Anxiety blows!
April 29, 2008 6:32 AM   Subscribe

Help me think of how to deal with increasingly severe anxiety problems until the next time I talk to my therapist.

I have massive anxiety problems, usually in the form of overthinking about things. If I'm presented with various innocuous situations such as putting a sock on my foot in a certain way at all, I will analyze them to death, and even if the situation changes slightly (time of day, how I put on my other sock, blahblahfuckingblah), I will freak out and wonder whether the results might be something harmful (even if intellectually I know that the chance of it resulting in something harmful is astronomically low). I intellectually know that much of this aforementioned situational anxiety is probably irrational, but there is the age-old problem of "WHAT IF THIS IS THE 1 IN A (GRAHAM'S NUMBER) CHANCE THAT THIS COULD BE THE CASE?".

I should add that these are probably partially endogenous, because there is an astronomically high chance that I have Asperger's and anxiety is usually a comorbid condition - the neural correlates of this condition are quite fascinating and I've actually thought about doing a semester or two of research in my department about this and its correlation to intelligence since it occurs VERY frequently in gifted individuals (I'm a student in one of the nation's universities' better-funded neuroscience departments). I also probably still have some major unresolved issues with my folks in my past, given the fact that my childhood was quite a bit farther from ideal than most people's lives seem to be, and I'm also profoundly gifted, so there is that sense of being able to be more observant and see more aspects in a situation (observation is usually good, but with the right quantity of anxiety, one's observing abilities can go a little haywire occasionally).

Please note: I do talk to a therapist.
posted by kldickson to Health & Fitness (16 answers total) 6 users marked this as a favorite
When is your next scheduled appointment with your therapist?

Does your therapist have a number you can reach them at? Most do, and many I know will encourage their patients to call them if they are suffering and need a quick pointer on how to cope with an issue. I bet your therapist can give you a few coping strategies to get you through today, and all the way to your next session. :) Perhaps call them up and say "I'm really dealing with a lot of anxiety right now, and I was wondering if you had any pointers for me on how to cope with that untill our next session?"

If your therapist has a problem with you calling them between sessions, I'm sure they will be up-front with you and let you know. Otherwise, feel free to call them.
posted by xotis at 6:37 AM on April 29, 2008

I agree with Xotis, call your therapist, ask to be seen sooner. There's little anyone here can do for you.

Since you correlate your anxiety to presumed Asperger's you should try to be assessed for that, but I noticed in your posting history that you stated you're "reasonably socially adept". I'm sure you know those two things don't go hand-in-hand.

Unsolicited advice that may get this deleted: Lay off the "profoundly gifted" thing. You sound like a pretty normal kid if a bit high-strung, and emphasizing how smart you think you are, particularly when it's irrelevant, may make people less inclined to want to help you.
posted by loiseau at 6:56 AM on April 29, 2008 [1 favorite]

No one else seems to be chiming in, so I'll offer my perspective: One becomes anxious when he is unable to trust in the providence of God. Rather, in "overthinking things" and attempting to solve every little unknown for himself--which he cannot possibly do in his state--the anxiety-sufferer only makes it worse. A therapist is likely only offering more ways that YOU can solve your problems. This might help some people, but you wouldn't be asking an online message board if it were working for you.

Try praying and asking for the ability to trust Someone other than yourself.

Hey, even if it's irrational, you admit it wouldn't be the first time you've behaved that way. :)
posted by resurrexit at 7:32 AM on April 29, 2008

Completely disagree with resurrexit's advice. Trying to believe in some supernatural Someone is never the answer. Rather I think you should practice what my therapist told me to do in similar situations. I also struggle with often paralyzing anxiety. So what you need to do is break up a task into smaller chunks that you can handle. Admittedly this is tough to do for putting on your socks, but you need to think logically about what could possibly happen to you if you did that wrong. Recognize that 0.00000000000...1 = 0. For an example, I usually obsess about writing emails. So I generally think about what I could possibly do that would make this email bad and what would happen in each situation. If I don't give enough information, the other person is just going to write back and ask for more. Basically I just argue with myself until I've at least temporarily relieved my anxiety.
Oh, and from one "student in one of the nation's universities' better-funded neuroscience departments" to another: that's no reason to brag.
posted by peacheater at 7:46 AM on April 29, 2008

I'm missing something or you don't have anxiety, you have pretty well developed OCD.

