Adventures in Anxiety: How do you handle days when your anxiety is more of a challenge than usual?
It’s the holiday season, which means not only do we get Christmas music in every store and platters of delicious once-a-year treats, but for some of us our stockings are stuffed with a little something extra — extra anxiety!
Just when you think you’re about to savor the most wonderful time of the year you take a big bit out of What the Hell Was I Thinking? as you attend yet another gathering that you know you should have said no to.
So to help you get through this time of the year that is both wonderful and full of expectations, I’m going to dedicate the next several entries of Adventures in Anxiety in managing expectations and boundaries, staying healthy as you travel, and, in today’s entry, what to do when you notice your anxiety is spiking.
First, a caveat — At the beginning my anxiety was far beyond what I can now manage through coping techniques. There are situations where I’ve needed do larger things. This post will focus on coping techniques for mild and/or moderate spikes. If the other is useful, I can write about that.
For me, 90% of my success comes from a good set-up. If I’m at a stable point most likely I’m taking care of the basics. But sometimes even when I’m staying true to these goals, my anxiety spikes. And both of these tend to be true during the holidays! This can take two forms:
- Higher level of generalized anxiety
2. Acute panic attack(s)
So today I am going to share some tips and techniques that I have found helpful.
- For higher level of generalized anxiety, some things I’ve done to cope:
- Talk with an ally: Saying what I’m feeling out loud has been the most powerful intervention. This could be with one of a few trusted colleagues or with my husband or my dad. Each of these allies understands that I’m looking for support, not solving.
- Manage physical symptoms: I know my anxiety triggers, but sometimes I slip up! Changing the physical environment can often help with this. That includes:
- Change clothes: Adding/taking off a sweater/scarf/jacket/shoes to adjust temperature.
- Changing body position: Find a different way to sit or sleep, or go from moving to static or static to moving.
- Moving to a different space: Find a different room or move inside to outside. This is harder to do at work, especially during meetings, but I still do what I can.
- Checking for hunger/thirst/other bio needs: For this reason I always keep a snack and water close at hand so that I always prepared.
- Focus on breathing: I’m not a big meditation fan, but if I am a little panicked is can practice simply breathing in through the nose can help.
- Do a CBT-inspired exercise: I struggle with mistaken beliefs and I can get into patterns in my head that are not ideal. Taking 5 minutes to go through an exercise has been incredibly helpful. I have several different exercises from The Anxiety and Phobia Workbook by Edmund Borne PhD that are my go-tos. Have I recommended this book enough for you to consider purchasing it yet?
- Medicate: This is always my last option — Lithium is what I use when I’m having higher anxiety that is not a panic attack.
So sometimes this will be just enough for me, if this low-level of ongoing anxiety stays in a moderate range. However, sometimes it progresses beyond that, and I end up having acute panic attacks.
2. For an acute panic attack, here are some of the things that I do to stay safe:
- Get somewhere safe: This is probably a restroom or empty conference room, or more likely my car when I’m at work. This is harder to do when I am out in the world or at someone’s house (a public restroom is safer, but not entirely comforting!). Why do I try to get somewhere that feels safe? If I’m somewhere more private I can remove the fear of looking weird or having people (and sometimes well-meaning people) ask me “What’s wrong?” which just exacerbates it. I have another post in the queue about how to support people who are having a panic attack — perhaps I’ll publish that next week!
- Tell someone what is happening: This normally involves a husband or parents call, simply for safety. Letting people know where I am and that I’m not feeling well is a basic safety measure that I always take.
- Tune into the physical symptoms: Physical symptoms like a racing heart, hyperventilating, sweating and/or chills, headache, dizziness, and visual aura prevent me from functioning. Finding ways to mitigate those is crucial. I start by focusing on breath, temperature, and closing my eyes. Or, in some cases, I just need to lie down and breathe through the pain. I’ve learned that part of an anxiety disorder is just learning to live with the discomfort. This is why it’s important to let someone know, especially if I am dizzy or have visual aura (hard to drive and walk, for example).
- Medicate: I do not like this at all, and it’s the last option. And, to be fair, I have become more accepting of this medicine because sometimes gets so bad that I don’t want to fight it anymore. Benzodiazepines (benzos, for short) act on GABA, a brain chemical that helps regular excitability. What that means in plain English is that they stop panic attacks in their tracks. You’re probably familiar with some of them by name, like Xanax, Valium, or Klonopin. I’ve tried them all, and some, like Xanax, make me feel entirely blank and devoid of life. The one that has worked for me is Ativan (generic: Lorazepam) — it’s also approved to treat insomnia, another condition I struggle with. Medication is another post entirely because there are many risks and side effects when you start messing with your brain chemistry. Benzos, in particular, should be used as sparingly as possible because they can cause rebound anxiety and several withdrawal. That being said, sometimes it is a necessary option.
So as we enter this season of joy and anxiety, I’m wishing you health, happiness, and self-acceptance. Be gentle with yourself, and with one another.
Cheers, Sarah
P.S. Happy Thanksgiving, all! This is a few years ago at our house with my brother (left) and my mom’s finger (top left). I’m thankful for family, friends and health this year!
