I’m sitting here shaking my head in grumpiness at myself.
Sitting in front of me is a rapidly cooling glass. In it was a sweet caffeinated fizzy drink, that I eagerly and carelessly consumed running in the door after a hot afternoon out at Mardi Gras Fair Day. Om nom nom, I thoughtlessly thought, in my thinking. And down that bevvy went.
Why does that matter, anyway? Just a drink, right? Get over it.
The problem here is that I’ve just broken a golden rule that I have for myself – an agreement I have with my psychiatrist. No caffeine ever, and if I’m silly enough to do it to myself, NEVER after lunch-time.
I, and a lot of other people have what is known as anxiety disorder – a broad term for a range of different psychological conditions that are characterised by an experience of heightened worry, panic and stress. There’s a range of different things you can experience, covering ‘mental apprehension, physical tension, physical symptoms and dissociative anxiety’.
In my case, I have generalised anxiety disorder punctuated by panic attacks, something which was diagnosed only a couple of years ago – much later than my bipolar disorder diagnosis. However, it is quite common for people with bipolar disorder to have co-morbid anxiety disorders. My father is a fellow traveller with bipolar, and he also walks the halls of anxiety with me. This is actually a great comfort – he’s usually the first person I ring when I’m bent out of shape. He helps me talk to my anxiety with a rational tongue in my head and makes it shut the hell up; sometimes a 20 minute conversation with him when I’m anxious can really help me get my day back on track. His experience makes him a good ally.
What does it feel like to have anxiety? I’ve had a few friends ask me this.
Anxiety makes me paranoid, fixated on all the things that could go wrong. I believe they will go wrong, I believe people think I’m a jerk, I believe I’m incompetent and stupid and ugly. Sometimes I feel ’emotionally’ fine but physically under stress. My heart pounds like a freight train. My hands shake (even more than their usual lithium hummingbird pace). I feel nauseous and my chest becomes tight. I get hypersensitive skin and I find it hard to breathe properly. I shake all over and cry, or feel on the verge of tears. I become really, really negative and indecisive – I fail to see all the beauty and loveliness just abounding around me. I wake early, really early – especially if I know an alarm is going to go off or I have somewhere to be (like work). I’ll just lay awake, my chest hurting, frustrated and scared.
That’s when I’m medicated with a good mood stabilizer (which can kill some of it). I’m not currently taking a medication specifically tailored to target anxiety, and I hope to correct this soon. Seroquel has been recommended to me by my father – it is also good for sleep. Some swear by seroquel, some hate it – it just depends on who you talk to.
When I’m not medicated…Jesus H on a bicycle. It is bad. I find it hard to leave my bed, I get into crying cycles that don’t stop, I shake so hard that it looks like I’m seizing and sometimes I feel a sense of impending doom so great that I just lay, paralysed, staring at the ceiling with my mouth open in a silent scream. It is important to state here – anxiety is a neurological dysfunction, so there is nothing about this I can control.
So when people tell you to just toughen up and get over anxiety, they’re basically saying “just toughen up and get over that Alzheimer’s”. Mental illnesses have a physical origin, thus when I’m vomiting and feeling a sense of palpable terror that doesn’t reflect my actual situation? Very, very real. You could no more “suck up” a broken leg.
I have many bright and brilliant friends who know what I’m talking about here. They struggle with anxiety every day, and it often kicks their ass.
But I have found that if I use certain strategies, I can kick back a bit. Through a couple of years of experimenting and talking to therapists and psychiatrists I’ve found the following vital in managing my anxiety levels:
- Accept that you are anxious. I seriously spend a lot of time feeling anxious about the fact that I am anxious. When I accept that I am having a bad anxiety week, or an anxiety attack, it helps shorten the loop that can lead to an anxiety attack that is purely because I’m anxious about being anxious. I usually say “ok, I see you thar. I see what you’re doing, anxiety. I gotcha.” And I eye it off, acknowledge it, and don’t fight to deny it in the hopes it will go away.
- NO CAFFEINE. Caffeine is some sincerely evil shit – one glass of coke can bring on an anxiety attack, or deprive me of sleep which can bring on an anxiety attack, or cause heightened rapid thinking, which can bring on an anxiety attack. I don’t drink coffee (decaf tastes like shit so I have nothing, really) and I drink decaf tea. I avoid coke, and too much chocolate in anything. And energy drinks? HAHAHAHAHAHAHAHAHA. They make me feel like I am going to DIE.
