In which we make me a less nervous person.
April 17, 2015 1:22 PM   Subscribe

I have now three times in my life developed stress-activated autoimmune problems. The first two times were during huge life changes, and the conditions completely abated after a few months, but today I just got diagnosed with another one, yet there is nothing specifically stressful happening right now.

I found a weird white patch of skin on my inner upper thigh, so I went to the dermatologist. She examined it and pronounced it vitiligo, and told me that, due to my history, and the appearance and location of my patch, mine is likely autoimmune and activated by stress.

(My other autoimmune disorders were: iritis in 2004, right as I was about to move and start law school, and psoriasis in 2009, right as I was about to move and start grad school. Iritis was cured with drops in 2 weeks and never recurred; psoriasis lasted a few months as an itchy gross-looking ankle, and then never recurred).

The doctor asked me if anything particularly stressful is happening in my life, and this time, the answer was no. Nothing happened. I'm not moving or going to school. I have a government job that is more boring than it is stressful. I get enough sleep. I eat healthily. I go to the gym 4-5 days a week. I hardly ever drink. I do not smoke. I live with my boyfriend in a nice apartment and we have a good relationship. I have no family stress and no friend stress. Nothing happened. So I told the doctor this, and then mentioned "but I am, in general, a nervous person."

So my instructions are to work on that. I know about meditation; my boyfriend is very into meditating and despite that fact that I have despised it in the past, I will work on liking it since it could possibly help. What I ask you is what are some other things can I do, besides meditation, to become, in general, a non-nervous person? What are strategies you've undertaken to have a generally calmer approach towards living?

The level and brand of nervousness we are dealing with here is a constant low-level anxiety about nothing in particular--maybe more of a general tension than an anxiety. I'm on permanent alert. I remain vigilant. Little surprises throw me off. I am terrible at letting things roll off my back. I like schedules and routines. I have been accused of rigidity. On the big-5 personality test, I'm very high on conscientiousness and neuroticism (and openness! I'm not all bad!). I'm an MBTI INTJ (yes I know MBTI is basically discredited; this is for descriptive purposes).

My anxiety isn't really about anything, though small things come up every now and then and I obsess over them. Right now I'm obsessing about the possibility of developing huge white patches all over my body, and the irony is not lost on me that the more I worry about this, the more likely it is to happen.

So, techniques to calm down? Advice about how to deal with specific fears or phobias probably isn't so helpful.
posted by millipede to Health & Fitness (15 answers total) 23 users marked this as a favorite
My therapist recommended a particular biofeedback device called Heartmath. I haven't yet tried it, but it might make sense to include it in your meditation practice.

Also have you looked into supplements? Might be worth a few visits to a nutritionist or naturopath or a bit of experimentation.
posted by vunder at 1:32 PM on April 17, 2015

Go down that road. Take a moment and allow yourself to see the worst case scenario. Your tiny white spot turns into a huge patch of white spots. You end up covered in them. It becomes so bad that you are reported to the CDC. Oprah wants to do a story on you and your bravery. You become the spokesperson for people with spots all over their body. You create a movement. There are parades..... I think you see where I am going with this. If you go down every road and get to the end, you see that the end is either too preposterous to worry about or not so bad that you couldn't handle it. That is how I deal with anxiety. I go down those roads.

Another way is to only spend time thinking about solvable problems. This takes discipline. When you notice a worry cropping up, ask yourself, 'is this a now problem or a nothing problem?' If it is a now problem, it is something that you have to create an action plan for and solve. If it is a nothing problem, something out of your control, then you have to forget about it. It takes a bit of skill but it's very zen.
posted by myselfasme at 1:54 PM on April 17, 2015 [3 favorites]

I've never managed the patience necessary to meditate. I'd probably be better off if I could.

But since I haven't managed that, I've found something else that works for me-- rock climbing. It's puzzley enough to keep my brain on task and not wandering off to worry about the rest of life. It's physical enough to keep me in tune with my body. On the down side, good climbing spaces don't exist everywhere. And if you are injured or sick, then you can't get your fix.

And boy am I a mess if I don't climb for too long.. I get clangry? I dunno.
posted by nat at 1:56 PM on April 17, 2015 [2 favorites]

I know, AskMe stereotype, but: are SSRIs and/or therapy (CBT, DBT, REBT, reading "Feeling Good", ...) out of the question? For me, the side effects of SSRIs ended up making them not worth it, but especially in retrospect, I notice that they did take away some of this chronic background tension, probably more than I gave them credit for at the time. They didn't make me "less myself" or anything. Therapy also helped me a lot: my therapist used a mixture of ACT, which incorporates meditation but has a lot of other features, and more psychodynamic approaches.

Also, I know this is partly just phrasing, but you said "I will work on liking [meditation]" and this is actually not necessary, and in a way it's putting an additional burden on yourself to say "not only am I going to meditate, but I'm going to like it!" Liking it is sort of orthogonal to getting benefits from it, like physical exercise.

