You are currently browsing the monthly archive for October 2006.

“The prospect of a long day at the beach makes me panic. There is no harder work I can think of than taking myself off to somewhere pleasant, where I am forced to stay for hours and ‘have fun’.”

— Phillip Lopate


A common argument in favor of medication is that, like any other illness, there’s no shame in taking medication for anxiety. It’s true that medications, especially SSRIs like Prozac, Zoloft, and Lexapro, adjust the brain chemistry in a way that reduces anxiety. Whether this “chemical imbalance” is naturally occuring or the result of our bad habits is a common source of contention, but we won’t go into that in this article. Rather, we will focus on a particular attitude that’s seen among the anxious. That attitude is best defined as “weakness.”

Disregarding medication because one doesn’t want to be “weak” is no different from any other fear. In this case, the fear is that we’re inherently unable to cope with life and that we need medication to help us get by. How many times have we heard others say, “I don’t want to be weak. I don’t want to take medications forever. I can do this on my own.” If you’ve made any progress in your recovery then you already know that what you want is completely irrelevant. The only thing that matters is what is. As with all fears, this fear of weakness is something that must be confronted. If you support this attitude, you’re likely supporting it with the same negative thought patterns that create your fears in the first place; this, in turn, only contributes to your anxiety.

Your ego is your greatest obstacle. Your ego tells you to be strong. Your ego tells you that you need not resort to medication. Your ego tells you that you’ll never recover. Your ego tells you that you need to do this, or that, or the other thing. In short, your ego is a non-stop source of worthless jabber. The sooner you stop listening to these irrational ramblings the sooner you’ll be able to see reality. The truth of what you’re dealing with is right in front of your face, but your ego wants to protect you from that truth.

Think of it this way: if your ego is telling you to be strong, that’s because you feel weak; otherwise, you wouldn’t need to feel strong. You’d know you were strong. Your ego is very adept at lying to you. The best solution to this is to learn to distance yourself from your ego’s incessant chatter. Question it at every opportunity. For example, if you catch yourself thinking, “I don’t want to take medications, I need to be strong,” then look at this closely. The only reason you’re telling yourself this is because you know you’re weak and you’re denying this. Instead, acknowledge that you’re suffering and that you need help. Yes, you may be weak right now, but strength is something that can be built and the first step in building strength is in embracing yourself, weakness and all.

If you allow your pride to get in the way of your recovery, you’re playing right into the hands of your “anxiety factory.” Forget pride. There’s no place for it here. You’re in the business of recovering from chronic anxiety and this requires a delicate, compassionate view toward yourself. You cannot be compassionate so long as you continuously reinforce your fears with nonsense about “being strong” or doing this “on my own.” These types of thoughts are the antithesis to compassion. They are, in essence, you beating up on yourself.

There is no shame in taking medications. When someone breaks a leg, they need a crutch to keep the weight off while their body does the difficult work of healing. The same goes for your mind and your emotions. When you’re suffering from chronic anxiety, there is absolutely no shame in using medications as a crutch while you’re in the process of recovery. We wouldn’t berate someone with a broken leg for using a crutch. There’s no weakness in it. The leg can’t heal without the crutch. Just the same, your mind can’t heal without a crutch. That doesn’t necessarily mean that you need medications, but one crutch is as good as another.

However, if you use medications as a way to avoid acknowledging your fears, then you’re again doing yourself a disservice. The trick is in finding a balance. We should never use medications (or alcohol, drugs, religion, or anything else) as a shield to protect us from what we fear. This behavior, in turn, forces the fear to dive below the surface where it will do more damage, only to surface at a later time of weakness. Rather, we use them as a way to help us develop the proper attitude, the proper perspective, and the proper coping mechanisms to deal with our fears. It’s incredibly difficult to do this while one is in the midst of constant panic attacks or chronic anxiety. You need a crutch to take the weight off while you’re in the process of recovery. If you use no crutch, you will make little progress.

Even if you end up taking medication for the rest of your life, so be it. Sometimes the leg just won’t heal and we may need a crutch for life. So long as you’re always focused on recovery — in the sense that you recognize that recovery requires that we work and not become complacent or lazy — then you’re doing your part and there’s no shame in it. Similarly, if you continually tell yourself that it’s okay to take medications because you’re “broken” then you’re again falling into the traps of egoism. You’re not broken, your ego just tells you this to keep you from feeling the sting of the truth that you’re not as strong you think you are and that you need help. It’s okay to admit that we need help. Be compassionate with yourself.

