What’s wrong with me? Anxiety Overwhelm Hopelessness
March 13, 2022 11:13 AM   Subscribe

YANMD, YANMT. Over the last year I’ve been having some new and different mental health issues and I’m trying to figure out if it’s just what life is like now or if this is something I could get help to improve. I’ve dealt with anxiety since birth but this seems to be a different animal.

I’ve always had a tendency to be anxious/worried about everything and several times I’ve been on a medication for anxiety. I’m not right now, since the medication seemed to lose effectiveness and I felt ok without it. I’ve also been in talk therapy and have a relationship with a therapist now “on-demand”, seeing her maybe 3-4 times a year for “tune-ups.”

I have some circumstantial stressors right now — started new job recently, planning a move to a more expensive place, partner’s employment is currently precarious — as well as the stressors everyone’s dealing with if they’re conscientious about COVID — not seeing family, socially isolated, stress over what to do now that mask mandates are lifting but COVID hasn’t gone away.

What I’ve been feeling for the past year has been different from the slow, steady feeling of dread and tendency to expect worst-case scenarios that I have felt in the past. For the past year, I’ll be feeling ok, going about my day (well as ok as you can be with… gestures vaguely… all this) and then something small will happen that will send me into a complete meltdown, panic, feeling of complete emergency.

Last week, my partner simply asked, “Where should we move?” as we were talking about apartment complexes, and mentioned that his coworker lives in an apartment complex in the area we’re moving to and said it was really loud there. I lost it - started sobbing, feeling overwhelmed and hopeless, and basically just feeling like if I work hard to get everything done, I can still be screwed over by living in a loud apartment where I can’t feel safe and secure. My whole reality shifted into EMERGENCY at the drop of a hat.

This weekend, I was coordinating a Craigslist pickup with some people for some heavy furniture we have. My partner expressed the logical statement that the furniture is heavy and some people may not realize that they’ll need two people to move the furniture, so the process may take more of my time to supervise. Again, I went from ok mood, just living my normal day, to SOBBING/ANGRY/WHY DIDN’T YOU TELL ME THIS BEFORE and envisioning them taking all day to pick up the furniture and wasting my weekend.

And also last week, I was pulled into a time-sensitive project with my new job, and went from being able to sleep through the night to waking up every few hours during the night wracked with fear over whether I’d made mistakes/was going to miss the deadline.

Basically instead of the low-level “fearful things lurk around every corner” anxiety of the past, it’s now this “Cool having an ok day, blah blah blah, THIS THING WENT WRONG AND NOW I’M IN DANGER AND HYPERVENTILATING AND WILL NEVER BE HAPPY EVER AGAIN”. It’s like I’m a 3 year old or something and I can’t control my emotions.

And then other times, I’m functional, energetic, somewhat hopeful (as hopeful as you can be in 2022). By the way I am a woman in my late 30s but I’ve tracked it and it’s not PMS, it’s not happening at the same time of month every time.

YANMD, YANMT, but I’m wondering if anyone else has an experience with this, and if there are any non-therapist, non-medication things I can try. I have a long-time relationship with a therapist, who I see occasionally, but when I’ve brought this up with her she’s been somewhat dismissive, maybe because I feel ok most of the time. And I could try to restart some sort of medication, but I’m super busy -- I'm literally expending all of my energy just on my day to day basics -- and don’t have the time or energy to seek out a psychiatrist to figure out medicine.
posted by rogerroger to Health & Fitness (17 answers total) 22 users marked this as a favorite
And then other times, I’m functional, energetic, somewhat hopeful (as hopeful as you can be in 2022). By the way I am a woman in my late 30s but I’ve tracked it and it’s not PMS, it’s not happening at the same time of month every time.

I hear you, but at the same time this seems so similar to experiences I've had during my cycle (not quite melting-down-sobbing, but definitely OMG EVERYTHING IS SO CATASTROPHIC at the drop of a hat) that I would suggest getting your hormones worked up. Late 30s is not too early for perimenopause, alas.
posted by praemunire at 11:33 AM on March 13, 2022 [11 favorites]

This sounds like one of the symptoms of depression I experience. I'm not sure what it would technically be called, but I name it to myself as something like very low tolerance for distress. It also goes along with irritability which correlates to you blowing up at your partner. I really strongly relate to this feeling of complete, tantrum-y meltdown, which doesn't track to "depression" in a stereotypical melancholic sense but I think is absolutely a symptom. I also was very rage-y and irritable as a child, which looking back I think was a symptom of undiagnosed depression. It's like your nerves are just very exposed and something which logically you could think through just becomes overwhelmingly intensely awful and stressful all at once. Unfortunately this seems to happen more often at/around other people which feeds into a charming self-loathing feedback loop of feeling like a monster.