Speaking of exercise, you mentioned going to the gym, but I'll say anyway that the single non-drug, non-meditation thing that helps me the most is really vigorous exercise, like just whaling away for 20-30 minutes on an elliptical or stationary bike at as close to my max heart rate as I can stand. Weightlifting helps too, but the weights have to be really heavy and I have to do full-body exercises to get the same sort of calm-but-awake feeling after. Can you increase the intensity or frequency of your workouts safely? Intervals are great for that.

You could also try the more challenging forms of yoga, like Ashtanga or Vinyasa, which will get you a little enforced meditation hit as well as elevating your heart rate. And you can also take opportunities to sneak in more physical activity on top of the gym: jogging up the stairs, for instance, or taking a brisk walk after meals.

Finally, watch your caffeine intake.
posted by en forme de poire at 1:56 PM on April 17, 2015 [4 favorites]

I would also suggest investigating food and gut-health in case you have low levels of inflammation that are working against you.

Additionally, could you experiment with relaxing your sense of control? Let your boyfriend plan something for you (a date? a surprise? a party?) and relax and let him do it. And see that the world doesn't go off the rails if you don't oversee things 100%. Even if it's not how *you* would do it, it's still ok.

Break your routine? Order something at random off the take-out menu and if it sucks say, eh, it was an experiment anyways.

Regular massage might help release tension. And exercise!

I have a tendency towards anxiety myself and yes meditation / relaxing into your feelings helps a lot. Just feel how you're feeling right now. It also helps that my partner mirrors back to me when I'm getting into an anxiety spiral. And then I remember that control is an illusion. We are paradoxically completely safe and susceptible to the slings and arrows of life in the same moment. I just had to keep telling myself that there isn't another shoe waiting to drop. There just isn't. And when I felt tension, I said to myself: welcome to being alive.

Even if you perfectly relax, there are body things that are beyond our control. So don't obsess over this spot that appeared. You may not be able to control it or meditate it away, and that's fine too.
posted by St. Peepsburg at 1:58 PM on April 17, 2015 [2 favorites]

Did the doctor run anything else, like Vit D or thyroid levels? Because there are some other conditions that can run with autoimmune diseases AND cause weird, free-ranging stress. (IANAD, but I have had one of these conditions. I thought it was just the fact that I'm kind of high-strung until oh, look, it's my thyroid. Huh.)

People will probably recommend exercise in general, which is true. Yoga in particular, however, has been demonstrated to be especially effective for anxiety and stress management, possibly because of the ways it teaches you to look at your breath. You don't have to take a class, either; there are tons of free YouTube videos online for all levels of yoga. Mats are cheap at Target or Marshall's and that's about all you need to get started.

So my instructions are to work on that.

So... I have had many things chalked up to "stress" and left there. The thing is, sometimes an autoimmune condition (or thyroiditis, or other shitty health stuff) JUST HAPPENS. Laid-back people can also develop health issues.

Don't get me wrong -- it sounds like working on the anxiety will be worth it for you. It's easier to be happier when you're not constantly anxious. But don't blame your health condition on yourself. And don't be afraid to push doctors when things are diagnosed as "just stress."
posted by pie ninja at 1:59 PM on April 17, 2015 [8 favorites]

So, I'm going to throw this out there; IANYD and feel free to disregard, but I think doctors have a tendency to invoke stress as a cause or contributor to almost everything. Most patients will admit to feeling some stress about something, and hey presto, we have a non-quantifiable, untestable reason to blame the patient's lifestyle for the problem, and, also, the patient feels empowered to do something by reducing their stress.

So, by all means, look for ways to reduce your stress. (Mindfullness meditation is great, as is getting unpleasant work or household stuff off your plate and spending more time relaxing alone or with friends and family.)

But also don't just assume that because your doctor says your condition is related to stress that this means that you are stressed and broken and maybe don't put unhelpful labels on yourself like "nervous person."

Because maybe it's not stress. Maybe it's nothing at all that you are doing or have any control over. (If that thought is more stressful for you than attributing the problem to your nervousness, then I apologize.)
posted by BrashTech at 2:11 PM on April 17, 2015 [10 favorites]

[Ah, got interrupted while composing my reply and didn't refresh to see pie ninja's even better response.]
posted by BrashTech at 2:15 PM on April 17, 2015

I would also suggest investigating food and gut-health in case you have low levels of inflammation that are working against you.

I will Nth this.

Your gut is about 70% of your immune system. I have a condition that is classified as an autoimmune disorder. (God, do I loathe that whole concept so fucking much.) I have done a lot to work on my gut health over the last 14 years and a side effect of that has been that a lot of "unrelated" health issues have gotten better and a consequence of that is that I am no longer suffering debilitating somatopsychic side effects, like chronic anxiety.

TLDR: improving nutrition and working on my gut health has done tons to improve my immune function and also dramatically improved my emotional state.

