How Can I Handle My Anxiety
November 23, 2020 7:40 AM Subscribe
Hi folks,
I think I have mild problem with anxiety. Most of the time, it is a nagging feeling that something bad is about to happen - I'll get a call that a relative is sick; I'll get fired from my job, etc.
Again, most of the time this is mild; I can't stop moving my leg, I have that nagging feeling of a negative outcome about to hit, and I have trouble concentrating. However, every once in a while, I feel like I'm having a mild panic attack (or what I think is a mild panic attack). Breathing is a bit labored, and I feel warm in certain areas of my body.
What can I do about these symptoms? I don't think they are terrible, but I do think they impact my quality of life. I can live like this, but I don't want to.
Thank you for any help.
A little bit about my mental health history: For a while in my college years, I suffered from depression. Over the years, I was prescribed a variety of medications, the only one I can remember being Wellbutrin. I have not felt depressed in a very long time, I never took any of the medications for more than a year, and the last time I took any medication had to be close to a decade ago.
A little bit about my mental health history: For a while in my college years, I suffered from depression. Over the years, I was prescribed a variety of medications, the only one I can remember being Wellbutrin. I have not felt depressed in a very long time, I never took any of the medications for more than a year, and the last time I took any medication had to be close to a decade ago.
I'm going to suggest the opposite of therapy: get a check-up and describe these symptoms to your medical doctor. Restless legs, labored breathing and anxiety may all have a physical basis that no anti-depressant will touch.
posted by SPrintF at 8:07 AM on November 23, 2020 [5 favorites]
posted by SPrintF at 8:07 AM on November 23, 2020 [5 favorites]
If anxiety is analogous to lifting heavy things, mindfulness meditation is analogous to strength training.
If you adopt a regular meditation practice, to be done at times in your day when you're not feeling anxious, you should find that over time you become quicker and more skilled at intercepting and defusing anxiety's patterns before they get a chance to rise to the level of causing unpleasant bodily sensations.
posted by flabdablet at 8:07 AM on November 23, 2020 [8 favorites]
If you adopt a regular meditation practice, to be done at times in your day when you're not feeling anxious, you should find that over time you become quicker and more skilled at intercepting and defusing anxiety's patterns before they get a chance to rise to the level of causing unpleasant bodily sensations.
posted by flabdablet at 8:07 AM on November 23, 2020 [8 favorites]
If it's possible for you, you should definitely talk to a therapist and seek treatment for anxiety. I am not an expert on anxiety or the symptoms you describe, but it would probably be a good idea for you to talk to a psychiatrist and possibly get treatment for anxiety if that's what the psychiatrist determines is the problem. The labored breathing also warrants a conversation with your doctor.
I have worked with a therapist a few times in my life to work through some issues, but had never taken medication for anything prior to this year. A few months into this year, though, and I decided to talk to a psychiatrist and ended up being prescribed a low dose of citalopram (Celexa). It's been like night and day. None of the things provoking my anxiety have gone away - the pandemic is still going on, Trump didn't go away - but my ability to deal with that has been greatly increased, and the nagging feelings are much reduced. (I feel like some feeling of impending doom is ... pretty much normal this year.)
Strongly recommend talking to someone.
posted by jzb at 8:11 AM on November 23, 2020 [1 favorite]
I have worked with a therapist a few times in my life to work through some issues, but had never taken medication for anything prior to this year. A few months into this year, though, and I decided to talk to a psychiatrist and ended up being prescribed a low dose of citalopram (Celexa). It's been like night and day. None of the things provoking my anxiety have gone away - the pandemic is still going on, Trump didn't go away - but my ability to deal with that has been greatly increased, and the nagging feelings are much reduced. (I feel like some feeling of impending doom is ... pretty much normal this year.)
Strongly recommend talking to someone.
posted by jzb at 8:11 AM on November 23, 2020 [1 favorite]
Hello! This is a ridiculously difficult time right now and I have battled these weird panic attack "lite" episodes over the last few months as well. Because receiving a call about a sick relative or losing your job isn't an unrealistic thing to be concerned about this year.
When I start feeling overwhelmed (for me it's a tight chest) I start box breathing: breathe in for 4 seconds, hold for 4 seconds, breathe out for 4 seconds, hold for 4 seconds. I also focus on the phrase "Right now it's like this."
It sounded corny at first, but it works for me because it slows me down. I hope this helps you too.
posted by kimberussell at 8:34 AM on November 23, 2020 [8 favorites]
When I start feeling overwhelmed (for me it's a tight chest) I start box breathing: breathe in for 4 seconds, hold for 4 seconds, breathe out for 4 seconds, hold for 4 seconds. I also focus on the phrase "Right now it's like this."
