What can I do to deal with anxiety episodes

May 28, 2015 7:14 AM

I would describe them as mini panic attacks. I had a full blown one a couple of times about 10 years ago that were complete agony. Lately I've been feeling the same way I'd feel leading up to those attacks.

"What doesn't kill you makes you stronger" has not applied to me in my life. When I was a teenager I was diagnosed with cancer and I beat it. That experience did make me stronger for a while, but then a few years later right after college it came back. This was a horrid time in my life because I lost all my friends and also found out that I couldn't trust the majority of my relatives. (They say when you get sick you find out who your real friends are and boy did I find out. Turned out I didn't have any real friends). I beat the cancer again but after this experience I changed as a person and it wasn't for the stronger. I became much less able to handle stress and started suffering from anxiety attacks. They were worse in the mornings where my heart would start racing for seemingly no reason. I would sweat and have terrible chest and stomach pains and nausea and having trouble breathing. These were things I never experienced before. There were two big attacks where I thought I was having a heart attack. My chest felt like it had been punched really hard it was so soar.

It had calmed down a bit for years (though it never entirely went away) and now that I've had a particular not great year the symptoms are coming back.
This past year has been very stressful for me. The only friend I had passed away; also my last grandparent passed away; My younger sibling got married and I was unable to go because I haven't spoken to most family members in 10 years due to what I went through with them during my second cancer bout. (not to mention how I feel about the fact that I'm older that her and not even in a relationship right now). I've had to deal with sudden high medical expenses and legal issues... all in the past year. And each one of these defeats has chipped away at me. I started getting those heart palpitations and trouble breathing and chest pains again. I haven't had a big attack yet but this feels awful enough and I'm afraid it's leading up to one anyway. Deep breathing seems to keep it from getting worse, but I'm still suffering. I think I'd do just about anything to make this go away. Are there any vitamins or home remedies? Should I go to a psychyatrist and get prescribed something? If I do that would it have weight gain side effects or other side effects? I'm open to anything that will help me be able to handle stress like a healthy human being again. Rather than going off the deep end.

posted by manderin to Health & Fitness (16 answers total)

Should I go to a psychyatrist and get prescribed something?

Yes. It doesn't even have to be something you take all the time. At least go for a consultation.
posted by mskyle at 7:20 AM on May 28, 2015 [7 favorites]

Anxiety is a beast. Don't ever feel like you're weak for experiencing it. It is a beast.

You will get loads of advice in this thread, so I'll keep my contribution simple.

- Yes, you should seek therapy for this ASAP. Even talking about it helps.

- If focusing on your breathing seems to help when in an acute state, look into practices that include this as a core facet. These include mindfulness. They don't help for everyone, though.

- Know that anxiety isn't always a psychological condition. It can be chemical. Physical. It is different from worrying about things. We don't really have good enough language to distinguish between these yet in conversation, and what constitutes "anxiety" for some (sometimes, apparently, most) is not even close to what I experience. When I have a sympathetic nervous system that is clearly about to be overeager, the first thing I do is drink a cup of chamomile tea, which contains beta blockers that immediately throw a spoke into the out-of-control cardiovascular effects. The moment my heart rate slows down a bit, I'm able to at least pretend I'm in control again. Sometimes, it's enough to stop the panic attack before it starts. Please try it.

- I haven't really found long-term medication (antidepressants and the like) that helpful for panic disorder, but I haven't tried them all yet. One quick note: benzodiazepines are immediately helpful, but should not be taken regularly. The long-term effects they have on our chemistry are worse than the original disorder.

I think you're really strong, and can fight this. Don't hesitate to message me if my struggle with this can be of any further help to you.
posted by tapesonthefloor at 7:41 AM on May 28, 2015 [4 favorites]

Sorry you've had such a rough go of things. I would recommend seeing your physician or psychiatrist as well. I've had panic/anxiety attacks in the past and having easy access to Ativan (or something similar, depending on what your doctor/psychiatrist suggests) makes it easier to bear. It sounds like you are recognizing the symptoms and actively trying to relax, take deep breaths, etc. This is really good, and your capacity to do so should get better if you end up having more attacks and you continue to try and control them. But even just knowing that you have a backup (medication) if you need it tends to help, and if you need to take it, it's there. Good luck, and you can also memail me if you need to at any point.
posted by meowf at 7:44 AM on May 28, 2015

But even just knowing that you have a backup (medication) if you need it tends to help, and if you need to take it, it's there.

