I have decided to describe a story of my grappling with and overcoming a panic disorder. Many people suffer from this terrible illness for years. For many a chance to overcome it seems hopeless. I have managed to leave it behind and I want to share this experience. I know how much people with panic and anxiety disorders need hope. I will be happy if someone finds my story helpful on his way to recovery. Or maybe somebody will just find it interesting. For me it is also an opportunity to recall and document events and feelings that are gradually fading away.
I have always been like that. With imagination, empathy and rather less than more courageous. But always full of ideas, thoughts, doubts and questions. I guess it’s good. More interesting and abundant life.
Anyway, those without imagination and sense of consequences may live an easier daily life, but often die young, go bankrupt or suffer other misfortunes.
When I was young I discovered that I had fear of heights. One day, still as an older kid, I couldn’t make it to the top of Świnica, one of the rocky peaks in the Tatra Mountains, and I had to wait for the group just a few meters below the peak. Also, I often felt an increased anxiety before some longer trips. But nothing really overwhelming.
For the first time I was really hit by panic when, with my friends, I smoked marijuana at uni. It wasn’t the first time that we smoked but before it had been different, still under the communist regime. The stuff was Polish, very weak, grown somewhere between tomatoes in a greenhouse or in a pot on a window sill. Everyone claimed to be doped but that was really bullshit. We felt a little strange. Were more talkative.
At uni it was different, it was already the beginning of the 90s. Real imported stuff appeared on the market. From Pakistan – the rumor had it. Somebody brought it to the dormitory and we smoked like we used to do with that Polish one. A lot of inhaling deep into the lungs, one inhalation right after another. Marijuana works with delay… Then it knocks down the mind…
This was probably the worst experience in my life. A full blown panic attack. Lasted probably for an hour. I was going through hell. I curled up and was sobbing like a baby. I remember that someone tried to calm me down. In vain. Then it stopped. My friends were a bit surprised that it hit me in such a strange way, but overall they showed much understanding because they had interesting narcotic experiences of their own. One felt like a cockroach crawling under the floor. The other stripped off his clothes… There is something weird in everyone…
It was obvious for me that it was the weed that caused the panic attack and that I simply would not smoke it again. Still over a couple of days I had two maybe three micro-attacks but I convinced myself that this crap was still in me. Maybe rightly so.
Then I forgot.
But I managed to overcome my fear of heights. I went through Zawrat pass, climbed Rysy – the highest peak in Poland, and was in a couple of other places. It was a big challenge. Trembling knees, vertigo. Then after completing a climb I just felt satisfied, but from today’s perspective I think that it made me believe that fear can be overcome. I mean that one can ignore it and continue on one’s way. And that courage doesn’t mean ‘no fear at all’ but rather mastering fear. I have a plate fixed to a wall of my room with a quote from John Wayne: ‘Courage is being scared to death – but saddling up anyway’. Very true! To certain extent of course, the most difficult amateur passage in the Polish part of the Tatra Mountains – Orla Perć (Eagles’ Crest) is still waiting for me .
Unfortunately, the story does not end on this optimistic note. The next act took place a couple of years later, abroad.
We had been planning emigration for a long time. Visas, logistics, even my new job, all had been arranged remotely. Everything at maximum speed. I hadn’t taken a single day off. Simply one day I finished my work in Poland and couple of days later started again at the other side of the world.
Meeting the new reality was not easy either. Different culture, different habits and attitudes. Hundreds of potential situation to become a mug, loads of stress. New language, new challanges. The pace was very high but gradually we started to settle down and enjoy life.
Two, maybe three months after arriving in a new country, we went to an unguarded beach. Not for the first time in fact. There were very large waves that day. Hundreds of miles away a tropical storm was dying down and the waves were its remnant. I jumped into the water to swim. The waves were turbulent so it was difficult to swim. I thought I would go beyond the place where they were breaking and swim at ease. About a hundred meters from the shore. I like swimming and I am a good swimmer. For some time it was very nice but then even bigger waves came and, in line with their nature, started breaking further away from the shore. Just over my head. Six to eight feet wave has immense power. Ocean is not at all like the closed Baltic sea I was used to. Not many people in my country know how dangerous big waves are and that surfers riding them actually risk their lives. Certainly, I was extremely stupid then. The wave torments, pushes to the bottom. Before you manage to swim up to the surface to grasp a bit of air, another one comes. After a couple of cycles, you are short of breath…
This is how it is. The world becomes darker. The vision narrows dramatically. Consciousness focuses on the immediate. Panic strikes through. The whole body gives a signal to escape but there is nowhere to escape. You need to fight. A whirlpool, a fight to swim up to the surface, a breath, a whirlpool, a fight to swim up to the surface, a breath… A bit towards the shore… This adrenalin, which is responsible for narrowing the vision, must have saved me. Gave energy to my muscles. I don’t remember how long it was. Probably a couple of minutes. To me it seemed ages. Trembling I went out onto the beach.
My unaware wife was sunbathing at ease.
Ten years have passed since then, but when I recall those events I feel like a dead man.
I think that this experience surpassed my resilience to withstand stress. Right after this I quickly returned to my usual self but about a month later I had an unprovoked panic attack. On Sunday morning, in a church. It lasted maybe a couple of seconds. Again the same darkness and horror. It is known in psychology. The response to trauma comes after certain time. Vietnam, Iraq – there is a whole literature about it.
