Coping with anxiety?
September 5, 2014 10:31 AM Subscribe
I have a number of psychiatric diagnoses, mostly involving panic and anxiety, but also throwing in depression, OCD, and (perhaps) conversion disorder. Everything's acting up right now. Appointment with a psychiatrist isn't until late October. How do I cope until then?
Lately, I feel like I'm trying to dance the Watusi, on a flaming tightrope, while wearing 4" stiletto heels, despite the facts that I have never learned the Watusi, have only seen tightropes on TV, and can't even walk in 4" stiletto heels. I know logically that I am functioning much better than I feel like I am. I'm dressed, I'm eating, I'm leaving the house, I'm getting things done. I just feel this overwhelming panic and anxiety about ALL THE THINGS. I'm self-employed (now), and haven't been able to schedule client appointments, network to build business opportunities, or even so much as deal with inventory in the comfort and safety of my home office, in weeks. Everything's flared up immensely since I left my horribly stressful full-time job, and left two other very part-time jobs. So now I'm down to one part-time (15-20 hours/wk) job and my business.
My home is a wreck, because my anxiety and OCD are at war. OCD says I have to clean ALL THE THINGS RIGHT NOW, then anxiety gets overwhelmed by the scope of the project, and I have a panic attack. I wind up in the fetal position under my kitchen table because I can't deal with cleaning off the damned thing. Dishes have backed up for two weeks because OCD insists that I have to scour them in the hottest water imaginable, then bleach them, then scrub them again in the hottest water imaginable, then set up some kind of hot air drying system (using a hair dryer, perhaps?) rather than just washing in hot soapy water and air-drying in the drain rack.
List of diagnoses: Agoraphobia, generalized anxiety disorder, OCD, panic disorder, PTSD, social phobia, major depressive disorder, situational anxiety, insomnia, and perhaps conversion disorder (not formally diagnosed, but my primary care physician and neurologist both strongly suspect it).
I can't get in to see a psychiatrist until October 22. (They tell me to keep calling to see if anything's opened up sooner. I'm calling twice a week, and so far have managed to move up 5 whole days (my original appointment was on October 27). I have to get things done before October 22. I have to work so I can pay rent and utilities and buy groceries and put gas in the car. I have to wash dishes so I have something clean to eat off of. I have to clean the house so I can conduct client meetings here when they prefer coming to me rather than me coming to them. My PCP won't change (or increase, or add to) the meds I'm currently on (20 mg Prozac, once a day) because she's uncomfortable dealing with higher level psych issues.
Not looking for medical advice, just some coping mechanisms. How do I get past the panic and anxiety to get things done? If you have any of these (yay fun!) diagnoses, how do you spend less time in the fetal position and more time being a functional human being?
(Please be gentle. I debated for several hours about whether to post this Ask at all, and then several more about whether to be anonymous. But I want to do my small part to help destigmatize mental illness, and put it on par with physical illness. This is really scary for me.)
Lately, I feel like I'm trying to dance the Watusi, on a flaming tightrope, while wearing 4" stiletto heels, despite the facts that I have never learned the Watusi, have only seen tightropes on TV, and can't even walk in 4" stiletto heels. I know logically that I am functioning much better than I feel like I am. I'm dressed, I'm eating, I'm leaving the house, I'm getting things done. I just feel this overwhelming panic and anxiety about ALL THE THINGS. I'm self-employed (now), and haven't been able to schedule client appointments, network to build business opportunities, or even so much as deal with inventory in the comfort and safety of my home office, in weeks. Everything's flared up immensely since I left my horribly stressful full-time job, and left two other very part-time jobs. So now I'm down to one part-time (15-20 hours/wk) job and my business.
My home is a wreck, because my anxiety and OCD are at war. OCD says I have to clean ALL THE THINGS RIGHT NOW, then anxiety gets overwhelmed by the scope of the project, and I have a panic attack. I wind up in the fetal position under my kitchen table because I can't deal with cleaning off the damned thing. Dishes have backed up for two weeks because OCD insists that I have to scour them in the hottest water imaginable, then bleach them, then scrub them again in the hottest water imaginable, then set up some kind of hot air drying system (using a hair dryer, perhaps?) rather than just washing in hot soapy water and air-drying in the drain rack.