It sounded corny at first, but it works for me because it slows me down. I hope this helps you too.
posted by kimberussell at 8:34 AM on November 23, 2020 [8 favorites]
I usually recommend people start with The Anxiety and Phobia Workbook, an easily-accessible book that will walk you through CBT 101 for anxiety. Not only is it helpful on its own, it gives you something you can take with you to your first therapy appointments so you're not so anxious about "how to start" that you can't start.
You can also start learning basic meditation from...basically anywhere on the internet at this point. There are guided meditations for free on Youtube, I use an app called Insight Timer that has a huge library (even in the free version) of various types and lengths of meditations. Youtube is also a good source of gentle stretching and yoga videos (peruse the entire Yoga With Adrienne channel, she's got one for every use case, including being a zombie) so you can release some of the tension in your body.
While depression and anxiety are often comorbid, anti-depressants are often not terribly good for managing anxiety, not necessarily making it worse just not really doing anything for it either way. It kind of depends on how much your anxiety is tied to your depression - for a lot of people those are two pretty different sine waves, coexisting and interacting but not necessarily pinned to each other. It's worth talking to your doctor, telemedicine is usually fine for starter treatment, and your doctor is having this conversation multiple times a day right now, I guarantee.
posted by Lyn Never at 8:50 AM on November 23, 2020 [2 favorites]
You can also start learning basic meditation from...basically anywhere on the internet at this point. There are guided meditations for free on Youtube, I use an app called Insight Timer that has a huge library (even in the free version) of various types and lengths of meditations. Youtube is also a good source of gentle stretching and yoga videos (peruse the entire Yoga With Adrienne channel, she's got one for every use case, including being a zombie) so you can release some of the tension in your body.
While depression and anxiety are often comorbid, anti-depressants are often not terribly good for managing anxiety, not necessarily making it worse just not really doing anything for it either way. It kind of depends on how much your anxiety is tied to your depression - for a lot of people those are two pretty different sine waves, coexisting and interacting but not necessarily pinned to each other. It's worth talking to your doctor, telemedicine is usually fine for starter treatment, and your doctor is having this conversation multiple times a day right now, I guarantee.
posted by Lyn Never at 8:50 AM on November 23, 2020 [2 favorites]
Nthing talking to your doctor. I was similar, I knew my anxiety was getting worse and affecting my life, but obviously I was living though it. My leg was shaking so badly it worried my mom (I no longer really even noticed it). My (canadian) doc was awesome about it. I simply mentioned (via telemed) i felt my anxiety was getting out of control, covid, other things in my life, etc, and pretty soon he was suggesting anti-anxiety meds. I too had done a couple rounds of depression meds in the past but they hadn't done much, and hadn't been on anything of that type in years. He got me started on Effexor and seriously, it made such a difference. I wish I hadn't waited so long to bring it up. I've often sat in bewilderment thinking "ok, normally I would be freaking out with anxiety right now because XYZ, and I'm... just not. Dang." I know I lucked out and and the first thing I tried worked, and that other people on the internet have mixed experiences. I'm not recommending any one medication for you, because everyone is different, but in my case, talking to my doc helped immensely.
posted by cgg at 9:05 AM on November 23, 2020 [2 favorites]
posted by cgg at 9:05 AM on November 23, 2020 [2 favorites]
When I was in my early 20s I started having anxiety attacks and then eventually panic attacks. That's about the right age for getting one of the big scary mental illnesses, I knew. So I thought I was literally going crazy. And I thought, I might be going really insane with an actual serious illness, but what I mustn't do, under any circumstances, is tell anyone or go to the doctor.
Some combo of stigma and ego and insecurity and c-ptsd kept me from seeking help until the problem grew from a series of minor episodes to a life altering pattern of agoraphobia.
I should have gotten help. Doctor or therapist, any entry point to the healthcare system would have worked. This stuff is SUPER treatable, help is available and your expectations for relief should be quite high.
posted by Horkus at 9:15 AM on November 23, 2020 [1 favorite]
Some combo of stigma and ego and insecurity and c-ptsd kept me from seeking help until the problem grew from a series of minor episodes to a life altering pattern of agoraphobia.
I should have gotten help. Doctor or therapist, any entry point to the healthcare system would have worked. This stuff is SUPER treatable, help is available and your expectations for relief should be quite high.
posted by Horkus at 9:15 AM on November 23, 2020 [1 favorite]
Definitely chat with a doctor. I had this kind of low grade constant anxiety with occasional mild panic attacks when my blood ferritin levels were super low. My doctor didn't know that low iron can sometimes present as anxiety, so you'll probably have to specifically ask for a blood test to check your iron levels.
