Coping with EXTREME Anxiety and Panic



Anxiety and Panic attacks can be SO SCARY!!!  If you agree, read on...

Hey everyone. I am experiencing some intense/extreme anxiety since yesterday, and because I've
become well versed in how to effectively cope even in the midst of feeling completely
"crazy" and terrified during anxious episodes, I thought I'd share with you, as I
know many here in the community suffer from this as well, and maybe you're even
struggling today.  I hope this post gives you hope and encouragement.  Remember, I'm
not a doctor or therapist, so I'm sharing from my personal, peer perspective.

I have a lot emotional vulnerabilities going on since the past couple of weeks, and I
haven't talked about them much.  Because of these, my anxiety level has been up and
down, with the highest being yesterday and this morning.

Just a glimpse: my grandma passed away last week and her service was Monday.  It's
never an easy time for this, of course.  I was so emotional for days, then I began to
feel accepting, since she was in her 90s and hadn't been doing well with her health
lately.   Another thing is I haven't been speaking to a very close loved one after
her choice to return to an abusive relationship (there are a lot of reasons why), and
I injured my ankle, so I've been on bed rest the past couple of weeks. I had an
important work-related meeting yesterday. It was the first significant out of the
house trip in weeks, and while the meeting went wonderfully, I think my nervous
system was jolted by overstimulation on my first day out (I'm very sensitive to such
things), and here I am in full on anxiety city.


Here are a few things I know to be true of anxiety and panic for me:

1.) As terrible as they feel, they cannot last. I think of the episodes as storms. I
can weather out the storm. If I can stay as calm as possible, not further work myself
up, and take care of my physical and mental health in the meantime, the storm will
not last as long, and it typically won't get worse.


2.) There is always cause for anxiety. We may have an idea or be very aware of what
has overwhelmed us to the point of panic and anxiety, but sometimes the cause is not
as obvious.  The good news is, we can begin engaging in self-care regardless of
whether we are able to pinpoint why we feel so terribly.  I have a well-meaning
friend who will ask me sometimes, if I have anxiety or panic and there's no obvious
cause, "But WHY, though?"  I just say, it doesn't matter -- something is going on
physiologically, too, and I need to address it.


3.) Anxiety and panic often makes us feel a sense of urgency to do something drastic
or to freak out.  Part of our brain is concerned we are in danger and is trying to
protect us.  I find that literally talking to myself from my Wise Mind with
reassuring statements, i.e. "I am safe.  All is well. This shall pass. Thank you body
and mind for trying to protect me.  I am not in danger" all the while slowing down my
breathing can help significantly.  I tell myself, "This isn't an emergency, even
though it feels like one. I can get through this. I have gotten through this before." 
And when thoughts start jumping into the future, i.e. "What if I still don't have an
appetite at lunch time?"  "What if I can't pull it together in time for work?"  I
remind myself that I only have to be concerned with this moment. I have no control
over 3 hours from now or really even 3 minutes from now. I remind myself that it is
is THIS moment that I can focus my breath, thoughts, and deal with my experience.

4.) The other thing I've noticed about anxiety and panic is that it often tempts me
to break my routine --- in a lot of ways. My appetite is one of the first things to
go when I'm very anxious, which due to past trauma is very triggering and anxiety
provoking in its own right.  So, when I get thoughts about how long will my appetite
be affected, I do what I did in number 3, reminding myself to be here now, then I
make sure I stay hydrated and nibble on things until my regular appetite comes back. 
The other thing I used to always do was panic and run to the crisis clinic (and
sometimes by the time I got there, the episode would be over, proving that anxiety
and panic episodes are really transient), so, now what I do is STAY in my routine as
MUCH as possible.  I get up on time rather then wrestle with the covers tossing and
turning and panicking with racing thought.  I feed the cats.  I have a little
something for breakfast and take my meds.  I floss. Brush my teeth.  Check social
media -- all of the things I normally do when I'm feeling fine.  I honestly believe this has a significant impact on the episode passing, as it is sending messages to my brain that everything is same old same old.  Now, I know it's not easy to brush your teeth and do tasks around the house when you're hyperventilating -- I just experienced that this morning (LOL!), but it can be done.  And yes, I go to work (which fortunately I work from home, but I do live classes online, so I'm "on.")