Oh my god yes this. I have had so many fewer anxiety attacks since I started carrying a couple of Xanax with me (prescribed, of course). Just knowing that it's in my purse will deflect a lot of anxiety, and I hardly ever need to actually use it. When I do, the effect is strong and immediate. I've had anxiety nearly my entire life and just having those tiny little pills bumping around has tamed it so much.
posted by fiercecupcake at 7:52 AM on May 28, 2015 [4 favorites]

In addition to all of the above, remember to drink a lot of water. It sounds sort of ridiculously small because I have totally been there with the panic attacks and anxiety and needing to have the benzos on hand, but drinking water is something I constantly forget about when anxious but it helps.
posted by sweetkid at 8:05 AM on May 28, 2015 [1 favorite]

I agree about going to the doctor, but also, if you're not exercising regularly, please try that as well. Exercise has a profound effect on anxiety for a lot of people. Both something higher-intensity (I think the ideal is a fairly long aerobic session, 35+ minutes, but anything could help, even walking) and yoga, which will help tense muscles relax and also help you focus on deep breathing. For me, yoga is as good as massage. If you're having trouble getting motivated, there's a good book called Exercise for Mood and Anxiety.
posted by three_red_balloons at 8:09 AM on May 28, 2015 [2 favorites]

I had a bad run of panic attacks several months ago, and ultimately medication has been the most helpful. (In my case, daily Celexa has dropped the attacks to near-zero, but I also have a stash of benzos for crises. I almost never use them but it's good to know they're there.) But it took a few months to get that lined up. In the interim I derived immense benefit from mindful breathing once the attacks were actually happening, and also reading up on cognitive-behavioral therapy and mindfulness and trying to apply them in a self-taught way to my daily life, to help keep me from getting to the panic attack point in the first place.

Other stuff I'm finding helpful, you may or may not want to try:
- Monthly massage as part of the ongoing stress-reduction efforts
- Exercise, ugh, but it does seem like it's helping a bit.
- Taking up a new hobby that required serious concentration. Knitting was a godsend in those first couple of months - hard to let my brain run away with me when I was focusing so hard on learning new motor skills.
- Some sort of mindless soothing activity. Coloring worked well for me.

I'm sorry you're going through this. But there can be light at the end of the tunnel, and I hope you find your best way toward that end.
posted by Stacey at 8:13 AM on May 28, 2015 [1 favorite]

Going to a doctor won't hurt. SNRIs/SSRIs can help in the long run and as others have mentioned benzo's help immediately. Your primary care doctor may be willing to prescribe both of those for you if there's a long wait to see a psychiatrist.

In the short term, since breathing helps, try running. I've found vigorous physical exercise can help. Not always practical, but if you're at home give it a go. If you don't like running, jumping jacks or jump rope can work.

500mg of Tylenol has been shown to be helpful for anxiety. Be careful about your max daily dose.

Benadryl can be helpful. More so at night when you don't have to worry about the sleepy side effects.
posted by MadMadam at 8:13 AM on May 28, 2015

The easiest thing may be to start by talking with your GP, as they may be comfortable with prescribing you something or will have a recommendation for who to see next. Psychiatrists are notoriously difficult to get appointments with, which can make anxiety even worse, which is why starting with the GP may be a good immediate option for you.

Not all anxiety medications come with side effects like weight gain. Don't worry about that, honestly.

You should also consider seeing a therapist who can provide you with some coping mechanisms for when panic attacks happen. CBT provides a good skillset for managing panic attacks, and I think some people also have success with DBT.
posted by joan_holloway at 8:14 AM on May 28, 2015

I also suggest just getting a prescription for Xanax to take in case you need it. I went through a period in my life where I was having a panic attack about twice a week. This went on for months and it was extremely miserable. I finally went to the doctor and got a prescription for Xanax, and the panic attacks stopped. I never took the Xanax. Just knowing that I had that option available to me in case of a panic attack made me feel safe enough to move through the anxiety on my own. Eventually I was able to throw the bottle away because I learned I have the ability to prevent my own panic attacks.

