Are there ways to manage anxiety without the use of medication?
March 27, 2008 9:19 AM   Subscribe

I'm anxious. All the time. About everything. Everything! Are there ways to manage this without the use of medication?

My anxiety is negatively affecting my life in major ways. I'm anxious about almost everything: that I'll be a failure, that people don't like me, that I'm no good at my job.

Oddly, it's not the ways I hear a lot of people talking about. Flying on an airplane? I'm completely fine with that. But that important work email that I was supposed to write and would only take 10 minutes finish? I've been worrying and procrastinating about that for 1 week.

It's not a hyperventilating panic attack, it's just a low grade feeling of being on edge that's constant and tires me out, like I'm wasting CPU cycles constantly predicting my own failure.

I'm so worried about being bad at my job that the only way I can get through the day is to surf the internet mindlessly to get away from my own thoughts... which means I'm not working and I've fulfilled my own prophecy.

I desperately want to deal with this but 1) I'm scared of using/ becoming dependent on medication to solve something that I feel I should be able to fix on my own.
And 2) I don't have health insurance (my job is freelance).

I've recently (1 month ago) given up all caffeine and started running 3 days a week.

What else can I do to manage this? Thank you for any help you can provide.
posted by anonymous to Health & Fitness (42 answers total) 81 users marked this as a favorite
Have you checked out and the getting things done recommendations ?
posted by iamabot at 9:22 AM on March 27, 2008

Having your work environment and hard drive tidy and uncluttered can make a huge difference to how stressed you feel. When did you last do a big purge of stuff you don't need?
posted by tomcooke at 9:30 AM on March 27, 2008

You're not the only one who feels this way, if that helps.

Meditation, positive visualizations, positive affirmations. I know these things have been parodied to death and seem trite, but approach them with a fresh mind - they do help. Avoid thinking of Stuart Smalley.

If you're avoiding something simple - which I do constantly, try and think 'long term'. Think about the things that are truly important in your life. Concentrate on the Big Things and you'll realize that these little things are trivial in the long run. Someone gets mad at you over this email? Doesn't matter. Avoiding doing something because you know it'll be problematic? You'll have forgotten in a few days to a week. What little things were bothering you six months ago? Can't recall? Exactly.

Send me some Mefi mail if you want.
posted by unixrat at 9:31 AM on March 27, 2008

I would start with seeing a professional therapist first. It's not that expensive to go once or twice to get a feel if the person can help you.

Hopefully a therapist would give you some tools to try to reduce the stress you are feeling and find ways to reduce your overall anxiety level.

Good luck.
posted by Argyle at 9:34 AM on March 27, 2008

Used in moderation, alcohol does help.
posted by matteo at 9:37 AM on March 27, 2008

Exercise. Outside.
posted by tiburon at 9:42 AM on March 27, 2008

You may want to poke through this recent question for advice on how to deal with anxiety.

I used to have a problem with constant low- to mid-grade anxiety (over any reason, or no reason at all). The only thing that has really helped me is Paxil, but, as I know that's not the sort of solution you're looking for, I'll mosey along.
posted by the littlest brussels sprout at 9:50 AM on March 27, 2008

I too have anxiety about daily life and family life. I am also known to avoid and procrastinate when I feel anxious.

When you avoid and procrastinate that is another opportunity to beat yourself up, and the anxiety worsens.

Taking action on the things I can control helps tremendously. If you write the email I'm betting some of your anxiety will lift. Yes, this is easier said than done. Do try to make an appointment with yourself to write the email and to get other things done that are in your control to ease some of the anxiety. Productivity is a good thing for the mental health.

You think people don't like you? Make a plan to chat with a coworker for five minutes or email a friend you've been possibly avoiding and see what happens. I'm betting the interaction will be positive. You should say to yourself: "That went well. Tom is a nice guy. People do like me." Replace People Don't Like Me with People Like Me! I'm a People Magnet!

I also find that it helps tremendously to admit your anxiety. You've done that here, and that is a very good thing, but try to tell someone else that you trust. I can tell my husband or my sister, "I'm feeling so anxious and sad right now about XYZ." Just by admitting the anxiety, I begin to feel a little better. The people I tell are also good at putting things into perspective and that helps a lot too.

