NYTimes Anxiety series

August 13, 2012 7:23 AM

"We worry. Nearly one in five Americans suffer from anxiety. For many, it is not a disorder, but a part of the human condition. This series explores how we navigate the worried mind, through essay, art and memoir." The New York Times is running a series of short memoirs written by sufferers of anxiety disorder. From the ways anxiety affects daily life to what happens when it's part of a marriage, many different angles are explored. (Previously)
posted by deathpanels (77 comments total)

I'm glad to see that some major media outlet is taking a look at something that affects so many people. Not that a singular attempt will remove the stigma around psychological disorders, but it's a start.
posted by bleachandink at 7:29 AM on August 13, 2012 [3 favorites]

This is profoundly beautiful:
His acts of heroism should dispel my anxiety, but it persists beyond the reach of his love. Yet, his love, too, persists.
I've felt that but never been able to express it so well.
posted by fiercecupcake at 7:44 AM on August 13, 2012 [8 favorites]

What, me worry?
posted by seanmpuckett at 7:51 AM on August 13, 2012 [1 favorite]

"It’s true that the anxious are rarely slothful in any typical sense. It’s more that we tend to be undisciplined, or somehow otherwise unwilling to see our anxiety for what it is — a habit of mind. ... Anxious thoughts — the what-if’s, the should-have-been’s, the never-will-be’s — are dramatic thoughts. They are compelling thoughts. They are thoughts that have no compunction about seizing you by your lapels and shouting, “Listen to me! Believe me!” So we listen, and believe, without realizing that by doing so we are stepping onto a closed loop, a set of mental tracks that circle endlessly and get us nowhere. This makes the anxious habit very hard to break. Over time those mental tracks deepen and become hardened ruts. Our thoughts slip into grooves of illogic, hypervigilance and catastrophe."

A useful frame.
posted by MonkeyToes at 7:53 AM on August 13, 2012 [17 favorites]

I think calling yourself an idiot and moving on is a useful tool if your anxiety is purely rooted in the mind, but bodily anxiety that makes your heart race or face blush or whatever, that can't just be shrugged off in my experience. A mind can be 100% on board and the body will be like, not so fast cool guy, I'm at the wheel. And I don't think any amount of name calling can derail that, more like meds and sleep. But I'm down to try it!
posted by pwally at 7:59 AM on August 13, 2012 [9 favorites]

Serendipitous: I just emptied my recycling and noticed (really staring me right in the face, I wasn't digging) my housemate's Abilify prescription. :(

I worry that we are too medicated, but then I also worry that there are so many people who are so anxious or sad. And then I worry that I worry too much! :s

What, me worry?

Yes. Marijuana helps.
posted by mrgrimm at 8:00 AM on August 13, 2012 [6 favorites]

Once I managed the bodily symptoms of anxiety (via medication), the mental symptoms almost entirely went away.
posted by desjardins at 8:11 AM on August 13, 2012 [3 favorites]

I'm sure that somewhere, there's someone out there against whose worldview of "normal" I could seem anxious, obsessive, or even depressive at times...but I can't worry about that right now because I have stuff to accomplish that makes me and my partner happy. :)
posted by trackofalljades at 8:18 AM on August 13, 2012 [1 favorite]

Once I stopped dealing with doctors, my anxiety went away.
posted by kinnakeet at 8:18 AM on August 13, 2012 [3 favorites]

Sounds like daily life in my house. I don't think there's a span of a couple of minutes in any given day where I'm not worrying over some aspect of our family's situation. It's very exhausting and depressing, and goes a long to killing our relationships.
posted by Thorzdad at 8:36 AM on August 13, 2012 [2 favorites]

While I think that first article contains is useful advice because it is possible to address anxiety disorder as a habit (I think that the anxiety disorder has to be relatively mild for it to be an option, but that is my own personal opinion), I think that the language is probably more harmful than helpful for many. It's words like idiot and lazy that often cause people to spiral in mental anxiety about their own character and capabilities.

I appreciate the point - you have it in you to beat anxiety disorder, but unless you're someone who responds well to a stranger judging you for your ability (or inability) to overcome anxiety disorder by having the mental discipline to distract yourself from an attack -- I think most aren't, that article is just more noise.

It's no wonder that the author responded well to his brother calling him on the carpet, his brother knows him, obviously loves him, and does it with love. It's also obvious why most folks with anxiety disorder, particularly a breed worse than the author's, may find it insulting, or at worse, despairing - "he doesn't know me!"

Full disclosure: I say this as a person who constantly recommends exercise, CBT and meditation to my anxious sisters and brothers.

At the root, that article doesn't address the fact that for those who have powerful anxiety disorder, particularly of the type that is intermixed with other mental/emotional challenges (clinical depression, PTSD, I'm looking at you), the suggestion that it is a matter of strength of will can be dangerous. Willpower is for sprints, not marathons, and those with anxiety attacks that come on more quickly and frequently than they can withstand with standard meditation or CBT techniques risk depleting their ability to fight it, which can make one feel really powerless. It's not impossible, but with a carefully guiding therapist, or even friend/partner -- someone who can catch someone when they fall into this trap -- a person is more likely to succeed. Alone and with only a blogger at the NYT to nag you into aligning your chakras, breathing and mentally kicking your own ass when it happens, not so much.
posted by pazazygeek at 8:38 AM on August 13, 2012 [5 favorites]

> Nearly one in five Americans suffer from anxiety

One in five Americans has a functioning sense of reality? Nasty disorder you got there, pal.

timely: L.A. Review of Books on All We Have to Fear: Psychiatry's Transformation of Natural Anxieties into Mental Disorders
posted by jfuller at 8:40 AM on August 13, 2012 [9 favorites]

"By “idiot,” I mean exactly what my brother meant when he tagged me with the epithet: an impractical and unreasonable person, a person who tends to forget all the important lessons, essentially a fool, one who willfully ignores all that he has learned about how to come to his own aid. A person who is so fixated on the fact that he is in a hole that he fails to climb out of the hole. An idiot, in short, is someone who is self-defeatingly lazy."

Oh God, He's right. I'm an idiot and I'm lazy. OK. OK. Stop being a lazy idiot. Stop. Stop now. Ok, C'mon. Close the tab, do some work. You'll be better off and happier if you get your work done. Then you won't have to worry. You'll be fine. Ok. Go! <ctrl-w>.

(five minutes later)

Augh! I can't take it! These stupid people and what do they want from me? How am I supposed to deal with this? Fuck it! <ctrl-t>metafilter.com

God I suck. Jesus, I should get my head examined. Oh hey, someone got their cat stuck in their scanner!
posted by Reverend John at 8:40 AM on August 13, 2012 [7 favorites]

Denial is a skill that's helped me a lot. Not joking. I think that at many points in my life, when I could have been just...happy, or content, that I somehow felt that if I wasn't worrying about *something*, then I was somehow being lazy or unambitious.

I mostly don't get anxious about stuff I can't control anymore, and my life is smoother and happier for it.
posted by rtha at 8:41 AM on August 13, 2012 [2 favorites]

Yeah, some of us struggled for years with undiagnoised Acually Really Bad anxiety which explained some ...colorful decision making in the past and then had the fun time of having bad reactions to every single drug prescribed. It took a lot of therapy, conscious effort, and like, replacement activities ( run for two hours! Low doses of a perfectly acceptable medical substance! Ask yourself how Buffy Summers would tackle this problem!) until I finally had a year without a major incident or attack. But god, it was so just ...exhausting to be nervous and physically unable to break it All The Time, and the really sick thing is that it drains you of your desire to even get better. Bad brain! Stop trying to kill me! Stop keeping me awake with stupid shit I did when I was ten! Nothing you are telling me is real and I'm going to medicate the fuck out of you cause this is my fault, this is your fault.

