandiose, and not an accepted part of a particular culture or subculture. 

Researchers note that there is no consensus on where the boundary between religious belief and psychopathology lies. 

Having an increased focus on religion or religious activities is a possible symptom of mania and hypomania in bipolar disorder. Bipolar disorder is a mental health condition characterized by extreme shifts in mood, activity, and energy levels. According to the National Institute of Mental Health (NIMH), approximately 4.4% of people in the United States experience bipolar disorder at some point during their lives.

What Are Religious Delusions?

Delusions are defined as false beliefs that are firmly held and conflict with reality. Different types include paranoid or persecutory delusions, delusions of reference, delusions of grandeur, delusional jealousy, and others.

Two of these, in particular, may express themselves in a religious context. Here are a few examples:

Religious Paranoid Delusions

“Demons are watching me, following me, waiting to punish me if I do anything they don’t like,” or “If I put on my shoes, God will set them on fire to punish me, so I have to go barefoot all the time.” Auditory hallucinations, such as, “The voices keep telling me there are devils in my room,” are often combined with religious paranoia.

Religious Delusions of Grandeur

“God has exalted me above you, normal people. He tells me I don’t need help, don’t need medicine. I’m going to heaven, and all of you are going to go to hell,” or “I am Christ reborn.”

Prevalence estimates vary considerably, with between 1.1% and 80% of people who have delusions reporting some type of religious content. One study found that approximately 38% of people with bipolar disorder experience religious delusions.

Mental Illness and Increased Religiosity

It isn’t uncommon for people to experience increased religiosity due to a mental health condition. A heightened focus on religion isn’t necessarily unique to bipolar disorder. It is also associated with schizophrenia, schizophreniform disorder, schizoaffective disorder, and other psychotic disorders.

The increased religiosity may take many forms—some more subtle than others, and not all are indicative of psychosis. Here are some examples (using hypothetical patients):

  • Janie was raised in a Protestant home but stopped going to church in her teens. After the onset of bipolar symptoms, though, she began going to more than one service a week, volunteering, joining study groups, and seeking personal religious counseling from the minister.
  • Ed had never been to any religious service or events in his life, but as he developed symptoms of mental illness and was later diagnosed with schizophrenia, he began talking to friends about God more and more, reading the Bible, eventually falling to his knees and praying aloud regardless of where he was.
  • When Terri, a devout Jew all her life, developed a schizoaffective disorder, she became convinced that God felt she was unworthy and attempted suicide.
  • Jerry, who has bipolar disorder, began to focus more on his religious beliefs when his symptoms began, finding that they helped sustain him in difficult times.

Terri’s doctor may provide an immediate diagnosis of having religious delusions. But in the cases of Janie and Ed, a psychiatrist might feel such a diagnosis would be premature. And in Jerry’s case, at this point, his beliefs appear to be supportive rather than problematic.

As psychiatrist Harold G. Koenig, professor of psychiatry and behavioral sciences at Duke University, wrote in a review of the literature on the subject, “While about one-third of psychoses have religious delusions, not all religious experiences are psychotic.”

Koenig found that some spiritual approaches may benefit the patient—as in Jerry’s case. When religious delusions aren’t immediately obvious, the treating clinician needs to examine the patient’s religious beliefs and behaviors carefully, Koenig concluded.

Cultural Effects on Religious Delusions

Cultural variables may play a role in how religious delusions are expressed. However, more research is needed to better understand how a person’s religious background might impact how delusions occur.

One meta-analysis of 55 studies examined the relationship between religious delusions (RD) and religious hallucinations (RH) in countries around the world.

  • In the United States, the level of religious involvement predicted the severity of religious delusions, and Protestants were more likely to experience religious delusions than Roman Catholics.
  • In England, there was a higher association between religious belief and religious delusion in subjects with schizophrenia.
  • In Pakistan, Muslim patients with schizophrenia in Pakistan were more likely to experience religious delusions and to hear voices of ‘paranormal agents.’ 

A 2021 review found that the specific content in religious delusions is more connected to a person’s immediate social and family environment rather than their cultural background.

Impact of Religion and Religious Delusions

Religious and spiritual beliefs can be a positive coping mechanism for people with bipolar disorder that can lead to better well-being and outcomes. One study found that suicide was less common in bipolar people who were religious.

Conversely, having religious delusions has been found to be associated with a more serious course of illness and poorer outcomes. Research has shown that patients with religious delusions had more severe psychotic symptoms, a longer history of illness, and poorer functioning prior to the onset of a psychotic episode.

You can see why, then, it’s essential for clinicians to be aware of these differences.

Doctors ought to include a patient’s beliefs in evaluating the patient as a whole and use care in distinguishing between strong religious beliefs and delusions.

Despite the conflicting research on whether a country’s culture affects the incidence of religious delusions, it is certainly an area of interest for further study. More research is needed to understand better how to differentiate between normal religiosity and delusional religious beliefs.