I also find that being with people that have no idea that I'm fretting and doing something fun is a good thing. I can go out to dinner and a movie with a friend and come home anxiety free. If you don't have someone to do something fun with, rent some comedies. It's good to get out of your head for a few hours.

This answer could be useless to you since I don't have constant anxiety. My anxiety pops up every three months or so. I'm feeling anxious over something completely nuts and out of my control at the moment. It might last another few days, maybe another week, I don't know. I've had these small periods of anxiety so many times before that I know it will pass soon.

Last but not least, there is always CBT, which helps a lot. For me, it took a weekly appointment for a few months to get things sorted out and into a healthier place to deal with my anxiety more effectively. It's money well spent.
posted by LoriFLA at 9:57 AM on March 27, 2008 [3 favorites]

Cognitive behavioral therapy. I don't know what your financial situation is like, but you should look into the cost of therapy and consider whether it's something you can afford.
posted by mr_roboto at 9:58 AM on March 27, 2008

Cognitive-Behavioral Therapy is extremely effective in treating anxiety. You can find a therapist who specializes in CBT, or you can even learn some of the techniques yourself through a book. The Anxiety & Phobia Workbook and the Feeling Good Handbook are two that are really popular.

The process sounds almost cheesy, as it involves taking your anxious thoughts and analyzing ithem, but, as someone who used to have nearly crippling anxiety, I can say that once CBT techniques become habit, they make a HUGE difference.
posted by tastybrains at 10:01 AM on March 27, 2008

I know you want an answer that's beyond medication, but it sounds like you have generalized anxiety and that's what medication is FOR. Please see someone who can prescribe it for you if you need it. What's the harm in trying it?
posted by agregoli at 10:01 AM on March 27, 2008

There are organizations that offer low-cost therapy, on a sliding-scale. Without more information about your location, it's not possible to help you find such a place, but they do exist. A therapist will be able to give you personalized advice. If your life is affected to the extent you describe, then it sounds like you could really use the help of a professional.

You can find them, it's not that hard. It's manageable. Do it.
posted by Ms. Saint at 10:01 AM on March 27, 2008

Yoga, yoga, and more yoga! It works wonders on calming the mind and strengthening the body. Try to aim for at least 3 times a week. I promise, it really does work.
posted by Maishe at 10:03 AM on March 27, 2008 [4 favorites]

Perhaps self-confidence would help - getting the point where you assume you're more than capable of taking in stride whatever life throws your way, so you worry about it less.
The most effective way of gaining self confidence that I know of, is putting yourself in a situation where you will discover your limits are much greater than you assume. Ie necessarily intensive. I suspect the easiest way to do that on a schedule, would be a course like Outward Bound. (Glancing at Google, "outward bound" seems to be almost an umbrella term, but I mean the sort of thing that is for adults, 2-4 weeks, etc.)
posted by -harlequin- at 10:06 AM on March 27, 2008

Okay, I have this kind of anxiety, and I've done lots of different things, been in therapy, been on Celexa, taken Xanax, and after all that, I feel successful in my approach at last. This is not a problem with a quick fix, but there are some easy lessons to be learned.

First is, anxiety is a physical state. You can mentally overpower your body's anxiety through breathing techniques, distraction, positive self talk (This is fear. Fear will pass. I don't have to be afraid.) and other little tricks which will vary in effectiveness from person to person. I strongly encourage you to buy and read The Anxiety and Phobia Workbook, and begin bravely trying some new things to see what makes a dent in your tension/anxiety

Second, as you know, anxiety is additive. You're worrying about things you've already done and things you don't know anything about yet. Your base stress level is higher than "normal." For this reason, I suggest you need to be very gentle and protective of your body, and help it manage stress better than "normal." That means a good diet (low sugar is important for me here), a regular sleep schedule, as much exercise as possible (a MIRACLE anxiety drug, I kid you not), and, imo, a Multivitamin PLUS a massive B-complex. Some of the B's aid in stress management. They are depleted by alcohol use, so while alcohol is a short term solution, the hangover or aftereffects can be really sad and scary. At least know how to recognize that you're sufferering from exacerbated anxiety due to alcohol if you've had some. Anyhow, for me, my anxiety and panic have decreased remarkably from the vitamins.