Bah, stupid brain.
posted by The Whelk at 8:46 AM on August 13, 2012 [11 favorites]

Using the words 'lazy' and 'idiot' are a means of getting the attention of those who are self-conscious about their own irrational anxieties and often apply those same accusations to themselves. I think he makes it rather clear he's not trying to call anyone a 'lazy idiot'.
posted by hellslinger at 8:47 AM on August 13, 2012 [2 favorites]

It's interesting about mental illness. For some reason, people don't believe there are as many mentally ill people as there are. When they hear statistics like "one in five Americans have anxiety problems", they seem to deliberately decide, "That's not possible. There must be some other explanation, like that 1 in 5 Americans are thoughtful, observant people. Or people are lying." I don't see what's so outlandish about the idea that so many people would suffer from unnecessarily heightened anxiety.

I've only reached my current level of functionality because of SSRIs. I've dealt with severe irrational anxiety issues my whole life, and the medicine eliminates many of them, and makes the rest bearable. I can't afford the often-recommended therapy, but I can (barely) afford the $20 for 90 days of pills.

I have been incredibly "disciplined" at dealing with my anxiety (OCD in origin). You have to be, if you are truly committed to coping with an anxiety disorder. I do benefit from explaining to myself how poor my reasoning can be, and from saying, "Oh my god, you are being stupid again with this crap! Let's think in a nonstupid way, on purpose, right now!"

But unfortunately, it's a damned mental illness and I can't just power through it through sheer force of will and logic. If that were possible, I'd been done with this crap years ago. I understand that the fact that I take medication makes a lot of people conclude I'm weak, and that my doctors are just tools of the system. That's cool. I don't care what idiots think.
posted by Coatlicue at 8:48 AM on August 13, 2012 [11 favorites]

Persistant anxiety is not just an attitude problem. The direct cause of fear, for example, isn't a tiger in your living room. Fear is caused by the chemicals your brain injects into your body. Learning to recognize and fear tigers puts the brain in touch with this physical process. This creates a feedback loop: tiger = eek! Two tigers = EEEK!! Our entire emotional landscape is orchestrated by this feedback loop.

This feedback loop can be tweaked, so that you are afraid even without having a proximate cause for fear. Some of the effects of PTSD are driven by this process. You can learn to be afraid of green shoes--your brother beats you with his green shoes every day for ten years--and the rest of your life will be a mess because you get adrenalin hits, hyperventilate, and so on every time you even think of green shoes. Or your brain can have, say, a lesion, which causes you to be afraid of green shoes, even though you may never have ever seen green shoes in your life.

Sometimes drugs can help restore the chemical balance. Sometimes counseling can help you deal with anxiety on a practical level, by identifying the process, so that you don't find yourself suddenly in the midst of a situation that pushes your buttons. I'm not sure that considering yourself to be an idiot is helpful, but who knows? Could be that calling yourself an idiot disengages the panic mode, so it's a good way to stop the rush to panic and start looking at the issue from an analytical perspective: Can I keep from abandoning my shopping cart in the supermarket aisle? Maybe not, but I might just go sit in the car for a few minutes and realize that I am not nuts, and when I calm down, I can either go back into the store or just drive home.

BTW--I used to think weed helped, but I had it backward. Weed actually encouraged psychotic episodes. Later on, after I got a grip on all this, I found a fat boy now and then was a good idea. More often, I made up some bud-tea, and worked out on my guitar for a while. COPD has rendered my fat boy usage unworkable, but tea or brownies now and then work okay. Mostly that's just to deal with bone pain, and to disengage the running dialogue in my head so I can sleep. Doesn't always work.

This brings up the other point: the rut. I was able to get out of that rut. I don't know if that's a realistic objective for everyone, but I haven't had a panic attack in maybe 20 years. I got out of the habit, is how it feels.
posted by mule98J at 8:48 AM on August 13, 2012 [2 favorites]

I've dealt with this for years, never getting a true answer on the root cause (although I have been told I must get to the root cause, by an EMT who said he'd been suffering from anxiety). Lots of well-meaning doctors and a bunch of condescending ones.

Best therapist I ever had took a no nonsense approach, validated my feelings, and got me on a schedule of walking every day ("yes it's cold, wear a jacket! Put on your headphones and listen to music!"), journalling or whatever hobby I wanted ("I don't care, just pick one and do it! You like writing, then write every day!"). She also had a sense of humor and was a genuinely caring person. She also treated me as an adult, not some ignorant child who was being willful for asking questions about physical causes.

I once asked an OBGYN if it were possible that a hormonal imbalance was in part contributing to my anxiety, because it seemed to really ramp up at certain times. She sneered at me and offered me some Zoloft, and then I had to explain that I had tried all the meds and a well-respected psychiatrist had told me that I am not a good candidate for SSRI's and benzo's, and a lot of shrinks fail to disclose this rather pertinent fact to their patients when whipping out the old prescription pad.

After doing the walking/writing/cutting out caffeine program with above said therapist, I saw a psychiatrist in her practice for an examination. He didn't push any meds on me, saying I was doing really well. Just recently, I noticed I was slacking in the cutting out caffeine bit and my anxiety levels have been getting worse. People with anxiety have to be extra vigilant about nutrition and physical well-being, because what won't trigger anxiety in one person could have severe consequences for an anxiety sufferer. Sucks, but that's the way it is for me, just like someone with diabetes has to watch their diet, so do I.

The worst part is the positive thinkers who tell you just to think positive thoughts and it will all be okay. Kind of difficult when your chest clamps up and you know it's a panic attack, because you've been to the ER 10 times and been told there's nothing wrong with your heart, "just go home and try not to stress out so much." If meds and meditation and affirmations work for someone else, yay! But my #1 prescription for myself is exercise, little to zero caffeine, and keeping my blood sugar levels even throughout the day. I don't always manage it 100%, but I know it can be managed.

And oh, I never went back to that OBGYN, or the other one who told me being a victim of abuse made me mentally deficient, and how about some of these $50 vitamins and fish oil pills, here's your $300 bill. Or the dentist who looked at me in dismay after I had a tooth extracted and had burst into tears, because they had just told me I needed a lot of work and I had a lot of anxiety about, you know, pain and cost, and said, "maybe you should go see a psychiatrist for your depression and get onto some Zoloft." Maybe you should treat your patients with fear of dental work with a bit of compassion, jerk!

You have to find what works for you and stuff anyone else who tells you they have the magic bullet. Because it's your body, your mind, and unless they have walked in your shoes your entire life, they don't have the magic bullet. They have an opinion, and we all know what opinions are like. And everyone has one.
posted by Marie Mon Dieu at 8:54 AM on August 13, 2012 [8 favorites]

I worry that we are too medicated, but then I also worry that there are so many people who are so anxious or sad.

I've learned to see my own experience with anxiety as a natural reaction to modern stressors. My triggers are crowds, especially crowded buses and trains, and unfamiliar social situations.