Yet again this attack passed like a bad dream.
A couple of days later I got a business request to travel to a very remote place to see a customer at their site. I was to go by plane but since a weekend was approaching I decided to take an additional day off and drive there together with my wife, sightseeing on the way. Hundreds of miles to nowhere. This ambiance of no man’s land, abandoned towns, must have added its share to the whole. I remember as if it was today, a creepy forlorn cemetery. Wind blowing between the graves more than century old. In the evening, in a restaurant I felt bad. Fear, darkness, bad thoughts, de-realization. Sweat coming out on my forehead. Tremendous need to escape. It wasn’t a temporary attack. It was like a dark cloud that covered my life. We came back to a hotel. I lay curled up in terror. After some time I fell asleep. When I woke up next morning I got up a usual way as if nothing had happened. Only after a longer moment the events from the previous day came back and darkness again filled my world. I had it that way during all my illness. For a microsecond after wakening up I felt normally. Before memory came to overwhelm me. ‘This’ was in my thoughts. Panic disorder is really an illness of the mind, not the biological brain. It’s our memory and thinking that distorts the chemical balance in our brain. Not the other way round like with schizophrenia. We are winding up ourselves with our own thoughts. That microsecond of normality after awakening was always a proof of this for me. And hope at the same time…
The way back took two days and was a nightmare. Attacks of suffocation. Thumping of heart. A need to escape, to return home. This tremendous feeling of unreality, illusion, being outside of one’s body. As if every touch, every word, had to break through a cotton wool. At the same time, the horizon rose and got gloomier. As if everywhere was up steep and sinister. This urgent awaiting of when I would feel normal. Seldom moments of relief and then immediate return of extreme tension.
We stayed overnight in a little town on the way. I was examined by a doctor in the local medical center, who concluded that physically I was ok. She was quite smart because she didn’t quite believe in a somatic background of my disorder and her suspicions were directed towards schizophrenia even though she didn’t say that explicitly (she asked me if I heard voices etc.).
In the motel I managed to catch some sleep, nevertheless my sleep deficit was growing. We arrived back home but this didn’t change my condition. For another week or two I was submerging into illness. I saw two doctors, each of them concluded that I was physically healthy, just exhausted. I was afraid to get up from bed, lost a couple of pounds. I had bad thoughts that I would suffocate with food. But then as I lost weight significantly I was afraid to starve to death. Obsessive thoughts were accompanying me for a long time: that I would do something stupid, or harm myself or my dearest, break a shop window, jump under an incoming car etc. Incredible easiness to imagine negative consequences was part of my state of utmost tension. Same as micro-visions of fear – inclination to identify images as threats. I had deeper panic incidents a couple of times – like the one ‘after the grass’. One of them I remember very clearly - it was when my wife went to attend lectures and I stayed home alone. I thought my heart stopped and that I was dying. Sweat, horror. I fell asleep, or rather fainted into sleep from exhaustion. The sleep problem was another issue. I couldn’t sleep. And my deficit of sleep grew to catastrophic dimensions. I felt constantly groggy and was falling into short naps during the day from exhaustion. At night I couldn’t sleep, sometimes I would only be able to sleep for an hour or two in an early morning. Even months later when I felt by far better, I had to go occasionally to my car during lunch break to get some sleep rather than food – after a sleepless night in bed.
There were moments when I thought that I would never come out of this and would go completely nuts. But somehow, deep inside, hope lived in me. Depression was secondary and in a way objective with regard to the state of tension that I was in.
I survived this period thanks to my wife. She supported me constantly. It put an enormous burden on her, which I cared to notice only much later. This disorder is like alcoholism, it touches the whole family. Patient support of someone very close is invaluable. Support but not empty advice. At some point my brother phoned me when the information had spread that I wasn’t doing well. I think he meant well, but in the end the only thing he said was that I should ‘pull myself together’. I wanted to reply to him to shove it up his ass. I didn’t do it only because I wasn’t capable of such a reaction.
It’s hard to say when I started on the way of recovery. At first I didn’t feel it at all, but from the hindsight I can see a couple of important points and a bunch of favourable circumstances.
First of all – even though I was ‘dying’ a couple of times, yet I never stopped living. It sounds a bit ironic now. Then I didn’t look at it that way and yet that grain of truth was sown in me.
Secondly – we were abroad and my wife didn’t work. I couldn’t shut myself away from the world. Luckily my job was fairly flexible. I could work from home, although I had to regularly visit customer sites. It is easier for men in that respect. Despite all the emancipation it is still possible for a woman to give up and withdraw inside four walls of her home. For men it is socially unacceptable. This helped me though it hurt a lot.
Finally, maybe most importantly, the continuous support from people of good will, first and foremost from my wife, which I already mentioned.
I was lying in bed for a couple of days, I was afraid to leave home. A full blown agoraphobia. I only went to see doctors and for medical examinations, and even this thanks to a car in which I felt safe – surely due to this two day return trip at the beginning of the illness. I called in sick and was on leave for some time, then I took additional couple of days of paid vacation. Altogether I wasn’t working for about two weeks. I still suspected that it could be a kind of infectious disease, meningitis or other. All such hypotheses were disproved in examinations, the results of which clearly stated that physically I was healthy. My wife started ‘pulling’ me outdoors, for a walk or to a nearby swimming pool. It was difficult for me, even deep down I didn’t want to admit that I was afraid, so even if reluctantly I gradually started agreeing to short goings-out.
