How anxious are you, right now, on a scale from one to ten? One being at peace and ten being, “Oh god, oh god, we’re all going to die!” Take a minute. Think about it. Really.
(This is, as evidenced by the title, part six in a series of posts I’m doing while reading a book titled the Complete Idiot’s Guide to Fear and Anxiety. I checked the book out from my local library, because I’ve been struggling with agoraphobia and panic attacks and generalized anxiety disorder for as long as I can remember. I’m moving forward in my life, but these things are hindering me and so I thought some self-help couldn’t hurt. The first part in the series is here: Conquering Fear/Anxiety – pt. 1. You don’t need to read the previous posts to still appreciate this one, but it may be helpful.)
My answer to the above question is about a three.
Mild anxiety . . . butterflies in my stomach; muscle tension, definitely nervous.
I would also consider this to be just about my base-line when I’m at home. There’s the nagging sensation that there is something I need to do, but haven’t. My jaw is tense, my back is stiff. I feel restless and yet mentally worn out. Still, I have the wherewithal to be grateful that I’m not higher on the scale. Especially since I go in to work tomorrow.
Level four is the level at which the book suggests you take action to prevent further escalation. At level four, you are experiencing marked anxiety and may feel “out of it,” have an increased heart rate, tense muscles, rapid breathing, and a worry that you’ll lose control. In other words, level four is not a happy place, but it’s still a manageable one.
It is me, in the car on the way to work. Or in Wal-Mart. Or studying for an exam.
The book suggests removing yourself from the situation that’s causing the anxiety, but I don’t think I agree with that as a tactic, because it seems like the road to agoraphobia. Surely facing the anxiety and coping with it is better than avoiding it? Another questionable suggestion, in my mind, is to do something repetitive. This does release serotonin, but seems like it could lead to the development of an OCD-like compulsion or ritualistic behavior that will also have negative effects in the long run.
I feel the other suggestions offered by the book are more useful and practical.
Talk to someone, get active, focus on your surroundings instead of your symptoms, do a puzzle that requires concentration, indulge in something pleasurable, visualize a calming scene, use positive self-talk,practice diaphragm breathing.
I do use some of those when I feel a panic attack starting or cresting.
At work, in the hospital, I offer to run an errand – such as getting a telemetry monitor or restocking a cart – in order to get moving and focus on something tangible. I also picture my significant other and use positive self-talk . . . when I can calm down enough to. It also helps me to talk with my patients, when I’m at work, because it shifts my focus to their problems rather than my own. On the other hand, charting is a welcome distraction and can absorb some of my restless within the routine nature of it.
The mind and the body are linked. As such, it’s not surprising that the physical and mental elements of a panic attack feed off each other. Recognizing that, the book suggests, can help to reduce or manage both elements during an attack. In that vein, the book provides lists of mental and physical “symptoms” that people experience during panic attacks, has you rate them in terms of their frequency or strength, and then brings your attention to their relationship.
My top five physical symptoms include the sensation of a lump in my throat, nausea/diarrhea, a feeling of detachment, heart palpitations, and tingling of the hands/feet. My top five mental symptoms/thoughts are I’m going to die, I don’t understand what’s happening to me, I’m going to have a stroke, something is really physically wrong with me, and I’m really scared.
I do see how the physical symptoms I experience as a result of my panic attacks (in addition to my general anxiety/agoraphobia) cause the thoughts I have. Feeling as though there’s a lump in my throat makes me fear dying – even thought I know from a logical standpoint that there’s nothing in my throat and that my breathing isn’t being hindered.
Of course, as noted in the book and as I’m sure most people who have suffered from panic attacks are already aware . . . sometimes nothing does prevent a full blown attack.
In those instances, the book also has some suggestions for shortening the duration of the attack and lessening the overall severity of it. Many of them reflect the above suggestions for preventing the attack from occurring, but one other struck me as interesting and a kind of novel idea. The book recommends resisting the urge to “fight” the symptoms.
It can feel unnatural, the book notes, but will generally lessen the attack’s duration, because you’re adopting a passive stance rather than an aggressive one. In a way, you intentionally lose the fight in order to end the attack.
Another exercise in this section of the book relates to the diagnosis of GAD – generalized anxiety disorder. Once I learned about agoraphobia and panic attacks, about a year ago, I dismissed the notion that I had GAD. But . . . in filling out this particular worksheet . . . I did score 21 out of 35 possible points. This indicates that I am at least chronically anxious. The question is then whether or not it is due to the agoraphobia and panic attacks or if it is an entity in its own right.
I was inclined towards continued dismissal, but then realized that I experienced all of the same things prior to what I consider the first panic attack and I attribute that first panic attack to my eventual development of agoraphobia.
So, maybe, I do still actually have GAD.
Also, disclaimer, I don’t think that self-diagnosing medical issues – be they physical or mental – is entirely advisable. I should, honestly, go get evaluated.
Helpfully, the book explains that anxiety prone people are likely that way due to a combination of nature and nurture. It explains that people who are genetically predisposed to anxiety may be more sensitive to loud noises, bright/flashing lights, textures. It goes on to note that people who are predisposed towards anxiety tend to see others as disapproving or indifferent and to worry about the safety of themselves/others more than average.
Technically, I’m not finished with this section, but this post is about as long as I’m ever comfortable making them. Instead of continuing on, I’m going to end this post here.
Not only due to the length of the post, but due to the fact that it’s approaching ten at night (which is my bedtime on work nights). Also, my SO wants to sit in my front of me so I can play with his hair and rub his shoulders.
A quote . . . to finish things out.
“It’s no use putting up your umbrella until it rains.” – Alice Caldwell Rice