For example, on my worst possible day, I walk to the train to go to my job, and when I arrive at the platform, it's packed to the brim. I wait ten, twenty minutes for a less-packed train, but it never arrives; every train that passes is completely jam-packed with miserable, sweaty people fighting each other to get to work. Finally, I give up and cram myself onto the next train. Little alarms go off in my brain the whole ride – "Hey, there's no room to breathe in here! What if it breaks down? What if..." Etc. And here are these dozens of unfamiliar people glaring at me, frowning and looking a bit panicked themselves as they jockey for position, pushing each other out of the way, pressing their bodies in on me. The animal in me wants to claw its way out of this dangerous situation. And of course, at the end of this trip, I end up at a workplace where I'm likely to be put into a difficult social situation through which I must somehow navigate, despite my already addled state.

This is just one example of how the physical flight-or-flight response affects cognition. Sometimes it goes in reverse. The anxious mindset makes you more susceptible to the physical symptoms. Or it predisposes you to put yourself in situations that you know will make you feel panicky, but that, in an already-panicky state of mind, you can't identify. It all seems so stupid and obvious in hindsight, and it's hard not to blame yourself.

The most frustrating part, of course, is explaining all of this to other people. As with depression and similar disorders, anxiety isn't "weird" enough that people feel a lot of sympathy for you. It's common enough that our culture can dismiss it as "nerves" or blame sufferers for being "antisocial." This results in years of telling friends you can't meet up with them because you "have a headache." And as with those other disorders, the problem exacerbates itself, because when we don't talk about anxiety, then everyone with anxiety feels that they're the only one with this problem, a perception that they're predisposed toward anyway.
posted by deathpanels at 8:59 AM on August 13, 2012 [4 favorites]

I have a picture of the entire visible universe hanging on my wall.

When I'm anxious I look at it.

It puts things back into perspective for me.
posted by ZenMasterThis at 9:01 AM on August 13, 2012 [8 favorites]

Denial is a skill that's helped me a lot.

I don't know if it's the same thing, but zen meditation has helped me in that regard too. I experienced something similar when I was younger and learning how to beat insomnia:

It's possible (for me, at least) to turn on/off certain parts of your memory or parts of your brain that concern themselves with specific events or people, etc.

So falling asleep is turning everything off, but it's also possible to turn off: my parents, my kids, my work -- I literally can inhabit a world in which these people or things do not exist for me. They are there, somewhere in the back (kids are the hardest), but it's easy not to think about something when you don't want to.

For example, on my worst possible day, I walk to the train to go to my job

I know "The Naked Ape" and evolutionary psychologists are fairly debunked, but one thing I got from that book that sticks with me is the important of eye contact among primates and what it can signify.

The simple fact of dealing with hundreds of strangers' eyes upon you is enough for any of us to stress out. I recommend a bicycle.
posted by mrgrimm at 9:03 AM on August 13, 2012 [1 favorite]

Reduce ambition; increase booze.

Always worked for me.
posted by Decani at 9:14 AM on August 13, 2012 [3 favorites]

Am I overreacting, or is this thread full of dismissive and stigmatizing nonsense? An anxiety disorder is not a problem you can solve by looking at an astronimical chart or deciding not to be lazy. Jesus christ.
posted by prefpara at 9:35 AM on August 13, 2012 [28 favorites]

Some people worry too much. Other people have anxiety disorders. They aren't the same thing. Habits that reduce worry can reduce the impact of anxiety disorders, but they don't fix them. If I don't have anything to worry about, my brain unmedicated happily invents things. I will wake up from a dead sleep in the middle of the night having a panic attack. I will break down over the fact that I'm out of whatever I originally planned to have for dinner, and freak out that the pizza delivery guy is judging my housekeeping because there's mail sitting on the table by the door. None of these things bother me in the least when I have my meds.

Worry will definitely make it worse, and stress reduction helps. But you can't just stop worrying and destress and get better, if you have an anxiety disorder.
posted by gracedissolved at 9:41 AM on August 13, 2012 [3 favorites]

How can I short-circuit my anxiety when there's so much out there that it's perfectly valid to feel worried about? I wonder that other people don't seem to care that much about those things; in fact I'm sometimes rather angry that they don't. Just fix yourself, it's your problem if you can't function well under the knowledge that the world is full of crappy, crappy things that are happening and will happen - the knowledge that you are one tiny person who will be affected by this shit but can't do much of anything about it. And the powers-that-be seem to want us to feel fearful and unempowered - many people call that paranoia. Is that all in your head? There's too much emphasis on the individual, that it's your issue - almost in a vacuum - so you cope with it. It's your weakness.

On the one side of the coin is too much denial and selfish obliviousness; on the other side is being crippled by your thoughts and emotions. Trying to find the stable balance between is probably the hardest thing I've ever done in my life, and there's not much of a roadmap for it.
posted by flex at 9:43 AM on August 13, 2012 [2 favorites]

word, prefpara.

I'm a little taken aback considering all the truly valuable AskMe advice to 'get a therapist', 'see if an Rx can help', 'do CBT'.

When the anxiety is rooted in early life experiences that may not even be remembered, some experienced, professional guidance might be more helpful than calling yourself an idiot. That particular approach wasn't at all fruitful for me.
posted by j_curiouser at 9:44 AM on August 13, 2012 [1 favorite]

CBT can certainly be useful, but on my worst day it didn't do much beyond give me metacognitive awareness that the delusional and exaggerated scenario that had me gibbering in the corner was delusional and exaggerated. I suppose that was sufficient to keep me from self-harm, but on the worst days, the work of arguing with my distorted perception of reality can be exhausting. Unlike the fiction and fairy tales, those ugly "what if" delusions don't vanish forever with a single incantation of, "you're ridiculous, I don't believe you." They come back on a daily, hourly, or, on my worst days, continual basis.
posted by CBrachyrhynchos at 9:45 AM on August 13, 2012

I spent my first 40 years in a constant state of anxiety. I over-analyzed everything, from what I said to my partner to what I wore to what I thought people were thinking about me. And when I say "over-analyzed," I mean that I often didn't sleep because I was picking apart a benign conversation I had with a friend to find the mistakes I must have surely made. I started things but didn't complete them (degrees, jobs, etc.). I didn't make decisions. I spent most of every week in tears.

I kept thinking if I just stopped being so stupid everything would be okay. It was clearly my own fault and I just needed to pull myself up by my bootstraps. It didn't help that my father always, always told me that mental illness in general was bunk and it was my own fault that I was a failure.

When my brain started getting in the way of my relationship with my children I decided I'd had enough. I thought I was depressed so I tried SSRIs. They helped a little but only when I started a medication that dealt specifically with anxiety (and depression) that I noticed a difference. I didn't realize that my biggest problem was undiagnosed anxiety until that anxiety was gone.

Everything is better. I can enjoy my friends and my family and my life. If not for medication, I would have spent the rest of my life the same way I spent the first part of my life. Thank god I don't have to do that.
posted by cooker girl at 9:47 AM on August 13, 2012 [5 favorites]

Am I overreacting, or is this thread full of dismissive and stigmatizing nonsense? An anxiety disorder is not a problem you can solve by looking at an astronimical chart or deciding not to be lazy. Jesus christ.