OCD, as I understand it, only gets worse from deep analysis. So you need to stop the thoughts before you analyze them. It's like a vortex, or something. You have your thought spinning around, and then you analyze it, and that thought spins faster, bringing with it additional thoughts. Till it takes over your whole brain.

You need to stop the thought dead in its tracks. One thing I've heard of is saying loudly NO NO NO (as in, out loud), when the thoughts start. Don't give in to thinking if the thought is rational. It's not. Putting your socks on is a pretty safe endeavor. So don't start analyzing whether your thought is rational or not. It's not your's the OCD. You can think of it as a seperate, and somewhat useless, brain. So don't take it personally and don't dwell on it. It's the OCD that's making these thoughts, not you.

Anyway, I don't know what I'm talking about, so go to a therapist. The above has been helpful to me.


Not that this has anything to do with anything, but I'd avoid describing yourself as profoundly gifted. That's probably never going to serve you well, in any situation, with any people, ever. And it's sort of meaningless, anyway.
posted by sully75 at 8:05 AM on April 29, 2008 [1 favorite]

What makes you think you have high-functioning autism? Do you have problems with social interaction? Communicational intonation? Is your use of language in some way unusual or idiosyncratic? Do you find humor to be empty of emotional meaning to you, leaving only its intellectual content for you to observe?

Just because you may be "gifted" or "intelligent" does not mean you have astronomical chances of having Asperger's Syndrome.

As far as your anxiety is concerned. It would seem that your problem is over-intellectualization. You say you are aware of the irrationality of your catastrophized-thinking, but perhaps you need to do something more than merely recognizing this fact? You could consider learning deep breathing exercises, or keeping a journal to explore these irrational dilemmas you get into as this facilitates a deeper probing of your thinking-patterns which might lead you to some insight (hopefully emotional insight).

Between sessions, if it's really that problematic, you could try minor-sedatives to bring your nervous system to a more low-key state, though this route should only be considered a safety-net.

And finally. Evaluate your line of thoughts. Take a moment to evaluate your post here, for starters: "given the fact that my childhood was quite a bit farther from ideal..."
You should stray from thoughts like this, as comparing yourself to others is only ever going to lead to a "grass-is-greener" mentality and that's only ever going to create pressure.

Why do you think your family life was so far from ideal? And why do you think you "probably" have unresolved issues? Do you or don't you? Just because you have anxiety doesn't mean you have to buy into a "well it's probably my unconscious" mindset - consider your current circumstances in life: your friends (if you have any - if not this is a problem already), your physical self and how you treat your body, your aspirations, your activities, your sleep schedule (or lack thereof), and whether or not things you are doing in life are meaningful or not. Become aware of these things, and evaluate them - not based on some external locus, not based on your friends or media portrayals, but based on what YOU want, and what you need - you may discover problem areas that are within your power to assume control over, and this will certainly help you in everything you do.
posted by tybeet at 8:26 AM on April 29, 2008

When is your next appointment? If it's not this week, call and ask if you can come in sooner.

If you've been working with this therapist for a while (3+ months?) and your #1 problem (overthinking) isn't getting better, you should either: (1) tell the therapist that and ask if s/he has other methods you could try, or (2) try booking an appointment with another therapist who has another approach. The therapist isn't going to change you into someone who never overthinks, but s/he should offer concrete advice about how to handle times when you feel overwhelmed -- and if you're not getting that, you need to make something change in your therapeutic situation. (IMO - I'm not a therapist)

When you go to your next meeting, print out all of your past questions and bring them to the session. Maybe you act very "together" in person, so your therapist doesn't realize how much this stuff goes round and round in your head while you're not in the session? It would be helpful to him/her to see that these same thinking patterns keep recurring over months.
posted by LobsterMitten at 8:28 AM on April 29, 2008

Are you me?! Your symptoms sound surprisingly similar.

