Fight or Flight in Anxiety, Depression, and Trauma
When I was asked to write this article, I originally politely declined… on several occasions. I’ve been off the grid for more than half a year now, as I found that my writing was being misinterpreted, misrepresented, and used as a centre for trolling. Since then, life’s ups and downs have taken their toll (as I’m sure they have with many people over the last year), resulting in four lots of counselling including Cognitive Behavioural Therapy (CBT), Interpersonal Counselling, Emotionally Focused Therapy (EFT), and Group Therapy (over Zoom, obviously), two referrals to The Samaritans (oh yeah, sh*t got real!), and one to a self-harm charity that I didn’t even know existed called Harmless. It was in the Group Therapy sessions that I met 9 fabulous people (8 women and one guy) who had felt what I felt, albeit in varying situations, and suddenly I didn’t feel so alone. When they found out that I [used to] write and that I had an interest and background in Psychological Science, they approached me about the idea of writing this article. My response was an unconscious physical recoiling, followed by a nervous laugh and a bunch of expletives. “So that’s a no, then?”, they asked, to which I responded “oh that’s a Hell No!”. As time went on and I got to know those people more, I started to understand that what they wanted from me was a platform to explain to the world what they didn’t have the words to say themselves. They wanted to show how mental struggles aren’t discriminatory across gender, race, religion, age, sexual orientation, social class or economical status. They wanted to explain to people who hadn’t experienced chronic anxiety or clinical depression, (a) what it was like and how isolating it can be when it feels like nobody understands, and (b) that they were not “broken” or “abnormal” (as many had been told they were), and that it’s OK not to be OK all the time. They wanted a voice. This is a lightly longer-than-normal blog post, especially written for Mental Health Awareness Week, so you may want to settle in with a cuppa and a chocolate hobnob (or a G&T) before we start. Please keep in mind throughout that the following is an anonymous amalgamation of 9 people’s experiences (given with their permission), as well as my own. If you’re reading this, it means that I put on my Big Girl Pants and posted the blog… the thought of which is making me anxious just contemplating it, as I told myself last year that I’d never go back into public writing. So, before you judge what you’re about to read, make fun of it or troll it, please remember that these are the lives of 9 other people who have been to the edge and back, and just want to be heard. If you want to troll me, go ahead, but do it in person – I will personally buy you a drink for having the balls to say whatever you’ve got to say to my face… we’ll got to The Winchester (or the nearest covid-secure / zombie-secure pub) and I will take everything you’ve got, over a nice cold pint.
Just a couple of things before we start. I will be referring to sensitive matters such as self-harm, panic attacks and eating disorders, so if you are currently going through some stuff yourself and these might be triggers for you, please feel free to put this article in your back pocket for a day when you feel better equipped to process it. Equally, feel free to contact me directly. Secondly, I will be referring to some theories from Emily Nagoski’s book “Come As You Are” and relating them to the context of understanding & coping with anxiety & depression. This was a text recommended to me by my therapist (yes, I am aware of how American that sounds), and has been my bible ever since. If you have ever been through trauma or been told that you are broken, this book will change your life. You are not broken, and there’s a whole bunch of science to back it up! Lastly, the general consensus of the group of people who pushed me to write this, is that regardless of whether they have experienced anxiety, depression, or trauma, they prefer to be referred to as Survivors, not victims. So this blog is dedicated to all the Survivors out there.
Fight, Flight, Freeze or Appease
Let’s start with a theory that I will be referring to throughout this blog. When I was in school, we were taught about two responses your body can make when it is faced with danger – Fight or Flight.
Let’s first separate the stressors from the stress. The stressors are the things that activate the stress response – bills, family, work, etc. The stress is the system of changes activated in your brain and body in response to those stressors. It’s an evolutionarily adaptive mechanism that allows you to respond to perceived threats. Or it was evolutionarily adaptive back when our stressors had claws and teeth and could run thirty miles per hour. These days we are rarely chased by lions, but our body’s response to a threat is much the same. When your brain perceives a threat in the environment, you experience a massive biochemical change, characterised by floods of adrenaline and cortisol and a cascade of physiological events, such as increased heart rate, respiration rate, and blood pressure; suppressed immune & digestive functioning; dilation of the pupils, and shifting of attention to a vigilant state, focused on the here and now. All these changes are in preparation for the action to come – what action that is will depend on the nature of the threat – it’s context dependent.
