Help me understand anxiety

Parent Cafe
1

A millennial close to me (extended family) has been diagnosed with anxiety. She has shared with me what seems like bits and pieces but I don’t have the full story and probably won’t get it. She lives independently and has a job related to her college major but she doesn’t enjoy it and knows she needs to find another but seems to create (?) huge barriers for herself in pursuing a new job. She also wants to go back for her masters but seems to create barriers to moving forward with that too. She has told me that she “catastrophizes” which means that she imagines that horrible things will happen if she mis-steps; thus, she can become immobilized.

She started seeing a cognitive behavioral therapist several months ago and, in conjunction, a psychiatrist who put her on medication. She says the medication has taken the edge off her anxiety. Beyond that, I don’t know how her therapy is going.

DH was trying to be nice and invited her out to dinner. He told her to pick the place and it would be his treat. He waited and waited and still no plans emerged. She disclosed to me about a month after the invitation that the had spent over 6 hours trying to find the right place in terms of price (dh had not mentioned anything about price), type of food, etc. Neither dh nor I had any idea that his invitation would be one more opportunity to cause her anxiety.

So, anyone who is familiar with anxiety, can you help me understand it? How can dh and I be supportive and/or helpful? I feel so concerned and she goes through periods when she seems so unhappy.

2

I’ve had anxiety for years. Even on treatment, I still have terrible anxiety.

I’ve always had a hard time describing it, so I’ll just give an example instead. About a week ago, I emailed my advisor and she didn’t respond (my email went out at like two in the morning). A rational person would think “Oh, she’s asleep. She’ll answer in the morning.” Instead, my brain went “She hates you. She saw it and thinks you’re stupid and doesn’t want you to be her student anymore. That means that you’ll be kicked out of the program and lose your funding which means you won’t be able to pay the bills and you’ll lose your house. All because you are lazy and stupid.”

I then proceeded to wake Mr R up because I was bawling and hyperventilating.

Logically, I always know that my advisor loves me and has done everything and more to make sure I get every accommodation and advantage that I need. Even while I am breaking down, I know the truth but the anxiety monster is far more powerful than the rational brain.

How to help: do not give us open-ended invitations if possible. The anxiety monster says “Oh, they’re just being nice. They don’t really want to go to dinner with you.” or “Well, THAT is a stupid restaurant. And so is that. And that one is too expensive and they’ll think you’re taking advantage of them.” and so on.

If you want to take her out to dinner, suggest something very concrete like “Hey, why don’t we go out to Papa Smurf’s on Friday night. How does that sound?”

3

The good news is that CBT and meds can be pretty helpful in the long run. I really hope they help your family member, @collage1 . Other than that, the best you can do is be forgiving, understanding, and supportive.

4

My understanding is that anxiety involves an inner critic that shouts horrible things at you ALL THE TIME.

5

anxiety over rides all other emotions and puts the worry of even the most “trivial” things at the top of your list and you can not turn it off. it is important to understand that a person with anxiety can not just snap out of it or toughen up . or just stop thinking about it. it is a brain disorder, genetic and nobody chooses to have it. it can not be cured but if a person gets on the right medicine at the right dose it can be controlled(different people respond better to different medicines and different doses) it is a long process to get to the right medicine/dose. and medicines like prozac, zoloft etc… treat the symptoms they do not cure it. so when people start to feel better they often stop the meds and it just comes back. (like a diabetic who stops taking insulin). a therapist may help some people but the medicine is the only actual route to control… for somebody with high levels of anxiety. and it is important for those who need to take meds or who already do to not see it as a sign of failure or weakness.

6

Interesting thread for me today, as it was five years ago today that my anxiety began a spiral that made for a really ugly almost two years - it was debilitating, so I know what your friend is possibly going through.

One important thing for anyone reading this who might be experiencing anxiety - please get a proper physical - some anxiety can be attributed to medical conditions. Mine initially was, but because we didn’t really catch it for several months, it was allowed to spiral out of control, so that once we identified a couple of medications that really needed to be tweaked (synthroid and BHRT), it was almost too late - it had taken on a life of its own. But there are some medications out there that can precipitate anxiety, so they need to be ruled out. Thankfully I had someone who had been telling me for several weeks to go get some of this checked out, and I initially ignored it, but when I followed his advice, it was revealing.

One other thing that people don’t often talk about or understand, is that people with a history of anxiety, can develop anxiety about their anxiety, which just exacerbates the situation. For example, although I’ve been well-managed and stable for three years now, in the past couple of weeks, knowing that my anniversary time was approaching, I started struggling a little - there’s always the question of, will it ever come back like it did then? I’ve had some really normal days, but some more difficult days. But thankfully five years ago I fired a number of my doctors (GP, GYN, endocrinologist) and replaced them with a solid health team, so that I try to remind myself if it gets bad again, they’ve got my back and I will not go to that place I was at five years ago.