In summary, if your ego is getting in your way, push it aside. Free yourself from the bonds of pride. Medications are a viable treatment and they work surprisingly well for many people. There’s no shame in using crutches to give the mind and body time to heal. So feel free to explore whatever options are available to you.

I’m 48 hours in front of a beautifully planned trip. On Monday morning I fly from my home in Florida to New York City (with a stop in Atlanta just for good measure). After five fabulous days in the Big Apple it’s off to London, England for another few days. There are all kinds of cultural delights in store: opera, Broadway, the West End, sightseeing and shopping. What could be better?

Would cowering in the corner of my bedroom really be better? Would being glued to my computer answering emails and posting on anxiety websites really be a higher quality life? Would staying tethered to car, house and familiar streets really be the best participation in an abundant world?

For someone who values her intellect these should be easy questions. However, since I’ve got a nice, healthy dose of Panic and Anxiety Disorder, these questions loom in my mind like real, serious discussion points.

Somewhere in my brain there is a single thought – posing as a rational idea– that says I’d be better off not to go. It is as if that thought-cell has some secret information and is trying to warn the rest of the cells in my body to avoid inevitable and imminent danger.

This is just not true!

I know that once I’m in the flow of the experience I’ll be okay. I will realize that I’m fine, and that I’m actually enjoying myself. I also know that the inexorable march of time will have this trip behind me before I can really experience it. (In my late 40’s I’m seeing the reality of this time-march and its rapidly increasing speed!)

However, those are future things – right now I’m simply in the anticipatory stage. And this, for me, is the most dangerous and most painful part of my life with Panic and Anxiety. It is never the crisis itself, or even the experience or event.

No, it is the lead-up, the anticipation. The underlying, gnawing “knowledge” that it is coming!

Like some B-movie out for Halloween this fabulous trip gets to dress up like an ancient mummy and lurch its way into my presence.

So, I’m going to practice my breathing, do some more laundry and maybe go to a REAL movie today.

So far, the actual sweaty, shaky panic is just an idea.

I’d like to keep it that way.

Here are three very powerful and very easy things I try to do on a regular basis to reduce stress and control my anxiety. These have worked for me and I know that these methods have even been scientifically proven – they reduce blood pressure, reduce stress hormones and increase the release of other chemicals in the body that create a feeling of wellness. I’ll write more about these scientific measures at a later date, though.

For now I just want to introduce you to three of my favorite methods for dealing with stress, anxiety and life, in general. They are all completely free and incredibly easy to learn (because you know them already). The key to make these methods work for you is practice. Like with everything else, practice makes perfect.

  1. Belly Breathing – A few deep breaths can instantly relieve stress. Take a slow, deep breath and try to imagine that you are inflating a balloon in your stomach. When “the balloon is full” hold your breath for approximately 4 seconds and then release your breath slowly. Repeat 10 times. Some people (even scholars) think this is the quickest, most efficient way to relax. It can even help with high blood pressure. Daily practice can reduce overall stress and anxiety. Try to begin and end each day by doing this.
  2. Smile – A smile is a very powerful thing – even when it is forced. The brain somehow tries to authenticate a forced smile so within a few seconds it has conjured up happy memories that turn that fake and forced smile into a genuine reflection of feeling good. Just try it out. And smiling is an instant relief for pain, anxiety and stress. Thinking about a loved one, a happy moment, a wonderful time. It brings a smile and makes it impossible to be bothered by stress.
  3. Slowing down – It is really important to learn how to slow down. Take the time to enjoy each moment. To focus on what you are doing right now. Look at something – a flower or running water, for instance – and focus on it completely. Direct all your attention towards it. Listen to it. Smell it. Feel it. Let your mind wander. Accept the world – at that moment – for what it is, with all its pain and all its pleasure. Embrace the moment and just feel calm. Don’t think about what you’ll have to do next or what is waiting for you. Just think about your point of focus. Try to notice the taste of your food, the next time you eat. Really focus on the taste and think about the texture, the flavor, the toughness, etc. Slow down. Relax. Enjoy this moment, for it too will pass.

