Hardcore Self Help- Fuck Anxiety

by Robert Duff

  Let’s start with generalized anxiety disorder (GAD). GAD is really a pain in the ass, because it is pretty hard to pin down. A hallmark feature of GAD is that it is non-specific. Unlike some of the other disorders that I will talk about, there is typically no identifiable stressor that is causing anxiety. Instead you basically have a persistent sense of fear and worry and become overly concerned with everyday matters to the point that the worry interferes with your ability to function well in life. If you have GAD, you will likely have a difficult time making decisions or remembering important things. Think of it this way. Remember how I told you anxiety is like a fire before? Well, with GAD you are basically roasting yourself like some low and slow BBQ. Woody Allen is someone that comes to mind as being on the highly neurotic side of this disorder. Everything is a big deal and all big deals lead to stress.

  One of the shitty things about GAD is the associated physical symptoms. Panic attacks, which I will talk more about in a sec, are terrible, but they are also awesome in that they usually come and go in a matter of minutes. With GAD you aren’t so lucky. You have many of the same features of a panic attack, typically to a lesser degree, but for a really long period of time. Your body isn’t designed to be under that sort of stress reaction for those extended periods and so you may find that you constantly have an upset stomach, muscle soreness, difficulty sleeping, constant fatigue etc. It’s not fun.

  Next up on the A team, we have panic disorder (PD). Now this is one that has constantly changing criteria, so I won’t get too wildly granular with this description. The general idea has to do with those panic attacks that we talked about earlier in the “Your Body is an Asshole, too” chapter. Basically, when you have PD, you experience those panic attacks where you have strong physical symptoms combined with intense fear and discomfort. They tend to peak at around 10 minutes and then cool down. The party isn’t over after that, though. The defining feature of PD is that after you have a panic attack, you suffer from intense fear of having another one.

  PD really sucks because you can start to have anxiety symptoms outside of legit panic attacks because you are so afraid of having another one and not being able to cope. It’s really a lose/lose situation, because being so preoccupied about the potential of future attacks makes you more sensitized and vulnerable to them occurring. If you fear them, they shall come.

  You are probably familiar with phobias. They are pretty straight forward, but people misuse the term quite a bit. To have a phobia does not mean that you dislike something strongly. For a specific phobia, it means that when you are in the presence of the feared object, animal, location etc., you experience intense fear and apprehension. I don’t mean you get uncomfortable. I mean you freak the hell out. Another feature of phobias is that you know you are crazy. You know that the amount of fear and discomfort you feel about this thing is in no way proportional to the actual situation.

  There are different subtypes of phobias. For instance, there is blood and injection phobia, where you pass out every time you visit the Red Cross. There is also social phobia, which is essentially an intense fear of social situations in which you feel like you have to be on stage and be judged by everyone else even though no one really cares wtf you’re doing. This is sometimes classified as a disorder in its own right (social anxiety disorder), but the main bad stuff that you are going to feel is a sense of overwhelming embarrassment or humiliation in most or all social situations.

  Next up is obsessive compulsive disorder (OCD). I’m just going to throw this out there. The world has no idea what OCD is. Most of what you see on TV or hear people say (“oh that’s just my OCD”) is referring to OCPD, or obsessive compulsive personality disorder. Basically people who are so anal and finicky that it’s super annoying. OCD is a bit more serious.

  As you might guess, the two major components of OCD are obsessions and compulsions. Obsessions are disruptive thoughts or images that pop into your head and persist there. These can get really disturbing, like imagining yourself crushing kittens or people you love dying. They are repetitive in nature and generally cause serious psychological discomfort. Compulsions are what you might be more familiar with. They are urges to perform very specific or ritualistic acts. A classic example is stepping on every crack (or every 3rd crack) on the sidewalk. These are often linked to the obsessions in a causal way, even though no real cause and effect relationship exists between them. In the previous example, a person with OCD might feel that they MUST step on each crack in the sidewalk otherwise a plane will fall out of the sky and kill everyone inside. Someone else might have to step back and forth 10 times before entering or leaving a house otherwise the home will get robbed. OCD can also exist with only obsessions or only compulsions, but these forms are much less common.

  The last anxiety disorder that I’m going to talk about is called post-traumatic stress disorder (PTSD). You have probably heard of this one in regards to the military. Troops in the armed forces are one of the most likely populations to get PTSD and it’s a huge problem in the United States right now. Basically PTSD is when you experience or witness some really fucked up stuff and it messes up your head.