It’s always interesting to see how additional stress impacts me - over two years ago I was diagnosed with endometrial cancer, had surgery with a great recovery, then at 7.5 weeks had an abscess that got infected and I was hospitalized for five nights with sepsis and sicker than I’d ever been in my life. I was convinced that my anxiety would return full force, and then some, but it really never moved beyond what any average person would experience if faced with the same health crisis, and after a few weeks of recovery from everything, I was fine.

The kind of unrelenting, debilitating anxiety I had can also lead to depression, and that is a whole 'nother can of worms that people need to take seriously and get properly treated. Sometimes I get really annoyed when people use hyperbole around anxiety, such as, “Oh, that (fill-in the event) gave me an anxiety attack,” and they’re saying it while smirking. People who have true anxiety rarely, if ever, kid about how bad it is. And most times, people under-exaggerate to those around them how bad it really is.

Hope this helps.

7

My millenial D has been seeing a therapist for over a year now and she is on medication. Collage 1 and Romani…your descriptions are very familiar. During the worst period choosing what to wear for the journey on the bus to work (work itself had a uniform) became a huge issue for my D. Her medication has been increased in strength twice and changed once. She is doing well but it is a lifelong issue. It’s also very difficult to understand if you don’t suffer from it…her therapist has told her not to avoid doing those things that cause her anxiety but to learn from them, realize they are doable and to think what the worst case scenario would be in each case, to thus become aware that she will get through it. Repeated exposure and finding a solution for it helps reduce her anxiety for that particular thing.

8

Those with anxiety may have difficulty stepping out of the house in social settings. It really varies from person to person. For some they don’t like big crowds but feel comfortable in small group events like dinner with a few close friends.

9

For me, sometimes I can point at a series of thoughts that are stirring up anxiety. I describe it as having enough space between me and my monkey brain (doing the shouting) that I can observe it, but not get tangled up in it. Paraphrasing Dan Harris, I like to say my monkey brain is kind of an asshole.

Other times, I’m just washed over with anxious feelings and I cannot seem to pinpoint the thought train that brought it on (which makes me think it might be hormonal, poor sleep or diet, or some other physical cause). In this case, it’s harder to shake.

10

My otherwise normal, brilliant, rational daughter walked with me into a Wegman’s supermarket (this is a NY based chain that recently came to Massachusetts), and promptly had to leave because the store was so massive and overwhelming and she was beginning to panic. She once went 48 hours without sleeping because she was so stressed about her exams. Like a lot of people with anxiety disorder, she has a diminished capacity for doing multiple activities because she needs more down time than most people. It has been hard to come to grips with this.

11

This is all so sobering to read about and I’m sorry to each of you either suffering with anxiety directly or with a loved one. These comments help give me some insight. Does anyone have any thoughts about what has been helpful or what someone can do to help? I most definitely will not suggest open-ended things like dh did when inviting her to pick a restaurant.

She really does need to look for a new job as her current one, which she’s had for about 2 years, makes her miserable. Am I wrong to encourage her? She seems to be able to search and find jobs to apply for but then the process of creating a cover letter seems almost paralyzing, as if she needs it to be perfect but, at the same time, she’s not able to make it perfect (however she defines that). She’s told me that she’s spent 8+ hours on one cover letter and still can’t bring herself to send it. I’ve offered to help and she’s declined. Is there anything else I can do, either with regard to this or in general?

I’m close with this person and feel sobered and helpless.

12

Was just rereading the responses and, @romanigypsyeyes, my relative sounds just like you. She has said that, in thinking about applying for a job, she imagines that the recipient will burst out laughing at her application, call her references who will say terrible things about her and that they, collectively, will blackball her from every other job in her industry. She will then lose her current, undesirable, job, and become homeless. OMG! Romani and anyone else who suffers from this kind of thinking, my heart just breaks. What kind of support can be helpful??

13

One of our kids has been greatly helped by a skilled DBT therapist. It’s a little different from CBT.

It’s mindfulness based, and clients work thru a workbook. The skills are concrete. This appealed to our kid. She said she understood the concept of CBT (first therapist) but didn’t understand how to make it stick.

DBT (different therapist) resonates with her, and is giving her useful life skills. The therapist likes to point out that DBT is evidence based therapy.

I like the concepts bc I have an interest in what the Buddhists taught re: how the mind works. It makes sense to me, and it takes practice, practice, practice.

You’re not a failure if it’s not easy, you’re just human!

14

One thing that was helpful for me was just going out for a walk with me, with no expectations as to how far we’ll go. I have found that, when I am most sedentary, my anxiety creeps up (which is why I was so concerned about the time I had my cancer surgery, then sepsis) without me knowing it until it’s too late. For people with anxiety, they need to find what sort of exercise is appropriate for them. I have learned through trial and error that high-intensity classes, such as Orange Theory and Crossfit, are not good for me. The same chemicals that some people thrive on during intense exercise can deplete me. I was actually talking to my internist about this last week - he’s an avid cyclist and big proponent of adequate exercise, and will lecture people who are not finding some appropriate way to be active - when I told him how I felt after doing these classes, he said he wants me out walking in nature, in the woods and on the trails, and do what I need to do during those walks to get my heart rate up. When I did the other high-intensity classes, yea, I’d feel physically exhausted afterwards, but my anxiety rate would shoot up after the exhaustion wore off (and yes, my diet is clean and healthy); but I’m also VERY sensitive to things like caffeine and added sugar to products. So over time, people learn what their triggers are and learn ways to adapt so that they feel more in control. Everyone has different triggers, whether they be emotional experiences, overstimulation (like @massmom’s daughter experienced in Wegmans), foods, physical experiences, etc.