We went a couple hundreds of yards to a swimming pool by car. I was standing there in water thinking only about when we would go back home.
The key was to admit that it was all about fear. That I was simply afraid to leave home (for fear of having another panic attack) and that I was unable to overcome that fear; that I was in a destructive loop of fear of panic. It really took a while to admit it.
I started to search for information. In a (very) nearby library, where I obviously went by car (that car was my mainstay, I am really surprised while writing this because now if am to go somewhere further I prefer to go by train rather than drive), I found a book about an anti-fear therapy with vitamins and food supplements. It was the first place where I found my symptoms described. I had read and I believed – I started to devour fistfuls of vitamins, plant extracts etc. Of course it didn’t have much effect other than ruining my budget but at least it put me on the trail of information on panic attacks and fear disorders. Even today my wife makes fun of my vitamin period. By the way, guys who take advantage of despair and this enormous will to recover, for the benefit of commercial goals of pharmaceutical and food corporations, should be sent for a short vacation to Guantanamo – a certified doctor with a successful practice, as was written on the cover! Well, maybe I am exaggerating; after all, that book was the first step to understanding my illness. I found more information in the Internet. No problem there, hundreds of pages popped out after entering: ‘panic attack’ or ‘panic disorder’, even though at that time the Internet wasn’t such an obvious source of information as it is now.
I was hesitating but finally, equipped with the recently gained knowledge went to see a GP, who I had seen before and who had made an impression of a competent man, capable of understanding a patient. He suggested doing a more extensive medical examination, including ECG and other, just to make sure, at the same time he suggested that I should see a psychiatrist.
I remember, that when had done the ECG and asked impatiently for the result, the nurse replied ironically: ‘ you won’t die, yet’. This was quite rude on her part, but at the same time I realized that there must have been a fundamental difference between the state of my emotions and the way I was perceived by others. Even though I had lost some weight, physically I was in good shape. I guess, that was the moment when I finally decided to fight. I don’t know how to put it, but I accepted my death. Somewhere on the rational level there was this grain of truth, that I wolud not die because I was physically healthy, which was confirmed by all medical tests. This however didn’t change the reality of my emotional state and dramatic nature of the resolution. It is hardly possible to describe it, since it wasn’t necessarily a logical analysis but I rationalized it, more or less, in the following way: Everyone has to die. Death is the inseparable element of life. So many people died before me and I will also die, no matter if get better or not. It’s just a question of time. I believe in God and He is my hope. Maybe there is nothing to fear at all. Maybe death is just a bridge to a better life. However if God does not exist (as you can see I really took all options into account) then let me follow the thought of Epicurus: ‘death is nothing to us – when we exist death is not, and when death exists we are not.’ So death is just an illusion of our imagination. Independent of the faith, this thought was very important in my therapy because it made me understand that my illness was just the matter of my emotions. Fear, bewilderment, dizziness, derealization, darkness, feeling of awakening and a whole set of other emotions are just feelings that I produce myself. Not an external objective situation. Somatic changes: increased heart rate, sweating, dilated pupils, blood retracting from limbs (all these are actually typical effects of adrenaline that our autonomic nervous system secretes through adrenal glands) are only derivatives of these fillings.
However this might sound like – I have accepted my death. I that sense I died and was reborn.
I didn’t have a good rapport with the psychiatrist. She prescribed a packet of oxazepam in case of panic attacks and suggested some form of psychotherapy, but I didn’t continue meeting her because I felt no thread of understanding between us. Nevertheless, oxazepam proved to be useful. Not because I started taking it regularly ( I still believed in vitamins and I also read somewhere that one could get addicted to benzodiazepines – which of course paralyzed me), but because it gave me some sort of assurance in case of an anxiety attack. Especially that when I first took the drug, I must have read the prescription incorrectly and instead of taking half of the tablet I swallowed the whole one (15mg). Of course I was waiting with distrust if it would be worse rather than better. I almost had a panic attack because of that. But oxazepam worked very well on me, possibly also because of increased initial dosage. I felt almost normally. I remember that moment, maybe fifteen minutes after taking the drug, when my face and neck muscles suddenly relaxed. I didn’t realize that they had been so tense all the time! It worked for the whole afternoon, I managed to go for a longer walk and even had a short ride on a suburban train (yes!), if I remember well. I went to bed relaxed. Even the early next morning was not too bad, only later the illness returned. It was a big step forward. I gained a protection buffer!
Later I started using the medicine occasionally but quite regularly, every other week or so I would treat myself to a short ‘vacation’ from anxiety. I started to find glimpses of joy in life…
The progress, I am writing about, did not change the fact that overall I was living a life of pain. All the time in extreme tension, as if beyond myself – I have already described the state of my feelings before. I could work from home a lot of time but I had to go to customer sites or to the office as well. At the very beginning my wife would go with me and wait in the car! I was at a particular site only as long as absolutely needed – and with pressing need to leave. I really had an understanding boss. Surely he saw that something was wrong, offered help but without being intrusive. He gave me a chance. Gradually I started to drive alone further and further away. It was only after a month from coming back to work when I was able to drive alone basically everywhere within the city limits. With a pack of tablets always with me.