I'm sorry you are going through this. It is very, very hard.
posted by Librarypt at 9:16 AM on May 28, 2015 [2 favorites]

Sorry you're going through this. Yes, definitely make an appointment with a doctor. I would start with a GP and ask for blood tests, such as for Vitamin D and B12 deficiencies, and blood sugar levels, thyroid levels, etc. You want to rule out any possible physical causes.

Are you getting it in the morning? You might find this article on morning anxiety helpful.

Things that have helped me:

- Eating a banana in the morning, along with some protein. Usually it's a yogurt and banana smoothie with milk and a little peanut butter and a B12 complex with extra C. But some days I'll have scrambled eggs and toast and on those days, I still eat a banana. I have no idea if the claims about bananas reducing anxiety have any real merit, but they make me feel better.

- Exercise. Walking. Yoga. Hiking. Dancing. Pick something you will stick with and keep at it. Use a video if you have to stay inside.

- Keep a log. "9:00 a.m., felt short of breath. Stopped and did deep breathing." That will help you and your doctor pinpoint possible causes (like low blood sugar or possibly just taking shallow breaths). Be sure to have your doctor check for mitral valve prolapse, which often doesn't require treatment but can mimic anxiety and panic.

- Make lists. I feel tons better when I write down a to-do list. It gets the swirling thoughts out of my head and the fear that I might forget something important diminishes. Helps me focus.

- Splashing my face with cold water or putting a cool wash cloth on my neck. you can use a paper towel in a pinch (if out in public, in a rest room, for instance).

- Music. Sometimes just putting on earbuds and blasting out a song and singing along badly helps.

- Crunchy things! Almonds, carrots, ice! Crunching helps, just avoid the potato chips and crackers.

- Aromatherapy sprays. I get a little bottle of lavender spray (Aura Cacia) at the grocery store. Spray on wrists and back of neck, wherever. It evaporates quickly so it doesn't offend people like perfume does. You can also spray it on your pillow before bed. There are tons of scents to choose from.

- White noise. I startle easily and noises bother me (big trucks idling, voices outside my window, etc.). I use a fan on rotate. I also have a little noisemaker that can play nature sounds, like a running brook. I'm sure you can get MP3's with these sounds. There are tons of videos on YouTube with relaxing nature sounds, as well as ASMR videos. Watching a mindless TV show can help.

- Prioritize. It sucks having sudden expenses. Your first priority has to be yourself, if you don't take care of yourself, you won't be able to deal with anything. Allow yourself time to heal and grieve, make sure you eat right, and push those other issues on the back burner (make a payment plan for $20 a month if you have to, etc.).

- Therapy. Talk therapy with medication is good, because you can explore the unresolved issues with your family and former friends. Do you want these resentments circling around in your head for the next 20 years? It's like stabbing yourself with a fork over and over again. After a while it becomes a reflex (ask me how I know) and the only way out is to come to some sort of closure in your head and make new friends. The old saying, "you can choose your friends, but you can't choose your family" is true.

- Hormones. If you are a female person, do you notice symptoms getting worse around that time of the month? If so, you might have to step up your exercise for a few days, pound water, etc. Again, just something to note and ask your doctor about as well.

Pick up the phone and call the doctor, don't even think about it, just do it.
posted by Marie Mon Dieu at 9:19 AM on May 28, 2015 [2 favorites]

Another thing that could help is taking a small magnesium supplement, since a deficiency can cause anxiety (and stress can deplete magnesium).
posted by three_red_balloons at 9:57 AM on May 28, 2015

Hello, fellow "what ever doesn't kill me makes me stronger; look at how hard core I am for enduring high levels of stress without a breakdown" person here. In the same way that I can't get by on all nighters and nights of heavy drinking, I can't tamp down anxiety any more like I used to. Yes, it helps for me to get a lot of regular exercise and maintain a normal sleep schedule. But it also helped to talk to a psychiatrist who was able to properly acknowledge the existence of the problem, prescribe me some medication, and keep regular tabs on me regarding my progress. It was really a revelation to me to realize that I don't have to live like I was living before I actually sought treatment.
posted by bright colored sock puppet at 10:12 AM on May 28, 2015 [1 favorite]

I had a six-week period recently where I experienced panic attacks twice a week or so. Thankfully, that has stopped. For me, one of the worst things about panic attacks and anxiety in general is that it isn't always logical. I wasn't having panic attacks about any particular thing -- they just came out of nowhere. Not understanding it made it worse, because not understanding it led to a secondary anxiety about getting anxious again. It's a brutal and self-defeating cycle, and panic attacks really suck, physically.