Baby steps, and don't give up. You can hold your own hand and get yourself through this. Once you're ready to address your organizational problems, then sure, pick up Getting Things Done. I'm reading it now, and as it turns out, the organization I did on my own when overcoming anxiety (over phone calls, bills, all that embarassing minor stuff that I somehow used to fear and conflate with my downward spiral into a mental institution or a life in the gutter), but it's going to be a good book, like the Workbook, to keep around as an aid.

Last, try try try to remember that you're not alone, and that it's okay to share this with the people in your life who care about you. Having a really good cry about it at some point is a good idea. I can only imagine how much pressure and terror you have built up inside, but I know that my life was derailed for about a year and a half while I picked up the pieces of my debt and bad academics due to sticking my head in the sand and panicking. You know that having your life under control will make you feel better, but you don't know how to get there. The first step is admitting that YOU CAN GET THERE.

Good luck, babe. Memail me if you need to talk about it.
posted by Ambrosia Voyeur at 10:07 AM on March 27, 2008 [11 favorites]

This is me several years ago. I was paralyzed by my fears. This led to catastrophic personal and professional failure. I hit my bottom, it was worse than the anxiety, and that was what enabled me to find a way out. I do not recommend this. It has taken me many years to get my life back together. Imagine the worst case scenario. If you get fired, and you're alone, will that be less expensive and difficult than affording therapy right now? Is being miserable less expensive in terms of your time and emotional energy than affording therapy would be?

Where are you? I bet you can find affordable therapy there, and if you name a state I will help you google down the resources.

And! While therapy and taking drugs are not equivalent, I do want to say that taking medication does not make you a failure. If I asked you to help me move my couch, would you feel like a failure because you couldn't lift it alone? It's normal and healthy to need and accept help. It's normal and healthy to be unable to solve every problem yourself. If you ask for and recieve help that enables you to solve your problem, you have not failed. You have solved your problem. If you do not ask for help and do not solve your problem, then you have failed. You need to ask for help.

I wish I knew a better way of saying all this. It's a lot easier for me to empathize with you than it is for me to tell you what you should do. Feel free to mefi-mail me anytime if you need to vent to someone who understands.

What you're feeling doesn't make you weak, it doesn't make you a bad person, it's actually very common. And it's OK. And it may not be something you can fix on your own. Which is also OK.

I can't tell from your post whether or not there is a network of friends or family who can support you right now. I hope that there are some people in your life to whom you feel you can turn. If there aren't, pick someone and force yourself to turn to them.

You don't have to be alone in this. I will think more and see if I can come up with specific things you could do to make things better. However, and I am really speaking from my own biases and my own personal experience -- I hate to think that you're as lonely and unhappy as I was. I really hope that you will consider finding a therapist.
posted by prefpara at 10:16 AM on March 27, 2008 [4 favorites]

i suffer from this kind of anxiety as well as other kinds, and i am on meds for anxiety.

that said, one of the best things i've done recently to get rid of the "bad thoughts" is to just get rid of the physical evidence of them. i deleted every single blog entry i'd made since 2001. gone. and all the negative posts about myself were gone too, so i didn't have to reread them every time i was looking for an old post on something. i deleted/shredded all my performace reviews (not because they were bad, but because there were always nitpicky things in there and they were about my personality and shit like that). i got rid of books from college that just reminded me what i could have been and what i could have done. i deleted old photos of myself from when i wasn't as fat as i am now. etc. you get the point. if there's anything like that around you, take care of it.

also, and i say this in all seriousness, when i used to smoke pot daily, i had a LOT less anxiety. that chill feeling was the thing i missed the most when i quit smoking a while back.
posted by misanthropicsarah at 10:36 AM on March 27, 2008

I know it's not the answer you're looking for, but medication is very effective. And it was exactly the same as yours--I wasn't anxious about scary things. I'd have knots in my stomach knowing that I had an appointment somewhere in two days, or feel sick to my stomach because I had to go meet up with some friends. It was wholly irrational, and I knew very well that I had nothing to be anxious about.