Why are you dismissing peoples' experiences?
posted by downing street memo at 9:50 AM on August 13, 2012

Flex, you make a good point. I was advised to cut back my daily news consumption if it triggers me. Because I can't be of much good to the world if I can't manage my health first. There's a tendency to put a lot of pressure on myself to remain calm in the face of everything, but the world is not going to stop spinning if I don't happen to read about something that gives me a honking big panic attack. There's a ton of stimulation on the internet and lately I've been making a conscious effort not to click on links that I know will be upsetting. If something really big happens, I'm going to find out about it one way or another (like on MetaFilter).
posted by Marie Mon Dieu at 10:22 AM on August 13, 2012 [1 favorite]

cooker girl, that hits pretty close to home. I've only recently gotten my "shit" under control, which is the code I use to tell people that I no longer experience persistent pain every waking second of every day of my life in a way that totally defeats every attempt at living. I quit so many jobs simply because I couldn't handle the stress of just sitting at my desk, imagining all the awful things people were thinking about me. Even trips to a library or book store were painful. Yet somehow I didn't recognize that this was a problem that was restricting my life. The mechanism for self-blame was already in place and fighting it was like resisting the urge to slouch when sitting – until you know the proper, healthy form, you just sink back into what's familiar.

When anxiety comes up, I'm always reminded of one horrible day a few years ago when I could not leave my apartment. At all. I tried and was defeated. I couldn't do it. I'd walked out the door with a plan to go buy groceries or try on a new pair of pants. I'd walk halfway down the street and then stop, totally overwhelmed by a feeling of dread, retreat to my apartment and pace around nervously, cursing myself for my "antisocial" behavior, then lay down to rest and get up and try it again. This process repeated four or five times that day. It was utterly defeating, and the first time I really had enough awareness of the problem to consciously recognize that this is not normal and to get more serious about solving it.
posted by deathpanels at 10:32 AM on August 13, 2012 [1 favorite]

I have recently begun to seriously consider trying marijuana to see if it would help me with dealing with mild anxiety & stress. I've never felt like it was severe enough to seek prescribed treatment (except maybe during a period of unemployment a while back), but I would really like the opportunity to spend some time without it.

However, my 'research' is providing mixed messages on whether pot is good or bad for anxiety. Is it worth giving it a try? (Assuming I can find some, that is.)
posted by sevenyearlurk at 10:35 AM on August 13, 2012

Pot is a really mixed bag regarding anxiety. It seems to work well for some people in some circumstances; in other people it can really make things worse. Assuming you find some and want to try, get a trusted friend to come hang out (and be sober!) while you try it. Smoke a little bit; wait 15 minutes; smoke a little more, if you feel you need to (like, if you don't feel anything from the first smoke). Have good music you like on, or play a game that you find relaxing. Go into it in a good, positive headspace, and if you can't get to that space, don't smoke yet.

Do not eat it! Eating it in brownies or cookies or tea means the effects last much longer than smoking, which means if it makes you *more* anxious, the feeling will suck for much longer than if you'd just toked a little.
posted by rtha at 10:41 AM on August 13, 2012

Every time there's a thread about mental disorders, I wish we could just fork it into two threads, the "I believe in meds" thread and the "I don't believe in meds" thread. Because I would definitely be interested in talking with other people who don't believe in meds, hearing their experience, and trading coping advice/tactics/skills.

I don't relate to the "I believe in meds" people. I don't doubt their truth or their experience, it's just that their solution is not an acceptable solution to me. I know, I know, I'm not allowed to think that, and "that's exactly the sort of thing I thought before I tried [INSERT DRUG HERE] and it changed my life!" but still. It would be nice to discuss this with people who are walking the same road as me and have a similar outlook on things.
posted by Afroblanco at 10:43 AM on August 13, 2012 [3 favorites]

Reality is the leading cause of stress amongst those in touch with it.
-- Lily Tomlin
posted by bukvich at 11:23 AM on August 13, 2012 [3 favorites]

Afroblanco, I'm curious - why is it not an acceptable solution to you?
posted by desjardins at 11:30 AM on August 13, 2012

My anxiety kicks up when I feel rushed and trapped. I've been having a hell of a time with a anxiety/depression mixture. I started to think my meds are kicking out on me. But in reality the facts are I'm 40 and not dealing with it well, I want to move to CA and be ok yet due to everyone else, I can't (newly widowed father with failing health, DH now reniging on his desire to move because of his biz), want to have more fun but don't have time/existing friends are LAME.

And that's why I feel trapped. It's get up, go to work, go home, go to bed. I always loved/cherished "me" time which means alone, no noise, maybe screwing around on the computer. When you're married and have a toddler and work full time, forget it. That doesn't happen. And then I explode in some way. The 3 year old overflowing the toilet after a mega dump was the final straw yesterday and I snapped. Off went DH and the kid without me to a friend's house. I slept for 4 hours (my self-soothing) and then screwed around/worked on the computer and all I could say afterwards is "thank fucking god". Because my alone times may come about once a year.

Of course, those from the outside will say "increase your dose, add abilify, exercise".

No, how about letting me feel like me again? I miss those days.
posted by stormpooper at 11:55 AM on August 13, 2012 [1 favorite]

As someone with OCD, I resent the comments here that imply everyone would be anxious if they faced reality, the modern world, etc. It's not a disorder unless it directly impacts your life in an ongoing and negative way. Most people's daily stress does not rise to the level of an anxiety disorder, but few seem to make the distinction. Heck, I still see people joking about OCD who have no symptoms even approaching it. Mental illness/disorders are definitely misunderstood.
posted by agregoli at 11:59 AM on August 13, 2012 [2 favorites]

Afroblanco, I'm curious - why is it not an acceptable solution to you?

It shouldn't matter; it's a personal choice. Some people don't eat meat. I don't believe in meds.

I'm not telling other people not to use them. That's their choice.
posted by Afroblanco at 12:03 PM on August 13, 2012 [1 favorite]

Every time there's a thread about mental disorders, I wish we could just fork it into two threads, the "I believe in meds" thread and the "I don't believe in meds" thread.

Except that is a false dichotomy -- an either/or paradigm that seems ideologically based. If you want to actually deal with whatever unique set of symptoms and causes you have then why not be pragmatic? I use both meds and meditation/exercise/conversations and other behavioural techniques according to circumstance. As some have said above, other people's choices may not be yours and that's OK. But why rule out a whole set of choices a priori?
posted by binturong at 12:31 PM on August 13, 2012 [1 favorite]

the work of arguing with my distorted perception of reality can be exhausting

Amen to that. Lately I've been trying to come to terms with the possibility that I may always be anxious, and by accepting my anxiety instead of fighting toward some abstract future where I'm fear-free, I've actually been able to make a lot of progress in defusing and reducing it. For me it's like a finger trap... the more energy I pour into it, the harder it is to get out. Reframing it as something other than a 'battle' that requires either victory or escape has helped a lot. It's not a panacea, and it may not work for everybody, but for me it helps. And if someday my anxiety rests dead at my feet, I don't think it will be because I finally planted a sword in its chest after a long-fought battle, but because I found a way to relax into it so much that it became irrelevant.

My anxiety is pretty under control these days compared to how it used to be, but I occasionally have moments where I realize how potent it still is, and how the greatest trick it pulls is the normalization of abnormal behavior. For example, I was parked outside my aunt's house for a family event a few months ago, just sitting in my car, when it dawned on me that I wasn't going inside because I was afraid. Not afraid of anything specific, there was no one I was dreading seeing, no unpleasantness I was hoping to avoid, I was just... afraid to go in. And the worst thing about it was realizing that it wasn't the first time I had done that. Likewise, I once made it all the way to the door of the bar where a meetup was happening and then had to retreat; I couldn't make it any further. And so on. It depends on what your trigger is, but the anxiety-sufferer's life is riddled with these sorts of stories, usually untold. I tell them to my therapist, and that helps, but it doesn't replace the sense of support that comes from affirmation and understanding in your own community of connections.