I've found that talking to a therapist isn't nearly enough - seeing a psychiatrist who specializes in anxiety disorders is the way to go. The thing with talk therapy is, if your condition is organic, sometimes you still need meds in order to give yourself the perspective to put the things you learn in therapy into action.

As a student, do you have access to decent health care? If so, I'd recommend asking your therapist for referrals for the things my psych has recommended to me: neuropsychological testing and cognitive behavioral therapy. (In my case, my HMO is being less than cooperative!)
posted by chez shoes at 8:31 AM on April 29, 2008

I'm with Sully75 on this. It's not easy but you need to learn to distract your own brain. As soon as you feel that damaging thought spiral beginning, immediately do something completely different that takes your attention away from the issue at hand. Take a shower, go make something to eat, if you have a hobby that you know distracts you then go do that, if you don't have a hobby that distracts you get one. Start learning to play an instrument or draw or something that requires your full concentration and that you enjoy. It's not an easy trick to begin with, but like everything, with practice it becomes second nature to switch your thoughts to another subject.

For context I had 30 years of anxiety disorder which was got rid of by seeing the right therapist, one who could work with me rather than trying to make me jump through therapy hoops.

Good luck, I know it sucks but it can be fixed. Memail me if you want to chat.
posted by merocet at 8:34 AM on April 29, 2008

"The thing with talk therapy is, if your condition is organic..."

Yes, we are all organisms, so of course it is organic. Perhaps you meant "genetic"? In which case, be careful: that's a huge leap of faith considering that hereditary and environmental effects have not been delineated one iota beyond correlations shown in adoption studies.

And be careful what faith you put into prescription drugs...
posted by tybeet at 8:53 AM on April 29, 2008

It sounds to me like you feel that Something Bad will happen if you don't do things a certain way, and then, aware that this is irrational, you start arguing with yourself. To me, that says OCD in big, neon letters. Cognitive behavioral therapy and possibly some nice pharmaceuticals could put you right, and fun exercise might also help.
posted by PatoPata at 9:08 AM on April 29, 2008

Meditation can really help with this. The Mindful Way Through Depression has a lot of detail about how it can help with anxiety and compulsive thoughts, with references to clinical studies to support its claims. It also has detailed exercises based on the practices used in those studies.

Also, it sounds like this is a recent issue for you, or at least recently much worse than usual. You probably want to look at what's changed recently, and explore the role that might be playing in your recent anxiety. For instance, when I first moved the US to commence graduate school, I quickly became far more anxious, because I no longer had the support of my family and I came to identify far to strongly with my academic performance. Some of what you write reminds me of that, but whether or not that's relevant, don't be too quick to discount exogenous factors. They are both the most likely explanation for a recent change and the easiest factors for you to manipulate.
posted by Estragon at 10:33 AM on April 29, 2008

Response by poster: Thanks, guys.

resurrexit: As an atheist, I do not appreciate being proselytized to by people who do not understand the concept of freedom of beliefs. Please find some way to respect the fact that not everybody is theistic, and, I suspect, most of those people who are theistic are probably not of your particular brand of theism.

LobsterMitten: My therapist already has a good idea of my issues; I'm asking about how to survive until the next therapist session. However, it's difficult to go in more than once every two weeks; this therapist is at University Health Services and, my university being a major research university, is usually booked solid.

chez shoes: I've already been through the neuropsychological testing and am, I think, diagnosed concerning the anxiety.