FWIW, I take Lexapro, which works well and is not addictive. The only "side-effect" is that it causes drowsiness for me, so I take it a couple hours before bed, when drowsiness is suddenly a "bonus." I went off it for a couple years (no side-effects), but about a year later, I was starting to feel anxious again, so I went back on it. My doctor then admitted that he has been on it for several years.

something that I feel I should be able to fix on my own.

You seem to imply that it's your fault that you feel this way. It's not.
posted by fogster at 10:58 AM on March 27, 2008

1. I spent a year managing my anxiety, with varying degrees of success. My breakthrough came partially when I stopped trying to manage it and started letting go. Started seeing myself and anxiety as separate; stopped identifying with the anxiety. Managing for me was a way of working with the anxiety that sometimes helped, but that often kept the cycle (I need to do this; I can't do this; I'm a failure; but I REALLY need to do this ...) going.

2. In the immortal words of Jemaine "David Bowie" Clement: "Do something outrageous." Do something, anything, that breaks you out of your normal routine. Go camping for the weekend, away from computers, with old friends or new friends or no friends; see a random movie in a town 50 miles away; put on Metal Machine Music and curl up under a table. Anxiety limits your sense of possibility so radically, collapses past and future into a nervous working present where nothing new or novel can be created or experienced. Forcing yourself into something unfamiliar or strange or destabilizing can help break anxiety's grip on you.

3. Exercise can definitely help, and it's good that you're doing it. I found, however, that completely exhausting exercise helped a lot more than routine stuff. Further, I found it easy to incorporate exercise into my anxiety. Biking—my exercise of choice—gave me lots of time alone in my head that didn't exactly help. And the relatively limited physical aspect of biking (legs legs legs) doesn't give me the release that, say, a night out dancing does, or anything that forces me to use more of my body.

4. I recommend finding an activity that forces you to simply react. Improv helped me a whole lot. I'll bet you can get a similar experience from sports or martial arts, maybe even video games (as long as you don't numb out, which is usually my problem with video games). Just reacting is the hardest thing for me to do in my daily life when I'm trapped in anxiety; there's a gatekeeper that watches everything coming in and everything going out. If you can find ways to reconnect with the reactive parts of your body and brain you may be able to start doing that on the regular.
posted by wemayfreeze at 11:07 AM on March 27, 2008 [6 favorites]

I gigantically recommend David Burns' When Panic Attacks. Ignore the title -- it's not just for panic attacks but for all kinds of anxiety. My wife is a cognitive psychologist and a big fan of Burns. (If you read it, do the exercises. They look simple and commonsense and you'll be tempted to skip them. Don't.)
posted by futility closet at 11:10 AM on March 27, 2008

On the other hand, if I exercise everytime I'm anxious I end up screwing up my sleeping. I fall asleep right away and then wake up 2 hours later or else fidget and thrash around all night and wake up feeling like I haven't slept at all. No sleep, insufficient sleep, and non-restorative sleep all make me anxious. (It took me months to figure this out, by the way.)

Also try: De-clutter. Extra calcium. Cut back on the number of commitments in your life even if previously they weren't overwhelming. Quit caffeine. Quit sugar. (And for me, quit TV.)
posted by small_ruminant at 11:16 AM on March 27, 2008 [1 favorite]

You might find this book interesting: A Brief History of Anxiety by Patricia Pearson (NYT link). More of a cultural critique and memoir by a woman who suffers from anxiety issues than a self-help book, but it may be useful for you to hear of a funny intelligent person who is speaking candidly about her problems.
posted by Admiral Haddock at 11:17 AM on March 27, 2008

