Anxiety and Panic

Anxiety has many faces. It may rear it's ugly head before you take a test, speak in front of a group at work, or maybe you're feeling anxious about getting some news from your doctor. We have all had that feeling. A pounding heart, sweaty palms, and all the "what if's" swirl through your head like and intoxicated armadillo on roller skates. It's craziness! Or that's what it feels like. People will do anything to avoid this feeling. I'll tell you what- coffee doesn't help. Coffee is one of my great comforts in life and at times of stress, I'm drawn to it for support (like a binky). Not the best idea to mix caffeine and anxiety. Just saying.

Anxiety reminds me of a swirling think icon...

When I'm assessing someone for depression and anxiety I will ask "do you have a history of panic attacks?" This is a confusing question for a lot of people. It's often followed with perplexed eyebrows and a cautious question- "what's the difference?" Anxiety reminds me of that little swirling "think" icon on your computer (or the hourglass) that totally puts a monkey wrench in your operation system. Things are no longer running smoothly. Everything is more difficult because your body is telling you something is wrong. Panic is anxiety with the volume turned up as high as it can go. You can read more about the symptoms for panic attacks here.

Anxiety is something people try to manage day to day but have a hard time overcoming. I have a lot of middle aged patients and they will report worrying about things like money, health, retirement, and politics. For someone in high school, it could be as simple as wearing the same jeans two days in a row. In my 20's, it was being able to make rent at the beginning of the month. Anxiety impacts us all. None of us are exempt from the tireless and repetitive taunting of it's internal monologue. It can certainly be overcome, but for some- it's a lifetime struggle.

Panicked about someone not liking our Facebook status.

When I describe this to someone that doesn't understand it first hand, I talk about how these instincts were designed to keep us alive. Long ago, we would become hyper-vigilant when being chased by a dinosaur or wolves on the prairie, to keep us agile and sharp enough to escape our predators.  These feelings of "fight or flight" kept us running to survive another generation. Yay us! The problem is that all these instincts that allowed us to evolve, now have us panicked about someone not liking our Facebook status. These things are literally not going to kill us, but try telling our bodies that! 

My own struggle with anxiety felt so powerless. At that time in my life, I can remember thinking that everything was going to fall apart and never be OK again. It's important that I express my understanding and empathy to people going through this, because when you're wrestling with nagging thoughts all day, it can make you feel like a crazy person. I hate that word anyway. Crazy. Let's wrap a perfectly understandable adaptive behavior in a shameful stigma- that results in continued suffering. That's a great idea! Soapbox. What I'm saying, is that for those who suffer from lifelong anxiety, they may have inherited a predisposition or watched a parent react to stress this way. Maybe you never had problems with anxiety until after a horrible break-up or lost job. Just like depression, it can be caused for a slew of reasons. The best thing you can do is get help for it.

Depression and anxiety are kissing cousins.

What can you do? In my depression article I talk about the brain chemistry behind depression. The thing is, depression and anxiety are kissing cousins. Like peanut butter and jelly. They are so closely connected, that one is rarely seen without the other close behind. The treatment is also very similar. There are two routes to go: medication and talk therapy. In counseling, you can learn through cognitive behavioral therapy (adaptive thinking strategies), relaxation techniques, and boundaries, that you are able to reduce, and eventually conquer anxiety! Yahoo!

If you take the medication route, there are a few options for treating anxiety. First, antidepressants. Why would you take an antidepressant for anxiety? There's that kissing cousin thing again. Depression contributes to anxiety and vise versa. People find that when they are taking an antidepressant, invasive thoughts and repetitive thinking simply diminish.  These are the things that perpetuate anxiety. It seems that these fall away almost effortlessly. These medications take about 4-6 weeks for their full effect. Secondly, we have the PRN or as needed medications. These are tricky because they work right away and can be very habit forming in the wrong hands. Ideally these are prescribed for people who suffer from panic disorder to help manage an attack when it comes, on top of the daily antidepressant. I usually recommend this in severe and even crippling cases. It's not necessary for everyone. 

The other things I would recommend to combat anxiety would be mindfulness techniques. I have a blog that goes into greater detail about the foundations on this topic, but I also want to offer you a free resource for mindfulness training with endless exercises and meditations to use for stress reduction. The hope is that with possible medication, counseling and implementing stress reduction techniques in your daily life, anxiety/panic will become a thing of the past. Speaking from experience, anxiety-free life is totally possible. What would that be like? Imagine for a moment, quieting your mind and retiring that crushing vice in your chest that fools you into thinking you aren't safe. You are safe. You are well. Hope is yours.

AM