The Anxiety and Phobia Workbook -- which has been recommended here many times (I learned about it from AskMe) -- really helped me with the understanding part. It gave me something for my brain to hold on to, and it gave me some (soothing) knowledge that I could/can call back to when I start to feel a potential panic attack creeping up on me.

Mindfulness meditation has also really helped, and I try (try!) to do it every morning. The point is to train yourself to be able to focus on this very moment right now, where you are safe and protected, and where past hurts and future hypotheticals don't get you swirling around in the anxiety whirlpool. You have to do it regularly for it to work, but I've found it helpful and enjoyable (unlike exercise yuck yuck yuck). I have Bhuddify and the Calm app on my phone. Calm has a 7- and a 21-day series of guided meditations that are really good. The app isn't free, but it's been well worth whatever I paid for it.

I'm also on Buspar 3x daily. It has seemed to help. Honestly, though, I think the understanding I learned from the book and the meditation have been more curative than the drugs. Oh -- and therapy. :)

Best of luck, hang in there, and do see a doctor. It feels really bad when it's happening, but you can absolutely get a handle on it. You just have to work at it a bit.
posted by mudpuppie at 10:33 AM on May 28, 2015

Have you tried L-theanine supplements? It is the calming ingredient in green tea.
posted by rpfields at 4:09 PM on May 28, 2015

Oh, honey child. I can relate to so much of what you're going through. Cancer, panic, feelings of abandonment and loneliness... if you were consumed with gender dysphoria, I'd figure we must be long lost twins.

There's a lot of really good advice here, particularly the stuff about talking to a shrink and trying some drugs. YOU MUST DO THESE THINGS. Seriously, trying to get through this stuff without the help of a shrink or some drugs is like trying to move to a new place way across town, without help. Or a truck. Sure, it can arguably be done, but why would you ever choose to do it that way?

I am going through a rough patch myself, but here are some things that have helped and things I know would help if I was better about doing them.

* When you're not feeling like shit, do everything you can to fulfill your goals and make your life better. When you are falling apart emotionally, your mind focuses in on everything that's wrong. If you don't have friends, for instance, that becomes a huge problem and you think you will never have friends again because you are broken and fated to die alone surrounded by jars of your own pee or something. So, whenever you have the strength (and sometimes even when you don't) work damn hard on achieving the things that really matter to you. That way, the next time you start to panic your brain will have less to torture you about. You can tell your brain, "Fuck you, I did all this stuff!" Don't let your brain bully you!

* Be grateful for the times when you are not consumed with pain and panic. If you are having a nice moment, stop, take a mental snapshot, savor it. It's good to have some good times to remember, when it seems like your whole life is nothing but bad times.

* Express yourself in some creative way, if you don't already. I've gotten through a lot of horrible dental procedures by sitting there trying to work out a plot problem on some story I was working on. The act of creation can give you a whole other reality to escape into.

* Everybody says exercise helps. I loathe the sweaty tedium of exercise, but they're right.

* Make some friends. Volunteer, try Mefi meetups, whatever. But find some friends and hold them close.

* Ask yourself if your relationships with your former friends and family are beyond saving. When people are young and they have never been really sick, it can be hard for them to understand what you're going through. Also, it's not unlikely you were a big ball of crazy stress and you were really hard to be around. There is such a thing as a fair weather friend (or family member) and don't make excuses for people who treated you badly. But ask yourself if these people are just bad, or if they cared about you but just fumbled because you were dealing with something beyond their understanding.

* Fuck the pain away. Seriously, lots of quality poking. Do stuff to feel sexy. Get dolled up, go dancing. Or go climb rocks if that makes you feel hot. Feeling like a sexy beast makes your body feel like a good thing, instead of a scarred, treacherous flesh-pile.

* Always have something to do, some busywork you can do even if you're going nuts. (I design covers for my eBooks. No matter how shitty I feel, I can still move words around and crop pictures.) That way instead of feeling like you've lost a day to panic, you'll know you've accomplished something and the day wasn't a total waste.

* Remember, it won't always be like this. Whatever is happening now, good or bad, it won't always be like this.
posted by Ursula Hitler at 5:21 PM on May 28, 2015 [3 favorites]