Anxiety Disorders and Relationships

Anxiety disorders impact more than just us.  They can often have major effect on our close relationships.  Understanding how this happens and having some tools to use to address the negative impacts can go a long way toward improving things for everyone involved.

  • When we change our behavior to accommodate our fear, we force those close to us to adapt.  Forced adaptation that they can’t understand can lead to frustration, anger and resentment.
  • Being entirely focused inward can cause us to unwittingly place very high demands and expectations on the people in our lives.  This is especially true in the case of your “safe people”.
  • Why don’t they get it?
  • Be brave.  Start to make an effort to face your fears.  This can turn things around in your relationships all by itself.
  • Take responsibility for your fear. The fear is real but the danger is not.  Let the important people in your life hear about it.  They need to know that you understand this.
  • Don’t be a victim.  You have the strength and power to improve your life.  Don’t expect anyone else to fix you or to enable a fear-driven lifestyle forever.
  • Be aware of people in your life that would rather have you entirely dependent upon them.  Those are controllers and they have a vested interest in keeping you where you are now.
  • Be aware of self-centered people in your life.  Those people can be difficult to maintain relationships with regardless of your mental state.

As always, comments, questions and general feedback is welcomed!  Comment on the episode here, or contact me on Facebook, Twitter or even Tumblr any time.

——–

Photo Credit: mendhak via Compfight cc

Intro/Ending Music Credit: Title Autumn Day (Kevin MacLeod – incompetech.com) Licensed underCreative Commons: By Attribution 3.0 

Just-The-Facts

Facing your fear without fighting or fleeing is a skill that requires practice. Before we get started, we have to get into an objective frame of mind. Learning to assess your physical and mental state objectively – sticking only to the facts without adding judgement, interpretation, inference or prediction – is vital to the success of your recovery efforts.  Lets look at what this means.

When we’re struggling with anxiety disorders – especially panic disorder and agoraphobia – we are focused almost entirely inward.  We are hyper-aware of every sensation in our bodies and we spend most of our time “inside our own heads”.  This generally means that we make a full-time career out of constantly evaluating and assessing our physical and mental state. This fuels the fear cycle, especially when we fall into the trap of adding judgement, interpretation and even predictions of the future to our self-assessment.

Often the trigger that leads to full blown panic is a simple phrase like “it feels like” or “what if“.  Learning to be objective – sticking to just the facts when it comes to our thoughts and bodily sensations – is the key to getting past this common hurdle.  This is especially important when it comes to the effectiveness of exposure therapy. Too many capable people label exposure therapy as a failure because “it stills feels like”. In that case its not exposure that’s failing us, its the cognitive patterns we drag into it.

Learning to be objective in our viewpoint means abandoning anything that involves predicting the future, guessing, or inferring. From a practical standpoint, this means completely abandoning the following phrases:

  1. I think …
  2. It feels like …
  3. What if …
  4. Is this …
  5. I can’t … 

Its important to understand the difference between the following statements:

“I’m feeling unsteady and disoriented.”

It feels like I’m going to die.”

See how the first is simply a statement of fact, while the second is a subjective interpretation of the situation?  A statement of fact stops after describing observable reality. It does not attempt to predict what might happen or explain why things are happening. Its just the facts. ma’am!  State the facts, then move on. Eliminating subjective interpretation is a HUGE step in not allowing that hot flash, dizzy spell or twinge in your shoulder to trigger a full on panic attack.

Of special note is the phrase “I can’t”, which will be the subject of its own podcast episode in the future.  This one is particularly evil because it allows small obstacles to blown into insurmountable difficulties all due to irrational subjective interpretations.  For now, I will tell you that before you ever say “I can’t”, you better be sure that you’re bleeding or have actual broken bones.What you think might happen should never lead to “I can’t”!

Finally, learning to be objective – sticking to the facts then moving on – can turn your long history with anxiety and panic into an asset! Its true.  When you can think objectively and rationally instead of going into  “Oh my God” mode, you can use the fact that you have not died or otherwise been damaged by the previous 10,000 panic attacks to your advantage.  That might seem like common sense, but common sense does not apply when our thinking is fueled by irrational fear.

—–

Intro/Ending Music Credit: Title Autumn Day (Kevin MacLeod – incompetech.com) Licensed underCreative Commons: By Attribution 3.0 

 

 

boardwalk-and-stars

Let’s build on what we’ve already learned in last few episodes to make an anxiety/panic/agoraphobia recovery plan. Since we know that anxiety disorders including agoraphobia are cognitive in nature we’re generally going to ignore the physical symptoms. Instead we’re going to address behavioral and cognitive issues, because that’s what makes a lasting difference.

We’ll lay out five general strategy points, then we’ll put a broad action plan in place.

