Adam Blatner

Words and Images from the Mind of Adam Blatner

Overwhelmed as a Diagnostic Category

Originally posted on May 28, 2011

Consider that being “overwhelmed” is a valid diagnostic description. It happens frequently in mild ways: The person feels, “I don’t know what to say, I don’t know how to respond. I may not be clear what is happening, I’m a bit disoriented.” It can be felt but not yet given words. The person may just gape, or shut down a bit.

Being overwhelmed in a benign, protected context can be simply a liminal state, a neutral opening to other possibilities, a role transition in which the new role is not yet clear, or the elements of loss and gain are not yet spelled out. It may be mildly dysphoric, needing only a deep breath, relaxation, and mental disconnection from the challenge. Whoa!

This is a vulnerable state, because if it feels “not okay” to be overwhelmed, the state can transform in various directions—anxiety, depression, rage. Thus, it can be a source for more complex negative reactions.

Regarding anxiety: Dr. Hans Selye, who did research on stress in the mid-20th century, noted that the greatest stresses arise when (1) a decision must be made; (2) the results of that decision are not trivial—they may involve a lot of money or some other distinctly negative consequence; but that (3) the basis for that decision is quite ambiguous. In such cases, overwhelmed becomes attached to anxiety.

As for depression: If the person believes that he or she “should” be able to cope, and/or significant others believe this, then being overwhelmed becomes an occasion for depressive negative self-talk, thus deepening any tendencies towards depression.

If the person feels somewhat self-possessed or entitled, or is supported by others who feel oppressed by that which overwhelms, the response may be rage. It’s very visceral, more than anger, because feeling overwhelmed is also very vulnerable and visceral. Lashing out can happen before one even realizes what is going on.

Yet at the root, thinking of the interaction in terms of those secondary elaborations—depression, anxiety, or rage—may be misleading. It confuses the expression of a disease—such as a rash—from its actual etiology—whether, in the case of a rash, it’s caused by allergy, some kind of infection, a dietary deficiency, and so forth.

Admittedly, not all depressions or anxiety states or anger states arise from feeling overwhelmed—this point should be emphasized! But sometimes that IS what’s going on, and it’s very useful to know this category exists so as better to be able to recognize it when it happens.

Being overwhelmed in turn may have a varying mixture of several elements:
– disorientation
– role demand in excess of ability
– degrees of fatigue
– various mixtures and ratios of interest and disinterest
– press of distractions or other role demands
… and so forth.

Keeping this in mind, for a parent, teacher, or compassionate other, seeking to empathize, it’s worthwhile recognizing that “feeling overwhelmed” is a common response, though those who feel overwhelmed may not know the words to use or feel free admitting it. Other phrases that might fit as well if not in some cases better: “Too much.” “Overload.” “Stop the world, I want to get off.”  “Whoa, now.” “Let’s just cool off and step back a bit.”  The luxury of being offered the option of decompression, of taking a break, is so very comforting and reassuring.

One of the benefits as well as the problems in this term is that it situates the problem not in the individual (to be fixed so that s/he “adjusts”) but equally or perhaps even more so in the situation. If a child is overwhelmed in a classroom, it could be because there are many elements:
– there is blackboard work and the child is nearsighted and this is un-diagnosed (not an unusual problem in mid-childhood); or there’s a hearing difficulty
– there are social problems of rejection and alienation, so the child’s attention is distracted into feelings of fear and shame
– there’s an intellectual mismatch, so that the teacher or principal is unaware that this kid is either in “way over her head” or undiagnosed gifted and bored
– the child is sleep-deprived, hungry (no breakfast), in chronic pain, or in other ways distracted
. . . and so forth. So, first, a good diagnosis, not in the sense of slapping on a label, but rather in getting a workable sense of what’s going on, so that constructive measures may be taken.

Looking back, I think this would have been a better starting place—the concept of “overwhelmed,” than many other diagnoses, which may distort the situation. With “overwhelmed” there are are fewer other assumptions to be brought in. Too often we imagine anxiety or depression to be afflicted with negative self-talk as a causative element, which it sometimes is—but not always! What I’m reaching for is the diagnostic equivalent of what for an artist is a broader palette of colors.

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