Sunday, February 21, 2016

Anxiety: what it is, what it's like, what helps, what doesn't help

What Anxiety Is Like For Me
Some of my earliest childhood memories are of worrying about things; big things, little things, important things, irrational things. All the things. It's something that has always been a part of who I am, as ingrained in my identity as my eye color.

It's something that has caused more than its fair share of problems in my life, something that other people have often misunderstood, and something that I've wished away more times that I could possibly even begin to explain.

It's never gone away.


I worry about literally everything. I go through every situation and over-analyze it, and I have to take each catastrophic possibility and run them out to completion in my head so that I feel like I'm prepared to deal with what might happen, even if the actual likelihood of ever dealing with that is minuscule.

I worry about worrying.

I worry about talking to people, I worry that I'm going to make an ass out of myself. I worry about whether they will like me or hate me or be intimidated by me or think I'm insane. I worry about the things I might say and what people will think of me for saying them. I worry about what I'm wearing and how I look and how I feel. I worry about doing things and I worry about not doing things. I. Worry. About. Everything.

I run a dialogue in my head constantly about everything. I rehearse any anticipated conversation in my head, then I replay the conversation after it happens on a loop, judging myself for every aspect of whatever I said or didn't say or wish I'd said or regret saying.

I worry about knowing where the bathroom is everywhere I go. I worry about being too far away from whatever. I worry about running out of gas. I worry about my phone ringing. I worry about having to actually talk to people. I worry about needing to actually listen to voicemail because it means that I might have to talk to a person.

Totally not even kidding, but I disconnected my land line four years ago because I was having panic attacks every time the phone rang.

This isn't normal. None of this is normal.

A certain degree of anxiety is normal, necessary and actually healthy. Episodic worry and fear is a good thing. Apprehension about things that might be dangerous to us is an excellent survival tactic. When it becomes more than that, though, is where we run into problems.

The dictionary definition of anxiety is a straightforward one: a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome.

The medical definition takes the ordinary definition and runs with it, much like those of us with anxiety disorders do: a nervous disorder characterized by a state of excessive uneasiness and apprehension, typically with compulsive behavior or panic attacks.

Types of Anxiety Disorders
Anxiety can show up in many different forms, in varying degrees of severity. I live with most forms of anxiety personally.

Generalized Anxiety Disorder (GAD) is when you are worried frequently, often when there is little reason to be legitimately concerned. You expect the worst to happen in every possible situation, even anticipate it. It can be short term or life long.

Panic Disorder is when you have sudden feelings of terror, manifesting in physical symptoms that can feel like you can't breathe or are having a heart attack. Racing heartbeat is common. Attacks are also referred to as anxiety attacks.

Phobias are specific fears that you may have to situations, items or things. The level of your fear is not considered equivalent to the actual threat posed, and can interfere with daily functions.

Social Anxiety Disorder is when you have fears or worry about social situations, fears of being laughed at or ridiculed or that you will embarrass yourself. It can actually result in behaviors leading to that.

There are other related conditions as well.

Obsessive Compulsive Disorder (OCD) is when a you have uncontrollable recurring thoughts and/or behaviors that you feel compelled to complete. It tends to be chronic. Women who suffer post partum depression with intrusive thoughts have a form of OCD. 

Post Traumatic Distress Syndrome (PTSD) is when exposure to a trauma leaves you with long lasting consequences. I will be discussing PTSD separately in its own post. 

Things That Can Help With Anxiety
In dealing with anxiety, it is important to understand that every person is different. What works for one might not work for another. As long as it works for you, that is all that matters. 

Medical Treatments - Medications can definitely help treat many forms of anxiety. Some physicians will opt to try short-acting medications to alleviate symptoms when they occur while others will recommend a daily medication designed to help constantly. Sometimes a combination of the two will be used. Some medications may only need to be taken for a short period, others may be a life long proposition. What works best for you will depend entirely on your individual situation, as well as the other medications you may be taking and other conditions you may be dealing with. It may not be necessary to use medication. It may be necessary. Please do not think that either using or not using medication means anything about your individual ability to cope with your conditions. We don't routinely tell people with diabetes that they should try not to use insulin because it's a sign of weakness, do we? Same applies here. I promise.

Therapy - Many people with anxiety disorders can benefit greatly from therapy. Some sub-types of anxiety are more treatable than others in terms of the management of symptoms. Often just knowing that you aren't alone in dealing with your issues helps tremendously. Treatment of phobias is frequently done with leveled exposure to the item or situation feared, to increase the individual's tolerance, especially in situations when the phobia is interfering with daily functioning. Cognitive therapy has to do with how you think about the anxiety, behavioral therapy addressed your responses in situations where the anxiety is triggered. Specific types of therapies may be used for specific types of anxiety. I highly recommend seeking out professionals with experience in your sub-type. 

Hypnosis - Hypnosis can be used to address the subconscious fears and worries that lead to anxiety in some people.

Exercise and Relaxation - Both exercise and relaxation techniques can help deal with anxiety. Exercise because of the release of endorphins and physical motion, relaxation because of the deep breathing techniques and centering. Both activities help to make you more mindful of yourself, of your surroundings and can help to dispel the anxieties you might be feeling. For me personally, yoga makes a huge difference.