List of diagnoses: Agoraphobia, generalized anxiety disorder, OCD, panic disorder, PTSD, social phobia, major depressive disorder, situational anxiety, insomnia, and perhaps conversion disorder (not formally diagnosed, but my primary care physician and neurologist both strongly suspect it).
I can't get in to see a psychiatrist until October 22. (They tell me to keep calling to see if anything's opened up sooner. I'm calling twice a week, and so far have managed to move up 5 whole days (my original appointment was on October 27). I have to get things done before October 22. I have to work so I can pay rent and utilities and buy groceries and put gas in the car. I have to wash dishes so I have something clean to eat off of. I have to clean the house so I can conduct client meetings here when they prefer coming to me rather than me coming to them. My PCP won't change (or increase, or add to) the meds I'm currently on (20 mg Prozac, once a day) because she's uncomfortable dealing with higher level psych issues.
Not looking for medical advice, just some coping mechanisms. How do I get past the panic and anxiety to get things done? If you have any of these (yay fun!) diagnoses, how do you spend less time in the fetal position and more time being a functional human being?
(Please be gentle. I debated for several hours about whether to post this Ask at all, and then several more about whether to be anonymous. But I want to do my small part to help destigmatize mental illness, and put it on par with physical illness. This is really scary for me.)
See a traditional Physician or Naturopath who gives a fig about blood work-ups and nutrition to find out what is going on biologically to create all of these symptoms!
All I can think of is Hormone Imbalance (Thyroid, maybe??), Vitamin/Mineral Deficiency, or some sort of Environmental Toxicity.
In short, get comprehensive Blood Tests and find someone who cares and knows enough to read them properly!!
posted by jbenben at 10:40 AM on September 5, 2014
All I can think of is Hormone Imbalance (Thyroid, maybe??), Vitamin/Mineral Deficiency, or some sort of Environmental Toxicity.
In short, get comprehensive Blood Tests and find someone who cares and knows enough to read them properly!!
posted by jbenben at 10:40 AM on September 5, 2014
If I could, I would come over and do all the cleaning for you so you didn't have to engage with it. Do you have any friends or loved ones who might be willing to come by once a week to help you get some stuff done? Or if you can, you could hire a maid temporarily if you can stand to have someone else touch your stuff (I can't, but I'm me).
Can you make a list of things to clean every hour? And then set a timer so you only work on one project per hour at a time?
(PS: if after reading our suggestions your immediate reaction is to refute them, fight that urge right now -- making excuses as to why you can't do something feeds OCD and anxiety.)
posted by Hermione Granger at 10:46 AM on September 5, 2014 [2 favorites]
Can you make a list of things to clean every hour? And then set a timer so you only work on one project per hour at a time?
(PS: if after reading our suggestions your immediate reaction is to refute them, fight that urge right now -- making excuses as to why you can't do something feeds OCD and anxiety.)
posted by Hermione Granger at 10:46 AM on September 5, 2014 [2 favorites]
Can you start therapy before you see your psychiatrist? Meds help pick you up off the floor but they won't give you the coping skills you need to work with this illness long term.
posted by crazycanuck at 11:00 AM on September 5, 2014 [1 favorite]
posted by crazycanuck at 11:00 AM on September 5, 2014 [1 favorite]
Short term - can you get a cleaning person or even a friend to come in and take care of that part for you? My daughter deals with anxiety and depression and cannot sometimes cope with her room which becomes an unbelievable mess. The times that she went out and I just took over cleaning it, gave her a huge sense of relief in order to deal with the things she did have to manage on her own (like schoolwork).
posted by maxg94 at 11:03 AM on September 5, 2014 [1 favorite]
posted by maxg94 at 11:03 AM on September 5, 2014 [1 favorite]
I have a serious medical condition. On July 4th, I made some significant changes to my life and the result is that, since then, I have been having a lot of anxiety. It took me three weeks to figure out that it was biologically based and what the likely mechanism was. I am pretty clear that, in my case, I am basically temporarily overproducing adrenaline as my body tries to ramp down from the amount it previously needed to produce for medical-related reasons. Those reasons are no more but my adrenals are being kind of slow to get the memo.
