I need some help with what I assume is adult separation anxiety.

May 16, 2014 6:19 PM

For reasons that I'm have not yet unraveled, I have developed an anxiety trigger around being away from home (away from Mom?) and getting sick. This is a complex issue, interwoven with other issues. I'll try to be succinct.

I have a diagnosis of panic disorder, but am very functional. I work, have a degree, etc. One of my main (THE main?) panic triggers is going somewhere (traveling) and getting sick (mainly stomach-related, as I have emetophobia as well). I'm afraid on several levels - not knowing when/if I need help then things getting out of hand because I couldn't/didn't know to ask for help, not being able to get help, feeling awful, people getting mad at me because I'm sick, having to then get home (travel again) while sick, not being able to take care of myself or having no one to help me which would lead to passing out and dying. Some of this has to do with assertiveness and speaking up for myself and my needs. Family environment has taught me that doing such is not okay. Some of this is just irrational-anxiety-brain that I can't seem to get around. Over a year of exposure therapy (regular travel) has not worked in lessening or eliminating this. I suppose I feel that I don't have to worry about being "on", being gross or smelly, or whatever with Mom. She's Mom, you know? And I know that she wouldn't abandon me and refuse to help me if I were sick. Anyone else, they could just walk away (or get mad and walk away, or fed up and walk away...). Oddly, given my just-stated comfort with Mom, my mother tended to get irritated/pissy/angry when we got sick (however "sick" manifested). I know that has something to do with my fears, as well. Not having had the very developmentally necessary experience of being on my own and building confidence in myself that I can, indeed, handle life, has been very detrimental as well.

I cannot recall ever becoming ill (aside from anxiety-induced physical symptoms) when traveling. I am intellectually capable of taking care of myself. Due to various circumstances, I've been forced to live at home for much longer than is healthy, and I know that has contributed greatly to this problem. That in itself is humiliating and embarrassing in a way that words cannot describe. I'm working on getting out, but money is a huge issue (as is this anxiety/sick issue).

Yes, I am seeing a therapist, but I'm loathe to bring this up with her as it is so embarrassing and childish.

Yes, I do work out to help the anxiety. Doesn't help when in the situation, though.

Yes, I do take medication for the anxiety, though I'm considering switching since it doesn't seem to help much.

I likely have IBS, which triggers the anxiety since it's a gastro thing.

This is a deeply ingrained problem and it is and has been negatively affecting my life in numerous ways. I'm at a point now where I'm considering moving a full day's drive from my family/current home. This issue is causing me great distress and will potentially prevent me from taking the very necessary and overdue step of getting out of here. I'm incredibly fed up with feeling this way and feeling limited in my life. If you aren't familiar with anxiety disorders and/or are of the mindset that I should suck it up or stop choosing to feel this way, please do not respond. That view is not helpful to me.

What I'm looking for:
Others with similar experiences
Suggestions for solutions or things to work on or do to change my thinking about getting sick
Insight as to why I might be so afraid of getting sick/being away from home
How to get rid of it
Anything else that you smart mefites think might be helpful

/parentheticals

posted by msbadcrumble to Health & Fitness (12 answers total)

Anything else that you smart mefites think might be helpful

Bring it up with your therapist. It is not childish, and it is way at the bottom of "embarrassing" things your therapist has heard if they've been in practice longer than a day. You're paying them money for help for stuff like this! Make use of it!

(Presumably, you have talked to your therapist about other family and life issues, so you know what? They're going to have a really good handle already on what's driving this particular bit of anxiety. You don't have to reinvent the wheel.)
posted by rtha at 6:41 PM on May 16, 2014 [8 favorites]

Oh I do feel sorry for you. I have had similar feelings of anxiety linked to travelling, though in my case it came on during travelling rather than being triggered by the thought of travelling. I felt the same awful things about dying right here in my seat on the train and couldn't shake it for quite a while.
What helped me was time and an antidepressant that worked for me (citalopram). As per rtha, it isn't't at all a silly thing to talk to someone about. This thing is having a real impact on your ability to make the most of your life and I'm sure your therapist will have some workarounds to help you out. I also managed to get some relief through putting together a decent playlist on my player and managed to get out of my own miserable brainspace by really concentrating on the songs.
Sorry you are having to go through this.
posted by Martha My Dear Prudence at 6:52 PM on May 16, 2014 [1 favorite]

Yeah, definitely change anxiety meds. Once you're in this sort of vicious anxiety cycle your brain is just going to keep making it worse. It is very, very difficult to think yourself out of this sort of irrational fear -- you need to change your brain chemistry to stop the cycle, and it's much easier to do that via meds than via non-med techniques.

In my experience with crippling anxiety, I needed a proactive daily anti-anxiety med (1mg/night clonazepam did it for me) instead of a reactive "take as needed" anti-anxiety med like Xanax, because if I waited until I was already having an anxiety attack to treat in then I was already in bad shape. Best to just stop that whole anxiety downward spiral chemical process from even getting started.