Go Outside - One of the easiest things I can do to help myself is to make sure that I get outside frequently enough. Traveling to and from the car in day to day activities probably isn't enough - I know it isn't enough for me. My anxiety is always worse when I've spent too much time indoors. Vitamin D exposure is beneficial in many ways. If you live in an area with limited sunlight, especially in the winter, Vitamin D supplements might be a good idea. Seasonal Affective Disorder (SAD) can absolutely make anxiety worse. 

Eating Well - This always seems to be the solution that people share on social media for all the ails the world. I'm not going to tell you even for one second that eating a kale smoothie will fix you, but I can promise you that eating a poor diet will definitely make you feel worse. If you're consuming a lot of empty calories, nutrient poor carbs, refined grains and sugar, you're going to feel worse. If you're not hydrated, you're going to feel worse. Taking care of your body is a part of taking care of your mind. 

Working Through the Fears - For me personally, my anxiety always gets worse when I try to ignore it. Instead, what does actually work is to let the worst case scenarios in my head run to their conclusions in the most expedient manner so that I can come up with a game plan and get on with whatever it is I'm supposed to be doing. 

Things That DO NOT Help with Anxiety
This isn't going to be an all-inclusive list because it would be impossible to mention everything that people do and say that make things worse, but here is my best effort...

  • Saying there is nothing to worry about. Just because you aren't worried or just because my worry is irrational doesn't mean it isn't real.
  • Saying that I need to get over it. I can't. I literally can't. If I could, don't you think I would?
  • Saying that my fears are silly. To me, they aren't. Actually, they're pretty disabling.
  • Saying that I should calm down. Duh. I want to.
  • Saying that I should only worry about the big things. To me, they're all big things.
  • Saying that everything will be okay. It might not. Maybe I thought that before and things weren't okay. 
  • Saying that everyone stresses out sometimes. This isn't the same type of thing. I'm not worried about something specific episodically. I worry about everything all the time.
  • Saying that my feelings hurt you somehow. I promise my issues aren't about you. Please don't put guilt on top of it all, because then I'm just going to worry about that too. Plus, I'll know that I can't rely on you for help when I need it.
  • Saying that I need to take my meds. Or have a drink. Or whatever. Maybe I'm taking meds. Maybe I'm not. Maybe I'm not drinking for a reason. Maybe drinking won't help and will only make things worse.
  • Saying that I should really be worried about ______. Insert literally anything in the world that people say I should be worrying about here. Humans can multitask and be concerned about more than one thing in the world at a time anyway, and minimizing my concerns won't help. 
  • Saying I just need to suck it up. Nah. Just don't do that.
  • Saying that I need to use this oil or supplement or whatever you are selling. Please don't try to profit from my issues. Kthanksbye.
How to Help Someone with Anxiety
I know that I can be difficult to deal with sometimes. There are ways that people can help, though. I thank those who stand by me. THANK YOU.
  • We don't let it define us, please don't define us by it.
  • Be patient. Sometimes it takes us a bit longer to work up the nerve to do something.
  • We're usually overprepared for catastrophe. That comes in handy sometimes, I promise.
  • If we get overwhelmed, let us have a break. Yes, we're hiding in the bathroom or in the hallway. It's okay.
  • Please don't point out that our fears are irrational. We know.
  • Celebrate when we conquer a fear. It's a huge deal.
  • Sometimes we just need to know you're there.
  • Sometimes we need someone who understands.
  • Sometimes we need reassurance.
  • We don't do change well. Change scares us more than it scares you.
  • We don't do what we do on purpose to hurt other people, and we hate when that happens.
  • We are used to people bailing on us. When they stick by us, we value them so much. SO MUCH.
There are some specific tips I'd like to talk about for dealing with kids who have anxiety. Often, though not always, anxiety can be passed down from parent to child. In those cases (as is the case in my house), I'm pretty well conditioned to recognize and help deal with it in my kids. If you aren't used to it, but have a child dealing with it, here are some points to consider.
  • Get down to their level. Literally. Breathe with them. I've often had to model my patterned breathing with them when the anxiety gets bad. 
  • Do not minimize their fears. To them, everything is big and scary.
  • They look to you for guidance and help, don't ignore their fears.
  • Talk through the fears. What are they afraid of? Why? Is there some way to address it? Break it down into manageable portions. Slay the dragons one at a time.
  • Talk about how often worrying is a good thing. It keeps us safe.
  • Don't tell them their fears are silly. They'll stop telling you what they're afraid of.
  • Allow more time for transitions.
  • Realize that even small changes take a huge adjustment.
  • Celebrate overcoming fears. HUGE celebration. 
  • Exercise and relaxation are just as important for kids as adults. Yoga is a wonderful mindfulness activity for kids with anxiety. 
  • Have set times daily or weekly to talk about worries, what went well, what didn't.
  • Make sure you don't overreact to their anxieties. You don't want to feed the fears or punish them for things they can't control.
  • If necessary, seek out a therapist who treats children with anxiety. It may be necessary to consider medication as well. 
If you have specific questions or would like more information about something I didn't cover, please let me know. Deep breaths, everyone. We got this.

2 comments:

  1. The prep conversation and the post conversation loop is a HUGE thing for me. A trigger for it usually if I've had a really good time with someone. Years of family eggshells that I cracked because of an ill timed joke, or me just being me.

    Thanks for putting yourself out there!

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  2. This is so thorough and so well done. I suffer intermittently with GAD and it's torturous. Thank God that, for me, it's been relatively seldom. It's so hard to explain to anyone how disabling and paralyzing it is. Thank you so much for this!

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