The most problematic thing about anxiety for me is not even the fear itself, but how alienating it is. It's difficult to relate to if you haven't experienced it. How, for example, does the anxiety sufferer describe periods of life where they were afraid to go to work/class or to talk to someone or even just to leave their own rooms? How it feels when your body is adamantly convinced you're about to die even when your intellect knows otherwise? Can someone else ever really know you if they can't understand this thing that plays such a large part in your daily life? Even if you're good at articulating it, it's still hard for others to grasp, and it requires a pretty large and challenging empathic leap-of-faith.

Sometimes it's hard not to feel that we don't fight our most important battles, if not all of our battles, alone. It's often true of grief, and depression, and anxiety, and a host of other things, too. It's nice to see a series like this putting a spark into conversations around it, even if those conversations can bend toward the controversial.
posted by Kosh at 12:51 PM on August 13, 2012 [6 favorites]

Afroblanco, what counts as medication? If you're speaking purely about prescribed SSRI-style medication, then there are a number of things people do instead of or in conjunction with medication.

I think any major modification in your lifestyle, whether it be food or vitamin intake, extensive exercise, or self-forced behavior modification are all large changes that, while not taking a drug, are similar in scope. More importantly, some or all of these might be more important than medication in the long-term, but frankly, not everyone can get over the initial hump to make these changes without the kickstart that medication provides. If you can, by all means, go for it.

In other words, trade the same advice as those people, but if they advise medication, then say "Thanks, I'd rather not." If they're doing nothing other than taking medication, then you can draw one of two conclusions:
1. Medication is a crutch, necessary or not, that may fix the situation without any other effort
2. Medication is only useful as a way to find real solutions, and get them into your life

Either way, your ideas about medication for psychiatric issues will be validated.
posted by mikeh at 1:01 PM on August 13, 2012

Trickle-Down Distress: How America's Broken Meritocracy Drives Our National Anxiety Epidemic
posted by homunculus at 1:06 PM on August 13, 2012 [2 favorites]

I've mentioned this before, but a big problem in discussions of mental health is that we use very similar terms to describe perfectly normal and adaptive reactions, and states of mind that are highly fucked up.
posted by CBrachyrhynchos at 1:26 PM on August 13, 2012 [2 favorites]

This really resonated with me:

Sometimes in the mornings I wake up feeling as if my world is about to fly apart, and it takes a few minutes to pull myself back into my bed, my bedroom, my house — the one where my kind husband moves around the kitchen making coffee, the one where a sweet, asthmatic cat has taken up the still-warm, vacated space on the bed next to me.

Personally, I have had to cut back on my news consumption because it stresses me out too much. But cutting back triggers that facet of my depression/anxiety that says that I'm a horrible person for not being as engaged as I can be and not doing everything I can to change the things that are wrong in the world because everybody is so apathetic these days and if I don't care who will and and and. It's been an uphill battle to just unplug from the internet once in a while and remind myself that the world will go on spinning even if I don't know all the latest up-to-date info about the many ways in which the world is crappy and how my generation is responsible for it. (And, of course, that triggers yet another mental trap in which I scorn myself for being egocentric and narcissist, for thinking my engagement matters at all.)

I still haven't found the solution. I was on anti-anxiety meds and SSRIs until last year, but they stopped working, so I stopped taking them, and I never bothered going back to the doctor. Yet another way in which I'm failing? Sure, why not. I've noticed that reading fiction calms me down, and reading a books a week is certainly more manageable than those mental crashes when I burn through 4-5 books in 24 hours in bed without even registering what I'm reading. But waking up without feeling dread about what the day will bring is rare indeed.
posted by Phire at 1:34 PM on August 13, 2012 [3 favorites]

Someone memailed me and asked me to expand on my previous comment. I have had a history of "upset stomach" since I was approximately 12 - coincidentally when I started being bullied, when my mom met my future stepdad (who I didn't like at first), and when hormones were starting to kick in. Somehow no one caught on that this was anxiety, and I was dragged to gastroenterologist after gastroenterologist. Tried elimination diets, medication for GI issues, etc. Nothing made any difference.*

I was anxious and depressed in high school, worked for a few years after graduation, went to college and was anxious and depressed there. I skipped a lot of classes due to panic attacks and missed out on a lot of the social scene, to my enduring regret. Somehow I graduated, worked for another couple of years, nothing really got any better. I'd come to thinking that barely leaving the house was normal.

Then I met my husband and went to grad school. I decided I was sick of living like this. It was really hard to have a relationship when the other person had to constantly reassure you that no, the world was not going to collapse if you went to the grocery store. It was really hard to go to grad school when I couldn't hide in the back of a lecture hall, when people were counting on me to be there for group projects and presentations.

So, I got help through my school's insurance and saw a psychiatrist. (I had been in talk therapy for years with not much result.) I was prescribed Clonazepam (Klonopin) and I think Zoloft first. Zoloft made me nauseous and weird and I quit after a couple of months, but Klonopin was a gift from the fucking gods. Finally I could short circuit the sweaty palms and the stomachache and the trembling and heart palpitations. My body felt calm, and my mind followed. I went to class, I gave presentations, I wasn't a nervous wreck around my boyfriend, etc. I did not turn into some frothing drug addict.

I went through another SSRI before my psychiatrist and I settled on Lamotrigine (Lamictal). This has evened me out so much that I very rarely take the Klonopin any more. It's not that I never get anxious - I worry about finances, buying a house, family members' health, etc - it's just not absolutely crippling me from performing my daily functions.

The other big piece of it was meditation. I've read a fair amount of Buddhist literature and while I don't want to get into a lengthy explanation of it here, the concept of no-self and impermanence is a great antidote to anxiety.

It's important to remember that this is all brain chemistry. That's all it is. Just reactions. Medications alter the chemistry. Breathing techniques alter it. Meditation alters it. I actually visualize little molecules whizzing around between my ears and I shush them. It works. Where the body goes, the mind will follow.

* I did discover in college that I was lactose intolerant, but the anxiety persisted after I stopped consuming dairy.
posted by desjardins at 2:03 PM on August 13, 2012 [4 favorites]

But why rule out a whole set of choices a priori?

Again, that's my choice. I've chosen not to take psych meds. I would like to have this discussion with other people who made the same decision.
posted by Afroblanco at 2:38 PM on August 13, 2012

Again, that's my choice.

No one's disputing that. But it's not a weird thing that people might ask you about it when you're the one who brought it up. I know that this can be an argumentative kind of place, so it's not surprising that you might not want to go into detail. But it's a little disingenuous to decline to talk about a thing you brought up unless they're already on board your train.
posted by rtha at 2:47 PM on August 13, 2012

I too, have had stomach upsets since age 12. No bullying, beyond normal stuff, but I tend to have to run to the bathroom whenever I get home from an outing. If I had done well with the meds, I would have for sure kept taking them, but over the course of many years and many shrinks, I am not willing to experiment, as the side effects were very severe.

Afroblanco, you may be interested in this book, Rethinking Depression. Been meaning to read it, myself. It's aimed at depression but anxiety and depression can go hand in hand. Some of the linked article seems to echo what Desjardins said.