  The traumatic event doesn’t have to be just combat but it can also include things like natural disasters, physical abuse, or rape. The group of symptoms that come along with PTSD is pretty distinct. If you know someone who has PTSD, you will know exactly what I’m talking about. The person with PTSD is likely going to have some sort of re-experiencing of the traumatic event either in the form of flashbacks or dreams. They deserve to forget, but their douchebrain keeps going, “Nope! Time to live it all over again.” They are also likely to be on edge and hypervigilant. This means that they are always looking for signs of danger and startle a lot more easily than other people. Emotional symptoms are also common with PTSD. These are a little different from person to person. Some become very withdrawn and anti-social, while others explode outward in anger and rage. I fucking hate PTSD. If you did your time and had to live through something so terrible, your brain really should do you a solid and just let you move on. Sigh…

  So those are the main villains in our anxiety story. They all deserve to die. Luckily for you, they are most certainly manageable. Many people have had success on their own, with therapy, with medication, or some combination thereof and have been able to change their lives and conquer their anxiety disorders. Don’t give up hope if you fit the profile for one of these. Your journey starts now.

  Ch. 8 How to Talk to People Who Don’t Get It

  Okay, so this is cool and futuristic. I tweeted out (@duffthepsych) that I was working on a second edition of this book and asked if anyone had suggestions. One awesome fan made the perfect suggestion of writing a chapter about dealing with people who don’t understand anxiety. I can’t believe I didn’t initially realize how useful that would be. Well, that’s exactly what I want to do this chapter because I’m fairly certain that nearly every single person that I have met who suffers from anxiety also suffers from some dumb dumb in their life who just does not get it. Maybe you have heard a few of these gems: “It’s all in your head!” “You just need to stop worrying so much!” “Dude, just breathe…” or even “What’s your problem?” I’m sure statements like these really help out, right? Of course not.

  These are telltale signs that someone simply does not understand what you are going through. Be happy for them. That means that they have not felt the true shittiness of anxiety the way you have. I do understand that this can be incredibly frustrating though. If this person is family, it tends to amp up the frustration factor even more. I think that often times we try to communicate what it’s like to have anxiety and then give up when it doesn’t seem to sink in for the other person. The process of trying to communicate clearly and find the right words to say can be anxiety provoking in and of itself. Couple that with the fact that you are exhausted from fighting your own private battle with anxiety all day, and it can feel pretty pointless.

  I want to help yo
u out by providing some ideas about ways you can communicate to these people. Here’s what we will do. I will write out a letter of sorts that you could recite out loud or even give as a written/typed note to the person in question. This does not need to be an exact script, but it might get you started in the right direction. After I finish writing the letter, I will retrospectively break down some of the things that I wrote by instinct and try to understand what some of the magic ingredients are for communicating with people who do not understand your anxiety.

  To whom this may concern,

  You are an important person in this individual’s life. That’s why you are getting this letter. My name is Robert. I am a therapist and the author of a book about anxiety that this person has recently read. This means that they are trying to find resources to help pull themselves out of the crappy feelings that you have seen them struggling with. It can be immensely hard to explain what anxiety feels like. If you have never had significant issues with anxiety, you are exceptionally lucky because it really sucks. I want you to know that the person who gave you this letter is not trying to be difficult. If they had a magic wand that could help them suddenly stop struggling with these issues, I 100% guarantee they would use it without a moment’s hesitation.

  Have you ever felt the “fight or flight” response? Maybe you’ve stepped out into the street without looking both ways and nearly missed getting hit by a car or perhaps you’ve had to speak in front of 1000 people and felt like you were going to puke, cry, and hyperventilate all at the same time. That’s what anxiety feels like, except it’s not just a fleeting state of discomfort that happens once. It is something that can come on without much warning, and it makes it very difficult to function. Trust me when I say that this person feels sad, guilty, and exhausted due to difficulties that anxiety causes them and the people around them. You don’t need to know how to make them feel better and that’s okay because it’s not your responsibility.

  If you want to be awesome, I have a few tips that can help you be the best support possible for this person when they are enduring a hard time. Firstly, don’t take it personally. They might act very differently when they are having a “peak” in their anxiety. Take the things that they say and do in context. I’m sure you’ve been through a hard time before and acted in ways that aren’t quite in line with your normal self. Asking them if there is anything that you can do to help is great, but don’t always expect to get a clear response from them. Things can be confusing when the anxiety monster is hitting hard, so knowing what would help is not always clear. One question that most anxious people can give you an answer to is “do you need some space?” If they say yes, please give them a little room to breathe and let them know that you will be around if they need you. Try not to tell them it’s all in their head, because they know that already. It doesn’t make the pounding in their chest, the pain in their head, the hyperventilation, the sweating, or the racing thoughts any easier to deal with. There’s no way that I can put you in their shoes, but I hope you believe me when I say that it’s not as easy as just taking a breath and getting some fresh air.