It makes sense that if you're too busy to prioritise taking care of your mental health then your mind can end up like a frayed electric wire which a slight touch can set off sparking. Looking into discussions around burn out might be helpful. Unfortunately I think more therapy and considering medication is something that would be good! An SSRI for me really felt like it took the edge off the scalding sudden intensity of HORRIBLENESS that I experienced.

If you really cannot pursue treatment, perhaps trying to cultivate acceptance for the facts of being in a stressful time, that it will pass, but at the moment it makes sense that your nerves are frayed. Is there anything you could do to "take the edge off"? Edibles? Wine? Bubble baths? Booking a holiday to look forward to? Giving up one of your more extraneous commitments so you have more time to rest? Just permitting yourself to doing whatever seemingly "unproductive" or "unhealthy" thing to get through can help. Sometimes life is hard and shit and putting pressure on yourself to be fine, nay, peppy, about it can make it worse.
posted by Balthamos at 11:45 AM on March 13, 2022 [1 favorite]

Maybe it would be helpful to think of this experience in terms of "nervous system overwhelm," regardless of whether hormones cause it, or life circumstances, or both, or something else, etc. There are some things you can do for a nervous system reset that brings you back to a feeling of relative safety, though they're in no way novel nor, in my experience, as easy as they sound when you're in the thick of it. Things like breathing (with longer exhales than inhales), feeling into your hands and feet until they tingle, dancing, singing, chanting, orgasms. Getting into your body and really letting yourself be there, in other words, can realllly help in a way that therapy (which tends to be heady) and meds cannot.

If you're anything like me (also a woman in my late 30s), you will feel significant resistance to this, almost like you're running away from your body, while flailing and yelling "nooooooo! don't make me live in there!" Don't criticize yourself for that resistance; that's the nervous system again, doing its self-protective thing. Just gently try to redirect your attention back to the body. I've been trying for even 2 minutes a day of this, with some improvements slowly making their way into my daily life.
posted by gold bridges at 11:55 AM on March 13, 2022 [12 favorites]

Are you giving yourself a full day a week to do absolutely nothing (besides whatever is pleasurable)? If not, I'd start - I know it might sound trite, but budgeting time for a proper recharge has had a positive impact on my own mental health.
posted by coffeecat at 12:06 PM on March 13, 2022 [4 favorites]

I am right here with you. I think just think this is way more common than we know. It's like if half the time you hear a beep someone comes in and punches you in the face, eventually that beep sound is going to start getting you extremely hyped up every time. I've been getting all this work dumped on me but the deadline never changes and every time I get a new one I just start screaming because I know this is all impossible. The thought of having to move, and all the fucking unknowns that come with that, like what if you get a bad one? That would absolutely trigger me at this point too. All of these things you mention are legitimate stressors & good predictions based on your experience, so it feels like getting hit with a ton of bricks, because you're accurately picturing getting hit with a ton of bricks. I have been thinking about water torture, where a drop of water in the same place in your body feels like nothing until you do it enough, because stress isn't transient, it just builds and snowballs and snowballs and snowballs.

So ok, what to do? one thing I can say is that tracking how often I feel stressed & how often these screaming & crying breaks are happening over the last year or so, makes it really obvious that this stress is happening to me rather than thinking of it as something I'm doing. I have a repeating item on my to do list to remind me to track this every day.

being able to actually see it drawn out like that & thinking of it that way helps me recover faster because then it becomes the same thing as throwing up if you eat something bad or being really out of breath after a tough workout, it's just something that happens when something else happens, and all you have to do is wait a bit to feel better.

Another good reason to track these things is at some point I'm going to go back to the dr about this and this time when they say "It doesn't sound THAT stressful" I can stick my phone in their face and say IS THIS STRESSFUL ENOUGH FOR YOU?

My other bit of "advice" I have is that once I have one of these, I try to get back to work, but if I can't get started again, I consider it a sick day event. Get into bed & order in your favorite kind of soup. I can at least confirm that treating myself kindly and taking it easy as much as I can preserves my mood & abilities for those times when someone isn't dumping 8 tons of shit on my head.
posted by bleep at 1:05 PM on March 13, 2022 [6 favorites]

I would approach this as if it is burnout and take appropriate next steps, and do that for a year or so before deciding this is just how it is.

I'd strongly rec going back on meds to see if you get back some resilience buffer. My personal solution has been Lexapro/escitalopram, which tends to work well with depression + anxiety in the kind of mishmash you describe. I require some sleep intervention with it (not that I was sleeping before either but it definitely does make my sleep a little thinner), but half a trazodone on school nights and the occasional treat of a whole one on the weekend, along with magnesium, have handled it.