5.)  When it comes to anxiety meds, I try to not take anything; however, my psychiatrist has repeatedly expressed the importance of reestablishing equilibrium through taking my prescribed anti-anxiety med only as needed, such as in cases where I've tried other non-medication routes (such as all of the ideas above), as well as progressive muscle relaxation and guided meditation (which I also did already this morning).  I decided to take my med as prescribed.  If I need the help when I know I'm doing everything in my power otherwise to help myself, I take the med.  Sometimes when the chemical aspect of my imbalance gets too far (or so I'm told by my psychiatrist and psychologist), the med is the most effective thing to help.

I hope my sharing helped you in some way today.

If you're experiencing anxiety, may you feel peace and ease very soon.  Know that you are NOT alone -- far from it.  Know that anxiety's bark is much worse than it's bite.  Know that this storm will pass, and you will feel better soon.


Huge hugs.  Thanks for reading. More soon.

In kindness,
Debbie

The Accidental Flirt: Setting Boundaries When You Have BPD (or BPD traits)



What is a boundary?  In interpersonal relationships, you might imagine yourself being in a protective bubble. This bubble grows or shrinks in size depending on who you are around.  The smaller the bubble, the closer and more intimate the other person can get to you, and of courses the opposite is true the larger the bubble.  You control the size of your boundaries, and it is the expectation is the other person will respect your limits.  This, of course, does not always happen.  With some people, you must repeatedly reinforce where you stand in term of your boundaries.  If they continuously disregard and disrespect the limits you have set, it may be time to re-evaluate whether this is a relationship you want to continue to nurture.

In the past, when I experienced the symptoms of Borderline Personality Disorder (BPD) fiercely, my overall sense of boundaries and enforcing them were non-existent.  I remember scenarios such as meeting a stranger at a bus stop, them being friendly, and me then literally unloading my whole life story (or at least the latest dramatic highlights) to them before the bus arrived.  As my stranger "friend" would board the bus and I'd wait for mine, I'd be left with feelings of regret and an ickyness that at the time I couldn't describe -- it just felt "dirty," I suppose -- I felt emotionally naked -- very vulnerable and exposed...yet I repeatedly did this all of the time.

Perhaps I longed for connection, and since my life in general was very unstable at that time, and I didn't have any healthy relationships that allowed for a balanced reciprocation of personal information, I tried to connect with anyone who would listen... anyone who had warm eyes or a soft smile... anyone who I thought would care to make a connection with me.  Unfortunately, a lack of boundaries often achieves the opposite of connection: it can push people away.

People who have a balanced set of boundaries can spot a person with poor boundaries from a mile away. Why? Because when we behave from a boundary-less place, it makes others uncomfortable.  By coming on too strong (as I did in the bus stop... or by "falling madly in love" over night with a potential partner or even a potential friend), people with a healthier sense of boundaries may see this as a red flag and avoid going deeper with us.  On the other side of the coin, there are some who prey on those with poor boundaries, and they make take advantage of the situation. I've certainly experienced both.

Another issue that I had with interpersonal effectiveness when my boundaries were poor is that men (and women) would hit on me all of the time.  When I was in a relationship with a steady boyfriend, he would get so upset, insisting that I'm "asking for it" by overtly flirting with anyone and everyone, including the cashier who rang up our groceries.  I would get so bent out of shape and offended.  I saw my boyfriend as jealous, possessive, and insecure, and I thought I must have been hot stuff to be hit on so often. That was my version of reality, and I believed it.  I would also sometime have (again, "dirty") feelings inside in response to feeling that men were being inappropriate with me "all of the time."

When I began to consider that I might have had some role in the situation, I began to change my behavior.  This did not happen overnight.  Even when I set the intention to be aware of the messages I was sending to others, I'd still find myself falling into automatic flirtation -- much to my own, and my boyfriend's dismay.  I had to admit that I had developed a way of connecting with others that sent messages I didn't intend to send.  I saw my behaviors, words, and actions as "nice," but they were often misinterpreted as signals that I was interested in something more with the person, usually of a romantic nature.