  Having anxiety does not mean that this person gets a blank slate to do or say anything they want. You still have a right to be upset if they do shitty things, but, like I said before, try to take it in context. If you want to address the way that they are acting or the things that they are saying, maybe consider doing it when things have calmed down a bit. I also want make it clear that you don’t have to understand them or agree with everything they do to be supportive. This person’s world feels chaotic and a good portion of their unease probably comes from feeling like they have no control over their environment and the things that happen to them. If they know that you are a constant who will be supportive no matter what happens, it can make a big difference.

  Lastly, I’d like to tell you good job! If you are still in this person’s life, then you aren’t like the others who have run away or disappeared on them so far. They need supports on this journey and they really want you to be on their team. If you want to learn more about what this individual’s experience with anxiety is like, then I encourage you to ask them. I’m sure that when things are at their least crazy, they would be more than happy to sit with you and help you understand.

  Sincerely,

  Robert Duff, Ph.D. on behalf of the awesome anxiety warrior that gave you this note

  Okay, so that was written basically off the top of my head based on my personal and clinical intuition. Let’s break it down a little bit to see what some of the key ingredients are and how you might be able to utilize them to better communicate with these people in your life who are having a hard time understanding your struggle.

  The first thing that comes to mind is that these people aren’t trying to be annoying or mean when they suggest things to you. These are unsuccessful attempts at solving your problem. You aren’t the only one who wants to make this crap go away for you. If they had a magic wand to make you feel better, they would also wave the hell out of it. However, anxiety is something that humans don’t come into this world well equipped to handle. What results is someone who cares that you feel better, is frustrated that things have to be this way right now, and has few good tools to do anything about it. Therefore, they tend to go to the things that work for them as a “normie” (someone who doesn’t experience these issues). Things like getting some fresh air, distracting yourself with other tasks, or thinking positively may be perfectly acceptable to solutions to a small ounce of everyday stress, but they are barely a starting point for legit anxiety issues. If you would like to communicate this to them, I would say that it can be helpful to do so during a time when you aren’t already super anxious. For instance, if you had a blow up the night before and got into a fight over this person ineffectively trying to help you, you might come to them the next day and say something like, “Hey, I’m sorry about yelling at you last night. It’s just that it’s really hard to deal with in the moment and when you say things like ‘just breathe’ it can be frustrating because I wish it was that simple. I’m trying to get better and I appreciate you trying to help, but next time I’m so worked up it would help me more if you tried to give me some space and didn’t try to suggest so many ways to help.”

  Another thing that can really help people “get it” is to help them relate your experience to something that they have been through at some point in their life. Things like weddings, exams, job interviews, sports games, emergency situations, and other high stress events are things that you might be able to point to as times that they have felt anxiety. They might say that these are times that everyone feels stressed out, but what they don’t understand is that this is pretty much the norm for you. You can say something like, “I want to tell you what it feels like to have this kind of anxiety. When you got married, did you feel nervous? Like right before you walked out and everyone was looking straight at you? Okay, well imagine that being your ‘normal’ feeling and when actual stress happens, it multiplies and makes you feel terrible.”

  I think that people also tend to not understand the other component of anxiety, which is the thoughts. Since your thoughts are invisible and you may or may not be making them known verbally, people in your life are likely to not understand what it’s like to have a whirlwind inside of your brain of persistent worries about god knows what. A good way to help them understand might be to make the analogy of rumination and worry being like a song that gets stuck in your head. Most people have had a song stuck in their head at some point in time. It’s funny at first, then after a while it gets a bit annoying. If it goes on for too long it starts to be downright unpleasant. I’m not talking about your favorite song here. I’m talking about when you get some stupid commercial jingle stuck in your head and you only know one line from the whole song and no matter what you do you can’t get it out and you are thinking about getting a spoon and carving the goddamn song straight out of your brain!! Okay that was a bit dramatic, but I think most people w
ill understand what I’m getting at. Now if you can get that person to imagine that intensity of thought and couple it with negative thoughts and worry, they might be able to comprehend just a little more how messed up the experience of anxiety can be.

  So that’s it for my bonus chapter about ways that you might be able to better talk to those who just don’t understand your anxiety. I will go ahead and put a printable of that letter up on my website at duffthepsych.com/letter so that you can actually hand it to someone in your life if you think that it will help. Just like everything else in this book, the information and tips contained in this chapter will not fix the entire situation for you, but I hope that these were some different and interesting ways of approaching the task of trying to explain your experience to someone who has never been there.