So, we did some research, and I am snacking on things with rosemary, sage or dill to take the edge off my anxiety and keep it manageable. It has been surprisingly effective. The anxiety is not gone but when it gets too much, I break out the rosemary triscuits or kalamata bread or whatever and it gets it enough under control to get me back to being functional for the day.
posted by Michele in California at 11:07 AM on September 5, 2014 [2 favorites]
So, we did some research, and I am snacking on things with rosemary, sage or dill to take the edge off my anxiety and keep it manageable. It has been surprisingly effective. The anxiety is not gone but when it gets too much, I break out the rosemary triscuits or kalamata bread or whatever and it gets it enough under control to get me back to being functional for the day.
posted by Michele in California at 11:07 AM on September 5, 2014 [2 favorites]
Some advice for panic/anxiety attacks
I think my biggest piece of advice is to first breathe. Breathe deeper than you think you need. Do it slowly, in and out. Acknowledge what you are feeling. Understand and name the emotion that you feel. Consider how it is affecting you, and then release it. Breathe in and out slowly and deliberately.
When your anxiety starts to creep up, try the breathing exercise. It's the first thing that I do when I'm having an attack. If that doesn't work, start either reciting the alphabet backwards (aloud or in your head), or counting upwards in increments of 3 or 7. It will help you to focus your mind on something else.
I'm sending you virtual hugs. It sounds like you are in place that is so familiar to me. Feel free to PM me for individual help, or to email me at my username@gmail.com
Don't you give up.
posted by Draccy at 11:36 AM on September 5, 2014 [1 favorite]
I think my biggest piece of advice is to first breathe. Breathe deeper than you think you need. Do it slowly, in and out. Acknowledge what you are feeling. Understand and name the emotion that you feel. Consider how it is affecting you, and then release it. Breathe in and out slowly and deliberately.
When your anxiety starts to creep up, try the breathing exercise. It's the first thing that I do when I'm having an attack. If that doesn't work, start either reciting the alphabet backwards (aloud or in your head), or counting upwards in increments of 3 or 7. It will help you to focus your mind on something else.
I'm sending you virtual hugs. It sounds like you are in place that is so familiar to me. Feel free to PM me for individual help, or to email me at my username@gmail.com
Don't you give up.
posted by Draccy at 11:36 AM on September 5, 2014 [1 favorite]
I see from your past questions that you joined a gym a few weeks ago. Go there and get some exercise. Things magically become a lot more manageable after some good physical activity. Go try it and report back! Put yourself back in control of how you feel.
posted by killdevil at 12:07 PM on September 5, 2014 [1 favorite]
posted by killdevil at 12:07 PM on September 5, 2014 [1 favorite]
I suffer from what can sometimes be crippling anxiety. The Anxiety and Phobia Workbook is pretty helpful. I also started yoga and the days I do yoga and the day after I always feel so, so good. I wake up not feeling "speedy," which is how I usually feel. I also take baths and burn candles with lavender because they smell nice and soothing.
Good luck. Hang in there. The fact that you are ready to get this treated is huge. It can take a long time to get to that point. Pat yourself on the back and take care.
posted by sockermom at 12:11 PM on September 5, 2014 [1 favorite]
Good luck. Hang in there. The fact that you are ready to get this treated is huge. It can take a long time to get to that point. Pat yourself on the back and take care.
posted by sockermom at 12:11 PM on September 5, 2014 [1 favorite]
First, I am so sorry you're dealing with this. That sucks. I've been there.