If it turns out to be iron deficiency, it's an easy fix with OTC iron supplements. If it's not, your doctor can help you find a medication that works for you.
posted by burntflowers at 10:35 AM on November 23, 2020 [1 favorite]
If it turns out to be iron deficiency, it's an easy fix with OTC iron supplements. If it's not, your doctor can help you find a medication that works for you.
posted by burntflowers at 10:35 AM on November 23, 2020 [1 favorite]
Another mefite suggesting talking to your doctor as a first point of call to get a full blood panel for the usual suspects (low iron, low Vitamin D, etc).
I had symptoms like this for a long time, then discovered through some medical checkups that my resting blood pressure is ridiculously (and potentially dangerously) high. I'm now on daily BP meds and, interestingly, the anxiety symptoms are much diminished and I feel physically calmer. I'm not sure which was the chicken and which is the egg in terms of the anxiety and the blood pressure relationship, but either way for me addressing the physical problem was key to unpicking the physical side effects.
posted by fight or flight at 11:26 AM on November 23, 2020 [2 favorites]
I had symptoms like this for a long time, then discovered through some medical checkups that my resting blood pressure is ridiculously (and potentially dangerously) high. I'm now on daily BP meds and, interestingly, the anxiety symptoms are much diminished and I feel physically calmer. I'm not sure which was the chicken and which is the egg in terms of the anxiety and the blood pressure relationship, but either way for me addressing the physical problem was key to unpicking the physical side effects.
posted by fight or flight at 11:26 AM on November 23, 2020 [2 favorites]
Hi, I had the same kinds of issues as you, but less anxious and more depressive type stuff, anhedonia, sleep disruption, psycho motor slowing. One twenty minute tele-health visit with my regular doctor (primary care physician) got me on the road to sorting it out via a combination of short term therapy and medication.
My path involved a few tele health visits with in staff mental health councilor, then back to doctor for another 20 minute tele health visit and a prescription for a medication.
I’m much better now. I agree with many above that behavioral changes also help but my COVID living circumstances make it extremely difficult to achieve daily physical fixes like long walks and uninterrupted meditation. This is where the medication helps.
I was dissuaded by many stories of mental health professionals being overbooked and unavailable. Yes my counselor had a 9 month waiting period for new patients, but also they had certain times in the week set aside for emergent or short term issues. I was able to get into that quickly and it was all I needed to take the next step.
posted by sol at 11:32 AM on November 23, 2020
My path involved a few tele health visits with in staff mental health councilor, then back to doctor for another 20 minute tele health visit and a prescription for a medication.
I’m much better now. I agree with many above that behavioral changes also help but my COVID living circumstances make it extremely difficult to achieve daily physical fixes like long walks and uninterrupted meditation. This is where the medication helps.
I was dissuaded by many stories of mental health professionals being overbooked and unavailable. Yes my counselor had a 9 month waiting period for new patients, but also they had certain times in the week set aside for emergent or short term issues. I was able to get into that quickly and it was all I needed to take the next step.
posted by sol at 11:32 AM on November 23, 2020
I would divide my anxiety into related-but-separate halves:
My mental/cognitive anxiety is when I obsess about things and start to think the worst is going to happen. It's very much tied to my depression and is triggered by certain thoughts/actions. Therapy and anti-depression medication helped a lot here, and I have much less of this than I used to (but am still working on it).
My physical anxiety is similar to what you describe, and therapy/antidepressants didn't really help it much. Therapy has reduced how often I get mini-panic attacks, but it does not stop my heart from racing in social situations even though I'm completely confident I will do fine. This is a very low-level fight or flight reaction. For me the only things that have helped this are CBD oil, and Beta-blockers which are also used for high blood pressure. My doctor put me on Metoprolol for my high blood pressure, and even though it didn't help with that it dramatically cut my adrenaline-based anxiety reactions. There are some side effects though, so now I only use it when I know I'm going to enter an anxiety-triggering situation that I can't avoid.
It helps to address both the mental and physical parts of anxiety, because they feed into each other. There are lots of ways to help with either side, so pick one that seems reasonable and start there!
posted by JZig at 2:10 PM on November 23, 2020
My mental/cognitive anxiety is when I obsess about things and start to think the worst is going to happen. It's very much tied to my depression and is triggered by certain thoughts/actions. Therapy and anti-depression medication helped a lot here, and I have much less of this than I used to (but am still working on it).