Weight training + cardio.
posted by stenseng at 11:36 AM on March 27, 2008

I've been through what you're going through, and only dealt with it when a few crises happened and my anxiety started manifesting itself in panic attacks. Ambrosia is exactly right that anxiety is a physical response, and learning that helped me to start dealing with it. I've tried to address it in a few ways:

1. Chanting/meditation - i took a few yoga classes and took from it their relaxation techniques, but found that for myself, i actually had to repeat something over and over in my mind long enough to stop my mind racing and let my body calm down. I went for the buddhist chant Nam-Myoho-Reynge-Kyo (Tina Turner is a rather famous user of this) because to my brain it's just cognitive white noise, but i think anything would work. I'm sure some of the links above and the CBT will give you a better idea of how to "hack" your mind to relax more.

2. Exercise - If you take a laid-back approach to exercise and don't make it another Problem to deal with or goal that you might fail, it's a great way to physically address your anxiety. My body just feels good after exercising, i rest better, and i seem to feel a lot more even because i exercise.

3. Cut out sugar and generally eat home-cooked, nutritious foods - i slowly phased sugar out of my tea, i stopped snacking on sugary items and went with savory snacks instead (like peppers and hoummous). If i don't actually think about how much sugar i'm eating, i'm introducing another physical cycle in my body that i don't understand and can't control, so i might feel wound up on a sugar rush and don't know why so start feeling anxious. I also cut out all soda drinks and went with tons of water instead. I switched to home-cooked meals almost entirely so i could feel more in control about my body and regulate my sugar levels and thus, my mood cycles.

Basically, i took a holistic approach to start controlling my body rather than letting it control me. I still have anxiety, but it's much less frequent and i'm getting better at not being anxious about it. It seems to be paying off in other parts of my life as well -- I'm enjoying learning new recipes, losing weight, feel more energetic, and i'm generally enjoying things a lot more now.
posted by ukdanae at 11:46 AM on March 27, 2008

I agree with those above that using anti-anxiety medication isn't somehow "failing." However, if you're wanting to try out a couple of things to see if you wrangle the anxiety without using meds, I think exercise is a good thing to try.

Not any old exercise, though. I've used exercise to deal with the stress/anxiety from my job for a long time, but what ended up helping ENORMOUSLY was switching to a workout before work rather than after I got home. Painful to wake up an hour earlier, but I feel much more centered and less anxious during the day now. Hour-long solitaire breaks to avoid doing work that stressed me out just to think about are (mostly!) a thing of the past. Now that I'm in the swing of morning workouts, it's clear to me that exercising after work was just a way to manage the anxiety after it happened--it didn't do much to lower my stress and anxiety during the day. Exercising before work seems to short-circuit it from happening at all (or at least cut it down quite a bit).
posted by iminurmefi at 11:47 AM on March 27, 2008

seconding the book Anxiety and Phobia Workbook. Managing the physical symptoms of anxiety goes a long way towards managing the mental forms. Meditation accomplishes both in one fell swoop, and I highly recommend it.

I'm scared of using/ becoming dependent on medication to solve something that I feel I should be able to fix on my own.

Well, I technically should be able to bike 20 miles to work, but given the shape I'm in, and my schedule, it's just not realistic. So I drive. Putting "shoulds" on yourself is just another form of anxiety. I'm going to go out on a limb and guess you're a perfectionist; when you can't get "simple" things done without tons of anxiety, you're probably putting undue pressure on yourself. This can be worked on in therapy, or the aforementioned meditation.

I'm on klonopin, and I'm 100% certain I'm not dependent on it, as I can go days without taking it to no withdrawal symptoms. Taking medication is a quality of life issue. I don't want to whiteknuckle through my day, every day. It takes a physical, emotional, and mental toll on me that I'm not prepared to pay over the long haul. With true anxiety disorder, there's no end in sight. It's not going to be magically OK after you finish this project or when the semester ends. I want to be able to enjoy my life without constant worry, and if a little yellow pill helps me get on that road, I'm all for it. It's not magic. Most of the work still has to be done by me.
posted by desjardins at 11:49 AM on March 27, 2008

Oh, and if you're okay with the "big things" like flying, do something spectacular, like jump out of an airplane. It makes the little things seem a lot easier by comparison.
posted by desjardins at 11:50 AM on March 27, 2008 [1 favorite]

exercise, sunlight, and good sleep hygeine (going to bed and waking up at the same time always) help me a lot.

although, the best thing for me was medication. but those things do help.
posted by thinkingwoman at 11:56 AM on March 27, 2008

Also an anxious guy, well I should say I was.

