How to deal with extreme anxiety over loved ones' well-being?
May 11, 2015 1:37 PM   Subscribe

I have a lifelong pattern of extreme anxiety attacks and imagining the worst when people I'm close to are not where they say they will be at the time they say they will be there and unreachable. It escalates quickly into a terror that they are dead and at worst ends in uncontrollable shaking and crying. How can I mitigate this?

I think that this is a PTSD reaction from something that happened repeatedly to me in childhood. My mother would be very late coming home, and my father, who has similar anxiety issues to mine (which I believe for both of us are related to being on the spectrum) would freak out and have a fit, saying he was afraid she was dead. For a seven-year-old to witness this was horrifying, and I feel like my mind reacted as though she were actually dead every time this happened. When she came home I would feel a huge endorphin rush of relief.

I've had EMDR about this, and since then, it hasn't been as bad as it once was. Before the EMDR, I would dissociate and have delusions when it got really bad. For example, I was separated from an ex I still loved and I was sure that if I opened the newspaper up I would see his death notice. I have wondered if my dissociation from reality during these attacks qualifies as a temporary psychosis because of its extremeness.

Usually when I fall in love with someone, the way I know I'm in love is if I end up worrying about the person to an extreme degree. For example, my current guy and I are not in the same city, so we have to rely on phone and internet. If he's a few minutes late, I can't stop my mind going to the "OMG he's dead" place. It usually takes much longer since the EMDR for it to escalate into a full-scale attack, but it's still pretty bad.

I have told him about it, and he's very understanding, but I know this is my problem and not his and I think it would be bad boundaries to make him responsible for it or demand he never be late. He's a very reliable person, but sometimes the unexpected happens.

I have had medication for the attacks in the past, but they were in the benzodiazepine family and I ended up going through withdrawal from them, and then I read that they may cause dementia later in life, so I now use valerian root and kava, and deep breathing. These only work a little bit.

If another person is around, I try to get a reality check. I'll ask them questions like, "it's too soon to panic, right?" and they will reassure me (though family members get pretty annoyed).

When I'm in the middle of one of these episodes, I lose touch with reality and have no idea when it is too soon to worry and I lose all ability to be rational. What I'm looking for are some cognitive strategies to deal with this problem, things I can write down when I'm calm and then look at when I'm freaking out to try to reach the rational part of my brain when it is being derailed. Any other strategies are welcome.
posted by Beethoven's Sith to Health & Fitness (5 answers total) 4 users marked this as a favorite
This strikes as being a bit beyond any cognitive strategies that might be offered on Ask MeFi. If possible I would urge you to find a therapist skilled CBT and who is used to working with persons experiencing forms of OCD/Phobias etc. There are also a number of excellent work books on strategies for dealing with issues such as this. I would think it might respond rather rapidly to a highly structured cognitive exposure or structured desensitization program. these can be difficult to self administer and it is very helpful to have a professional guide you through it/them. Also, given the chronic and recurrent nature of this benzodiazepines would be problematic for many people. Have you been on SSRI's--although they wont eliminate the anxiety they should reduce the intensity/duration of the anxiety facilitate some cognitive strategies.
posted by rmhsinc at 2:41 PM on May 11, 2015 [2 favorites]

I would strongly, strongly encourage you to look into seeing a doctor about this and trying medication -- it doesn't have to be benzos, there are other options! This is dramatically beyond normal anxiety and your quality of life will go way up if you can get help with it.

In the meantime, I have no idea whether this would be helpful, but: instead of trying to convince yourself that nothing bad has happened could, could you say to yourself, "Well, it's possible that something bad could have happened -- but even if it did, it's almost certainly not catastrophically bad"? If trying to suppress mental images of something terrible happening to him just make them come back stronger, try to replace them instead. For example, say the worst has happened and he was in a car accident -- but in the United States, about 70 people are injured in car accidents for every 1 person killed. Imagine him sitting in a waiting room, with a few bruises and scrapes, but essentially OK.
posted by ostro at 2:58 PM on May 11, 2015 [2 favorites]

Just don't go there. This seems simplistic, but, there is a line between love and control. There are some, in fact most things you can not control. When you get to the edge of this, this is when you lie down somewhere safe, and revisit your younger self, find your younger self because this intensity comes from the gross misunderstandings of childhood. You won't be in a better position to fix it than this, find your inner kid and make that kid safe, as the understanding adult you can be. Love that kid, tell that kid the truth about the people who harmed your understanding, breathe with that kid, and come back up through time in better shape.

I had horrible fears, now not so much. It is hard work, and lonely work reparenting the self.
posted by Oyéah at 3:11 PM on May 11, 2015

Ooooh yes, I know these feels. Agonizing by yourself, humiliating in front of others. I am so sorry you're going through this. I used to go into full on dissociative panic attacks over things like this. ALL THE TIME. It started in childhood for me, around age 6. My mom did the same thing (she's medicated for anxiety now, so it's better).

Then one day, when I found out my (now former) husband had fallen off the wagon again and was drunkenly climbing around the exposed beams his office after staying all night without calling me, something in me just...gave. I suddenly snapped out of my panic about whether he would fall off and break his leg and / or drink himself to death. I had this moment of clarity that even if something were to happen to him, I had absolutely no control over it, and worrying was not going to help one bit one way or the other.

I told myself, if there's something you can do about the thing you're worried about, go do it. If you can't do something about it right now, then you have to stop worrying. Because then it's like praying for what you don't want. And the panic response just...stopped. It's like I wore out my capacity to worry. I had no more adrenaline left for it or something. It was so liberating.

Ever since that moment, my anxiety levels really dropped. Even when my current boyfriend comes home late or something, it doesn't phase me. I also read a book on CBT called Three Minute Therapy, and that really helped too. I want to let you know it IS possible to get past this, and that you're not the only one who feels like this.
posted by ananci at 3:56 PM on May 11, 2015 [3 favorites]

I'v mentioned this many times, but I use a prescription called hydroxyzine, which is not addictive, and is the same thing they give you coming out of surgery to keep you from being nauseous. It does make you groggy the next day, but that wears off as you get used to it. I take a small dose (25 mg) an hour or two before bedtime and it works for me. You can't mix it with certain painkillers or alcohol, so be sure to talk to your doctor about those things.

There are other medications that might help as well. I have tried a slew of them and had really weird side effects, and as you say, benzos longterm aren't really a solution.

I have tried beta blockers, SSRI's, and a whole bunch of herbal things. This is what works for me, and while I might have some mild anxiety during the day, it is not anywhere near the type that you are describing, which I have experienced in the past.

I also make sure I hit myself up with a high protein smoothie in the morning, there is nothing like low blood sugar to freak me out. Or even plain Greek yogurt and a cup of frozen blueberries (nuke them 30 seconds, dump in yogurt, stir). If I have any sort of anxiety or insomnia at night, I get up and have a bowl of cereal with lowfat milk, bran or frosted Mini Wheats.

You might also want to see a dietician to give you an idea of an ideal diet. Often, what I experienced was partly low blood sugar, and I would crave carbs. I don't eliminate carbs from my diet, but I lean more toward things like hummus, cottage cheese, poached chicken breasts (which can be done in one shot and saved for the week ahead).

I think for me, before I can do the cognitive work, I have to calm down the excitatory part of my brain that makes it impossible to even think about doing it. So it's: that pill at night, high protein in the morning, being active shortly thereafter, then hitting it with some more protein and veg, small amount of carbs, and then chilling in the afternoon, and more protein and veg at night. I don't always adhere to this, but when I don't, I notice it.
posted by Marie Mon Dieu at 3:59 PM on May 11, 2015 [2 favorites]

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