I began to notice.  I began to pause before engaging in interaction. I became mindful of my words, tone of voice, body language, and choice of words.  This might seem like a lot off trouble and like a process that requires a lot of energy -- and it does; but, I knew it would be worth it to me.  I was so fed up with boyfriends accusing me of deliberately flirting, even in front of them, disrespecting them, myself, and the relationship.  I needed to know if I really was doing anything and then make adjustments and changes to alter the course of this repetitive pattern.

As a result, over the years, I've become more reserved in my interactions with strangers or people I do not know well.  I sometimes feel the need to clarify if I am concerned that I've sent the wrong message or led someone on a way that I did not mean to do so.  For the most part though, I've learned to modulate the intensity of my level of sharing and enthusiasm with people until the relationship naturally progresses to a place where there would be less room for misunderstanding of my intentions. 

I have also learned to (most of the time!) share personal information in a way that makes sense to the relationship and at a pace that makes sense for the type of relationship. (No more bus stop life stories!)  I also take the time to observe how a person responds to my sharing and what level of respect and dignity my sharing is treated with... and this determines how much I share or do not share in future interactions.

Boundaries are a very important part of life and can be a challenge when we are emotionally sensitive or have BPD.  Can you relate to any part of my story?

One of the books that has helped me over the years is "Boundaries: Where You End and I Begin."

How are your boundaries at this point in your life?  Have you noticed a shift over the years?  What has helped (or what do you think might help) you to establish healthier boundaries?


Thanks for reading.

More Soon.

In kindness,
Debbie

PS -- If you struggle with boundaries, check out my live, weekly, ►online course◄ where I can work with you on this issue.

Are you selfish for being skillful?



There is a set of skills widely known to help those of us with Borderline Personality Disorder (BPD), those of us who have BPD traits, and those of us who identify as being emotionally sensitive.  In particular today, I'll be highlighting  "crisis survival" aka "Distress Tolerance" skills.

These skills can be used to help us better cope with distress, because if you could actually solve the problem (or multiple problems) you are facing, you would likely be turning to problem solving skills. If there is no immediate solution and you're finding yourself becoming emotionally dysregulated, these skills may help. They do in my case and for many others I know who try them.

We can turn to these skills when we are experiencing emotional distress over things that we have no control over in the moment. In just a bit, I'll give you a very real example of my own, as I am calling upon these skills in my own life right now.

What sometimes stands in the way...

1.) The thing about Distress Tolerance skills is that many of them may, on the surface, appear to be simplistic too work. Because of this, we may readily dismiss the skills instead of using them. If you have this thought, the encouragement is to just notice it, and give the skills a chance anyway.


2.) Another thought that sometimes stands in the way of practicing is that we are doing something "wrong/selfish," or "non-productive."  I'll address each of these concerns now.


Thinking you are wrong/selfish about using distress tolerance skills to soothe and distract you during a crisis:

I'm dealing with a number of very stressful issues over which I have no to little control. Where I do have little control, I'm exercising it.  In the other areas, I am choosing to be skillful, even though to the outside world I may look wrong or selfish. 

For example, I just found out yesterday that my Grandmother, my only loving grandparent who lives 3.000 miles away, is in critical condition in a nursing home*. She likely only has a short time. I, of course, became so sad and cried. I then called her. I tried to speak with her, but she can no longer speak. This was really hard to bear (very emotionally distressing.)

The nurse held the phone to my grandmother's ear as I told her I loved her as other important things. My wonderful, stubborn grandmother never really wanted to learn much English, and my Italian is extremely limited, but I said what I could, and I know she can hear me.

Now, my emotional mind can be unreasonable. It suggests that I need to dwell upon, ruminate, and get very anxious over what's happening. 

I understand and have compassion for that part of my mind, but is any of that REALLY going to help anyone, or does it have the potential to make matters worse? (That's my Wise/Rational/Reasonable Mind talking back.)

