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Help me overcome debilitating anxiety about the health and well-being of people I love
January 25, 2012 7:35 AM   Subscribe

For over a decade I have been worrying on a daily basis about the health and well-being of people I love, to a debilitating degree. Can you suggest any tactics to address it?

For example, if a loved one is having a health issue, or fails to respond to a phone call, my mind leaps directly to the worst possible scenario. I have vivid images and scenes in my head of possible futures: wistful conversations, heartbreak and loss. These images occupy my mind constantly, causing me be unhappy and sometimes act erratically (in the past, OCD-type behavior, although that hasn't happened for a long time).

Worse, I manage to inject sadness into happy moments by telling myself of some impending doom, and imagining myself looking back on those moments as "happier times… before it all went wrong".

I've noticed that this cycle seems to be associated to guilt; that is, if I feel guilty about how I have acted with someone, e.g. after an argument, I often then worry about their well-being. I've also seen that it intensifies when I hear that others are suffering bad times.

The catch is that I'm very aware this cycle is counter-productive. I know my mind is playing games; I observe it latching onto everyday events and weaving them into horror stories. I know that it wants to KNOW, and that for my mind, even a false vision of the future is better than it not knowing at all. I also know shit happens, people get sick and die, and everyone else lives through it. Despite this, I don't feel strong enough to stop this reflex.

Background: Male, mid-thirties, creative person. Did CBT a few years back, which helped with other issues. Happy childhood but mother a worry-bag, father a controller. Otherwise fine career and life wise.

MeFi, have you been here? Do you know short-term coping tactics for this, to help me simply ACCEPT that bad stuff happens, and cultivate a healthy approach to life?
posted by anonymous to Human Relations (11 answers total) 17 users marked this as a favorite
I have just managed to address this exact same tendency with Cognitive Therapy.

I recommend going back to Cognitive Therapy, specifically focusing on "positive thinking" and "self talk" management. The secret is that you are likely talking yourself into the anxiety/OCD type behavior and that if you can get a handle on that internal monologue you can very likely short-circuit the cycle before it gets the better of you.

This technique can also be used to great effect against traditional OCD type behaviors.

It's not the only technique, but Cognitive Therapy and counselors in same can very likely train you in this and other tools in OCD-type anxiety issues.

(NOTE: I strongly resisted these methods before I tried them because they seemed like happy horseshit, but honestly they worked very well for me once I tried to stop shooting them down.)
posted by kalessin at 7:40 AM on January 25, 2012 [1 favorite]

My experience is you're not strong enough to stop this reflex. Bear with me. You can't use brute strength of mind to stop something the mind's doing. It's not a failing of personal strength - it's just how the mind works. A further aspect is that I now have a working model that suggests that perhaps in any case where I see someone doing something 'strong' - kicking an addiction, for example, or losing weight or getting on with work - against which I can judge myself as 'weak' and lacking in mental and emotional strength and stamina, it might be that they're doing things differently, not just more.

I'm a bit of a Pyrrhonist as well as still in a place of shaky mental health, so I do apply some scepticism to this and wonder if I might still to some degree be genuinely working less hard at life than others. Scepticism also applies to slightly dogmatic statements about the mind. But in general, in order to get on, I accept that I can't really solve the comparative experience problem, and the dogmatic-ish statements work for me, so I go with them.

Practical side: The Mindful Way Through Depression is designed for what it says on the tin, but it is especially good in the whole area of automatic thoughts (the 'my mind is running away with me' thing). The key is not just the noticing of the mind, which you've got down already, but some sort of brief emotional acceptance, repeated over and over, which takes practice. The book says a lot of things you already know - things like the mind frets in order to know, which is something that was revelatory to me - but contains concrete advice, evidence and exercises to get you there.
posted by lokta at 8:06 AM on January 25, 2012

I found non-CBT therapy that looked more deeply at what I was trying to protect myself and others from by thinking that way very helpful. When I started realizing what my true anxieties were, I was much better able to acknowledge them and move on, exiting that spiral of catastrophism that sucks the joy out of life in futile hope of avoiding pain later.
posted by ldthomps at 8:13 AM on January 25, 2012