On some level, accept it. You are going to do whatever you are going to do, with or without anxiety. Worrying about how anxious you are during & after tasks is just an excuse to worry more.

Identify what contributes in your life to your anxiety, if you don't know what it is, or understand the details of what is making you anxious then that creates another negative loop. Be in control of what influences you.

And just have fun, we're only on this peice of sh*t rock for a blink of an eye, I'm not going to waste any of my time feeling bad.
posted by Submiqent at 11:58 AM on March 27, 2008

Besides, or in additional to therapy and meds, which are certainly worth considering, you might want to get down with some sort of personal productivity management scheme, like GTD. If you can capture all the stuff you're supposed to be working on and break it down into actionable items, crossing a few of those off your list goes a long way toward calming inner fears and building a sense of worth and accomplishment.

The point is to stop focusing on you and start focusing on things that need to be done. Listing them out and organizing them into projects (real ones that can be accomplished, not big amorphous ones that can't, in any real sense) helps.
posted by wheat at 12:23 PM on March 27, 2008 [1 favorite]

I have had this problem on and off throughout my life as well. I echo the recommendations of cognitive behavioral therapy, but I have a book recommendations for you, since the biggest manifestation of your anxiety (and kudos to you for recognizing this, it's not something that many people do recognize) seems to be procrastination: I really can't recommend the book The Now Habit enough.

I can't remember if I got this technique from that book, or elsewhere, but one thing that helps me when I find myself procrastinating because of a fear of failure or anxiety, is the following:

Set a timer for 10 minutes. Tell yourself "I am going to do this thing that I am scared of, or don't feel like doing, for exactly 10 minutes. If I want to stop after that, I can."

What's amazing is that you find that you usually a.) get it done in ten minutes, or b.) get past the part that was scaring you and keep working. It's rare that I've actually stopped after ten minutes, but it does happen sometimes, and I have to start the cycle again.

Also, when you do this enough, you create the habit of just doing that nasty, unpleasant thing and getting it over with, even if it's something that isn't a difficult task, but a scary one, like calling the lady whose car you scraped in the parking lot yesterday, which I am about to do now.
posted by pazazygeek at 1:11 PM on March 27, 2008 [2 favorites]

Booze is a short-term solution but it causes a bad rebound effect the next day, making the anxiety cycle worse. Not a great idea for self-medication, ask me how I know.

I have a tendency toward low blood sugar, and I was on a great diet given to me by a nutritionist years ago and not only did I lose weight, I felt great. I fell away from the diet and wham! More anxiety, panic attacks, a diagnosis of Generalized Anxiety Disorder and prescription drugs that made me hallucinate. Subsequently, I was told by a shrink that I am one of those people who has an adverse reaction to SSRI's and Benzos like Xanax and Klonopin. And I have to manage my lifestyle or I slide back into anxiety mode.

A couple of years ago, I was able to see a therapist on a sliding scale rate through a state mental health program. She was great, and the accountability of going back every 2-3 weeks was enough motivation for me to follow through with doing the right things: exercising, hobbies, etc. I also had an evaluation with a shrink (low cost through the same state/county program) and by the time my appt came up, he said I was doing fine on the therapist's program and didn't need any meds. But I knew the offer of meds was there if I felt I needed them. Given my history, I am leery of taking any of 'em and he didn't push them on me.

Currently, I'm following The Schwarzbein Principle book for nutrition and it's very much like the diet the nutritionist had me on years ago. The book was recommended to me by my doctor. No sugar, no caffeine (yikes, I'm still workin' on that one but I have a couple cups of coffee in the morning and NO caffeine after noon). I also have a cheap gym membership and plenty of walking trails, a gentle yoga DVD that I got at Borders for about $20 (with a mat). Gary Bromley if anyone is interested. I love it because it has a woman standing nearby who does easy postures for beginners.