If there’s one thing that researchers do agree on, it’s that those who treat people with psychoses need to be sensitive to a patient’s non-delusional religious beliefs, both in distinguishing them from delusions and in evaluating how helpful they are potentially to the patient.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  6. Cook CC. Religious psychopathology: The prevalence of religious content of delusions and hallucinations in mental disorder. Int J Soc Psychiatry. 2015;61(4):404-25. doi:10.1177/0020764015573089

  7. Grover S, Hazari N, Aneja J, Chakrabarti S, Avasthi A. Influence of religion and supernatural beliefs on clinical manifestation and treatment practices in patients with bipolar disorderNord J Psychiatry. 2016;70(6):442-449. doi:10.3109/08039488.2016.1151930

  8. Grover S, Davuluri T, Chakrabarti S. Religion, spirituality, and schizophrenia: A review. Indian J Psychol Med. 2014;36(2):119-24. doi:10.4103/0253-7176.130962

  9. Iyassu R, Jolley S, Bebbington P, et al. Psychological characteristics of religious delusions. Soc Psychiatry Psychiatr Epidemiol. 2014;49(7):1051-61. doi:10.1007/s00127-013-0811-y

  10. Koenig HG. Religion, spirituality, and psychotic disorders. Revista de Psiquiatria Clínica. 2007;34(1):40-48. doi:10.1590/S0101-60832007000700013 

  11. Lucchetti G, Koenig HG, Lucchetti ALG. Spirituality, religiousness, and mental health: A review of the current scientific evidenceWorld J Clin Cases. 2021;9(26):7620-7631. doi:10.12998/wjcc.v9.i26.7620

  12. Caribé AC, Studart P, Bezerra-Filho S, et al. Is religiosity a protective factor against suicidal behavior in bipolar I outpatientsJ Affect Disord. 2015;186:156-161. doi:10.1016/j.jad.2015.07.024

By Marcia Purse

Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing.


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Why You Have Sexual Fantasies, and When to Act on Them


Key Takeaways

  • Sexual fantasies are normal and can help improve sexual experiences.
  • Communicate with your partner about fantasies that are safe, legal, and consensual.

We all have places we go in our minds during sex or when we feel aroused, and everybody is different. Put plainly, a sexual fantasy is a mental image that promotes one’s desire for sex and can help enhance the sexual experience.

While the people, themes, and frequency may change, sexual fantasies are completely normal, and nothing to be ashamed of, no matter how taboo or dirty they might seem.

Still, it’s common to question these desires and wonder whether or not we should discuss them with our partners or keep them to ourselves. In many cases, it can be fun and freeing to give your sexual fantasies a try, and we’ve got some suggestions to help you get started.

Common Sexual Fantasies

Sexual fantasies can be separated into two categories: typical or atypical.

Typical Sexual Fantasies

Typical sexual fantasies are generally considered “normal” or healthy. A 2021 review of research indicates that the most common typical sexual fantasies include those related to:

  • Anal or oral sex
  • BDSM includes consensual bondage, discipline, dominance, submission, sadism, and masochism
  • Watching pornography

In a 2020 study, nearly a third of adults reported that being in an open relationship was their favorite sexual fantasy. The study also found that most participants reported fantasizing about being in a consensually non-monogamous relationship.

Atypical Sexual Fantasies

Atypical sexual fantasies are often referred to as being “deviant” or even contributing to criminal behaviors. Some of the most common atypical sexual fantasies involve obtaining sexual pleasure or gratification in the form of:

  • Exhibitionism: Displaying one’s genitals to the opposite sex
  • Fetishism: Being “turned on” by a specific body part, object, or activity
  • Frotteurism: Rubbing parts of one’s self (usually the genitals) on another person without their consent, oftentimes in a crowded place
  • Masochism: Sexual pleasure derived from your own physical pain or humiliation
  • Paraphilia: Abnormal sexual desires, many times involving extreme and sometimes dangerous activities.
  • Sadism: Sexual pleasure derived from inflicting physical pain on someone else
  • Voyeurism: Watching others in sexual situations without their knowledge or consent

What People Change About Themselves in Sexual Fantasies

In a study of 4,175 Americans, social psychologist Justin Lehmiller found that nearly everyone (97.1%) is in their own sexual fantasies at least part of the time. Yet, people often change major factors about themselves when participating in these fantasies.