This answer has two parts.
a) You know you best, but this sounds like its reaching crisis level. Since you're already on the phone with your prospective psychiatrist's office regularly, please let them know that it is a crisis. Use the word "crisis." Sometimes that gets things moved around in your favor, and sometimes it just leads them to tell you to stuff it/go to the ER. That being said, you don't have to be suicidal or self-harming to go to the ER, and they do deal with panic attacks, so don't rule that out as an option. If you're not a threat to yourself or others, they won't admit you inpatient, but sometimes ER docs can initiate emergency treatment (for example, a benzo to take the edge off enough to get you through a couple more weeks) and expedite access to an outpatient psychiatrist. Bring someone with you if at all possible if you do this, to keep you company and take notes.
b) That being said, access to psychiatrists sucks basically everywhere, and you do have to survive to your appointment, as you pointed out. When I've been in this situation, the most helpful things to do have been to 1) cut out as much as possible and focus on the bare minimum you have to do to get by 2) outsource or reschedule what I can, and 3) self-soothe. Drop anything you don't need to do to survive until that appointment. Do you have to meet your clients in your home, or is there somewhere else you can go? Can you eat tv dinners or use paper plates to eliminate the dish problem temporarily? Can you afford to have a cleaner in once or twice? You mentioned growing your business, but now is probably not the time to super push yourself into making your work harder. If you have clerical tasks to get done, can you get someone to assist with those, even if it's just a friend's bored teenager on the weekends?
Finally, self-soothing - when my anxiety level is to a thousand, the things that help me personally the most are long walks outdoors (if nothing else, the sunlight is good for you), deep slow breathing (there are some breathing exercises and apps out there if you prefer guidance), smelling lavender, watching or reading a favorite absolutely unchallenging movie or book, and listening to recordings of windchimes. Obviously, that's very personal, but the Google term you're looking for is "distress tolerance." Distress tolerance is a concept from dialectical behavioral therapy that is all about getting through a crappy moment/situation without escalating the problem, and there are many lists of suggestions for things to try out there.
Good luck! I hope the doctor squeezes you in very soon!
posted by bowtiesarecool at 1:20 PM on September 5, 2014 [2 favorites]
This answer has two parts.
a) You know you best, but this sounds like its reaching crisis level. Since you're already on the phone with your prospective psychiatrist's office regularly, please let them know that it is a crisis. Use the word "crisis." Sometimes that gets things moved around in your favor, and sometimes it just leads them to tell you to stuff it/go to the ER. That being said, you don't have to be suicidal or self-harming to go to the ER, and they do deal with panic attacks, so don't rule that out as an option. If you're not a threat to yourself or others, they won't admit you inpatient, but sometimes ER docs can initiate emergency treatment (for example, a benzo to take the edge off enough to get you through a couple more weeks) and expedite access to an outpatient psychiatrist. Bring someone with you if at all possible if you do this, to keep you company and take notes.
b) That being said, access to psychiatrists sucks basically everywhere, and you do have to survive to your appointment, as you pointed out. When I've been in this situation, the most helpful things to do have been to 1) cut out as much as possible and focus on the bare minimum you have to do to get by 2) outsource or reschedule what I can, and 3) self-soothe. Drop anything you don't need to do to survive until that appointment. Do you have to meet your clients in your home, or is there somewhere else you can go? Can you eat tv dinners or use paper plates to eliminate the dish problem temporarily? Can you afford to have a cleaner in once or twice? You mentioned growing your business, but now is probably not the time to super push yourself into making your work harder. If you have clerical tasks to get done, can you get someone to assist with those, even if it's just a friend's bored teenager on the weekends?
Finally, self-soothing - when my anxiety level is to a thousand, the things that help me personally the most are long walks outdoors (if nothing else, the sunlight is good for you), deep slow breathing (there are some breathing exercises and apps out there if you prefer guidance), smelling lavender, watching or reading a favorite absolutely unchallenging movie or book, and listening to recordings of windchimes. Obviously, that's very personal, but the Google term you're looking for is "distress tolerance." Distress tolerance is a concept from dialectical behavioral therapy that is all about getting through a crappy moment/situation without escalating the problem, and there are many lists of suggestions for things to try out there.