Best of luck.
posted by Michele in California at 2:29 PM on April 17, 2015

Not only does everyone have stress and not only does every doctor and so forth blame shit on stress, but that is true to the nth degree with auto-immune disorders. Why? Because, quite seriously, we know fuck all about auto-immune disorders. Why does the body attack itself? I don't know, it must be stress related. I have two+ auto-immune disorders and when I get flares, they tend to come out of nowhere. My boss has an auto-immune disorder and when he gets a flare, his wife crossly tells him that he ate something wrong. That's the layperson's version of "it's caused by stress". In other words, blame the victim.

I love my doctors, but I especially love my doctors who don't use a fallback like "caused by stress" as camouflage for "I don't know why you suddenly flared for no apparent reason."

One thing that is absolutely true about auto-immune disorders is that the best treatment is collaborative. There's a great website that has helped me tremendously, Part of what I really appreciate about it is that I hear there about what other people have found helpful for their symptoms. I've gone to my gastroenterologist a few times with a request for medication that he hadn't suggested but that I learned about on HealingWell and he's very easygoing and will discuss it with me and then prescribe it.

At times when you do feel stressed and do want to work it out, my favorite is weight training. Far better than cardio, I find that resistance work gives my stress someplace to land and do good, instead of flying around in my head and body and causing disruptions.
posted by janey47 at 2:30 PM on April 17, 2015 [6 favorites]

In my household, if I was a superhero, I'm known as The Membrane. I'm sensitive emotionally and physically, often anxious, have at least one but maybe two autoimmune disorders (I think that alone will cause anxiety) - but I try to remember that being a membrane works both ways. I'm incredibly positively responsive to interventions. I did 5 minutes on an elliptical yesterday (seriously - I'm that out of shape) and I felt like million bucks. If I eat well for a single meal - all vegetables and lots of hydration - I feel good! Sign me up!

Anyway - it helps me a lot to know that I don't have to do everything right all at once in order to start feeling better.
posted by vitabellosi at 6:48 PM on April 17, 2015 [1 favorite]

"Do One Thing Different" may be a good place to start finding creative ways through anxiety.

Another question: are you anxious, or is there another emotion hiding behind that? Sometimes anger masks as other things that seem more acceptable to express, like sadness or anxiety. Have you tried journaling? Maybe take a class learning something new, with others who are also beginners themselves? Seeing that others are "new" to that thing, just like you, might be a good community experience, along with others who are nervous too. This might sound really basic but I think sometimes anxiety comes from a place of feeling disconnected and alone, separate from community. Just a thought.

RE: meditation, have you tried the Headspace app? I tried this from many recommendations on AskMe, and it teaches you the "how" of meditation in a way that is not spiritual or ethereal in any way. It's practical. I highly recommend it, especially if you hate meditating. I've been trying to meditate on a regular basis for 10 years and never "got it" until this app. It always just pissed me off. Now I'm on day 30, and just started the Anxiety series. It's quite helpful, particularly the "noting" exercise.
posted by onecircleaday at 8:26 PM on April 17, 2015

You are a worrier, but don't worry about worrying. It might just be a latex allergy, or a mild allergy to gym disinfectant. If you take a huge vitamin, or a s-ton of B complex, just get a middle of the road, multivitamin. There are aome preservatives in skin creams that cause irritation. If you are at the gym 5 days a week and live in a moist climate it might be fungal. Not to give more worries, just that medications for auto immune diseases are often worse than the little problem, and have serious side effects.

Increase the cotton content in your gym wear. Good luck to you.
posted by Oyéah at 9:35 PM on April 17, 2015

I'm a high alarm type person. My inner world seems to be triggered very easily into a state of defensiveness, which can then cascade into worry, fear, anger. I don't usually act out when I experience these states, unpleasant as they are to experience.
Over time as I analyzed my daily experience, I could see that there was a relationship between my fitness level and my well being, and that this extended to my alarm system as well. It wasn't enough to simply be active, I felt a need to really get fit and strong. I now think perhaps I'm simply normally attuned to the environment, only my body was so unfit that I didn't really react with anything like normal reactions.
Getting into a fitness regimen that I do daily, has really helped me. As my fitness level has gone up, my overreactions have gone down. I rotate weight work, yoga/pilates, speed work, yoga/pilates in a four day cycle and I do it all at home so no trips to a gym. Also ride my bike almost daily. Between that and mindfulness meditation I've begun to feel pretty normal now.
It's hard to factor in the gut/mind equation. As I've gotten more energetic I've relaxed the whole food paranoia and try to eat close to the earth and enjoy what I am eating.
posted by diode at 8:56 PM on April 18, 2015 [1 favorite]

What are strategies you've undertaken to have a generally calmer approach towards living?

The book meQuilibrium by Jan Bruce has some great strategies that might help you
posted by tiburon at 6:08 PM on April 19, 2015

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