After some time I had a crisis. Even though I was functioning somehow, an impression grew in me that I wouldn’t make it, that I needed to run away from this. I demanded from my wife that we go back home to Poland. This was the moment when I realized in what tension she had been living. She replied that I musn’t not toss her life like that, that she was trying to come to terms with all this. Settle down. Build some social networks. Finish her studies. That I needed to take her into account, that her life couldn’t be only about my illness.
I felt like in a cul-de-sac. I had no choice and had to struggle on. We stayed and it was a good decision.
In the Internet I found a couple of books and ordered them from the Amazon. I remember that one of them was written by a woman who argued that she regained full balance thanks to a conversion within one of new Christian sects. Only at the end of the book she admitted that she was taking xanax continuously. I felt sorry because of that. Unfortunately in the state of anxiety disorder people are very susceptible to influence and suggestion and sometimes others take advantage of this fact with no scruples.
Luckily among the books ordered I found ‘Peace from nervous suffering’ written by Claire Weekes – a doctor with great empathy for sufferers (who apparently overcame panic disorder herself). It was a common sense psychotherapy – a mixture of understanding of fear reactions, some techniques to reduce tension and behavioral therapy. I owe a lot to this book. Not so much the improvement of my state, it was already happening, but my later complete recovery. And when I am writing complete, I don’t only mean the lack of symptoms, rather that I don’t need to be afraid that it might come back one day, because I know that in fact it is not an illness at all (in a biological sense) but just a state of mind in which I found myself due to certain circumstances (and inborn inclinations) and which I myself maintained.
Later I bought yet another book of the same author: ‘Hope and help for your nerves’. It’s a pity that these books are not available in languages other than English. Many people could benefit from them. I was thinking of preparing a Polish edition but then the daily hectic life returned and I never found the time. I am a bit sorry about that.
I will describe in short the auto-therapy, that I applied to myself based largely on doctor Weekes’ books and how it helped me. In fact it still helps as my personality and emotional construction haven’t changed.
First of all comprehend your illness. Below I enclose some information on panic disorder. Most of it is also valid for ‘normal’ stress and can be easily found in vast literature on this topic. Understanding how our organism reacts in stressful situations is important because it allows us to accept that nothing particularly extraordinary happens to a person in panic (or stress). On the contrary, the organism follows a strategy created by millions of years of evolution. This strategy is to switch on a ‘fight or flight’ mechanism which consists in switching the organism into a condition best suited to fighting or running like hell. It is possible thanks to a set of hormones – adrenaline, cortisol and others –secretion of which is automatically triggered by brain in response to a perceived threat. This means – in time of awaiting the danger – emptying the body from unnecessary substances (faeces, urine) and abstaining from food – the body will be more agile and efficient and if it receives deep wounds they will heal better.
(Sometimes in guerilla or war films a message is conveyed that fighters shouldn’t eat before a combat mission. The order hardly necessary. I don’t think a soldier before a deadly mission would be able to swallow much – unless he or she had their adrenal glands amputated ).
In the moment of the danger – first of all the heart rate increases (thanks to that more oxygen reaches the muscles), the body temperature is reduced through sweating (cooling of muscles during the effort, thickening of blood), blood retreats to important internal organs and muscles – felt very often as coldness of feet and/or hands, also eye pupils dilate – increasing sensitivity and contrast of vision. All the changes listed above increase the chance of survival in a real danger. I am not a medical doctor and I don’t claim this to be absolutely strict but in general this is how the body works. More than that! The changes also affect our mind. Quality and creativity of processing of information give way to speed and concentration. The reason is clear – recognizing if the tiger is more or less speckled is not so important as this couple of milliseconds, by which it is sooner recognized as a threat. In the moment of stress our mind concentrates on a rapid recognition of danger (micro-visions) and on building threat scenarios (obsessive thoughts). Also the fact that in time of looming threat the organism gives up sleep shouldn’t come as a surprise. This mechanism saved lives of many our ancestors and we should be happy that we have it.
It saved me from drowning.
But there is a certain problem with it. This strategy hardly corresponds to a modern civilization stress – pressure at work, deadlines, furious boss, exams, traffic jams, etc. There is no tiger in sight. As a result our brain desperately looks for a ‘replacement tiger’. This is a straight way to anxiety and panic disorder. The misfortune starts when the brain identifies symptoms of stress as a threat. A feedback loop manifests itself then. The more we fear the more symptoms we produce – more symptoms produce more fear. Panic attack strikes and develops till hormonal ammunition runs out.
Useful therapeutic conclusions can be drawn from the above. Primarily, an anxiety struck organism ‘only’ follows a preprogrammed strategy and from biophysical point of view nothing extraordinary or dangerous happens to it. Secondly, to come out of anxiety, the murderous loop of fear of fear needs to be broken.
In very practical terms it means that in case of a looming panic attack, regardless of how devastating your thoughts are, you HAVE TO repeat and persuade yourself that sensations you feel are normal physical symptoms resulting from biochemical reactions within your body, that they can only become more severe if you worry about them and that they will go away very soon. They always go away after a period of time because the capabilities of the brain to react to hormones of fear are not unlimited! If the input of this amplifier is overdriven then the sound will get ‘fuzz’ but won’t be any louder. At most you will get into a state of unreality. It’s when our brain revolts against logically reasonless stimulation from fear hormones and says to its autonomous half: ‘hey, it’s a bit too much, must be some error, will try to ignore it’. We are much calmer in this state of unreality, aren’t we? This is additional help from our psyche.