Imagine you are being chased by a lion. You can either fight the lion, or you can run from the lion – fight or flight. In case you’ve never been to a zoo or watched Wildlife On One, lions are big, strong, and scary. Your brain says that in this context, your best chance of survival is to run (flight). There are two outcomes – you run, the lion catches you and you die, in which case the rest of this section is irrelevant; or you outrun the lion and are safe. In the second option, Emily Nagoski refers to this as “completing the stress cycle” with a beginning (“I’m at risk”), a middle (action – escape), and an end (“I’m safe”). Worry, anxiety, fear and terror are stress responses that initiate a flight response to stressors. Therefore, when something makes you anxious, you want to run away – keep this in mind for the next sections of this blog.
This time, imagine the context is different – you are confronted by angry-looking youths on your way home who demand your money. Your brain decides that your best chance of survival is to fight (you have some self-defense training, and the money you have on you was a birthday present from your grandmother, so you are unwilling to relinquish said cash to chavvy millennials in their skinny jeans (you also feel some resentment that after 2 kids you no longer fit in skinny jeans)). You feel anger (“I’m at risk”), fight (action), and complete the stress cycle by eliminating the stressor and the stress (the youths see you are a badass and back off, unscathed yet embarrassed). Irritation, annoyance, frustration and anger are stress responses that initiate a fight response to stressors.
These two responses – fight or flight – are both accelerator stress – the sympathetic nervous system, the “GO!” of the stress response. Fight emerges when your brain determines that a stressor should be conquered. Flight emerges when your brain determines that a stressor should be escaped.
However, since my school days, the fight or flight theory has been updated to include the additional responses of Freeze and Appease (or Fawn, as it’s also referred to as). Freeze is a response that the body chooses when the brain decides that the stressor can’t be conquered or escaped, for example, if the lion bites into you, so you play dead. This is when you get the brakes stress response – the parasympathetic nervous system, the “STOP” activated by the most extreme stress. Your body shuts down – you might even experience “toxic immobility” where you struggle to move. This is the response commonly reported by survivors of sexual crimes. Freeze is a trauma response, but trauma isn’t always caused by one specific incident; it can also emerge in response to persistent distress or ongoing abuse. In that context, a survivor’s body gradually learns that it can’t escape and it can’t fight; freeze becomes the default stress response because of the learned pattern of shutdown as the best way to guarantee survival. Emotional numbness, shutdown, depression and despair are stress responses that initiate a freeze response to stressors. People who experience depression are often accused of “not caring”, “not trying” or being apathetic. In reality, they are dealing with stressors by implementing a freeze stress response.
The fourth option is that you try to tame the lion (appease). In the absence of lions running wild in England, take the sadly more realistic situation of Domestic Abuse for example. The person being abused could physically stand up to their attacker (fight), try to leave the relationship (flight), do nothing (freeze) or try to mollify the situation (appease).
Appease is often a response developed in childhood trauma, where a parent or a significant authority figure is the abuser. Children go into a fawn-like response to attempt to avoid the abuse (which may be verbal, physical, or sexual) by being a pleaser. In other words, they preemptively attempt to appease the abuser by agreeing, answering what they know the parent wants to hear, or by ignoring their personal feelings and desires and do anything and everything to prevent the abuse. Over time, this fawn response becomes a pattern. Individuals carry this behavior pattern into their adult relationships, including their professional and personal interactions. Some key signs that the appease response is in use include:
- You are constantly trying to please the people in your life
- At the first sign of conflict, your first instinct is to appease the angry person
- You ignore your own beliefs, thoughts, and truths and accept those of the people around you
- You feel self-anger and guilt some or most of the time
- Saying no to those around you is a challenge
- You are overwhelmed at times but take on more if asked
- You lack boundaries and are often taken advantage of in relationships
Individuals with the appease response pattern can be targeted by those who are narcissistic or those with a desire to control and manipulate people around them. This can also interact with the flight response, creating feelings of anxiety if they feel they cannot meet the needs of the narcissist, and ultimately a freeze response in the form of depression if they feel inadequate in the eyes of the narcissist. They are trying to tame the lion, but every day the lion gets hungrier, angrier, stronger and faster.
