Help me to help me
August 18, 2010 10:45 AM   Subscribe

Several months ago I had a bad anxiety attack. Since then, I have had an extremely heightened sense of self-awareness and have even become a bit agoraphobic (I understand this to be common after an attack). Common situations/activities that once felt natural, effortless even enjoyable (driving, shopping, taking kids to the park) can now induce panic because I over analyze everything. How can I return to my "normal" level of self-awareness and learn to go with the flow? Meds? Mind hacks? Cognitive therapy?
posted by punkfloyd to Health & Fitness (13 answers total) 10 users marked this as a favorite
 
Although I have not personally been treated for this problem, I know people who have, and it is my impression that the most successful course of treatment is mood stabilizing medication. In order to get the right medication and the right dosage for your individual needs, you have to see a psychiatrist and get a prescription.
posted by grizzled at 11:12 AM on August 18, 2010


The part of your brain that learns from panic is very effective and very fast--as it should be, if you're learning something like "I better run away from this tiger chasing me--and better remember every element of the experience, in case it comes up again." Unfortunately, it's just as good at learning things like "That panic attack was really scary, so I better think about my pulse and respiratory rate every few seconds in case anything goes horribly wrong...and probably safer to stay in my cave in case it happens again."

To get back to that previous level of self-awareness takes a couple of things. First, keep getting into those common situations and activities, even if they're scary. The more you wall yourself off from them, the more your brain is able to say, "See, there's something wrong there, because I'm terrified, and I wouldn't be terrified if something wasn't objectively dangerous about them." Second, confront the fear. What are you actually afraid will happen? It can be hard to pin down. Car accident? Throwing up your guts in front of everyone at the park? Heart attack next to the dairy case? Fear is very good at hiding itself behind generalities, but if you interrogate it, if you try to figure out the things you are actually afraid of, it's easier to make rational choices about it. (I think I mentioned in a previous answer, how I demanded an echocardiogram from my doc, just to prove to myself that there was nothing wrong with my heart--so afterwards I could tell myself, "Your heart isn't beating out of your chest because you're about to drop dead--it's just the adrenaline rush of panic, and it is physiologically incapable of lasting forever; it will stop, you will feel better, and that will be the end of this episode.") Come to think of it, reading about the physiology of panic is pretty good, too.

Therapy helps. It's hard to interrogate fear on your own. Meds can help too, to lower the anxiety in the first place so you can work on this stuff. But I think it always goes back to those two core strategies: Keep active, and keep questioning.
posted by mittens at 11:24 AM on August 18, 2010 [2 favorites]


This book takes some time investment to get started, but it's really, really good:
http://www.amazon.com/When-Panic-Attacks-Drug-Free-Anxiety/dp/076792083X
(despite the terrible title)

This book is also very good:
http://www.amazon.com/Focusing-Eugene-T-Gendlin/dp/0553278339/

And, of course, surround yourself with supportive friends and a professional.
posted by zeek321 at 11:28 AM on August 18, 2010


And be gentle with yourself while simultaneously living your life as fully as you can.
posted by zeek321 at 11:29 AM on August 18, 2010 [3 favorites]


I was really bad when I was younger. I wouldn't leave the house and had panic attacks for hours and hours.

The only thing that helped me was medication. I started with an anti-depressant and xanax (as needed).
After a while, I didn't need the xanax.

It's been a year since I've been off medication due to lack of health insurance - and the phobias and anxiety are back. Way less than when I was 18 or so, because I can talk myself out of it [usually].

Other things I tried but didn't work for me (but may for you) were natural supplements such as KavaKava and St.John's Wort, plain therapy, deep breathing, diet changes, etc.

Now that I think about it, Cognitive Behavior Therapy actually did help a bit.
If you can't afford or don't want to see a therapist there are plenty of books about it. they make for an interesting read on abnormal thinking patterns.

Another thing - if this anxiety just happened only a few months ago, you may be able to benefit from just therapy instead of medications.
posted by KogeLiz at 11:39 AM on August 18, 2010


I still carry xanax, just in case, and almost never take it. Some medications predispose your body to panic attacks; check w/ your doctor. I learned from a therapist that cold water on the face will stop panic attacks; it's physiological. Carry a washcloth. If you have a panic attack, go to the bathroom, run cold water on the cloth, and use it as a compress on your face.

The more you think of panic attacks as a physiological response and not as a moral failing, depression, stupid habit, whatever, will help. good luck.
posted by theora55 at 12:25 PM on August 18, 2010 [3 favorites]


Response by poster: Thank you all.
posted by punkfloyd at 12:30 PM on August 18, 2010


You may want to look into aniracetam. The "racetams" are cognitive enhancers that are all so well-tolerated that you do not need a prescription, but aniracetam has an anti-anxiety effect as well. Comparing its side effects to that of, say, zoloft, has led me to decide to try that before I consider other meds. IANAD, YMMV, be careful, etc.
posted by Earl the Polliwog at 12:34 PM on August 18, 2010


Sounds like you lost your groove temporarily. Had a set-back. Getting back on track takes time. EFT might be of some help as well as NLP. Google them. Also believe it or not, exercise like biking can be a major help to you and your psyche. Take small steps but firm ones. The rule of thumb is - one step forward - even minute baby steps - but forward it must be. Eventually, even if it's one centimeter at a time, you'll get back on track and stronger for the experience.
posted by watercarrier at 12:35 PM on August 18, 2010


Hey, me. To be quite frank with you, anti-anxiety meds have worked wonders for me. I encourage you to take to a psychiatrist and consider it.
posted by Lutoslawski at 12:43 PM on August 18, 2010


I did 10 weeks of cognitive behavioral therapy to deal with generalized anxiety. This was over 10 years ago, and I still use what I learned -- basically, that the sensations won't hurt me and won't even keep me from functioning. I no longer fear the sensations themselves, since they don't have power over me, and the spiraling anxiety has ended. I'm still a worrier, but now it's a minor personality flaw rather than a reason not to go to the grocery store.

I went to a place that specializes in CBT for anxiety disorders, which I think helps: we got right down to business, and it was understood that this would be a time-limited course of treatment.

You might start with the book recommendations, and if it sounds like it might help, you could do a course with a therapist. For me, it helped to have the personal tailoring.
posted by palliser at 1:53 PM on August 18, 2010 [1 favorite]


CBT was big for me--I have had times when I could tell I was at risk of developing new fears (mainly from reading about them while working on recovering from an anxiety disorder, ah the irony), and one thing I know from doing CBT is that is you can create vicious or virtuous circles. So, if you're afraid of elevators and let that make you take the stairs (or miss an event that's so high up you would have to take an elevator to get there) you're just reinforcing your own idea that elevators are scary and need to be avoided. So, for me, there were these times when I could tell I was on the cusp, and pushing myself to not avoid the things that were making me fearful helped me get past the fear.

The Anxiety and Phobia Workbook was a big help to me.

Also, meds as needed. More than once in my life I have resisted getting on meds when things got bad, falling into the idea that it was somehow weak to need them, and then, once on them again, have said, "Why did I wait?"
posted by not that girl at 3:20 PM on August 18, 2010 [2 favorites]


When I was recovering from mono and felt anxious that I might collapse in public (which was how the illness manifested), I had a variety of "security blanket" items I kept with me at all times. Full water bottle, a couple different upset stomach meds, hard candy. Just having these on hand helped a lot, and I rarely used any of them. Think about what makes you feel safe when you know you have it on hand, and carry that with you. In time, you'll stop feeling so anxious.
posted by Scram at 9:29 PM on August 18, 2010


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