It's hard not to think of Grandma and get sad. That's NORMAL, of course. After that I have a choice. I'm 3,000 miles away and unable to travel back to her at this time.  She's in her 90s, and I have no control over whether this is her time.  Getting myself sick by not taking proper care of my own health or acting out due to the distress won't help my Grandmother, it won't help me, and it won't help anyone else.  I have to make the CHOICE to keep it together and get/stay skillful.

In conjunction with practicing a skill called Radical Acceptance (a mindfulness practice), I'm finding ways to distance myself from the intensity of the emotions I'm feeling (consciously and without suppressing or denying that I have real and valid sadness), and I'm soothing myself, including by watching an intriguing show on Netflix (at the moment, it's Breaking Amish.)

So, am I wrong or selfish for taking a time out and getting engrossed in a television show while my grandmother's health is failing and I cannot be by her side?  Of course not. She would not want me in constant despair.  It's easy for us to see others as not being selfish but we often accuse ourselves of being so. Consider this the next time you judge yourself in this way.


Thinking you are being non-productive by disconnecting from the distress and doing something to distract and soothe yourself

This couldn't be further from the truth.  Engaging in activities that help take down our emotional intensity for a while when we are in great distress is actually PRODUCTIVE.  Think of your resting and restoring as a way of recharging your batteries so that you can cope from a place of strength and wise mind for the long haul.  Of course if you take a friend's offer up to go for a mani-pedi while something terrible is going on, you are not doing anything to solve the terrible problem. Chances are, that's exactly why you're getting the mani-pedi -- to take a respite, a much needed break from the intense emotional dysregulation that can come with feeling distressed.  Getting your nails painted won't solve your problems, but it can provide a needed break to recharge and at least feel "ok" while difficult things are going on in our lives.

The bottom line is: It's OKAY and ENCOURAGED to take breaks and practice distress tolerance skills in order to support our mental health and get through difficult times.

It may seem selfish or unproductive to others, but that's THEIR story.  It doesn't need to be part of yours.


Thanks for reading.

More soon.

In kindness,
Debbie

*Since I began drafting this post, my Grandma has passed away. I continue to cope skillfully and effectively.

Another Contributing Idea: Distress Tolerance Application



In life, it's often the little things that matter and that end up making the most difference.  I am a big drinker of Zevia soda (this isn't a promo for them, but in brief, I turned to it from Diet Coke years ago because I no longer wanted to consume aspartame and caffeine, and theirs is an all natural cola. It's the only soda I drink.)  

Whenever you purchase 6-packs of soda no matter the brand, they come with plastic rings that hold the pack together.  I remember someone telling me years ago how important it is to break up these rings by cutting all of the loops.  The reason being is because birds in landfills get caught in them, and it can be tragic. Same thing if these end up in the water or in other places where wildlife can come into contact with them.  So, I have a little box next to my soda stash and when I have a few built up, I cut the rings before disposing.

This is an example of how you can practice the Distress Tolerance skill of Contributing.  We often think we need to do something massive or grand in order to be practicing  this skill, but it can really be something simple, like helping someone with their groceries, opening the door, helping with a chore or task, or cutting up 6-pack rings, which most likely saves the life of a bird, and that's pretty big! :)

Contributing works to help us tolerate our emotional distress because it's something we can do and have control over, even if we have other problems over which we have no control in the moment.  It is a way to skillfully distract ourselves.  And, in helping others, we get two positives: witnessing their joy as well as ours as a result of seeing that we've made a difference.  All off this can elevate our mood and help us to get through rough times. 

Often the urge or impulse is to retreat and hide when we're feeling badly.  What if we, instead, found a way to be of service to others?  Imagine the potential benefits.

What are some ways you can contribute to improve your mood and a moment in someone else's life?

I look forward to your ideas.

Thanks for reading.

More soon.

In kindness,
Debbie

Tips for Managing Intense Emotions




In this video, I chip at the tip of the iceberg of skills we can use to manage very intense emotions.  I also share a bit of my own personal story around how devastatingly intense my emotions used to be and what began to help me take back my life. (Hint: It has to do with a set of skills known as Emotion Regulation from DBT: Dialectical Behavior Therapy.)

I look forward to your thoughts.





Thank you for watching and listening.

More soon.

In kindness,
Debbie

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