I also think trying to learn more about what she experiences through asking on a message board is a good way to help, too. As far as encouraging her with her job search and grad school possibilities, I suspect she is working with her therapist on how to best approach these and be successful with them, so I don’t know if I would encourage anything other than what she has possibly shared that she is working on with those professionals. People have defense mechanisms and sometimes they’re there for good reasons, and shouldn’t be challenged in the current state they are in, or until they have a better leg up on their life and are more confident - professionals are in a position to help navigate the timing for life transitions as appropriate.

Depending on how much the person is getting out and participating in life, you can offer to tag along on some of the more difficult errands, i.e., if she’s having a difficult time managing her weekly trip to the grocery store, etc. Also, when I was with my friends, it often helped to just listen to what was going on in their lives, as opposed to being asked all kinds of questions about what was going on with my anxiety. Take her lead on what she wants to share with you. Drop her an email or text her from time to time, telling her you’re thinking of her and hoping she’s finding strength to get through the day. If she should reject some of your social outing offers, don’t stop asking, because it’s likely she’s worried you’re taking it the rejections personally and feeling guilty. I can’t really remember anything specifically, but if you really want to learn more about what’s going on with her, ask her if there are any books she’s read that she could recommend to you, from a memoir or autobiography perspective. I know with bipolar illness, someone recommended the book An Unquiet Mind by Kaye Redfield Jamison, who suffers from bipolar, but has had a very successful career as clinical psychologist and professor of psychiatry at Johns Hopkins School of Medicine. The book gave me an insight into bipolar that I don’t think I could have ever gotten without reading it. Like I said, I can’t remember if there are any similar books written by people with anxiety.

15

Anxiety can manifest in different ways. Panic attacks, social anxiety etc. But at the root of it, anxiety is fear of loss of control.

CBT helps you learn to identify your automatic “cognitive distortions” or incorrect thoughts. Like Romani’s immediate thought that her advisor hates her. You need to identify the auto thought, then challenge it (“do I have other evidence that my advisor hates me? Is there another more logical explanation why she didn’t call back?”) and then find NEW more helpful thoughts to substitute in for the distorted ones.

Anxious people also ruminate, which it sounds like your relative is doing.

Here are some PDFs on CBT skills. Also DBT can be helpful too.

https://www.apsu.edu/sites/apsu.edu/files/counseling/COGNITIVE_0.pdf

16

So glad to see this thread. I am friends with someone who suffers from anxiety and depression. It is difficult to be friends with this person because it seems that the friendship is fraught with landmines - did I just say the wrong thing to him, did I just do the wrong thing, etc. I often have no idea what I should say or do. What would be helpful and what would harm the relationship. So I hope to read about some things that are good to do when you are friends with someone who suffers in this way.

He does say that walking in nature is very helpful but I notice that he rarely does it. And so I get frustrated with him (quietly - I never say this aloud) - why don’t you do something that is good for you. I’ve offered many times to walk with him, but he has cancelled more times than I can count. So I said to him that he needs to plan the next time we go walking,but of course,that hasn’t happened. I don’t know if I need to push the issue or just give up. I have never been so challenged in a friendship before.

17

I actually was able to find the name of a book I read several years ago, Monkey Mind: A Memoir of Anxiety by Daniel Smith. It was terrifying as well as enlightening.

https://www.amazon.com/Monkey-Mind-Anxiety-Daniel-Smith/dp/1439177317

18

@bookreader, I think it’s wonderful that you are trying to be a good friend. The exasperation you feel is understandable because to those of us who don’t have this illness it doesn’t make sense but to the person who is consumed by it, doing something that is good for you is easier said than done. Even doing something as simple as arranging a walk or having something on your agenda that’s normally not there, is stressful to them. With my D, the landmines are always there…we are just getting better at avoiding them and sometimes diffusing them.

19

Just FYI, since I didn’t see it mentioned yet. Young women on the pill (sorry I don’t know which exact formulation) OFTEN begin to have anxiety. My DD began to have anxiety attacks and couldn’t sleep before exams and after three years it was getting worse and worse. She stopped the pill and it went away. Talk to Dr about it if your D’s are on the pill.

20

I have General Anxiety Disorder and today it is flaring up. I am talking to myself and trying to calm my self done.
I also have GI symptoms with my anxiety flares up and I have those symptoms right now.

I find the best thing is to talk myself down. I also do take medication for this chronically (Buspar).