Good luck! I hope the doctor squeezes you in very soon!
posted by bowtiesarecool at 1:20 PM on September 5, 2014 [2 favorites]
I have a lot of the same issues you do. And am on way more medication. It is so frustrating when you have to wait for help from medical people.
The best advice I can give is to give yourself permission to let go of the housework as much as possible. Keep your home as your safe place, do client meetings at a local library or coffee shop if necessary. Lie, if you need to. Invent a sick pet, home damage or DIY project in progress, visiting sick relative. Whatever it takes. You need to remove the added stressor of public exposure of your private life from the equation. Then you might be able to do the rest of what you need to do to survive until you see a psychiatrist.
This is basic pared down survival mode and it is OK. It is choosing what battles you can fight right now, and what you can let go. Just to get you through until the help comes through. Get some paper plates. Or wash all the dishes, put them away, and just keep out one set that you wash every time you use them. I have done this, and stranger things, to keep from losing my grip on everything.
This is the time for any easy comforting you can do for yourself that won't cause lasting damage. Six weeks of Hot Pockets and TV binging might be better than banging your head against the kitchen. Being outside yourself is sometimes a good thing.
To me, this is the psychological equivalent of a broken limb. There is no way you can expect to do everything the same as before, and it is ok.
posted by monopas at 1:27 PM on September 5, 2014
The best advice I can give is to give yourself permission to let go of the housework as much as possible. Keep your home as your safe place, do client meetings at a local library or coffee shop if necessary. Lie, if you need to. Invent a sick pet, home damage or DIY project in progress, visiting sick relative. Whatever it takes. You need to remove the added stressor of public exposure of your private life from the equation. Then you might be able to do the rest of what you need to do to survive until you see a psychiatrist.
This is basic pared down survival mode and it is OK. It is choosing what battles you can fight right now, and what you can let go. Just to get you through until the help comes through. Get some paper plates. Or wash all the dishes, put them away, and just keep out one set that you wash every time you use them. I have done this, and stranger things, to keep from losing my grip on everything.
This is the time for any easy comforting you can do for yourself that won't cause lasting damage. Six weeks of Hot Pockets and TV binging might be better than banging your head against the kitchen. Being outside yourself is sometimes a good thing.
To me, this is the psychological equivalent of a broken limb. There is no way you can expect to do everything the same as before, and it is ok.
posted by monopas at 1:27 PM on September 5, 2014
Diphenhydramine (Benadryl) is an over-the-counter drug that helps with anxiety.
Join the FlyLady email list and just clean what she says to clean each day. No more, no less. Her system will get your house clean eventually (thus satisfying your OCD) and the structure should help with your anxiety.
Call your psychiatrist's office and tell them you've having a crisis and need to be seen ASAP.
posted by Jacqueline at 2:17 PM on September 5, 2014
Join the FlyLady email list and just clean what she says to clean each day. No more, no less. Her system will get your house clean eventually (thus satisfying your OCD) and the structure should help with your anxiety.
Call your psychiatrist's office and tell them you've having a crisis and need to be seen ASAP.
posted by Jacqueline at 2:17 PM on September 5, 2014
I also came in to say Benadryl in small doses not too frequently. Exercise if it helps you (some people, like me, it triggers worse panic). Try to keep your blood sugar steady. When mine gets too low, panic city. For some strange reason, I'm finding upping my water intake it helping my anxiety.
How is your sleep? You said you have insomnia. Some people like Melatonin. Or Benadryl.
Come join us on health month and set some baby goals. We cheer each other on really well.
Do you have a camera and someplace pretty? I like taking pictures as a relaxing activity.
Sorry for the brain dump, meds are hitting hard right now.
posted by kathrynm at 2:37 PM on September 5, 2014
How is your sleep? You said you have insomnia. Some people like Melatonin. Or Benadryl.