Getting on the clonazepam was like magic for me. Before I had been a total shut-in afraid to leave the house, answer the phone, or open my mail, but within 3 days of starting the clonazepam I was feeling much better and within a week or so I was back to my old self. So definitely try a proactive daily anti-anxiety med, or if you're already on one either try a different one and/or increase the dose.
posted by Jacqueline at 7:04 PM on May 16, 2014 [1 favorite]

Yes, I am seeing a therapist, but I'm loathe to bring this up with her as it is so embarrassing and childish.

I agree that no therapist is going to think this is childish or judge you for it.

I also get panic attacks, mostly on trains, airplanes, or any enclosed or crowded space where I worry I may not be able to leave THE second I feel the need to.

I have, in a way, an opposite worry to you, however. I worry that I will start to feel so bad (due to the panic attack, or some physical discomfort that helped bring the attack along) that I will turn to someone next to me in the seat, or find the train conductor, and say "I feel bad" pleading pathetically. Then they will look at me really weird because though I probably look near tears I can't explain what's wrong (no random person is going to understand why a panic attack feels like the most vulnerable horrible situation that must end now). Then they'll just think I'm a "crazy" nutcase and I will make a spectacle. I also worry that I will start to take off my clothes and shoes. I can burn up and get hot really, really, quickly and when I'm getting an attack I'll do ANYTHING to make it stop, hence I worry about all the ways I can make a spectacle of myself and start pleading to others who are properly minding their own business with stoic, stone, unsympathetic faces. I also get weak in the legs to the point I can't stand and I worry a lot that I will randomly sit down in a totally inappropriate spot (like in the middle of the aisle in a train car between a bunch of people standing. The thought I will have to do that terrifies me in the midst of an attack.

This is off the top of my head as I'm no psychoanalyst but when I was little I was never, ever acknowledged as having an experience, or asked how I felt about anything (even after really dramatic, traumatic events). I've spent so much psychic energy in my life hiding and repressing because I was taught you don't show others your experiences (as I think we're all taught to a large degree, we can show a little in private circumstances but that's all), you pretend you don't have any. I think that's why I am so scared of making a spectacle of my bad feelings, and telling someone "I feel bad" like I need their help desperately. Maybe your mom also made you feel bad for being sick, like it's not okay to be sick and everyone will hate you for it. And paradoxically even though it's your mom who said this, not all of society, you've internalized it so you believe it is bad in itself. Maybe you are more okay with being sick with your mom because you have the experience of having been sick with your mom and in that sense it's more "okay".
posted by Blitz at 7:10 PM on May 16, 2014

Have you ever lived away from your Mom? Just curious. I mean, a lot of it seems to be afraid to live a life away from your Mom. And that she would be the only person who would put up with you. Which is pretty weird and sad. Because that's not true, you know that, right? That there are a lot of people who would like you and put up with you and live with you and maybe even love you for a long time, the rest of your life, beside your Mom. And be your friend and want to hang with you. And want to know your opinion on things and really value you and go "eh, I never thought of that!" and buy you a beer and chat with you. Or just go shopping with you and tell you if that shirt fits you right or not. We really are here for you, the rest of us.
posted by Marie Mon Dieu at 7:12 PM on May 16, 2014 [5 favorites]

My experience was that when I dealt with the gastro issues, most of the anxiety went away. I discovered (way too late in life) that I am lactose intolerant. Cutting out dairy solved SO MUCH of my issue. Limiting caffeine and alcohol also helped a lot.

But, I do also take nightly anti-anxiety medication, and I have a prescription for clonazepam as needed. if I know I will be going into a stressful situation (say, flying or public speaking) I will take one beforehand and I'm almost always fine.

Talk to your therapist (really, this is quite common and they won't think less of you), but also consider seeing a gastroenterologist (to see if it's something that can be treated directly).

My life changed completely with medication and diet modifications; I really wish I'd gotten help long before I did.
posted by desjardins at 7:13 PM on May 16, 2014 [2 favorites]

Yeah, I would absolutely go with "talk to your therapist about this" as your first step. It's not childish, it's human. We're all worried about being weak in public and disliked by strangers; you just have a heightened version that's negatively impacting you. Luckily you're currently paying a professional who is absolutely trained to help you with this. I want to reiterate that I don't think it's childish at all.

What really sticks out to me in your question is the way you talk about strangers being potentially angry with you for being sick. This has never been my experience - in fact, the opposite has always held true. Strangers show a great deal of empathy and concern for people who are physically distressed in public. The only time this doesn't hold is when we're talking about someone obviously homeless and mentally ill in an urban area where this is common. From what you've written, it's very unlikely that strangers will read you as someone in that position.