Distracting oneself is a rather foreign notion to me, I admit; it's just something I've never been good at doing, so I don't understand how it is. How do you distract yourself if you do stuff like that?

tybeet: I study neuroscience, so I'm fairly familiar with the neurochemistry behind these things and SSRIs do work, although it's dependent on the neurological milieu. I'm aware of the SSRI issue; this does not invalidate their efficacy by a whole lot because they work for a whole lot of people. On the contrary, even if you read the article a little closer, it means placebos have a lot of untapped ability - and Prozac, Effezor, that one drug, and Paxil aren't the only SSRIs. Neurochemistry has an interesting way of changing if someone is convinced of something. There are also SNRIs, dopamine drugs, and MAOIs, although I wouldn't use an MAOI unless my life depended on it. Plus, I think when she says "organic" she means "endogenous", but as I said, my anxiety is not wholly endogenous.

Estragon: My anxiety is not recent. It's just come to the point where I have to and can do something about it.
posted by kldickson at 3:31 PM on April 29, 2008

Consider asking for an allergy test. An allergy has the possibility of affecting someone in no other obvious than simply mood. A friend's wife has a wheat allergy and she becomes very depressed if she consumes a normal amount of wheat. I have a peanut allergy that annihilates my inhibitions of revealing things normally kept quiet. Something as simple as eliminating a dietary substance may work amazing wonders. Seriously, check into it.
posted by Quarter Pincher at 7:40 PM on April 29, 2008

kldickson, it sounds like the way to survive is to take steps to "get outside of your head" -- set up an exercise regimen, take on jobs like tutoring that have you doing tasks that are easy but absorbing. Get out of the house, get out of situations where you have a lot of free time to dwell on these thoughts. See if there is a juggling club, boardgame club, video-watching club, etc on campus, or a casual frisbee game, or an art exhibit or other final project that could use extra hands for set-up; see if there are interesting talks this week that are not in your subject area. A university should be an easy place to keep busy! If you want to get off campus, see if there is a volunteer organization in town that could use some extra help in the evenings this week (just look in the phone book -- maybe the Humane Soceiety/ASPCA could use people to come sit with the animals? maybe there's a soup kitchen or low-key church food pantry that could use people to wash dishes? etc)

To distract yourself if you have to be in one place (eg at a job), plenty of options, here are a few:
- Get a crossword or sudoku book, or a book of logic puzzles, etc. They should be challenging enough to engage you, but easy enough that you can finish one in about an hour. When you feel yourself obsessing, start a new puzzle.
- Try to memorize a long poem. pick one you like, print it out and bring it with you. recite it to yourself, and memorize more lines. Maybe it could be a long story poem about some heroic or funny deeds -- something that is nice to think about, not angsty.
- Basic meditation: lie on your back on the floor (or other comfortable relaxed position) and try to empty your mind of those worries. Count down from 20 like this: deep inhale 20, deep exhale 20; inhale 19, exhale 19; and so on. If you lose count or start getting wrapped up in those thoughts again, start back at 20. (I've heard meditation described as being like training a puppy to sit. The puppy (our worrying mind) wants to wander off and get into trouble, but we are the gentle trainers, and when the puppy wanders off we pick it up and put it back in the sitting position. No guilt, no anger -- the puppy just doesn't have discipline yet, and we'll be patient with it and bring it back gently to the calm sitting position.)
posted by LobsterMitten at 9:38 PM on April 29, 2008

Know you are not alone. I have a habit of overanalyzing things too. Like, if a friend hasn't text messaged me lately, I won't change my cell phone wallpaper until they do. Like that has any influence on whether they text me or not! Or sometimes I won't listen to songs about saying goodbye.

I use a lot of ways to distract myself... chatting in IRC is one way. Something interactive is more helpful than just sitting back and reading or watching TV, for me anyways. And sometimes in those IRC chats I talk about my problems.

Medicine isn't always the answer but Klonopin has been a blessing to me in dealing with acute periods of high anxiety. I don't take it every day... only as needed.
posted by IndigoRain at 12:31 AM on April 30, 2008 [1 favorite]

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