A recent study has found that anxiety, depression, and memory-problems are not a significant reason to treat subclinical thyroid dysfunction in the elderly (“subclinical” meaning exactly what it sounds like: mild). You can find the results of the study here.

I doubt this will apply to most individuals living with chronic anxiety considering that the vast majority of anxiety sufferers are under the age of 65 (the elderly threshold for this study), but if I’m not mistaken, studies like this usually have implications that extend beyond the reach of the study. We’ll see if anything more comes of it.

“Worry is a thin stream of fear trickling through the mind. If encouraged, it cuts a channel into which all other thoughts are drained.” — Arthur Somers Roche

I just have to say that I’m really becoming aware of how closely linked conflict and panic are in my life.

Conflict of the slightest type – someone is mad, not even at me – can cause me to have heart palpitations, shallow breathing, and a fear that something dire is going to happen.

Usually nothing happens. I don’t live in a terribly chaotic style, nor am I in a war zone, a flood plain or near the San Andreas Fault. But when conflict is present I get anxious. My fear causes mental chaos. Conflict seems to suggest that some conflagration of a personal and immense nature will …. what? Destroy my life? Who knows…. I haven’t gotten it all figured out yet.

But I am able to see yet another direct correlation between events in the outer world and my reaction to them. And how this connection can lead me into panic.

More later when I try the “dog fear” suggestions on regular, run-of-the-mill conflict!

MSNBC has posted an interesting article about conquering your fear of dogs. Here’s a snippet:

“To me, big dogs looked like wolves, and little dogs are so jumpy. If I see a big dog, I’m terrified. Little dogs I avoid because they bark and I’m always afraid they’re going to nip,” she says.

Sometimes phobias develop after a bad experience with an animal or simply through lack of exposure to them, but often they originate as a type of panic disorder, for no apparent reason, says David Carbonell, author of “Panic Attacks Workbook.” “This kind of fear can be really powerful.”

I think the most interesting thing about this article is that those of us who deal with chronic anxiety on a regular basis can really relate to the symptoms and responses that are described in this article. Yet, for me, a fear of dogs seems completely irrational. I love dogs more than most humans. In fact, I honestly don’t know if I could’ve made it this far in life without my canine companions. My dogs have helped me through rough patches, and not by being soothing or caring, but by reminding me that they had no idea what was going on and they didn’t really care so long as I continued to feed them and hang out. I think the genuine simplicity of dogs is unparalleled and we could learn a lot from it.

But I’m getting off-topic.

As I was saying, one individual’s fear is another’s love. You may fear dogs but I want to approach even the most ferocious looking animals. So the core problem here isn’t the “trigger.” You’re actually not afraid of dogs per se, you’re actually afraid of your perception of dogs. Perhaps misperception is a more accurate word. When you see a dog, your mind generates thoughts, ideas, and images, and it’s this automatic response that tells the brain “beware!”

Anyway, my point is this: always keep in mind that your fear of dogs or cats or clowns or heart attacks is not actually caused by the trigger itself, but rather by your reaction to it. By changing your reaction, you can significantly alter your perception of the feared object/event.

Check out the article.
It’s not too shabby.

It’s not quite as dramatic as the full-blown panic attack that sends me to the ER gasping for my last breaths, certain that my heart has attacked and killed me, but isolation seems to be a key ingredient of my panic and anxiety disorders.

Sometimes I find myself either mad at the world, or vicitimized by the world, alone, misunderstood, and baffled by the experience. Most of the time I view myself as pretty positive and pleasant, a person who tries hard to get along and “play nice,” and as fairly intelligent. So it is with surprise that I ask myself how did I end up all alone at the far end of some opinion, isolated from my fellows and nursing hurt feelings?

I think it has to do with anxiety, and it is one of the more subtle features of my disease. Over many years I have learned that anxiety can spread in an almost invisible mist over my whole psyche – and, indeed, through an entire crowd of strangers. It masquerades as common sense, a well-thought-out-opinion, a core-belief or even as a sum-of-my-experience. This giant boulder of anxiety builds itself with tiny, imperceptible bricks of “fact” – this is right, that is wrong, he is mean, she is hurtful, this pain is serious, that behavior is dangerous. I may convince myself that I don’t swallow some idea whole, but over time I may swallow enough little pieces of things to stuff myself on an anxiety-producing belief. Then,
I act on these beliefs and avoid certain activities and people. If I collect enough of these beliefs, and avoid enough people and activities I can find myself alone, and boxed in to a very tiny mental space. All in the name of self preservation.