Something quick you can try while looking into more complete therapeutic approaches: Schedule an hour a day to do nothing but indulge in the wildest of wild catastrophes your mind can conjure. Then, when you catch your mind beginning to weave a horror story at any other time, stop and tell yourself you'll continue weaving it during Worry Hour. Heck, put it down in a Worry Hour To-Do List if you're so inclined. You know how you keep thinking about unfinished tasks till you work out a schedule of how you'll tackle them? This works on the same principle.
posted by michelle lightning at 10:18 AM on January 25, 2012 [1 favorite]

Battling intrusive thoughts is like a trying to keep a beach ball underwater. It may help you to read about "purely obsessional" OCD and ways to cope with that. Definitely look back into CBT. One important jumping off point is to remember that just because you think it doesn't make it true. Remind yourself of the things you DO know when you start to obsess i.e., "this isn't about my beloved dying, this is about my anxiety." Don't fight your obsessions per se, just let them go by and redirect your energy towards feeling less stressed/guilty/etc. This is your imaginative, creative energy being used for evil. Catch yourself when you start to play into your post-tragedy fantasies, stop making up dialogue, even if it seems not to be bothering you at first.

I think you do accept that bad things happen. Part of obsessive thinking is seeking answers to "unanswerable" questions. I.e., "I know that it wants to KNOW, and that for my mind, even a false vision of the future is better than it not knowing at all". To me, this is not about accepting that bad things happen or finding some comfortable alternative vision of the future. Your mind keeps changing the goal posts, making you doubt, or coming up with ever more scenarios to complicate your accepting. This problem is a psychological one, your answer is breaking the pattern of obsessive rumination.

These kinds of obsessions form powerful pathways in your brain so I recommend against actively indulging in obsessing. Indulging will only make it harder to turn off. Maybe your defenses are weakened right now, but part of therapy is building up your resiliency to handle life stresses.
posted by Katine at 12:03 PM on January 25, 2012 [2 favorites]

Also wanted to add: it's going to be okay! You are strong enough to handle this. And, obviously by the answers in this thread, you are not alone.
posted by Katine at 12:10 PM on January 25, 2012 [1 favorite]

You've got a good grasp on the problem, and you want to get better. Therapy is the answer, perhaps with some medication. You haven't said you've tried medication previously, so here's the deal: There very well could be a biochemical imbalance contributing to the situation, in which case a good psychiatrist (aka psychopharmacologist) could be of great help.
posted by exphysicist345 at 12:33 PM on January 25, 2012

Maybe you've heard this one before? A story for you:


Once upon the time there was an old farmer who had worked his crops for many years. One day his horse ran away. Upon hearing the news, his neighbors came to visit. “Such bad luck,” they said sympathetically.

“Maybe,” the farmer replied.

The next morning the horse returned, bringing with it three other wild horses. “How wonderful,” the neighbors exclaimed.

“Maybe,” replied the old man.

The following day, his son tried to ride one of the untamed horses, was thrown, and broke his leg. The neighbors again came to offer their sympathy on his misfortune.

“Maybe,” answered the farmer.

The day after, military officials came to the village to draft young men into the army. Seeing that the son’s leg was broken, they passed him by. The neighbors congratulated the farmer on how well things had turned out.

“Maybe,” said the farmer.
posted by The ____ of Justice at 3:03 PM on January 25, 2012 [1 favorite]

There was a time when I also connected the worry/guilt/caretaking cycle of emotions. My work in therapy helped me acknowledge my anger and resentment about being saddled with responsibilities that should not have been mine alone.

It was very hard to admit that I resented this because I felt it would just destroy me to see myself as a hateful, uncaring person. I gradually learned that feelings just are and do not make me a good person or a bad person, they are just feelings and if I don't accept that I have them, they will stew and torment me and (Gestalt-wise) literally eat me up from the inside. I learned that I could love someone and resent them for making more work for me or frightening me and it didn't mean I was a bad person or an unloving person. I had all those feelings--sometimes conflicting ones at the same time--and so did everyone else. I could choose what to do but my feelings were meant to show me my needs and desires. I don't have to do what I feel like doing but it costs me to refuse to recognize what my feelings are.