Fight, flight, freeze and appease are all stress responses to stressors and the key to managing stress effectively is to make efforts to complete the emotion cycle. However, in modern life, stressors are less commonly acute (like being attacked by a lion, or a millennial in skinny jeans), and more commonly lower intensity but more ongoing; these are known as “chronic” stressors. Acute stressors have a clear beginning, middle and end; completing the cycle (e.g. running, surviving, celebrating) is inherently built in. However, with ongoing/chronic stress, we don’t take deliberate steps to complete the cycle and all that activated stress just hangs around inside of us, causing side effects such as decreased ability to experience pleasure, fatigue and illness due to ongoing suppression of the immune system. When people express that they feel “sick and tired” from stress, they may literally be sick and tired as a direct consequence of activating a stress response and not being able to complete the cycle. For example, one of the difficulties with being on Lockdown for the last year due to Covid19 is that it may be harder to physically escape some of the stressors that evoke a flight response. This means that the person is trapped in a groundhog day situation whereby an anxiety response is triggered but they are unable to complete the stress cycle by escaping the stressor, resulting in a constant feeling of “I am at risk”. This is how Chronic Anxiety manifests.
I hold my hands up and ashamedly admit that I never really understood what anxiety was… until it happened to me. I’d heard people talk about being anxious but I just took this as meaning a little bit worried or on edge. I remember someone telling me that they struggled to leave the house because they were struck down by anxiety, and whilst I tried to remain sympathetic on the surface, inside I was thinking “just get over yourself – leave the house, it can’t be that hard”. Then my anxiety attacks started and my world came crashing down. It was like that “Sunday night feeling” when you were a kid and you knew that you had to go to school the next day, or that feeling of panic when you realise in your dream that you’re going to miss your flight and you’ve not packed anything and you have to first take a test that you’ve not studied for but you’re too distracted by your teeth all of a sudden falling out, hitting your naked legs on the way down because for some unknown reason you’re not wearing any clothes and the whole school watches as they release a lion that chases you, butt-naked and toothless, through the exam hall. Yeah, like that. Apart from there’s no relief when you wake up and realise it’s just a dream, because that sicky feeling like you’ve been punched in the stomach, that doesn’t go away – that’s what anxiety feels like. Well, that’s what it feels like for me, and one of the difficulties in diagnosing anxiety is that it is a subjective experience and differs for everyone. Sometimes it is coupled with other physiological symptoms like muscle weakness, nausea, headaches, memory loss and a loss of appetite. When you are assessed for anxiety, one of the standard psychological scales you are given is the GAD-7, whereby you are asked to decide how much you have been affected by particular statements e.g. “Not being able to stop or control worrying”. Personally, I think the GAD-7 scale should be replaced with the Hedgehog Cake Scale below. On anxious days, I rate a solid 3 on the HCS:
Generalised Anxiety Disorders (GAD) are usually characterised by:
- Chronic worries running through one’s head. They occur over and over again like a broken record
- Hating uncertainty. Wanting to know what is going to happen in the future and finding the experience of ‘not knowing’ very difficult indeed
- Feeling restless, on edge and unable to relax
- Having trouble falling asleep, maintaining sleep, or experiencing unsettled sleep, because one’s mind is constantly ticking over with worry
- Avoiding situations that could provoke worry, anxiousness or nervousness
A great deal depends on the lifestyle of that person, the types of life stressors they have encountered, and how they cope with such stressors. Stressful, traumatic, and often uncontrollable life events may contribute to the development of generalised anxiety. When such events occur, some people may come to believe that life is dangerous and unpredictable, and that worrying about possible future negative events is a way of coping with the uncertainty of life. They may think that worrying helps them achieve a greater sense of certainty and control, by making them better prepared for anything. They mentally discuss the event with themselves over and over again and think about what would happen should the event occur. As such, worrying is a type of vigilance for threat, and an ‘attempt’ at mentally ‘solving problems’ that haven’t yet happened. We say ‘attempt’ because often a solution doesn’t arise, and people are left thinking they will not be able to cope should their worst fears happen. They are unable to ‘complete the emotion cycle’ and are therefore left in a suspended state of high alert; “I am at risk”.