According to this study, the changes that people tend to make are different based on gender and sexual orientation. Here’s what it found:

  • Women, followed by gay and bisexual men, are most likely to change their bodies in their sexual fantasies. Men are most likely to fantasize about changing the appearance of their genitals.
  • Men tend to fantasize about themselves at a younger age, while women fantasize about a future version of themselves. Lehmiller also found that men are more likely to have sexual regret, so their fantasies of returning to a younger age could correlate with them going back to missed opportunities or “the one that got away.”
  • Gay and bisexual men are most likely to report personality changes in their sexual fantasies. Personality changes are also more common in people who are introverted or neurotic, while people who are conscientious are least likely to change anything about themselves.
  • Men often fantasize about being more submissive than they typically are and women often fantasize about being more dominant.
  • Overall, nonbinary people tend to change themselves the most in their sexual fantasies, except for changing their age.

What Do Sexual Fantasies Mean?

So, what do your specific sexual fantasies say about you? The images that you find arousing can provide insight about your personality, attachment style, and cultural identity.

Personality

The changes a person makes in their sexual fantasies may tell us more about their personality. For example, if you fantasize about being more dominant, you may be introverted. If you fantasize about changing your body and personality, you may be more neurotic.

A 2020 study found a connection between people with personality traits that are considered maladaptive—which includes being antagonistic or disinhibited—and sexual fantasies involving domination and humiliation.

Attachment Style

Lehmiller’s survey found that people with anxious and avoidant attachment styles were more likely to change themselves in every way. He speculates that people with an anxious attachment style use their fantasies to avoid worrying about rejection. Conversely, those with an avoidant attachment style use their fantasies to create more emotional distance.

Another study backed these findings, adding that people with avoidant attachment styles typically don’t have sexual fantasies involving romance.

Culture

Finally, fantasies clearly say something about culture. For example, women, gay men, and bisexual men were the most likely to focus on changing their physical qualities. Men were more likely to enhance their genitals in their fantasies. All of these are clear reactions to cultural body ideals.

One study also found that sexual fantasies often reflect how men and women are depicted in romantic movies and novels, or even in sexual videos.

Lehmiller notes that not all of the changes that we make to ourselves in sexual fantasies have deeper meanings.

Sexual fantasies can play a positive role in people’s lives. For example, evidence indicates that sexual fantasies help women get aroused and even help them achieve orgasm during sex with a partner.

When to Act on Sexual Fantasies

Oftentimes, the changes that occur in our sexual fantasies are just a product of an active imagination. Such fantasies don’t mean anything of deeper significance.

Since they’re fantasies, we often create idealized versions of ourselves. Just because you imagine yourself or your partner differently in your fantasies, it does not necessarily mean that you are dissatisfied in real life.

Sexual fantasies serve a variety of purposes. They can help people become aroused or more sexually confident. They can also be a way to explore sex that they might not actually want to pursue in real life. 

In some instances, unmet needs may contribute to sexual fantasies. As long as your fantasies are safe, legal, and consensual, you may want to discuss them with your partner.

Communication is critical, and that includes before, during, and after. Do some research, set some ground rules, and go slow.

Remember that just because you have a fantasy about something doesn’t mean you should act on it. If you’re in a happy relationship and you have a fantasy about cheating on your partner, that doesn’t necessarily mean that your subconscious is trying to tell you that you’d be happier with someone else.

Sexual fantasies are both normal and common. However, if your sexual fantasies are creating distress or contributing to feelings of dissatisfaction, it may be time to work with a therapist for support.


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Katharine Chan

What Is Acute Stress? And How to Tell If You’re Experiencing It

Key Takeaways

  • Acute stress disorder (ASD) is a recognized psychological disorder that can occur after a traumatic event.
  • ASD differs from PTSD in that it occurs soon after a traumatic event and lasts no more than one month.
  • ASD involves emotional, psychological, and physical symptoms and can be treated with psychotherapy.

I was in a car accident over a decade ago, but I remember the event like it was yesterday. Crash! Boom! Lights and sirens. I get checked out, and I’m cleared when the tow truck comes. I’m numb. I don’t cry, scream, or show any emotion. It doesn’t hit me until a couple of days later. 

Experiencing an extremely stressful event has a profound impact on your life. Could you have post-traumatic stress disorder (PTSD)? Or could it be a different mental health condition triggered by traumatic events called acute stress disorder?

What Is Acute Stress?

Julia Kogan, PsyD, a health psychologist and stress and insomnia specialist, explains that acute stress disorder (ASD) is a cluster of symptoms that occurs within a month of experiencing a traumatic event.

A traumatic event is an occurrence that causes the person to experience significant distress, fear, or risk of death. These can include assaults, accidents, injuries, or life-threatening situations. 

It’s hard to say how many of us have ASD, as it is highly variable and dependent on the type of traumatic event and duration of symptoms.

A systematic review looked at the prevalence of acute stress disorder following a violence-related injury treated at the emergency department. It showed that ASD was reported less than one week after the injury at 24.0% to 24.6% and one to two weeks after the injury at 11.7% to 40.6%.