From one of your previous questions I see that you're probably in the Northern Virginia area. I spent most of my adolescence there, and I despised it, mostly because of the general attitudes of the people. I found strangers cold, lacking in empathy, false, and selfish. That being said, I also experienced numerous instances where I was scared, sick or hurt in public and benefited from the kindness of strangers. Seats given up for me, escorts when I was lost, first aid administered, bathrooms pointed out and then guarded, longer bathroom breaks given without a single word. I had plenty of times when strangers reacted poorly to me, but never when I seemed vulnerably sick or hurt. Now, I read as a young white woman, so it's possible that you're in a demographic that doesn't have my privilege. And I completely understand that anxiety is irrational in what it focuses on. But your fear of anger really strikes me as something misplaced, and something that's worth investigating and unraveling. And perhaps my experiences can be a little data point for you to consider.

Apart from talking to your therapist and seeing about changing or adjusting your meds, the idea above about listening to certain music is a good one to try, I think. My anxiety is not triggered by the same things as yours, but music helps me break that spiral of fear and anger. I have to change it up, though, because if I listen to the same things every time I get anxious, I start associating the two together. It seems like I respond best to really aggressively funky tunes, like epic funk bass from the 70s and afro-cuban jazz. I know a person who finds black metal the most calming genre of music for her. Playlists are great for bus rides and planes, particularly if you time them for the length of the trip, because then you know how far you've gone with what track you're on.

Again, nothing about your question seems childish, and it's excellent that you've got tools in place to work through your anxiety. It seems like you just need to tweak them and maybe add a couple things.
posted by Mizu at 7:15 PM on May 16, 2014 [1 favorite]

I suppose I feel that I don't have to worry about being "on", being gross or smelly, or whatever with Mom. She's Mom, you know? And I know that she wouldn't abandon me and refuse to help me if I were sick. Anyone else, they could just walk away (or get mad and walk away, or fed up and walk away...). Oddly, given my just-stated comfort with Mom, my mother tended to get irritated/pissy/angry when we got sick (however "sick" manifested). I know that has something to do with my fears, as well.

As paradoxical as this is on the surface, I think it makes perfect sense.

Severely neglected children removed from their families and placed in foster care will often display sharp hostility to foster parents and construe true benevolence and a sincere desire to help them in amazingly cynical terms, and I think the reason the neglected child reacts this way is that it helps them to maintain their relationship with their mother and their belief that their mother loves them in return, both of which would be threatened if they allowed themselves to realize total strangers could give them the care and concern they long to have from their mother but have not received.

I think you have dedicated yourself to sustaining a similar belief about your own mother and your relationship with her in the face of a lot of experience to the contrary, and that what you're really afraid of is that you'll get sick and people will step forward to help you--but of course you can't admit that to yourself, because that admission would amount to an acknowledgement of the very thing you're trying to hide from yourself.
posted by jamjam at 8:22 PM on May 16, 2014 [2 favorites]

exposure therapy is one great way of dealing with phobias - neuro linguistic programming is another approach that works brilliantly - and completely differently - on phobias. worth a shot?
posted by Mistress at 1:05 AM on May 17, 2014

If you haven't already, check out Dr. Claire Weekes' book Hope and Help for Your Nerves. It's written in a really understanding, approachable way and the methods have helped a lot of people break the anxiety cycle. (Take a look at the reviews.)
posted by flod logic at 3:19 AM on May 17, 2014

This might sound like a superficial solution, but boy howdy did it make a huge dent in my sickness anxiety/emetophobia: find a doctor who will prescribe you Reglan (or Zofran)--a super-strong antinausea, anti-emetic. First off, these things work. You can feel like nauseated death, take one, and ten minutes later you are 100% back to good.

I started taking a small prescription of this with me whenever I went somewhere with high odds of gastrointestinal problems (one of the scariest things for me is actually a party or a wedding where I might end up feeling sick from hangover, actually). I hardly ever actually take it; just knowing I have it available makes an enormous difference. When the sickness anxiety kicks in I mostly just have to say, "it's okay, if I start to feel sick, I have something that will make me feel better right away."

So give that a shot, perhaps? It can be hard to find a doc who will prescribe it because you're not technically sick, but mine is pretty good with anxiety issues in general and pretty much wants to help me manage them however possible.
posted by like_a_friend at 9:38 AM on May 17, 2014 [4 favorites]

After a lifetime of health anxiety and, later, panic attacks that made me so miserable I just wanted to die already, I finally asked my psychiatrist if there were any meds that might help. I've been on 10 mg of citalophram daily for about 2 years and it has dramatically improved the quality of my life. I still get anxiety from time to time but I'm no longer disabled by it. YMMV. Talk to your therapist. Good luck!
posted by Bella Donna at 2:24 PM on May 17, 2014 [1 favorite]