However, truly and honestly, when was the last time you had this really terrible panic attack? Quite a while ago, wasn’t it? Rather at the onset of the illness. Now, you are only continuously waiting in anxiety that it comes back, aren’t you?
If you suspect a truly physical disease then do comprehensive medical tests: ECG, viral, parasites, tumor markers and whatever else contemporary health service can provide. Do it anyway, just to be sure. But if all test results are within norms then at some point tell yourself to stop and trust your mind that physically you are healthy. Oppose the constant need to monitor your body! It only winds up the fear spiral. Your body will monitor and regulate itself perfectly well! (Of course, if you do suffer from a chronic disease e.g. hypertension or allergy, then treat THIS SPECIFIC disease as prescribed.)
Ok, if it is so simple then why is it so difficult to get rid of a chronic anxiety? Why after understanding the anxiety reaction doesn’t it just disappear out of hand? Surely we don’t want to live in fear. Intellectually, we understand that we shouldn’t be afraid.
It is because our system, due to constant tension, has become sensitized and used to certain reactions. A narrow path between perception of danger and the ‘fight or flight’ mechanism has changed into a multilane highway. Our thoughts constantly run in this single direction. We concentrate on danger. Constantly triggered neurons in our autonomic nervous system flash restlessly. Even if we break the fear loop, it will take months before we can calm them down. Before the highway gets abandoned and reclaimed by nature. The brain has a genius function of forgetting but it takes time. Habits change slowly. (Particularly if we got used to them and sometimes feel comfortable with them? Like in that old joke about a deaf grandpa who never hears requests for help with housework but quickly responds when somebody calls him an old deaf ass.)
The behavioral therapy (changing the behavior learned through anxiety) and some other techniques are very helpful to reduce tension. I will describe them below.
Changing the behavior learned through fear
A strong negative stimulus like a panic attack shapes our behavior and forms reflexes. This is how we are built to act. Like the Pavlov’s dog that has learned to salivate when it hears the ring even though it is not accompanied by food.
Home is our safe haven. This is quite natural. Leaving home always creates certain tension. So much more during the anxiety disorder because of fear of panic attack and all imagined personal and social consequences. Whenever we want to leave our home (abandon our safe base because it doesn’t always have to be our home, the comfort zone is personal and can be very weird) the tension grows rapidly and punishes us for such daring attempt, though looking objectively there is no specific reason why panic attack should be more probable when travelling or at work rather than at home.
Such lesson is not to be forgotten. Soon even a thought of leaving home produces feelings of threat.
This needs to be patiently unlearned. It can be done because our neural network has by its nature unlimited capability to adapt and constantly integrates new experiences on top of the old ones.
Practically it means that you continually need to test and widen you safety zone. If you are bound to your home, try go to the porch, then the pavement, do a short walk, do shopping, ride one stop on a bus, on a train, plane etc.
Easier said than done!
Whenever you get close to a boarder of your safety zone your tension increases, heart pounds, sweat, trembling legs, the piercing need to escape appears, maybe dizziness and whatever else is left in the emotional arsenal. Thoughts circulate only around the fear and what will happen… I will die, faint, crowd will gather, I will make a fool of myself etc.
If such exercises are to bring any effect and not only trauma, they HAVE TO be accompanied by a proper mental attitude. IT’S NOT ABOUT OVERCOMING FEAR! It’s not possible. The more you try to feel normally, the more you concentrate on the tension and its symptoms, the bigger those symptoms are. The fear loop grows. You will fail! Don’t fight fear and its symptoms! It’s your mind that is looking for an enemy to fight with! Do something exactly opposite. ACCEPT FEAR AND ITS SYMPTOMS! Rationalize in the following way: I am subject to all these feelings and symptoms. I feel the need to escape, have shivering legs, my heart is pounding, I am sweating. I can’t consciously help it. My body is sensitized and this is the way it reacts. Nothing bad will happen because of that even if it feels extremely unpleasant. I will ignore these symptoms as long as I can. I will go a couple of steps further, wait a bit longer, will ride one more stop, etc. When I cannot bear it any longer I WILL DECIDE MYSELF to come back to my safety zone (or will take a medicine as it was occasionally in my case).
This way we have a chance for a positive feedback loop. The longer/further we withstand the feelings and symptoms the bigger our sense of success will be and improvement of our frame of mind in the end. This gives strength to move ahead. Accept the feelings of fear and gradually they will be weaker (sooner than you think). By ignoring them you break the loop of fear.
Help and support of a close and trusted person who can understand and appreciate our effort, even if it is just one step on the porch, can make miracles too! It’s worth sharing the success with somebody.
Below are the key elements of the therapy that helped me…
Don’t fight your feelings.
Accept and ignore them.
Program yourself with positive arguments of your reason.
Fight your weakness.
Reducing constant tension
Good. So you understand what anxiety disorder is about, you accept feelings and symptoms which accompany it and you try to ignore them. You have started to enlarge your safety zone. Maybe you have first achievements. However it does not change the fact that you still feel wretched. Even at home you feel constant tension, sometimes it seems as if hundred pound weight sat on your chest, sometimes you feel unreal, sometimes helpless, self-pitying.