Dr. Kogan shares that you may have a higher risk of developing ASD if:

  • You have prior trauma
  • You have a mental health condition
  • You cope by avoiding
  • You’re experiencing trauma related to an assault

“It is helpful to know that not everyone who experiences a traumatic event will meet the criteria for acute stress disorder. This will largely depend on how the person experiences the event, their general coping skills, pre-existing mental health concerns, and other factors,” Dr. Kogan says.

Signs You’re Experiencing Acute Stress

Dr. Kogan says that symptoms of ASD may include:

  • High levels of stress and anxiety
  • Avoiding reminders of the event
  • Distressing memories or nightmares about the event
  • Disruptions in sleep and focus
  • Feeling more on guard

“Not only does someone experience these symptoms, but these symptoms cause a disturbance in day-to-day life, such as at work, socially, or other areas of functioning,” Dr. Kogan says.

Allison Paugh, a psychiatric mental health nurse practitioner (PMHNP), shares the following emotional, physical, and psychological symptoms of ASD:

Emotional Symptoms

Emotional symptoms can include:

  • Inability to feel happy, successful, or in love
  • Feelings of numbness
  • Avoiding thoughts or memories associated with the traumatic event
  • Avoiding people or places that may remind you of the traumatic event
  • Irritability
  • Distressing memories

Physical Symptoms

Physical symptoms can include:

  • Tachycardia (fast heart rate)
  • Strong startle response
  • Panic, including shortness of breath, feeling of choking, or feeling as if you are actively dying
  • Gastrointestinal (GI) symptoms such as “anxious stomach”, upset stomach, and nausea

Psychological Symptoms

Psychological symptoms can include:

  • Insomnia
  • Nightmares
  • Distractibility
  • Hypervigilance (abnormally alert to surroundings)
  • Detachment from self and emotions
  • Dissociative amnesia (memory gaps about important information about yourself)

Is Acute Stress Always a Bad Thing?

Acute stress is a natural, temporary response to perceived threat or pressure. But if unmanaged or frequent, Dr. Kogan explains that acute stress disorder can have a significant impact at work, in relationships, and in activities of daily living.

For instance, people may have difficulty focusing due to higher levels of stress, sleep disturbances, and intrusive memories, making it hard to work. Their relationships may be negatively impacted due to increased irritability, feelings of detachment or numbness, or isolation. 

She says that ASD can affect physical health as higher levels of stress and anxiety can increase blood pressure, impact heart health, and cause other physical issues. Some individuals may engage in negative coping behaviors such as using alcohol or other substances excessively.

How Does ASD Differ From PTSD or Adjustment Disorder?

Paugh explains that the primary difference between ASD and PTSD is duration:

  • ASD occurs for at least 3 days and lasts up to 1 month after the event. ASD can often be a predictor of PTSD.
  • PTSD symptoms occur for more than 1 month. While ASD can occur immediately after an event, PTSD can develop months or even years after the traumatic event.

She says that ASD is typically diagnosed after a traumatic event causing an acute stress reaction; however, adjustment disorder is usually the result of less severe events that may not be traumatic (i.e., losing a job, breaking up in a relationship, moving to a new school, or environment).

When Acute Stress Becomes a Pattern

Paugh explains that most people can recover from ASD once removed from the event, environment, or situation, and are provided support that is understanding or empathetic of their distress:

  • Psychotherapy: Trauma-focused cognitive behavioral therapy (CBT) is considered the first line of treatment and is an evidence-based practice for those with ASD. She adds that this form of therapy can help reduce the risk of ASD evolving into PTSD.
  • Professional support: Psychotherapists and health care providers can provide professional support by explaining symptoms, recovery, and coping skills. Assessment of suicidality is vital during these visits.
  • Psychotropic medication: Paugh says psychotropic medication may be needed if symptoms are severe and distressing. Currently, there is a limited number of medications specifically for ASD; however, there are some for PTSD that help with some of the same symptoms as ASD. The treatment plan can also include medication to assist with sleep problems and nightmares.
  • Support by loved ones: Paugh shares that if you have a loved one with ASD, practical and emotional support is crucial for their recovery. This could involve assisting the person in completing police reports (if an assault or accident has occurred), setting up appointments, filing work release forms, and offering comfort and empathy. 

“Reaching out for professional help is recommended for anyone experiencing acute stress disorder symptoms. The sooner they can reach out to someone, the more likely they are to be able to manage symptoms and prevent posttraumatic stress disorder. Working with a trained professional qualified in trauma-focused CBT is considered the best clinical practice,” Dr. Kogan advises.

Katharine Chan

By Katharine Chan, MSc, BSc, PMP

Katharine is the author of three books (How To Deal With Asian Parents, A Brutally Honest Dating Guide and A Straight Up Guide to a Happy and Healthy Marriage) and the creator of 60 Feelings To Feel: A Journal To Identify Your Emotions. She has over 15 years of experience working in British Columbia’s healthcare system.


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