Part of the Positive Psychology Movement. Here's an FAQ. Not well versed in it, just something I've been meaning to explore more in-depth.
posted by Marie Mon Dieu at 2:51 PM on August 13, 2012

I meant to mention the very helpful book The Anxiety and Phobia Workbook, which explores both medicinal and non-medicinal treatments.
posted by desjardins at 3:04 PM on August 13, 2012 [1 favorite]

I have spent a lifetime being told to just relax and that the things I'm panicking about are not a big deal, and that I should just get some perspective. When I was 23, I had a complete breakdown. My mother told me at that time that she'd lived her entire life with constant panic attacks, and that I should talk to my father too, because he also dealt with severe anxiety. I discovered around that age that I get truly violent reactions to many medications. I have learned how to work around symptoms, and did find a medication that works when I have acute panic attacks. I resent the idea that the crippling mental illness I deal with is just me being an idiot who can't come up with the right perspective and who just hasn't fought hard enough.

I wish I had unlimited resources and could keep taking the time to see if the right medication was there for me, but I can't afford to miss more than one day a month. I have gone through a number of unhelpful therapists who don't understand that objectively understanding that I'm panicking about something I shouldn't just fills me with shame that I can't stop it.
posted by Nimmie Amee at 3:20 PM on August 13, 2012 [1 favorite]

From the wikipedia page on Kierkegaard Concept of Anxiety:

For Kierkegaard (writing as a pseudonymous author, Vigilius Haufniensis), anxiety/dread/angst is unfocused fear. Kierkegaard uses the example of a man standing on the edge of a tall building or cliff. When the man looks over the edge, he experiences a focused fear of falling, but at the same time, the man feels a terrifying impulse to throw himself intentionally off the edge. That experience is anxiety or dread because of our complete freedom to choose to either throw oneself off or to stay put. The mere fact that one has the possibility and freedom to do something, even the most terrifying of possibilities, triggers immense feelings of dread. Kierkegaard called this our "dizziness of freedom."

There is an inference that this is a human universal. I would be very interested if that is an actual fact. I do not get it on heights so much; but if I am in a train station standing on the platform and an express comes roaring through at 60 miles an hour, the desire to experience what it would be like for a couple seconds anyway to throw myself in front of that train is pretty damn intense. This is something I would never tell one of those physicians or nurses or screeners when they ask me if I have any thought of harming myself or others. I have always assumed that according to the medical people Kierkegaard's description is profoundly not normal and in fact very sick.
posted by bukvich at 3:22 PM on August 13, 2012 [3 favorites]

But it's a little disingenuous to decline to talk about a thing you brought up unless they're already on board your train.

Well, I made a statement, which is that I wish I could have this discussion with people who've made the same choice as me.

I've declined to talk about the reasoning behind my choice because that discussion would be nonproductive.
posted by Afroblanco at 3:33 PM on August 13, 2012

There is an inference that this is a human universal. I would be very interested if that is an actual fact.

I get this with heights, and it is why I generally tell people I'm afraid of heights. I mean, I'm afraid of heights qua heights in certain situations (those glass-floor over a giant drop type things make me feel wibbly), but it's really more that possibility of falling or flinging oneself off that gets to me. I've also had the fleeting desire to walk into traffic/walk in front of a train/drive off a cliff, which like you I assume is a Very Bad Thing when it comes to mentioning it to any health professional, but which has always manifested in me as a very dispassionate, fleeting sort of thought. I have never seriously contemplated doing any of those things, and I've always filed such thoughts under intrusive and let them pass without much mental handwringing about them.

But, y'know, I've got anxiety issues. I've often wondered over the past few years whether my anxiety is serious enough to see a professional about, and I always settle on no because I can almost always reason myself out of my own anxiety, and my own mental and physical coping strategies do well enough. But it's really hard to gauge what a "normal" level of worry or anxiety is when you're in the middle of the anxiety. I always feel so relieved when I share my experiences with anxiety with other people, and it can feel like "permission" of a sort for coping strategies. Like, I'm not being an uninformed lazy wimp for not keeping up with the news, I'm trying to take care of myself by not subjecting myself to something that just makes me anxious. And if I start getting into one of those mental trap feedback loops of anxiety-you're a terrible person-more anxiety, well, I've gotten really good at distracting myself with fiction or music or tv or whatever.
posted by yasaman at 4:38 PM on August 13, 2012 [1 favorite]

I have always assumed that according to the medical people Kierkegaard's description is profoundly not normal and in fact very sick.

My professionals have generally been of the belief that fleeting ideas about mortality and self-harm are normal, persistent and obsessive ones are not.
posted by CBrachyrhynchos at 5:10 PM on August 13, 2012

Afroblanco: I get your angle.

For me, the advantage and disadvantage of meds is that they are extremely powerful mood/personality/life altering substances. They may in fact largely solve my significant anxiety and depression issues.

But, as I've found, taking proper steps to address those issues without meds induces me to enact significant changes in how I approach my life. Jobs, relationships, where I lived, how I handled money... all of it came under review and no cow was or is sacred. I've truly up-ended my life to make any progress addressing my issues. My entire outlook from top-to-bottom was and is part of the problem, as I've discovered.

The first step for me was to try meditation. And like with anything I tackle, if there's a rabbit hole I will tend to fall down it to the bottom. So instead of occasionally sitting in meditation for a few minutes I embarked on episodes of somewhat regular monastic levels of Zen Buddhist practice. Only at that level was I able to get the slightest clarity on the pervasive and debilitating emotional and spiritual dis-ease that underlies my anxiety and depression. The following few years saw big changes for me, and I'm still on my journey. But that was my start at least... I can describe more if you have any interest.
posted by danl at 5:14 PM on August 13, 2012

The older I get, the more time I've spent studying the behavior and psychology of happy, calm, and confident people. And the longer I watch them, the more clear it becomes that they are predominantly happy, calm, and confident for two reasons, the first of which is actually less significant than the second: (1) they lead blessedly lucky lives, and (2) they have extremely different internal physiologies from mine.

We all agree that, for most of us, if you transplanted us into a life filled with truly dangerous stresses, we'd all lose our happiness and calm pretty quickly. But watching these happy folks dealing with situations that make me a nervous wreck, it's also abundantly clear that they are not (for the majority) happy because they have healthy mental habits, a strong sense of perspective, and a useful toolbox of healthful thoughts. Rather, they are mostly happy because they have more serotonin and all that other great stuff constantly flowing through their brains, keeping them upbeat and unworried by all the various minor risks and tasks that get others down.

The longer I watch those folks, the more clear it is to me that, were their consciousness suddenly transplanted into my body (and brain), they would just as quickly end up riven with unhappy thoughts as would anyone transplanted into a genuinely dangerous life. In fact, most of those happy folks have far less developed mental habits, concepts, meditation practices, and so on; they never needed to learn that stuff. (And I guess more power to them, having presumably spent that time on other useful things.) Thoughts and intentions, while obviously causal in the short term, are generally the result, not the cause, in the long term. That's not to say that meditation, CBT, the right ideas, and hard-working intentions can't make a big difference in the long term. It's just that it's orders of magnitude harder than is imagined. Those who believe otherwise are often those who have never carefully observed how the other half thinks, behaves, and feels, because they never had to.
posted by chortly at 5:25 PM on August 13, 2012 [4 favorites]

OK I read all 35 or so of those New York Times anxiety op-eds.

This one might be the best.

There is a footer on most of those pages that they are soliciting submissions from the whole world if anybody wants to give it a try.

If you do not have javascript enabled for nytimes.com on your browser they cannot count that you have exceeded your monthly free quota and you can browse all that you want.
posted by bukvich at 5:29 PM on August 13, 2012 [2 favorites]

Afroblanco:

I'm a pharmacist, but I always champion medication-free interventions first when treating a medical issue (when people ask).