You can reduce that tension that is inside you through different activities and techniques. They serve the same purpose – breaking the fear loop: tension that creates bad thoughts and physical symptoms, which in turn maintain tension and so on.
The idea to reduce tension is fairly simple and its implementation not necessarily unpleasant: ENGAGE YOUR THOUGTS in something. Redirect them to a topic different than constant pondering threats and analysis of feelings and symptoms. THE WORST THING YOU CAN DO IS AN ACTIONLESS RELAXATION! Sometimes your well-wishing friends or family might suggest to you something like: ‘you should go to your parents’ cabin in the country, lie down in a sun-bed, without kids, relax, regain strength’. This is not a good idea. A trip like this might ruin an already achieved progress! In a prolonged time of idleness you won’t manage to master you thoughts and they will turn obsessively to threat topics. The fear loop will tighten.
Try to keep your consciousness busy all the time! Preferably with something that requires concentration and engagement but by itself does not create big tension.
Films and television
To me personally, the most helpful were not-too-thrilling crime stories (Frost, Mid-summer Murders, Colombo, etc – pretty vintage now ). I had my ritual of watching them in the evening. I always felt better afterwards. Very often, after watching a movie, I had a feeling of awakening, return from a long trip. This could last for quite a while. You can also notice that after an interesting film, for a couple of seconds you feel completely normal. You are still ‘living’ the film plot. Only afterwards the memory and burden come back
The same situation. I read through a shelf of likeable crime stories in a local library. Surely, these could also be romances , as long as they draw you into the plot, away from thoughts.
Housework and DIY
Anything that we enjoy and which keeps us busy. For me personally it is typically some technical DIY – home or car improvements etc.
I even wanted to buy a classical car for renovation but in the meantime I got better and gave up that idea. (Yes, I know. For women it doesn’t sound fascinating but boys have such fancies )
Friends, meetings, discussions, excursions
They should be engaging and absorbing
Apart from engaging in a game or a competition it improves health and well-being. Pure advantage. I started to run at some point in time and it proved very helpful. It relieves tension. In addition, in each sport activity there are gadgets that you need to have, subtleties you need to discuss, the whole halo around it. Gives you a lot to think about.
Reasonable faith enlarges the horizon and helps relativize the problem of illness. Gives hope and strength. Of course not everyone is a believer but if you happen to be one, then you have one more pillar of support. Treat it as a source of energy. In connection with Christian or Buddhist meditation (and surely also that of other religions) it helps to rise above the current state of emotions. What else is enlightenment in Zen if not ignoring emotions, imaginations and perceiving things ‘as they are’?
They aim at achieving tranquility. There is much literature on this. Just be careful during such exercises and make sure that your thoughts during the time of relaxation do not obtain unwanted freedom to play around the topic of your illness and threats. Do not meditate on these topics! If you feel that your mind pulls you in that direction then it is better not to use relaxation techniques at all.
I believe the list above is sufficient to understand what I mean. Engage you mind in something different than constant thinking about your condition. You need external triggers to achieve this because gravitation of your thoughts towards the problem is too big.
Some other important elements or considerations of self-therapy:
The anxiety feedback loop can be broken chemically with medicine by influencing neurotransmitter receptors in the brain responsible for fear stimulation (alcohol works in the same way). It is possible then to return to normal life and start forgetting the disorder. In my opinion such unconscious forgetting will require a long time, a couple of years potentially. Then the memories fade away and bad experiences are covered by new ones. This will hardly work with tranquilizers because they addict quite fast, soon the dosage needs to be increased and after that the drug discontinued, still long before new positive experiences are built. But it may work with antidepressants which do not addict and can be taken for many years. One problem remains though. You will owe the recovery to drugs and not yourself. You will not build resilience. If in the future a new very stressful situation arises then the anxiety may come back unexpectedly and again the only solution will be pills. But apparently they can be taken for the whole life.
What worked for me was to prop up with a tranquilizer sporadically in very difficult situations (in fact there was just one such situation, although I always carried tablets in the pocket) and as a planned relief from anxiety occasionally (seldom) in the period when my illness was still severe.
Sleeplessness is one of the symptoms of anxiety. Similarly, as in case of other symptoms, fighting it brings opposite results. A frequent paradox is that when taking a mild sleeping pill, falling asleep is even more difficult than without it. We so much expect the medicine to work, we so much want to fall asleep that the tension rises and sleep doesn’t come. The more we want to sleep, the more difficult it is to fall asleep. Of course there are drugs that will make a furious elephant sleep but it’s hard to call such a sleep a healthy one.
According to the Maslow’s pyramid of needs sleep is one of the most basic physiological needs of the organism (like breathing and drinking water). The safety need is at a higher level. This results in a simple fact, that regardless of how much you are afraid you will drop off anyway. My personal experience was that I could spend sleeplessly or almost sleeplessly two consecutive nights. During the third one I would fall asleep. Of course the days after sleepless nights are difficult. What to say? It’s hard… It’s worth defining regular bed hours and stick to them. Do not sleep during the day unless absolutely necessary! As the therapy progresses and tension falls also the sleep improves.
If you have a big sleep deficit, the sleep will come as soon as you stop awaiting (it) with tension!