Come join us on health month and set some baby goals. We cheer each other on really well.
Do you have a camera and someplace pretty? I like taking pictures as a relaxing activity.
Sorry for the brain dump, meds are hitting hard right now.
posted by kathrynm at 2:37 PM on September 5, 2014
Start writing fiction, if you don't already. Throw yourself into it, even if you have no intention of ever publishing it. Imagining other places and putting yourself in somebody else's skin is a great way to escape your own life for a while. A few years back I had a really tough dental situation, and I was able to escape by trying to figure out plot problems and dialogue for a novel I was working on. The novel never got finished, but I had a blast working on it and I feel a strange gratitude toward those characters. They helped me through some dark days.
If you think you suck at straight prose, start writing plays or screenplays so you don't have to worry about all of the scene descriptions and stuff and you can focus more on character and dialogue. Put your energy into devising characters who are compelling and then make them do things. Get invested in their lives.
Seriously, try it. There will be times when you are losing your mind and you can actually use your writing like an escape pod. Just hop right in, seal the hatch and then GET THE HELL OUT OF THERE!
Another benefit: if you can create characters you truly like, it may make you feel better about yourself. You'll think, "I really like this person. And this person came out of my very own mind. Maybe... I don't suck as bad as I thought I did?"
posted by Ursula Hitler at 3:53 PM on September 5, 2014 [1 favorite]
If you think you suck at straight prose, start writing plays or screenplays so you don't have to worry about all of the scene descriptions and stuff and you can focus more on character and dialogue. Put your energy into devising characters who are compelling and then make them do things. Get invested in their lives.
Seriously, try it. There will be times when you are losing your mind and you can actually use your writing like an escape pod. Just hop right in, seal the hatch and then GET THE HELL OUT OF THERE!
Another benefit: if you can create characters you truly like, it may make you feel better about yourself. You'll think, "I really like this person. And this person came out of my very own mind. Maybe... I don't suck as bad as I thought I did?"
posted by Ursula Hitler at 3:53 PM on September 5, 2014 [1 favorite]
I see … you joined a gym a few weeks ago. Go there and get some exercise.
By far the best form of which for peace of mind is swimming. Swim if you can. Not so much exercise that you get overtired, though.
posted by ambrosen at 3:54 PM on September 5, 2014
By far the best form of which for peace of mind is swimming. Swim if you can. Not so much exercise that you get overtired, though.
posted by ambrosen at 3:54 PM on September 5, 2014
Can you call your PCP or your psychiatrist and ask for a short term script of tranquilizers? Tell them you're having panic attacks and ending up curled up in the fetal position under the table when you try to clean, that you haven't been able to do the dishes in two weeks and anything else that show how serverely this is hurting your ability to function.
If you explain how you're calling all the time to get your appointment moved up and don't want a script for any longer than until you get to see youre psychiatrist, one of the doctors might feel enough sympathy for you to write a script. Try all the ideas that other people have suggested but this seems like a situation where temporary medication would really help.
posted by stray thoughts at 5:44 PM on September 5, 2014
If you explain how you're calling all the time to get your appointment moved up and don't want a script for any longer than until you get to see youre psychiatrist, one of the doctors might feel enough sympathy for you to write a script. Try all the ideas that other people have suggested but this seems like a situation where temporary medication would really help.
posted by stray thoughts at 5:44 PM on September 5, 2014
Doing mindfulness meditation every morning helps me a lot when my anxiety is up.
posted by humboldt32 at 10:01 AM on September 6, 2014
posted by humboldt32 at 10:01 AM on September 6, 2014
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It may be much easier to get an earlier appointment with a psychologist, MCSW, or LICSW. It may even be easier to get an earlier appointment with a different psychiatrist. Ask your PCP if she can recommend someone.
Keep the 10/22 appointment on the books until you have an earlier appointment with another provider. That way if you don't find one, you still have the 10/22 appointment to fall back on.
posted by tckma at 10:37 AM on September 5, 2014