In addition, I use aromatherapy products, and have a cream tailor-made for me by a friend who took a class in it, and named it "In Control." I did some work for her so we traded (consider bartering for stuff if you're a freelancer?). It's got Lime, Geranium, German Chamomile, Rosemary, Cypress and Frankincense. There are tons of aromatherapy products out there, as well as the Bach essences that many people swear by (Rescue Remedy). I also by Aroma Naturals soy candles for about $2 at the grocery store.

Hot baths help me a lot, and good-smelling bubbly stuff. Lime coconut is great one bubble bath.

My suggestion is to grab the Schwarzbein book from the library and read through it. You could be wearing out your adrenals with a constant state of anxiety and this plan helps heal and nourish your body. Also, I know tons of folks who can't get by w/out their Xanax or Klonopin and I don't think any less of them (and would take them myself if I could!). If you needed blood pressure medication, well, you'd take it, right? So if it gets to be too much, seek out a county or state program or a therapist who will do sliding scale fees and take care of yourself. Also, I find I have to do something physical every day, not three days - walking, yoga, heavy housework, etc., early in the day (before noon) to keep it manageable, YMMV.

Good luck!
posted by Marie Mon Dieu at 2:07 PM on March 27, 2008 [1 favorite]

I also like When Panic Attacks. Ditto that it's for anxiety in general.
posted by zeek321 at 3:54 PM on March 27, 2008

I used to be like this. Here's what many years of living has taught me:

I used to be very anxious at work, thinking I wasn't good enough. Eventually I started looking around at all the other people around me behaving badly and saw they weren't killed for it.

I used feel guilty if I didn't worry about something and then it happened. I got this from my grandmother. I had to remember that one doesn't have anything to do with the other.

One day after some incident - and I don't remember what - I made a conscious decision to stop being afraid all the time.

Tell yourself that being anxious does not fix anything so you might as well stop.

And here is the key: Drink Water! If you feel anxious, drink water not alcohol. A lot of it. Anxiety makes you dehydrated.

And if these mind tricks don't work then yes, look into medication.
posted by andreap at 6:15 PM on March 27, 2008

Yoga and Ativan.
posted by hapax_legomenon at 9:51 PM on March 27, 2008

As someone procrastinating for anxiety reasons on her homework RIGHT NOW (thanks for the kick in the butt, btw) ... adding to much of the very good advice above, a note on meds. Would you tell someone who takes insulin for diabetes that they ought to be able to handle their illness "on their own"? What about someone with a heart condition? No? Well, then. Look, it's not just "in your head" (well, it is, but ...) - it's a chemical misfiring in your brain. When people are able to solve their anxiety problem without using medication, it's not because they have "more willpower" than people who do use meds, it's because they were able to kickstart their bodies into fixing the chemical misfiring. Sometimes your body needs a little extra help with that, and that's not a judgment on you. My anxiety is managed (okay, so I'm having a relapse this month) with a combination of meds and talk therapy - the therapy does most of the work at this point, but I could never have chilled out enough to do the therapy properly without the meds.

Since you're without insurance, I would check into local sliding-scale fee clinics in your area. They probably won't be free, but much cheaper. And definitely, check into cognitive behavior therapy; it's practically made for this stuff.
posted by bettafish at 7:28 AM on March 28, 2008

I like Kava. Its natural and its effects are subtle but noticeable.

Also make sure to get yourself checked out physically. All sorts of weird things can make you panicky. My last diagnosed "panic attack" anded up being a series of pulmonary embolisms, and I'm only 29.
posted by ryanissuper at 9:36 PM on March 28, 2008

Would you tell someone who takes insulin for diabetes that they ought to be able to handle their illness "on their own"? What about someone with a heart condition? No? Well, then. Look, it's not just "in your head" (well, it is, but ...) - it's a chemical misfiring in your brain.