My physical anxiety is similar to what you describe, and therapy/antidepressants didn't really help it much. Therapy has reduced how often I get mini-panic attacks, but it does not stop my heart from racing in social situations even though I'm completely confident I will do fine. This is a very low-level fight or flight reaction. For me the only things that have helped this are CBD oil, and Beta-blockers which are also used for high blood pressure. My doctor put me on Metoprolol for my high blood pressure, and even though it didn't help with that it dramatically cut my adrenaline-based anxiety reactions. There are some side effects though, so now I only use it when I know I'm going to enter an anxiety-triggering situation that I can't avoid.
It helps to address both the mental and physical parts of anxiety, because they feed into each other. There are lots of ways to help with either side, so pick one that seems reasonable and start there!
posted by JZig at 2:10 PM on November 23, 2020
Best answer: N-thing recommendations for therapy and getting a medical check-up to rule out any physical causes.
Beyond that, I have two books to recommend: When Panic Attacks by David Burns, and Embracing the Fear by Judith Bemis. (If you have to pick just one, choose Burns.) Both of these have a Cognitive Behavioral Therapy (CBT) angle. It's amazing how much anxiety you can cause yourself via critical/fear-based self-talk and various cognitive distortions. Both of those books will help you work through the thought patterns that ramp up your anxiety. I once had anxiety/panic so bad I was unable to work or live on my own, and those books helped me SO MUCH.
But the other thing that helped me was medication. My experience is different than Lyn Never's; I don't have any depression at all, but anti-depressants have been LIFE CHANGING for my anxiety. I've taken Lexapro every day for the past 4 years, and my quality of life has never, ever been this high in my entire life. Definitely worth looking into!
posted by leftover_scrabble_rack at 4:39 PM on November 23, 2020 [1 favorite]
Beyond that, I have two books to recommend: When Panic Attacks by David Burns, and Embracing the Fear by Judith Bemis. (If you have to pick just one, choose Burns.) Both of these have a Cognitive Behavioral Therapy (CBT) angle. It's amazing how much anxiety you can cause yourself via critical/fear-based self-talk and various cognitive distortions. Both of those books will help you work through the thought patterns that ramp up your anxiety. I once had anxiety/panic so bad I was unable to work or live on my own, and those books helped me SO MUCH.
But the other thing that helped me was medication. My experience is different than Lyn Never's; I don't have any depression at all, but anti-depressants have been LIFE CHANGING for my anxiety. I've taken Lexapro every day for the past 4 years, and my quality of life has never, ever been this high in my entire life. Definitely worth looking into!
posted by leftover_scrabble_rack at 4:39 PM on November 23, 2020 [1 favorite]
Different things work for different people with regards to anxiety. In my case, mindfulness meditation made it much worse (I actually had a full-blown panic attack). CBT didn't do much either. I saw a doctor and was put on a somewhat obscure medication called Buspar. It only works for about 10% of people, but when it works, it WORKS. It removed my non-productive anxiety. That doesn't mean I wouldn't get anxious if, for example, I was in an earthquake. But it eliminated the daily hum of anxiety that was making my life difficult, and the only side effect I had was wildly vivid dreams. Success rate for friends with anxiety who have tried Buspar (working with their doctor, I didn't randomly had them meds!) has been about 50/50. And by the end of one week, it's either working or it's not and you can move on to other solutions.
Another thing I will suggest because I don't see it above: check your caffeine consumption. I still get free-floating anxiety if I drink too much caffeine...and "too much" is not very much. It is not the "caffeine jitters" I hear so much about, it's anxiety. And it's surprisingly easy for me to drink 6 cups of coffee in a day if I'm not paying attention.
posted by rednikki at 7:45 PM on November 23, 2020
Another thing I will suggest because I don't see it above: check your caffeine consumption. I still get free-floating anxiety if I drink too much caffeine...and "too much" is not very much. It is not the "caffeine jitters" I hear so much about, it's anxiety. And it's surprisingly easy for me to drink 6 cups of coffee in a day if I'm not paying attention.
posted by rednikki at 7:45 PM on November 23, 2020
I agree with rednikki - mindful meditation hasn't really helped me for anxiety. (YMMV, of course!) It does help me not feel so reactionary in day to day life, and it's worth it for that.
I wish I had a suggestion for anxiety. Buspar made me feel spacy so I quit it.
posted by getawaysticks at 6:45 PM on November 24, 2020
I wish I had a suggestion for anxiety. Buspar made me feel spacy so I quit it.
posted by getawaysticks at 6:45 PM on November 24, 2020
This thread is closed to new comments.
(I don’t mean that to be flip, just that you’ll get more success from figuring out where the anxiety is coming from rather than just trying to stop shaking your leg)
posted by raccoon409 at 7:55 AM on November 23, 2020 [3 favorites]