Remember that we said anxiety is a flight stress response – activating the “escape from threat” mechanism and making physiological changes in the body to do so. One of these changes is the shut down of digestive processes. From an evolutionary perspective, we are suppressing any process that is “unnecessary” to the current goal of escaping the threat. It therefore makes perfect sense that someone whose stress response manifests as Anxiety may temporarily and unconsciously lose their appetite. If you’re running from a lion, the last thing you want to be thinking is that you’re hungry – additionally, all that blood pumping around your system can be used to power your legs to run rather than being tied up in the stomach. However, when the person’s Anxiety becomes chronic and ongoing, this suppression of appetite can result in noticeable weight loss (normally noticeable by others before it is noted by the person, as it is not something that they are consciously in control of). Over the last 9 months, my weight has fluctuated, at times to the extent that people have passed comment that I am “too skinny”. At first I didn’t believe them and I took it as a compliment. I have been called many things in my lifetime – chunky, bulky, substantial, Thunder Thighs; but never have I been “too skinny”. It was pretty awesome to be fair, as I wasn’t consciously trying to alter my weight in any way, and I’d always wanted a defined six-pack. At one point I dropped from 85kg to 63kg in just 3 months. It was only then that I realised that something wasn’t right. I was diagnosed with ARFID – Avoidant Restrictive Food Intake Disorder – which is an eating irregularity induced by anxiety. Unlike anorexia, which is also characterised by selective or restrictive eating, ARFID does not involve any distress about body shape or size, or fears of fatness. Once I understood the link between my stress responses and my appetite, I could in effect manage my food intake/tolerance by managing the stressors and/or stress. The difficulty being that as soon as the stressor became uncontrollable, so did my stress response, and my appetite. I have since relapsed twice, but am currently in remission.
Depression & Low Self Esteem
In contrast to the flight response of anxiety, depression is an emotional shutdown – a freeze response to stressors. There are many causes of depression, but one of the most common sources is Low Self Esteem. Low self-esteem might begin with negative life experiences, especially during childhood and adolescence. These negative experiences can influence how we see ourselves and we can come away with some negative conclusions about ourselves, which we call Negative Core Beliefs. What is meant by Self Esteem is often misunderstood because it is context dependent. For example, Sally holds a Negative Core Belief that she is a bad parent. She tells Anne that she is feeling down and explains that she has Low Self Esteem. Anne dismisses Sally’s claims of Low Self Esteem because she saw Sally on Instagram in a bikini and therefore she must be a confident person. Anne has confused body confidence with Low Self Esteem. Yes, Low Self Esteem can be caused by Negative Core Beliefs about body image e.g. “I am ugly”, but Sally’s Negative Core Beliefs were focused around her parenting skills, and therefore were not directly related to views on body image or her holiday pics on Instagram. Below is a diagram to help explain how our Negative Core Beliefs are reinforced and related to stress responses such as depression.
In order to protect our self-esteem and continue to function from day-to-day, we develop rules and assumptions for living. These rules guide us to behave in ways that end up not being very helpful because they serve to keep our negative core beliefs intact. While we are able to stick to these rules for living, we can feel okay about ourselves, but the low self-esteem remains dormant. Just because a person can appear OK on the surface, does not necessarily mean that they are OK deep down, it just means that they are following rules that allow them to hide their self esteem issues.
The second part of this model shows that at some point in our lives, we will encounter at-risk situations because it is extremely difficult to live up to our rules and assumptions, which are unrealistic and rigid. When these rules are at risk of being broken or have been broken, our negative core beliefs become activated and we engage in negative thinking. We expect that things will not work out (biased expectations) or criticise and blame ourselves (negative self-evaluations). We also engage in unhelpful behaviours and together with the unhelpful thinking, lead to negative unhelpful emotions and our negative core beliefs remaining activated. It is then that low self-esteem becomes acute.
For example, Tom was bullied in school (negative life experience) and holds the Negative Core Belief “I am worthless”. He creates the unhelpful rule that “I must make everyone else happy to be accepted”, leading to the unhelpful behaviour to say yes to all requests and go out of his way to please people. Tom encounters an “at risk” situation where his sick dad makes an unexpected visit and he has to move dinner with his boyfriend at the last minute. His boyfriend is not impressed and makes him feel bad. Consequently his dormant low-self esteem becomes acute and he makes the negative self-evaluation that “I am useless and pathetic” and “I shouldn’t let people down”, which activates the negative core belief that he is “worthless”. Tom’s resulting unhelpful behaviours include apologising profusely, putting himself down and overcompensating when trying to make it up (e.g. rescheduling dinner at a time that is not convenient to him). Unhelpful emotions arise such as depression and guilt, which confirm his negative core belief – “I was right – I am worthless” .