Actually, doctors do prefer to have diabetics manage their illness without medication, if possible. I have the exact same problem with anxiety and my doctor wanted to put me on anti-anxiety, but after taking a week off to work on a farm, where I felt incredibly happy, I realized it wasn't me that was the problem, it was my life. You know, humans didn't evolve to sit at computers and churn out e-mails and datasheets. If you can't make major changes in your life, there are still some things you can do.

I personally, found running was useless. I need to get outside and do meaningful varied work. I joined a Prairie Restoration group, where I cut brush and plant seedlings every Saturday, and that gives me a welcome break from the anxiety. Start a garden, if you can. I did CBT for awhile and it didn't really help me. What I like about manual labor is that, usually, when it's done there is a tangible result and it's well...done. Whereas, in my work, no matter how much I work, there is always more more more I should be doing.

None of these things are magical, but they are worth trying before going on medication.
posted by melissam at 1:25 PM on March 29, 2008 [3 favorites]

I used to have pretty bad generalized anxiety and periodic panic attacks. Here's what worked for me:

Cognitive Behavioral Therapy. I know it has been mentioned above multiple times, but it is the most important element of a plan. I used to have negative thoughts running through my mind all day long, and after a few months of effort with CBT I had made drastic improvements in my anxiety level. I replaced the negative thoughts with positive thoughts and, at the suggestion of a few sources, even put them to music in my head. Sounds cheesy, I know, but if you make up a little tune and sing to it in your head something like, "I complete tasks, I complete tasks! I'm a good person, I'm a good person!..." etc., it can actually get STUCK in your head, just like a pop song. It was amazing to me how uplifting this was.

Drugs for occasional use. And I mean very occasional use. I had one prescription of xanax that lasted me a year, because I only took a pill in extreme panic cases. Don't be afraid to have some drugs on hand to help bring you down when you really need it.

Try to focus some of your analytical energy away from your self. It can be addicting to fervently examine your own behavior. I used to have heightened anxiety about conversations I had over a decade ago, where I would remember exactly what I said and how it may have made me look bad. When you notice you are picking at yourself and looking for imperfections, just break away. Tell yourself to stop it and engage in something else.

Good luck. There is plenty of hope because this is a common problem with plenty of options for help, from professionals to CBT exercises to do on your own.
posted by DarkoBeta at 8:08 PM on March 30, 2008

My partner is currently undergoing treatment for anxiety; one thing that seems to help (and that you could start doing right now) is regular relaxation exercises. Download the first two from this page.
posted by primer_dimer at 5:11 AM on March 31, 2008 [1 favorite]

For a stop-gap measure you might try acupuncture and Chinese herbs. They worked for me as a sort of preventative thing, though once I had an out-and-out anxiety attack going they didn't do anything. They couldn't help when I hadn't slept in a couple days, either.

Also: Calcium (+ Vit D). I found this out by accident a couple weeks ago- I started taking it out of osteoperosis fears and suddenly a huge amount of anxiety and depression lifted. Turns out when you don't have enough calcium your nervous system wigs out. Why couldn't my MD tell me this? I have no idea.
posted by small_ruminant at 10:16 AM on March 31, 2008 [1 favorite]

I know you said you are giving up caffeine, but when I asked a friend (a pre-med no less) this question not so long ago, she advised me to give up coffee, but to drink plenty of black tea.

It turn out that black tea has been shown (in legit studies) to significantly reduce anxiety levels, primarily by lowering/controlling levels of cortisol, a "stress hormone." As one scientist noted, tea is chemically very complex, and while they don't know exactly what causes the stress reducing effects, they think caffeine plays a part in it, as counterintuitive as that may seem to anyone who's ever had too many cups of joe.

I've never had my cortisol checked, but I took her advice, and it seemed to help, especially at work, where most of my anxiety was residing - it gave me the coffee focus without the jitters. Placebo effect or not, the ritual of preparing and sipping a warm drink is soothing on several levels.

Obviously, tea is no substitute for lifestyle change (exercise is huge, good for you), or possibly medication, but maybe worth a try.
posted by Prevailing Southwest at 10:50 AM on April 3, 2008 [3 favorites]

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