There are many non-pharmacologic ways of managing anxiety & depression (they are inextricably linked), already alluded to in the thread: a program of regular and cardiovascularly challenging exercise, formal meditation, talk therapy, eating more fruits/vegetables and minimizing carbohydrates, getting at least 8 hours of sleep nightly, little or no caffeine or alcohol intake, not smoking (nicotine or otherwise), being on a news or internet fast...which pretty much adds up to: taking good care of yourself, and treating yourself kindly.

It's at once incredibly simple yet deceptively difficult, because our culture doesn't champion good self-care. Good self-care doesn't have to cost a dime, because it is ultimately about one's relationship to oneself, an attitude of compassion and kindness, if you will.

That said, sometimes a person simply needs medications (as much of a necessity for diabetes as for psychiatric issues).

Hope this helps, and good luck! Also, pls feel free to memail me.
posted by Pocahontas at 5:44 PM on August 13, 2012 [4 favorites]

This thread is making me anxious.
posted by danl at 5:46 PM on August 13, 2012 [1 favorite]

It just seems like some of the people who don't know a lot about anxiety disorders have no concept of the difference in scale between worrying a lot and knowing for a fact that you are having a heart attack and preparing for death. Or, if you want to leave panic attacks out of the mix, the difference between feeling worried and feeling that if you leave your room, something terrible will happen, and it's not necessarily clear what, but something roughly equivalent to you shitting yourself with diarrhea in front of your crush, boss, sternest professor, and worst social enemy.

I absolutely believe that there are mental habits that can help, and I have benefited from some of them, but I have also benefited from Xanax. I failed to solve my anxiety problems by any of the other means I tried, but I shouldn't have to say that any more than I should have to apologize for finally, after a long struggle, giving in to weakness and accepting surgery for my appendicitis.
posted by prefpara at 6:02 PM on August 13, 2012 [5 favorites]

Correction for my anecdote: I started out taking "regular" anti-depressants that found them not so helpful. Only when I switched to SSRIs did I find relief.

Also, there was no outside reason for me to be depressed/anxious. I love my husband, he loves me. We have great kids who don't cause us any trouble other than the normal kid stuff. We have a nice home, steady jobs, time to pursue volunteer work/hobbies, wonderful friends, and plenty of disposable income. I should have been happy - and I don't mean happy every single day. That's a ridiculous bar to set. I'm not happy every day now even on the SSRIs, I'm just not curled up in my bed for hours on end, sobbing for no reason.

Along with the SSRIs, I meditate, exercise, eat really well, get plenty of sleep, etc., etc. But I did all those things before I tried medication and I can unequivocally say that the medication has made my life worth living again.
posted by cooker girl at 6:05 PM on August 13, 2012

It just seems like some of the people who don't know a lot about anxiety disorders have no concept of the difference in scale between worrying a lot and knowing for a fact that you are having a heart attack and preparing for death.

Exactly. At the height of my anxiety disorder I was having panic attacks on average once a day, which often meant I was afraid I was going to DIE RIGHT NOW.

It wasn't intellectual anxiety, like "I'm worried about climate change". It was pure primal panic and fear, brought on for little to no reason. Not something I could just reason myself out of, once your body has hit that state and adrenaline is coursing into you it's just not as effective.

For me, medication dealt with the worst aspects of it (mostly eliminated the panic attacks). Still was left with underlying anxiety (now more akin to what most people think of) which _is_ better treated through therapy, working through it myself, etc. But I could never have gotten to that state while still having those intense panic attacks.
posted by wildcrdj at 6:55 PM on August 13, 2012

*hugs*

Everyone needs a hug. Especially in here.
posted by fiercecupcake at 10:22 AM on August 14, 2012

Because I would definitely be interested in talking with other people who don't believe in meds, hearing their experience, and trading coping advice/tactics/skills.

posted by Afroblanco at 6:43 PM on August 13

I wouldn't say I don't believe in meds. I would say I am deeply wary of them, and I avoid them as a solution for myself. Shit, I don't even take Ibuprofen. Similarly I absolutely do not believe in "therapy", but this could be largely down to my being British and over fifty years old.

I could bang on for a very long and tedious time indeed about why I feel this way but the broad-brush reasons are that I think meds are, ultimately, sort of avoidance tactics: drug yourself better. Drug the reality away. That sort of thing. And I am a great believer in facing down the monster, whatever form it takes.

Now, I am on highly dodgy ground here because I freely admit that I recreationally use alcohol to chill myself the fuck out, but in my defence I would say that this is not something I need to do. I can (and do), knock it on the head just like that if I have a good reason to do so. Alcohol doesn't really cure anything for me. It's just fun. I wouldn't do it if all it did was cure me. How very tedious that would be.

As for therapy... eh, Brits of my age just see it as too self-obsessed, too precious, too self-regarding... not tough enough. It's terribly unfashionable to say so but we actually do think that for many of the modern ills and griefs we really ought to just consider hardening the fuck up a bit. My parents were in WWII. my grandfather was a trawlerman. He got killed by German fighters strafing his trawler, but his life was so hard before that that it's extremely hard for me to see lying on a couch and whining about myself and my worries as being a decent way to deal with modern first world problems. Please, my dear American chums, don't bridle at this: I am not saying that is what therapy is, I am saying that's how people of my stamp, ilk and kidney feel about it. I am explaining why I, personally, don't hold with it. I am fully on board with the idea that I may be an ancient, knout-headed and thoroughly incorrect British oaf.

Anyway.... err... that was supposed to be a response to Afroblanco's request to hear from other people who are dubious about meds. I seem to have meandered a bit. I should probably have some booze now. Oh... I am doing!
posted by Decani at 12:45 PM on August 14, 2012 [1 favorite]

Decani: Drug yourself better. Drug the reality away.

These statements strike me as pretty far removed from reality.
posted by CBrachyrhynchos at 12:57 PM on August 14, 2012

Decani, would you advise someone with a broken leg to "face down the monster" or would you tell them to get an x-ray and a splint?
posted by prefpara at 1:44 PM on August 14, 2012

And I am a great believer in facing down the monster, whatever form it takes.

The problem with, say, panic attacks is that there IS no monster to face down. By definition, they're irrational, and you cannot combat irrationality with reason.

Again, we're not talking about stuff like "I'm worried that the euro will collapse." That's a rational fear! You can do some research to see how valid that worry is, you can keep tabs on what is happening in the world, and you can figure out how to protect your finances.

But when you seize up in the middle of the grocery store for no apparent reason, when you're sweaty and trembling and you just have to get the fuck out of there... There's no monster to face down. The grocery store is not a monster. Your adrenaline system has gone completely haywire. Cortisol is flying everywhere. You're not "drugging away reality" if you take something to calm you down, because freaking the fuck out is not reality.
posted by desjardins at 1:55 PM on August 14, 2012 [4 favorites]

And you know ... I don't care if you never take drugs. It's none of my business. I think the reason many people react so strongly to anti-medication folks is that once again we're being called weak and avoidant. I have never once met an anti-medication person that wasn't a hypocrite. Every single one has, at least once in their adult life, taken an aspirin or visited a doctor or had a beer or hell, even brushed their teeth. Taking care of oneself is the very opposite of avoiding reality.
posted by desjardins at 1:59 PM on August 14, 2012 [2 favorites]

The monster that wanted me to kill myself when I was 17 was not real; it was the product of some irrational thinking and wonky brain chemistry. Fortunately, I did not kill myself, and I did not spend years Bucking Up and Toughing It Out on my own - and thinking that I was some horrible weak person because I couldn't do it all myself - because I was able to get help from people who knew a bunch of shortcuts and techniques that helped me not die, and all without reinventing the wheel. Awesome, that.
posted by rtha at 2:08 PM on August 14, 2012

Because I would definitely be interested in talking with other people who don't believe in meds, hearing their experience, and trading coping advice/tactics/skills.