Feeling depressed can confirm your belief that you are ”worthless,” because a symptom of depression itself is thinking negatively about everything, including yourself. The unhelpful behaviours (eg., acting in a passive and apologetic way, trying to overcompensate, or withdrawing) mean that you are acting in a manner consistent with the idea that you are “worthless.” So, if you act as if you are “worthless,” you will continue to think you are “worthless,” and feel sad or depressed. Unfortunately this is a cycle that is often difficult to escape, especially in times such as the last year when a sense of normality has been taken away from us. Lockdown has meant an increased isolation, physically and mentally, fewer distractions from stressors, and fewer ways to escape the lion, increasing the cases of emotional shutdown and depression. There are only so many times you do something with a negative result before you give up – it’s basic psychological conditioning. There are only so many times you can fight having your negative core beliefs reinforced (e.g. told you are a bad mum, even in a ‘joking’ way) before you stop fighting and initiate a freeze response instead of a fight one.
In the past, social media has been blamed for reinforcing low self esteem through photoshop-ed insta-perfect body stereotypes. However, it has become more apparent recently that is it less to do with the Vogue-style magazines and more to do with the keyboard warriors in the comments sections. There has been a shift in the direction of body-positive posts, where people are living their best lives with their scars, cuves, cellulite, spots, lockdown hair and other ‘imperfections’ on show for all to see and they are #proud. And yet they are getting knocked back time and time again by people who are mean, jealous, or simply don’t understand. These trolls accuse the post authors of being self-absorbed, vain, attention-seeking or humble-boasting. Let me take this opportunity to explain what social media posts mean to someone with Chronic Low Self-Esteem. Those “likes” are a vital confidence boost. For example, if their negative core belief is “I’m rubbish at everything” and an instagram post of them doing a handstand results in 50 ‘likes’ and 5 nice comments, then their beliefs about themself are challenged and the negative emotion chain is broken. On the flip side, if someone is constantly discouraged from posting on social media because they are told it makes them ‘egotistical’, then it becomes harder for them to gain that external recognition and, especially during a National Lockdown, can result in becoming dangerously isolated with their unchallenged negative beliefs. This is particularly true for women, as we seem to have cultural permission to criticise ourselves, but we are punished if we praise ourselves. For example, how often do we sit down to lunch with our friends (pre-Covid, obviously) and say “I feel so beautiful today!”? Rarely, at best. But how often do we sit down with those friends and say “Urgh, I feel so fat today!”? Far more often. Self-criticism is a form of stress, and it is directly linked to depression. When we think “I am inadequate”, our stress hormone levels increase and our bodies react as if we’re under attack. It’s like saying “I am the lion!”. However, it is difficult to stop these self-criticisms because a common misconception is that we need them as a driving force to become better people. To stop criticising ourselves would be to admit defeat – it’s like saying “I can’t stop running/fighting/playing dead otherwise the lion will eat me”. But beating yourself up is the equivalent of treating yourself as your own internal lion, experiencing yourself as a threat that needs to be escaped (which is impossible), conquered (which is literally self-destructive), or avoided through shutdown (which is counterproductive, to say the least). This brings us back to the title of this blog – Living With The Enemy – when you become your own lion.
So why can we sometimes deal with stressors in life, and sometimes those same stressors make us want to throw objects, ourselves, or unsuspecting passers-by out the 4th floor window? Context dependency. Our brain is able to cope and process stressors as long as we have the available resources to do so. If you lose your car key, you call the AA and get another one – an expensive mistake, but something you can deal with. If you lose your car key and your house keys are locked inside the car and you’re in the middle of a snow blizzard and the AA can’t come out for 4 days and you have 2 infants to keep safe and you’ve lost your income due to Lockdown and you’re home-schooling and you’re simultaneously trying to grieve a recently passed family member (true story)… then you are less able to effectively cope with the additional stressor. This is why it is dangerous to assume that just because someone appears to be coping with life, the Universe and everything, that they actually are. Over the last year, I’ve had several people express “oh you’re so strong, you always seem to cope with whatever the world throws at you and you just keep smiling”…. to which I nervously laugh and change the subject, because on the inside I am crumbling. I’m like an armadillo – hard on the outside, soft on the inside (how many readers over the age of 30 and now resisting the urge to shout “Dime Bar – smooth on the outside crunchy on the inside!” lol). A more sciency explanation of this context dependency for my fellow geeks out there (oh come on, you didn’t honestly expect to get through this whole article without a bit of geekiness did you?!), is the Mesolimbic Cortex. In short, it’s a region of the brain that contains