I feel pretty okay now most of the time. I'm going through some sad shit right now with two dogs dying in a very short period of time and I am capable of feeling ALL the feelings and being super sad at moments, but the difference is that I am still capable of making the necessary decisions and I can manage the sad and I'm not just vapor-locking in total inability to process or think.

I also recommend the book Burnout, which approaches the subject as a neurological and biological/somatic condition and provides really actionable techniques for managing/recovering that are for normal people with lives that can't just be abandoned.
posted by Lyn Never at 1:24 PM on March 13, 2022 [5 favorites]

Everything bleep said. I've been tracking every time I cry in a Twitter thread for more than a year and a half now, and it's been useful to even just document it and pull me out of the mindset. (Oh, that happened again, now I gotta document it, basically.) Note: The Twitter thread could be triggering, as it lists everything that's triggered me.

Also, regarding praemunire's initial thought, even if it's not perimenopause it could be something else hormonal; a few years ago, I started to have extreme ups and downs and some other issues, and it turns out I've got like two endocrine disorders (and of course it took several years to figure it all out because that's how it goes with women's reproductive health and mental health). Medication helps to deal with those specific issues. So definitely recommend following up with an endocrinologist to get some blood drawn and check your hormone levels, just in case. Stress can exaggerate hormonal changes as well; dealing with what feels like more hormones than usual too this week.

I bought the book Lyn Never mentions but haven't read it yet, but even just the taste of its topic matter that is covered in this interview (there's a transcript too, if you scroll down) gave me some useful practices to consider.
posted by limeonaire at 1:31 PM on March 13, 2022 [3 favorites]

This is a depression symptom I have had and understand a helpful might be "distress tolerance", your ability to tolerate distress has degraded. Now that I'm on the right medication for depression, my depression AND anxiety are improved.
posted by wellifyouinsist at 1:40 PM on March 13, 2022 [3 favorites]

Before you get on another psych med, exclude any medical causes. Second that it could be hormonal even if not perimenopause. That could be a fibroid messing things up, a (benign) pituitary cyst increasing prolactin, lots of things. Nutritional deficiencies can cause mood issues, especially with B vitamins, D, iron and magnesium among others. (If you have malabsorption due to digestive issues that could be part of it, too). Sleep apnea and other sleep disorders definitely cause mood disturbances. First look at these and only if you’re good in all those ways start a psych med, otherwise you risk masking the underlying reason (if there is one).
posted by cotton dress sock at 2:14 PM on March 13, 2022 [1 favorite]

I dipped into and back out of something very similar. One of the real issues was my sleep was minorly messed up for reasons that I figured would sort themselves out but I really discounted the effect of not-enough-sleep, over time, on my already anxious brain. It was a real problem! I'm perimenopausal (ish, possibly menopausal) and that may have been part of it but also there's just a lot going on.

And for you, some of these stressors are serious ones! New job and a move with a precarious work situation can grate on you even if each of the things feels like individually they're okay. A few things that helped me that I would suggest

- coffeecat's suggestion of "doing nothing" or only things that are pleasurable even if they seem like work to others. Like, for me, organizing little parts of my house puts me in a nice happy flow state and helps me get out of my own head. Do you have something like that?
- EXERCISE. I know, it's what everyone trots out and I find it of variable efficiency but when it works, especially for sleep, it really works. Is there an exercise you like?
- Being mindful of things like eating better, watching vitamins (I take D during our short winters and have a sun lamp), staying hydrated, limiting caffeine
- other people who you like. If you are like me you may have a wide variety of people who you can hang with, some of whom are more happymaking and some of whom have other qualities but not that. Think about reaching out to one of the happymaking ones, get a little societ time, say that you've been a little sad and afraid and could use some company (not for venting but just to be with another person besides your partner)

Also if you had meds in the past that worked okay without bad side effects, starting them back up just to lower the cognitive load might be helpful. I know getting a psych prescriber is a pain in the ass, especially if you are feeling overwhelmed but it might really have results. One of the things I have to self-coach about a LOT is that my anxious brain wants to STAY THAT WAY in some maladaptive way, so it tells me to not take meds, not go to the doctors, etc and I have to swim upstream from that feeling (which I hate and is frustrating but is part of it and I try to be a friend to me and work on the things that I know work for me).

You will be happy again. I am really sorry this is happening. Time will also help with some of the things but it's okay to take more active steps now too.
posted by jessamyn at 3:10 PM on March 13, 2022 [6 favorites]

Oh good, someone has already mentioned distress tolerance. This is a big thing that a lot of people who previously hadn’t had to wrangle with mental health challenges are running into now so I’ve explained it a few different ways to different folks.