For instance, flying is a good example. If I read enough news articles, books and stories, or watch enough TV and film versions of plane disasters, I can collect images and beliefs that flying in airplanes is dangerous – and even stupid. I can avoid traveling, going places I love, accompanying people I love, and attending functions I love. I can convince myself that I’m safer if I just stay home. Over time, I realize I have missed out on weddings, vacations, musical and artistic performances; that I have missed out on the opportunity to live life at its most abundant. Yes, I’ve been safe, but I’m now also alone, bored, resentful and misunderstood. I get sad. I get depressed. I am anxious. I think I’ll have a panic attack.

This goes with people as well. I can collect hurt feelings like other people collect pennies in a jar. And then one day I’m full of hurt feelings and so I avoid all those people, that situation. I’m alone. I’m sad. I’m bored. I’m resentful. I get anxious. What is wrong with me? Is that a pain in my chest? I think I’ll have a panic attack.

Of course I don’t consciously choose this line of thinking – nor do I consciously choose to have a panic attack. But if I allow myself to go down these many (sometimes inviting) roads of judgement, avoidance and isolation, I can find myself back to the very familiar place of a full-blown panic attack. Part of, maybe a HUGE part of, my recovery is to pursue self-awareness, in order to recognize the subtle clues that I may be putting myself in place to get slammed by the disease. I’m coming to believe that knowing and avoiding this is my responsibility.

But these warning signs are quiet and small. They are good at disguising themselves in “normal” clothes. Maybe 95% of all people would say that this person is a jerk, or that flying is dangerous. Maybe they’re right. However, I need to be careful of this kind of thinking. Like caffeine, it may be fine in small doses and it doesn’t necessarily CAUSE a panic disorder. But it is the kind of anxiety that, for me, can build into a full blown attack.

And I need to remember this about myself. It is up to me to choose something else.

Jonah’s post got me thinking – I read the title and thought one thing, read the post and realized it was about another thing. That happens alot with me and anxiety and panic. I think the pain or symptom is one thing. But really it’s all about something else.

When I first saw his title I thought of “Anxiety as stained glass” as a metaphor for equating panic and anxiety with multi-colored windows – that kind of stained glass. Immediately my mind associated with the various colors, and how different a stained glass window is from regular, clear glass windows. How the sun is still the sun outside, but the colored glass changes my perception of light. And how the beauty of the glass shapes requires a light source. It was a very comforting metaphor.

Then, I read the post, and even though it was a very different kind of stained glass, I resonated with that too. There is a sense I get sometimes that life is coming at me with a problem already inherent in the delivery.

And actually both of these perceptions are true for me – anxiety and panic fit into my life in both of these ways. It is not either/or. Life is becoming more both/and.

I guess the cool thing about this insight for me is that I am learning, in all areas of my life, that there is more than one way to look at a thing. More than one way to hear a thing. More than one way to FEEL a thing. And each different way helps me see, hear and feel with a little more wholeness.

I don’t have to view my anxiety as a totally terrible affliction. It brings some altered perceptions into my life that are actually creative and beautiful. And in dealing with it, I become more and more aware of how much it all depends on my own perception. Life and pain and fear and death is not so much an “outer” phenomenon. It is more of an inside job.

I’m not talking so much about turning all the bad things into good things, making lemonade out of lemons. I am thinking more that embracing the ‘stained glass’ of Jonah’s post helps me also see the beauty of the ‘stained glass’ of my imagination. The contrast holds for me a way out of my own conviction that I’m going to die immediately. It teaches me to be still, and let the feeling, the symptom or the thought express itself and then transform – because all things change.

I don’t have to hold on to just my one idea about anything – even a group of words like ‘stained glass.’ I can embrace many ways. And in doing that, maybe I’ll find the middle way.

"Drag your thoughts away from your troubles... by the ears, by the heels, or any other way you can manage it." -- Mark Twain