Narrowing the horizon
Sometimes a crisis strikes and you think that you won’t make it; that it’s not known how much longer this will last; if you endure the coming months. Your imagination builds extensive scenarios. Try then to narrow the horizon of your imagination. Think this: “Maybe a long therapy is still ahead of me. My imagination suggests many bad scenarios. Instead of considering them I will concentrate on the immediate actions. I will drink this big bowl with a spoon. Sip by sip. Step by step. I can make a little step. I will worry about the next one later.” This is an exceptionally effective technique also when you want to deal with a normal stress caused by excess of obligations and personally I use it very often. Sometimes it seems to me that I am so overloaded with commitments or expectations that I will not be able to get through the coming month or quarter. Recently I have taken a mortgage and started a complete renovation of an apartment. When I think how much work it still needs to be done I feel sick. So I don’t think about it! I do it step by step…
Widening the horizon
When depression comes and you grieve over the lost time and your poor condition or when an unexpected period of increased anxiety strikes, try to widen the horizon and see your situation from a more relative perspective. Think along those lines: ‘I am feeling really bad now, but this will pass soon because it always passes. From the perspective of my whole therapy it’s just an episode that needs to be waited out.’
Think also that despite dramatic difficulties you also have tiny joys; because of your relatives, children; maybe you are needed by someone; you are physically healthy etc.
What requires caution
I have written that before. Avoid boredom and idleness! Your thoughts will then gain extra freedom and will be attracted to the topic of illness and symptoms of tension, sometimes quite unexpectedly. Such a dangerous moment may manifest itself for example in church! Many people experience panic attacks during the Sunday mass. If the service is boring and sermon unattractive then engage your thoughts in something else e.g. planning housework etc. Don’t let them flow astray.
Superstitious religion, magic, occultism, horror films etc.
Everything that pulls you into some gloomy irrational reflections is perilous. Your are too weak to control your imagination that can be stimulated by that kind of triggers. Avoid at all costs!
I think that psychoanalysis was helpful and innovative at the beginning of the twentieth century, when most of the people lived in a very tight corset of superficial morals. Today it is rather a rarity. If you were harmed in childhood or you have seriously abnormal relations with your parents; you displace your basic instincts and needs, particularly sexual, then psychoanalysis might help you. If however, you don’t see such problems in your life then it will only draw you into pointless and endless discussions about your childhood, or murky deliberations if it is good or bad that you dreamt (or actually never dreamt) about an intercourse with your mother or father (Oedipus/Electra complexes are key in psychoanalysis). This can bring an adverse effect, increasing tension. You should try to resurface to light and not submerge into the darkness of archetypes, often unfounded. It’s ok to try but if you feel that it brings adverse effect or simply no effect at all and you discuss again and again a topic of little importance from your childhood or still again you describe your feelings, then do not hesitate to give it up.
In the descriptions above I have used many times the term to break the fear loop. It was useful to depict the idea but wasn’t quite precise and I would like to explain it better. It’s not about breaking in the sense of an abrupt action: stop, it’s broken and done. Maybe it is possible but in any case wasn’t part of my experience. It’s rather about gradual loosening until the loop stops functioning, like with untying a knot made from many threads. One has to loosen one of them, so that another one can be eased, then the second and the third, so that the first one can be loosened yet more and so on until the knot is untied… Through accepting and ignoring the feelings of fear we reduce the tension which in turn causes a reduction in obsessive thoughts and visions and through that fewer opportunities to produce fear. If we add to that an activity of the mind in different areas, to reduce time it has to produce bad ideas and representations then our brain will gradually start to calm down.
So, this kind of therapy I applied to my disorder. The fact that I worked was an advantage because it significantly reduced the time I had to analyze my condition. I was supported by the closest person. Surely, my in-born disposition to rational and pragmatic solutions was also very helpful.
The results came relatively quickly. The acute phase of the disorder ended within two months, a moderate one in 6-9 months. For a year or two, maybe three, I felt some mild and more and more sporadic symptoms but they disturbed my life and well being very little if at all. More than ten years have passed since then. I remember my feelings and symptoms from the acute phase quite well. Not surprisingly – they were dramatic. Those from later phases have faded away in my memory and it is sometime difficult for me to recall precise chronology. I remember that one of the last symptoms I used to have even two years after the illness was a sensation of delicate dizziness during a very light but sunless day – much light without contrast. Also an increased sensitivity to noise. I learned to use earplugs – which I recommend. My observation is that we underestimate the impact of noise on us – for example since I started using earplugs during flights, I have always left planes fresh and rested. These mild symptoms lasted quite long, maybe a couple of years. But let me tell this in sequence.