A person’s threshold for where they become actively distressed varies over their lives. Of course, if you are experiencing acute trauma, it’s a lot lower. But what many people don’t think about is cumulative trauma having the same effect. And it’s like, what isn’t traumatic these days?? Even if you were previously doing well without meds, you might still be more vulnerable to bad shit chipping away at your distress tolerance levels than other folks. I went back on sertraline last year, after a few years of no meds, and the change has been HUGE. I can actually feel my mind making the active choice not to be shrapneled by the free floating awfulness every time I check the news. I can take anger that I feel and make it into productive energy. The key has been getting the right dosage. In my case, I doubled what I had been taking previously at the recommendation of a psychiatrist after two telehealth interviews. I suspect I’ll be taking something for the rest of my life for anxiety, but probably not always this drug or this amount. And it’s entirely possible I will taper back down in a few years if the world manages to be less on fire.

My point is, please don’t discount medication because these are interesting times and very unusual circumstances. Lots and lots of people need the extra help and what you are describing is pretty common, at least in my circles.

For non-medication options, there are different things that can help depending on your personality and lifestyle. Some people do find regular exercise is invaluable for their emotion regulation and resiliency. Some people respond really well to different forms of meditation - I can sometimes do walking meditation, which might be something for you to look into if you have issues with fidgeting like me. Absolutely do check in with your GP and check things like iron levels, thyroid function, etc because even though you have preexisting anxiety there are plenty of things that can lower a person’s distress tolerance that aren’t purely mental. Like, with everything you’re juggling right now, how is your diet? A friend of mine went accidentally vegan while super stressed in grad school and passed out on the street, got diagnosed with massive B12 deficiency, started taking a prescribed supplement and eating some eggs and was shocked!! at not just how much better she felt but how bad she had felt before and didn’t realize.

Anyway, some more things to help build up distress tolerance are things that probably will feel a bit unobtainable to you right now, because a lot of it is about predictability. Making a schedule and sticking to it, having regular visits with loved ones you can depend upon, making meals predictable via stuff like taco tuesdays, getting your bedtime really regular and making your sleep as restful as possible… You might be able to get help for some of this from your partner, of course. But basically the idea is, give yourself simple things to depend on and build your days around, so when things go awry, you can rely on these things among the chaos.

If you were previously successful with a common anxiety medication, chances are high you can get a prescription from your GP for it. You probably don’t need to actually go through a psychiatrist unless you want to switch meds or had bad reactions before.
posted by Mizu at 6:24 PM on March 13, 2022 [6 favorites]

Just moving would make all those meltdowns fully reasonable, at least to me. And adding a partner’s uncertain job/$$ situation? I would have lost it completely. I’d say you are doing fine, and hope you can find a way to sneak a little rest and relaxation in, because I think that would be helpful. I hope it all works out and that you feel safe and secure very soon.
posted by asimplemouse at 6:55 PM on March 13, 2022

I've been trying to think compassionately about my anxiety because that seems to help, but:

It's sneaky sneaky and changes up how it presents when I've got a handle on (ignoring) the old way of presenting.
posted by freethefeet at 7:00 PM on March 13, 2022 [2 favorites]

Everyone is really raw right now. As a society we’re clawing our way back to our old normal, but the bill is coming due on a lot of the compromises we made with ourselves to stay sane.

Don’t cheat yourself. Allow yourself to be fragile and off your game for a while.

On a more immediate basis, I find daily breathing meditation helps prepare me to deal with sudden bursts of panic. I’ve had some significant mood instability recently and I’m really glad I’ve kept up the meditation practice.
posted by Tell Me No Lies at 2:03 AM on March 14, 2022 [5 favorites]

This was a super common experience for me until I started taking lamotrigine, a mood stabilizer. My depression would sometimes 'drop me off a cliff' and the dysphoria was so intense that I ruined some relationships and made very poor decisions trying to solve whatever problem seemed like the cause.

I have literally not had a single episode of that since I've been on this medication.
posted by ananci at 2:09 PM on March 14, 2022 [1 favorite]

Response by poster: Oh man, thanks everyone. I had been thinking about posting this Ask for literally months and I'm glad I took the time to type it out. I really appreciate people sharing their experiences, makes me feel less alone. Will think over these responses and update if I do take action. <3
posted by rogerroger at 7:54 PM on March 14, 2022 [3 favorites]

Further "you are not alone" material:

1. That's exactly what I'm like when I'm at the end of my tether, zero to catastrophe in an eyeblink. In your position I would be reacting just the same way. (I haven't found any real fix for it other than waiting it out, though I'm definitely more emotionally robust when I'm sleeping better and getting more exercise, which is obviously easier said than done.)

2. More importantly, I think you'll appreciate this Strange Planet cartoon.
posted by ManyLeggedCreature at 1:31 PM on March 15, 2022

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