The Winding Road of Recovery And Setbacks

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The path to overcoming anxiety disorders can be winding and unpredictable.  There’s rarely a straight line between anxious train wreck and “normal”.  There are good days and bad, ups and downs, and there will be set-backs along the way.  Knowing what to expect and how to objectively and accurately judge your progress can make the process a bit easier on us.

Recovery Is Not Linear

Even the greatest athletes in the world don’t turn in dominant performances game after game.  Even the world’s most successful business leaders fail now and then.  You are no different.  Your progress is not going be rock steady. There will be good days and bad, and sometimes you’ll feel like you’re stuck or going backward.  So long as you’re putting in the work and following the right path, just stay with it.

The smaller the time interval you examine, the more likely you are to be discouraged. Worrying about feeling badly at noon after feeling good at eight AM isn’t terribly useful in the long run.  Recognize that you have to “zoom out” to see your steady progress.  Try to stay focused on the big picture.  Don’t obsess over what’s happening at any given moment or on any given day.  Progress is measured and observable over longer time periods.

Panic and Anxiety Are Part of the Deal

This is HUGE. If you are going about the business of challenging your fears and facing them, you WILL experience panic and anxiety along the way.  This is supposed to happen!  If you are afraid to fly, you can only overcome that fear by ultimately getting on an aircraft and taking off.  The same applies to losing your fear of panic or anxiety.  You must experience it for this to happen.  Do not expect otherwise or you will be disappointed.

A Panic Attack Isn’t a Setback

This is such a common issue. Having a panic attack is not a setback in any way. We already know that panic and anxiety are going to be part of your journey forward, yet many still attempt to engineer a panic or anxiety-free situation.  That’s not realistic or helpful in any way. Experiencing panic is actually a positive thing in that you need the practice in order to lose your fear.  Setbacks are measured not by panic or anxiety, but in how you react to them.  Panic.  Be anxious.  Just work on not reverting back to your avoidance or escape rituals when it happens.

Be Realistic In Your Goals

If you’ve been housebound for a year, deciding that you’re going to attend a wedding 100 miles away in four days is probably not realistic. While you can learn a fear or phobia almost instantly, un-learning that fear takes work, and TIME. Understand that progress will come in small doses on an almost daily basis if you’re working at it, but that those tiny steps will add up to giant leaps over time.

Be Patient. Be Persistent.

Frustration and discouragement is to be expected, but they’re really counter-productive.  When you feel this way, acknowledge how you feel, understand that its normal, then do your best to find some patience and to allow yourself the time you need to make more progress. Don’t judge yourself harshly for going “too slow”, but at the same time you must be persistent and tenacious in your work.  If you’re doing the work every single day regardless of how you feel, then you’re moving at the right pace. Being persistent and tenacious in your approach means you don’t have to wonder if you’re working hard enough.  You are.  This can help you find the patience you need to reach your ultimate goals.

Appreciate The Journey

When you’re struggling with an anxiety disorder – especially agoraphobia – its very common to view your life as “on hold”.  We often hear the phrase “getting my old life back” in conversation.  While its easy to see where this comes from, try not to forget that your life is happening every day. You’re living it right now while you read this post or listen to this podcast episode. Do your best to appreciate the positive things in your life, no matter how small they are, and also to appreciate the fact that you’re rising to meet a challenge.  The greatest human stories almost always involve overcoming adversity of some kind.  We all encounter it.  Take heart in the fact that this experience isn’t going to bring the “old you” back.  This is helping to create the NEW you!  A stronger you.  A more confident you.  A new and improved version of you that’s better equipped to handle future challenges. There’s a silver lining in all this, and the journey you’re on now is helping to reveal it.

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Exposure Therapy Mistakes and Misconceptions

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While many panic disorder and agoraphobia sufferers have tried exposure therapy and succeeded, many have tried and called it ineffective or a failure. Often this is simply due to misconceptions about what exposure is designed to do and mistakes in exposure technique. Exposure therapy is – as part of an overall cognitive behavioral therapy strategy – one of the most effective tools we have to deal with our anxiety issues. Mountains of clinical evidence backs this up.

What Is The Goal?

The goal of exposure therapy is not to make your anxiety or panic go away. The goal is to teach you not to fear those things and to change how you react to them. HUGE difference. As is so often the case, many are primarily interested in stopping the symptoms and sensations of anxiety stop. This is often a frustrating endless game of whack-a-mole. Instead we’re better served by learning through direct experience that there’s no reason to be afraid. You can close your eyes tightly and hide under the covers all night or you can just look under the bed to see that there’s really no monster there.