Till the end of the acute phase, I pushed back my safety zone to an extent that it allowed me to move freely by car within the city limits. I tried to be busy, either to watch, read, or plan something. Gradually I started to take a challenge of longer trips also without a car. I remember a 10 kilometer scenery walk on the outskirts of the city. It required not only to cover the distance on foot but also to come back to a car by bus… This meant of course the necessity to accept the feelings of fear caused by continual challenges. And it cost me a lot of energy. But there was also a reward – I felt more and more assured in my inner safety circles. Such a big breakthrough came when my wife suggested flying for a week-long escape to some warmer place. It was about 6 months since the onset of the illness. I agreed because in fact I wanted to have such a challenge but on the other hand as the trip date was getting closer, more and more dramatic thoughts were bouncing my mind. As if a black cloud was hovering somewhere above. I was paralyzed with anxiety whenever I recalled my vacation plans. A couple of days before our departure I didn’t believe it would ever happen. It seemed to me an illusion. But I did not give up and boarded the plane. Of course the most important piece of my hand luggage was the pack of oxazepam tablets – for the time being not needed. I was covered with sweat but I remember that when we took off I actually felt quite relieved and light – airborne . It was still ok when we landed. We travelled a bit in the area in a rented car, saw a couple of landmarks. But this was not the end of challenges. We treated ourselves with a sea trip. And I got so excited that we chose a budget traveler solution as we would have done in the old days. Not on a big ship to the nearest lagoon, but on a small fisherman boat, a couple of hours into the sea. This was a bit too much. There was no way to escape from this boat or to hide on it. Additionally everyone was looking at each other. I was considering different scenarios. That I would jump off the board so that they call the coast guard etc. Obsessive thoughts and visions were rolling over my head like stormy waves which had tried to drown me before. I would like to, but I can’t really say that I was accepting and ignoring them! No, I was just trying to hold on. This was all that I could afford. This had to suffice and finally it did suffice. Fortunately my wife was always with me, which was comforting. Luckily, even though I must have looked really poor – I was literally soaked with sweat – that did not make much impression on anyone because the boat was swinging on waves and some other people got seasick. The others looked at us with compassion. But I was pale and sweated from fear…
When we arrived at the island I was so exhausted that I was unable to leave the cabin. I remember that guys who were navigating the boat looked at me with contempt. But here begins a brighter part of the story. My very worried wife suggested, with tears in her eyes – it must have cost her as much as me, that maybe I should try to use the pill. It was the only time when I used it in a crisis. And it worked! I felt so much better that finally I put on my fins and dived into the sea! Apart from the medication there was certainly a positive loop at work caused by the sense of victory!
The way back was also very difficult… This time due to waves which made me sick. Fantastic feeling! It was the most marvelous, disgusting sea-sickness in my life!
This way I made another step forward. I knew that I could make it. I was less and less worried about my disposition and more and more engaged in usual business of life which in turn had positive impact on my wellbeing.
Sometime later, through a group of friends from a certain international goodwill organization we were often in touch with, I met George. Eighty years old, a nice old gentleman was an ex-amphetamine addict and alcoholic. He got hooked on the drug during his medical studies. Amphetamine was then easily available and treated as a sort of energizing tonic. After seventeen years he switched to alcohol and drank, together with his wife, for decades. I don’t want get into his story. What is important is that finally he dropped that habit!
George listened to my problems with understanding, sharing at the same time his own difficult experiences. He suggested that I should give it a try and meet his trusted psychiatrist – maybe he could help speed up recovery. It was approximately nine months after the onset of the illness. I felt already quite well but I guess another, light crisis of exhaustion struck me. So much effort, so much time and still I didn’t feel completely ‘normal’. I did try. The psychiatrist turned out to be also a psychoanalyst. He proposed a couch and confiding childhood memories. I told him a couple of things but eventually decided that it was a waste of time. I did not see any key in my childhood. All possible problems I could think of resulted rather from inclination to anxiety and not the other way round. He did not insist, just suggested that I try antidepressants. Honestly speaking, I don’t remember the name of the prescribed drug. I never saw the psychiatrist again but I did try the medication. I took it for about a couple of days. Of course the tension caused by uncertainty of taking tablets increased slightly and I did feel a bit unsure. After a couple of days I had an impression that my tension started to decrease, but I felt as if it was an artificial limitation, as if I was on a leash. It’s funny but it seemed to me that my feelings were attached to a pole they could not cut free from. It is difficult to say if this was the actual effect of the medication or just my emotional imagination reacted that way. It’s enough to say that I decided that it didn’t have any sense and put pills away. This was in fact the end of my illness. Still for some time, maybe a year or two, I had to push further my comfort zone to be able to travel alone on a long distance train, later by plane. It was a bit difficult as there were fewer opportunities. It’s not every day that one flies intercontinental routes. It’s surprising how much I was attached to such circles of comfort leaving which still caused some tension. Gradually also that subsided. It could have been quicker if appropriate challenges had arisen more often.
We came back to Poland, built a new house, children were born. Simply speaking the usual hectic routine came back and this was the final step to my complete recovery. I don’t know when I finally felt normal, I guess a year, maybe year and a half after the onset of the disorder.
Am I completely free from anxiety? Of course not. There are moments of increased tension. Once every couple of months I even feel anxious sweat coming over my body, particularly when I get myself into too many challenges at work, or frustrate myself by excessive obligations. But everyone has it from time to time. Maybe I wasn’t made to be a paratrooper or speleologist. That level of adrenaline might be too high for me. But who knows? I got myself very immunized to fear. I have my techniques and I have internalized that fear passes away when one does not concentrate on it and lets it go. With this experience I might go through a truly traumatic situation better than some of the boasting ‘rough-necks’.
But for the time being I am not looking for such situations
To conclude I want to say something that can be difficult to understand if one is still deep into this illness. Well, I am actually very happy that it was part of my experience and that I went through it. It gave me insight into myself but also into other people. I understand much more now. It somewhat disrupted my career, destructed some plans, but let me understand that it is not what matters most…