I'm part of this group, although I have plenty of friends and family who have taken medication for anxiety and depression and I would never think any less of them. I have pretty strong social anxiety that affects my life on an almost daily basis and occasionally leads to panic attacks.

Why don't I take meds? I'm afraid of adding yet another substance to my "addiction" list (along with caffeine and ciggies). I'm lazy and don't have a family doctor, so it would be complicated. I foolishly attribute some of my good characteristics to the anxiety. While I think there are some great things about modern medication for all kinds of issues, I'm also kinda uncomfortable personally with the big pharma industry and I do think that doctors reach for the prescription pad instead of actually interacting with patients more often than they should. It would be hypocritical of me to believe these things and also take daily non-life-saving medication. (I also don't like taking tylenol when I have a headache, etc etc.)

I do go to see a very nice talky therapist a few times a year when things get very intense. I do a lot of cognitive stuff ("but why am I thinking that?") and lately have taken to quickly jotting down anything that sets off my anxiety in a notebook. When I review it at the end of the day I can calmly assess what was an actual threat and what anxiety and self-esteem issues, and with repetition it definitely helps.
posted by jess at 5:32 PM on August 14, 2012

Decani, would you advise someone with a broken leg to "face down the monster" or would you tell them to get an x-ray and a splint?
posted by prefpara at 9:44 PM on August 14

No indeed I would not, of course. Because a broken leg is a very clear and physical problem with a very clear and physical method of fixing it. I do not believe this is comparable with many (not all, perhaps) of the vague and amorphous ills that people have when they go to whine to a therapist. You know, things like "Oh dear, I am worried about my self esteem" or, "Why can't I get what I want?", or, perhaps, "Ooh dear, I am unhappy in my life because I can't get a shag and I'm getting a bit old and crumbly now". I'm just pulling a few caricatures out of a sarcastic hat here. I realise I am not being entirely fair but hey, that's sarcasm for you. Hopefully you get the underlying drift.

I think that sometimes - perhaps even often - those are ills that could be better handled by hardening the fuck up a bit. They're really not like a broken leg at all, now are they? As I mentioned, I am British and over fifty years old so YMMV and all that.
posted by Decani at 7:00 PM on August 14, 2012

I have a non-falsifiable, philosophical conviction that psych meds are wrong for me. You can think of it as akin to a religious belief; we could argue about it till the cows come home, but what it always comes down to is a fundamental difference of opinion.

Now, I would not judge someone for taking meds any more than I would judge someone for being Muslim or Buddhist or Hindu or whatever. Totally their choice. I will admit, it was something I took into account when choosing a mate. But friends, strangers, random-ass people on the internet? Who cares what they put in their bodies. People should do whatever works for them.

I can only speak from my own experience, since I have only lived my own life. I've had high highs and some ridiculously low lows. I've been through some shit I wouldn't wish on my worst enemy. I have a form of OCD that wasn't recognized until recently, prompting a number of (wildly) false diagnoses. But I've found that any time I was severely depressed or obsessed, it was because :

1) I was lonely
2) I hated my job
3) I hated where I was living
4) I was taking too many recreational drugs

or (usually) some combination of the above. Once I eliminated those stressors from my life, things always got better.

Now, I know this isn't the case for everyone. Some people have debilitating-ass can't-get-out-of-bed-in-the-morning-type depression for no (visible) external reason. And to them I would say, "do whatever works". I would never expect anyone else to agree with me philosophically, and I would never begrudge anyone their solace, even if it comes in pill form.

Onto my original comment. This is a conversation that I generally can't have with people. The conventional wisdom is that psych meds are okay, and when I tell people I don't believe in them, they either think I'm insulting people who take meds (I'm not), or that I'm a Christian Scientist or Scientologist or something (I'm an atheist). And then all the well-meaning people weigh in with the counter-arguments I've heard a million times, or else they offer that most useless of all things, anecdotal evidence. And none of those things will help me. I have challenges that I'm dealing with in my own way, and "I started taking pills and they helped" does not help me. What IS helpful is hearing from those who walk the same road as me -- and thus my desire for an meds-free anxiety forum.
posted by Afroblanco at 7:17 PM on August 14, 2012 [3 favorites]

There's a parable in my family history against hardening the fuck up. I figure if I end up in the territory between the utterly awesome scientist, and the crazy old bird who destroyed every friendship and family tie through fear and paranoia, it's not a waste.
posted by CBrachyrhynchos at 9:34 PM on August 14, 2012 [1 favorite]

But when you seize up in the middle of the grocery store for no apparent reason, when you're sweaty and trembling and you just have to get the fuck out of there... There's no monster to face down.

Is it not modern civilization or humanity itself? I've experienced what I believe were panic attacks and mostly they had to do with a fear of dying, i.e. I am going to die right now in my apartment and no one will find me for days.

I think the reason many people react so strongly to anti-medication folks is that once again we're being called weak and avoidant. I have never once met an anti-medication person that wasn't a hypocrite.

Amen. If there's one thing I know, it's that we still know very little bout the things we ingest, and we're all medicated in one way or another. There's fluoride in the water, eh?

a broken leg is a very clear and physical problem with a very clear and physical method of fixing it. I do not believe this is comparable with many (not all, perhaps) of the vague and amorphous ills that people have when they go to whine to a therapist.

You are being an ass, and you are trivializing mental illness. Not everyone with a mental illness needs to be institutionalized, and we all deal with varying degrees mental illness. Talk therapy is a proven treatment for mental illness. You are discounting the fact that some mental illness is very painful for people, and again, you're being an ass about it.

I am British and over fifty years old

You seem to think it is, but that is no excuse for being an ass.
posted by mrgrimm at 9:11 AM on August 15, 2012 [2 favorites]

Is it not modern civilization or humanity itself? I've experienced what I believe were panic attacks and mostly they had to do with a fear of dying, i.e. I am going to die right now in my apartment and no one will find me for days.

I don't know. Trying to explain anxiety disorder as existential angst doesn't work for me because it strikes me as rationalizing the irrational. Existential angst is rational. My fears are usually not.

I see it as more akin to a phobia. A member of my family has a phobia of snakes. He can rationally sit in a living room and explain that he knows that most of the snakes he's likely to encounter in his garden are perfectly harmless little things that have nothing to do with him. But knowing that in the living room, and knowing that in a blind panic in the garden are two different things.

One of the big take-aways from CBT and mindfulness training for me is that my first thoughts are sometimes wrong, delusional, and overly-emotional. That bill isn't going to send me into a pit of shame and poverty where the only solution is suicide. It's a thought that's just as objectively foolish as a phobia of snakes or the number 13.

Therapy is a constructive way of pointing out that I'm frequently full of shit. As I referred to above, my negative role model is my grandmother, who worked herself into believing patently ridiculous paranoid bullshit about the people around her. But she was a tough old bird whose delusions involved sex, drugs, gossip, and being cheated out of her income rather than mind-control rays and cancer-causing food, so her nuttiness usually went unnoticed unless she was spoiling for a fight.
posted by CBrachyrhynchos at 10:13 AM on August 15, 2012 [1 favorite]