Strategy Points

  1. It’s all about goals and expectations. Have the right goals in mind. In our case, making your anxiety and panic stop or go away is NOT the goal. The goal is to learn through experience that anxiety and panic are not actually dangerous and therefore are not to be feared and avoided. The end game here is to simply not care if experience anxiety or panic because you no longer fear them.
  2. Be resigned to the fact that you’re going to have to be afraid and uncomfortable – especially in the beginning – to get things moving forward. Sorry.  There’s just no way around this.
  3. Stop focusing on your physical anxiety and panic symptoms . Stop thinking about what you can swallow – natural or otherwise – to make them go away.
  4. Think and start small. If you haven’t left your house in three weeks or you haven’t gone shopping alone I two years, don’t start by planning a three week trip to Paris. Don’t worry about how impossible it might seem to get back to being “normal”.  You’re in the business of un-learning negative behaviors and re-learning old skills.  That’s done in small steps.  Every step, no matter how small, is a step you can build upon.  Its all matters.
  5. Be consistent. Be persistent. Be tenacious. This is what matters most. A panic-fueled white-knuckle run through the shopping mall you’ve been avoiding, followed by four days of not leaving the house, is pointless. You’re way better off walking around your block four times every day for a week. When you win a battle, don’t stop to admire your work or reward yourself with a rest. Don’t make excuses. Keep going! Be tenacious.

Our Action Plan For Recovery

A. Learn to calm your body and your mind. These are skills that must be learned and practiced all the time. Muscle relaxation, relaxation breathing and basic meditation are good places to start. The goal is to be able to use these skills to relax “on demand”. It’s hard. Work at it!

B. Every single day, as often as you possibly can, intentionally put yourself into situations that make you anxious. When you feel the anxiety or panic, start using your relaxation skills. Don’t run. Don’t fight. Don’t expect to be able to make your symptoms go away. Just focus on your breath and the tension in your body and work on those things. Ignore the catastrophic thoughts racing through your head. This is where the meditation skills help. If you do these things and truly accept that you are not in danger , you will find that your symptoms will not escalate and will begin to level off or even decrease in intensity as the adrenaline gets flushed out of your bloodstream.

That’s it! That’s the action plan.  There’s nothing else. Everything else is mechanics and fine tuning.

Naturally the situations you expose yourself to will change over time. Start small. Very small. Gradually expand your circle and take on larger challenges. Be consistent. Be persistent. Be tenacious. Expect to fail sometimes. Expect to be terrified – especially at the start. Expect to be uncomfortable. Expect to work hard, but that’s hard work you’ll be happy you did. If you stick to this plan and really work it, you will be amazed at how fast you can progress. Things you thought impossible will begin to seem within your reach. You’ll start to build confidence and you’ll be emboldened to keep going. Above all, you’ll learn that YOU are in control of the process and that you are not a helpless victim of some horrible mental illness. You’re not! Your brain has just gotten into some bad habits and it’s time to set things right again.

In upcoming podcast episodes we’ll talk about the specifics of things like relaxation, calming your mind and exposure therapy. In the meantime you can get started right now by talking your first step forward. There’s no need to wait for any reason. You can do it!

 

—–

Intro/Ending Music Credit: Title Autumn Day (Kevin MacLeod – incompetech.com) Licensed under Creative Commons: By Attribution 3.0 

How Panic Attacks Become Panic DisorderPanic disorder.

You hear the term often, especially if its a part of your life, but do you understand the difference between panic attacks and panic disorder?  Knowing this can be an important part of building a foundation for overcoming your panic.  Lets take a look at how panic attacks can become panic disorder so we can learn to focus our recovery efforts more efficiently and effectively.

The highlights:

 

  • Panic attacks are physical.  Panic disorder is cognitive and behavioral.
  • A panic attack is a discrete physical event with a beginning and and end.
  • Having panic attacks does not mean one has panic disorder.
  • Panic disorder is characterized by how you focus on your panic between attacks and how you change your life to avoid or cope with them.
  • Many people have regular panic attacks without ever developing panic disorder.
  • Since panic disorder develops based on learned cognitive connections between perceived danger and the behaviors we engage to either escape that danger or avoid it altogether.
  • Since panic disorder is cognitive, focusing on eliminating the physical sensations of panic tends to be a dead end.  You must work on the cognitive and behavioral side of things to be most effective.
  • This means working on facing your fear without engaging in escape, safety or avoidance behaviors. This is how the cognitive connections that fuel panic disorder are broken and un-learned.

 

Intro/Ending Music Credit: Title Autumn Day (Kevin MacLeod – incompetech.com) Licensed under Creative Commons: By Attribution 3.0 

Photo Credit: Rebecca L. Daily via Compfight cc