- Avoid loud and stressful people. Crowds, people with really intense and boisterous personalities, people who invade my personal space or touch me too much, people who want to talk AT me and not TO me – these are not people I can be around too much of the time. They can often make my heart race and I have to excuse myself to do some breathing exercises. This means I often miss queer and kink events because of the high dosage combination of loud+intense personalities+intense events transpiring+crowds+touchy feely. It isn’t that I don’t love that combo sometimes, it just means I do what I can. And sometimes that ain’t much.
- Speaking of which…Do Breathing Exercises. I often breathe counting down from fifty, sitting somewhere with my eyes closed. If I am at home, I lay on my back and do a visualisation exercise during it – focusing on my body one part at a time and wriggling it, or projecting myself somewhere calm and nice. Meditation audio discs can be really helpful, as can classical music with slow, regular beats. Avoiding fast, pacey or angry music is a good idea in the middle of an anxiety episode.
- Think about something you are looking forward to. This odd one is taken from my Mum. When I was a kid, I’d get scared and stressed at night and she’d always say to me “think about something you’re looking forward to…like Goggy and Pa visiting at Christmas!”. That actually really helped, though usually I thought about the next night’s dinner and imagine my mouth closing around mash and peas and gravy. Even now as a grown up, it helps. I still think about dinner. 😀
- Do something physical. I find having sex helps, or going swimming. It loosens up the knots in my tummy and makes them go away for a little bit and I feel less uncomfortable. Being around or in water, or being held really tight and hard by someone, makes me feel safe and like it will all be ok.
- Remember you will not ACTUALLY die. I often say to myself, “this feels like I will die, but I will not ACTUALLY die.” I don’t know why this helps. But it does.
- Avoid interpersonal drama, if it is within your control to do so. Amazingly, leaving my husband and my ex girlfriend and my old city made me a far less suicidally anxious person. Lithium and community helped yet even more. Now, due to a lack of interpersonal drama, I am a low anxiety person. I avoid anyone I feel will bring undue drama into my life. That means that sometimes I miss out on relationships with some creative people with wild personalities – but it is worth it for not feeling like I’m having a freakin’ heart attack so much of the time. Keeping relationships and communication as simple as you can is really important. Give toxic people the boot as soon as you work out the fact that they are toxic.
- Take your meds. Yes, I’m a pro meds person (where appropriate and accompanied with an accurate diagnosis). While I accept patient autonomy and the right to not take them, I know that taking mine makes me feel better. I can’t speak for everyone, but I know going off mine would be very fucking stupid. Without them, I can’t function in any rational way.
- Get proper sleep. Even if my anxiety is stopping me from sleeping, going out every night partying doesn’t help my sleep and in turn doesn’t help my anxiety. Less sleep = less time for your brain to settle and repair itself. Often my sleep operates in direct relation to my anxiety levels. Getting adequate rest is so important in keeping my anxiety in check.0
- Don’t abuse drugs and alcohol. They just really don’t help matters. Fucking with your brain chemistry too much, while fun, will be bad for your anxious mind. I know people who smoke weed to help with anxiety attacks and while I understand this to be a good short term fix for them, it probably isn’t a bright long term one because of how it alters your brain function and behaviour. I drink a little bit but keep it to a few drinks a session, and no more than a couple of times a week. At the moment I’m lucky to drink once a fortnight.
- Talk to your friends about how you are feeling. Because saying stuff out loud often makes it seem less big. And then they hug you and give you some love. That’s really gratifying when you feel like shit.
- Have an anxiety ally. Mine is my Dad but at parties and social outings it is my friend Nina. This is the person you can talk to honestly about your feelings of grossness, trust to not tell you to “get over it” or flippantly that you’ll “be ok”, and to look after you in the event of a full blown anxiety attack at a party. I have asked Nina before a party we attended together to be my person who gives me a subtle exit if needed, or to come chat to me/snuggle me/help me breathe if things go totally wrong.
That’s about it. I’d put “see a therapist” on that list but I feel like it is a bit obvious, and doesn’t always help with chronic anxiety disorder (sometimes does – just hasn’t for me personally).
What strategies have you used to manage anxiety?
I’m now off to go drink a bunch of water and work out ways to make myself sleep tonight after that glass of caffeinated evil. I am rather grumpy with myself.
Which leads to my last tip! Be mindful of your strategies. They aren’t any good to you mouldering on the shelf, are they? (Are they, Brimstone?)