Once I could say (to myself, after much practice and starting and stopping), "this pisses me off and I don't want to be bothered with it; it's an imposition to make this my problem but I do care and it has to be done so I'll take care of it" then I could deal with problems and worries in a much more normal way. If my feelings were particularly strong I could also change the situation or leave. I had options.

But before, I had been so terrified of being an angry person and that my rage would be so huge if I let it into the light of day, it would probably kill somebody that I stuffed it down and it made me sick. I learned also that my abnormal worrying was partially a way of punishing myself for feeling angry about being responsible for more than I felt I could handle.

Now when I feel things that I think are not noble, or I'm cranky because I hurt or something, I can laugh and say, "we are just little animals, our bodies, we just want what we want." I don't have to hate myself for that. And I don't have to act on it. I can feel it and let it go.
posted by Anitanola at 11:15 PM on January 25, 2012 [3 favorites]

There are many different levels of anxiety, and if not dealt with, can lead to some...well...awful outcomes (not only for yourself, but for others as well.) In my case-hell, I'm a little anxious as I'm writing this-it took a year involving a death, a foreclosure, a relapse and a divorce to start the process to taking control. I learned a few things on my own, and a few things from counseling. Hope these help....(as I've been reading the responses, it's apparent that different people deal with anxiety in different ways, as you will too.)

First off, ya gotta realize you can't control everything. I've been a control-freak all my life. Had to have my finger in it, some way, some how. I remember when I was a little kid I would worry that my parents would never come back when they went out for the evening....and my parents have never abandoned me. Controlling does nothing but destroy you in the end-and can destroy other people as well. You are NOT responsible for anyone's health other than yourself and your dependents. Other points to consider-what are you doing to YOUR health when you worry? As one healthcare professional put it, "You've been doing this so long, it's what you know, it's what you're used in fear."

Sounds like you may benefit from some pharmaceutical therapy, even if it's just for the short term. I lost weight, quit smoking and learned coping mechanisms while I was on meds-when I came off them, I still had the coping mechanisms to carry me through (LOVE michelle lightning's worry-hour-list idea!)

What distractions do you use? Do you have hobbies? Close circle of friends? I'm not really all that much of a social person right now, but I am in love with my camera. Keeps me sane. Ever thought about keeping a log? Sometimes when I'm "spinning", I write down what's going through my mind-worries, scenerios, current stressors, etc....and then read them. If you do, keep this in mind; Is this (scenerio, stressor, worry) reasonable? And if this (again, insert word) did come to fruition, is there ANYTHING I can do about it?

As Anitanola stated, to paraphrase, we're all human. I honestly believe that in an age of instant-technology-gratification-know-everything-at-a-glance, some people believe that they can take on everything at once. Not realistic at all. Find a starting point and go from there. If you try to fix everything at once, you'll just overwhelm yourself and crash-personal experience.

I still have anxiety. I still have days where I spin. But now I realize that I have different resources to tap to get out of the cycle. Some days are just worse than others. I've accepted that. Bottom line up front; the only person I'm responsible for is myself.

From one who has been there, best of luck to you!!!!!!!!!
posted by BeastMan78 at 8:11 PM on January 28, 2012

This question is old now, but in case you're still reading, I have a response for you.

I have an extremely similar problem, and it's 100% because of my OCD. You say you've had OCD behaviors "in the past"? Well, no, you're having them now, too. Definitely check out Pure O, if you haven't already. This is totally OCD.

As someone who has the same issue that you do, I find a some of these answers a little unhelpful. You are not going to be able to rationalize yourself out of OCD behavior, no matter how hard you try. You aren't going to be able to magically "accept" anything until you've broken out of this awful cycle.

The CBT is a good idea, but please: Try medicine. I refused to take medicine for a loooong time after my OCD started flaring up again, and it only made me miserable. Therapy helped a little, but not nearly enough. A few weeks ago, I finally gave in and started taking the Lexapro my doctor prescribed, and I already feel so much better than I did. I'm not all the way back yet, but I'm so much better that I'm pissed I held out for this long.

Please try medication, at least for a while. I KNOW how much it sucks to start pills, but I also know how much it sucks to be where you are right now. And the pills suck a lot less.
posted by Coatlicue at 7:56 AM on February 4, 2012

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