several structures that work together to process all of your emotional/motivational systems, including stress responses (fear, aggression, and shutdown), disgust, and pleasure. Emily Nagoski refers to this as the “One Ring” (a play on The Lord of The Rings one ring to rule them all). Basically, the different components of the Mesolimbic Cortex can influence each other e.g. the same parts of the brain light up when you eat chocolate or take cocain, as do when you have sex. But this also means that these same structures can fight against each other and act as inhibitors. For example, a part of the brain called the Nucleus Accumbens controls whether you go towards something (approach behaviour, or “ooh, what’s this?” behaviour), or away from something (avoidance behaviour, or “what the hell is THIS?” behaviour). Effectively pleasure or threat responses, or in our case “yes, I’ll deal with this thing that has happened” or “OMG I can’t cope!”. If the top of the Nucleus accumbens is activated, then approach behaviour is activated, and if the bottom is stimulated, avoidance behaviour. However, put into a stressful environment, any stimulation of the Nucleus Acumbans activates a threat response. Stressed out humans interpret all stimuli as threats. This explains why when we are overloaded with stressors in our environment, we are less able to effectively cope with each of those accumulative stressors individually. If you’ve ever wondered why depressed people are in the mindset of “the glass is so half empty”, it’s because the parts of the brain that process the “the glass is half full” arguments are being overridden by the greedy parts that constantly guzzle the Pinot Grigio and never get a round in.
When we feel this emotional overload, we sometimes adopt coping strategies that aren’t healthy. These can include things like overeating (“comfort eating”), smoking, and excessive alcohol consumption. They can also include thoughts or actions of self harm and at the most extreme, taking one’s own life. Before we continue with this section, I need to make clear here that having been on both sides of this – knowing someone who took their life, and having been referred to The Samaritans myself – although it is important to do what we can for those reaching out for help, if someone has made up their mind, there is very little you can actually do or say to convince them otherwise. It’s not your fault and you should not carry that guilt. Suiside is a last resort, often when a person’s previous cries for help are not heard or are dismissed. Using language like “don’t be so silly”, “don’t say stuff like that”, “that’s not nice to say”, or “don’t say things you don’t mean”, although it may come from a good place, it is often perceived as dismissive, unsympathetic and almost doubting of the true weight of the situation. From talking to the people who asked me to write this blog post, the general consensus is that the most comforting response is actually to acknowledge that yes, things might be shit right now, and nothing that can be said will magically change the way they feel, but that it would get better and that they were not alone. Mental Health Professionals usually ask a person feeling this way what their safety thing is; their reason for living. Mine was Jessica. When I was pregnant and suffering with depression behind closed doors, I didn’t have much respect for my own life, but I couldn’t bear the thought of compromising hers. Similarly, after she was born, I was so utterly in love with her, that when my mind went to the darkest of places, I couldn’t leave her on her own – she needed me. However, I continued to beat myself up, emotionally and physically. Beating yourself up is the Emotional One Ring equivalent of treating yourself as your own internal lion. Self-harm is a fight reaction, whereby you are trying to punish yourself for your emotions. Self harm can be many things for different people: a cry for help; a way to feel something; or a form of punishment. Sometimes people have scars on show, sometimes they have scars they hide, and sometimes they harm in ways that you can’t see. One lady in the group told me that she had admitted to a friend that she had self harmed and the friend responded with “well you don’t have anything to show for it”. She explained that when self-harm is carried out as a way to punish oneself rather than a public cry for help, if people can’t see, they can’t ask questions or judge you.
So with all this information, what do we do now? Well, nothing. My job was to explain to you how this group of 9 individuals felt, what they had suffered through, and why they may have acted in certain ways. Hopefully you are now able to better understand without judging. Unfortunately there is still a stigma that surrounds mental health issues and that stigma is fuelled by judgement by those who don’t have all the facts, and the fear by those who suffer, of being judged. Emotions are like tunnels, you have to go through the darkness to come out the other side, and to get to the other side you have to complete the emotion cycle – just because you have eliminated the stressor, doesn’t necessarily mean you have eliminated the stress. Some way to do this may include physical activity, sharing affection, a primal scream or a good cry, muscle relaxation, meditation, and self-care such as a bath or massage. Most of all, we have to stop living with the enemy – we know that if we are our own lion, we can’t fight ourselves (self-destructive), escape ourselves (literally impossible), or shutdown (leaving the emotion cycle incomplete), but we may be able to learn to appease ourselves. Learn self-compassion. Tame our own lion.