There’s A Reason They Call It Exposure Therapy

Exposure means confronting your anxiety and having intimate contact with it, with each session lasting a bit longer than the last. This is the key, and where most make the fatal error. Exposure is not an arms length hit and run affair. Driving to the supermarket and virtually running through the frozen foods department in an effort to get back home as quickly as possible might be OK in your first few sessions, but the real goal is to start to slow down and to stay longer and longer in the situation you fear. This is the way we learn that being in the supermarket won’t kill or hurt us.

Quantity Is As Important As Quality

This isn’t something you hear often but in the case of exposure therapy it’s true. One trip to the dreaded shopping mall every two weeks when you feel up to it isn’t going to be terribly effective. You must push yourself to practice every day no matter how you feel. If that sounds hard, it is, but that’s how it works. Effective exposure is always gradual but is almost never easy or comfortable – especially in the early stages.

Safety Devices

This is a debated issue. Safety devices, safe people and safety rituals might be used to help you get the ball rolling, but you’re going to have to leave them behind and go it alone and “raw” at some point. Being able to pick up your kids from school only if your mother or girlfriend is with you is better than not going at all, but that’s not really your goal is it? Just as a child must take off the training wheels to learn to ride his bicycle, we must ultimately drop our shields and rituals to achieve our goals.

(Special note regarding stopping medication: If you’ve been taking a benzodiazepine (benzo) like Xanax or Valium or Ativan regularly (i.e. once or more every day, or ever other day) for any length of time, you can NOT simply stop taking it.  Stopping a benzo cold turkey can be dangerous.  Please involve your doctor should you decide that you do not want to take your benzo any longer. The same applies with many classes of antidepressants, which must be tapered slowly in order to avoid problems.)

When Failure Isn’t Really Failure

If you’ve decided that exposure doesn’t work for you, ask yourself if you’ve fallen into any of these traps. Were you doing the “hit and run” thing to escape your fear? Were you waiting for “good days” to do your exposure work? Were you expecting your anxiety to go away after five trips to the mall? None of this makes exposure therapy – or you – a failure. They’re very common mistakes and misconceptions that ambush lots of smart people. Maybe it’s time to reevaluate and make a new plan. Success might be right around the corner for you!

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Why Does EVERYTHING Make You Panic

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For people dealing with panic disorder and agoraphobia, a common complaint is that virtually anything can be a panic trigger.  Lets take a look at why that happens.

Fear Of Panic Symptoms Turns Our Focus Inward

When we do not accept our panic and anxiety symptoms, when we fear them and worry about when they will next appear, our mental focus turns almost entirely inward.  We become consumed with how we feel at any given time and we worry about how we will feel in the future.

Hyper-Vigilant

When our inward focus becomes extreme in nature, we enter a state of hyper-vigilance.  This has us scanning our bodies and minds almost constantly to find the early warning signs of danger.  Our mistaken belief that we need to be saves from our anxiety symptoms puts us on constant alert, ready for the next attack.  Often we go to great lengths to be ready to enter “safety ritual” mode instantly if needed.

Hyper-Sensitive

Being worried about the possible appearance of anxiety symptoms ultimately puts us into a state of hyper-sensitivity. In the same way that a world class athlete gets into “the zone” during competition, we often go into the zone ourselves, but on a 24×7 basis.  As any war veteran will tell you, being constantly prepared for battle is exhausting, draining, and can have negative impacts on our bodies, our ability to reason, and our emotional stability.

“Emotional Bad Aim”

When we erode our ability to reason and our emotional stability, our brains often lose the ability to effectively manage stress. We prepare for fear.  We worry about fear.  We dread fear.  We wait for fear.  We effectively train ourselves to have bad emotional aim.  Every stressor results in the fear response. Got a promotion at work?  Panic.  Fight with your spouse?  Panic.  Excited that your favorite football team is winning the Super Bowl?  Panic.  Whereas only dangerous situations would normally trigger the fight or flight response in our bodies, in an inwardly-focused-hyper-vigilant-hyper-sensitive state, any situation can trigger it.

Its Not Just Stress

When we’re on a hair trigger, its not just stressful events that can trigger panic.  Virtually any stimulus can do it.  A change in temperature.  The variation in lighting as a fluffy cloud passes across the Sun. An odd smell. A bite of food that “doesn’t taste quite right”.  The sound of an ambulance in the distance.  In our over-sensitized state almost anything can trigger an anxiety or panic attack.

When you’re working to overcome panic disorder or agoraphobia, the last thing you need is to feel that you can’t control your anxiety in any way.  The good news is that you can, but the trick is to stop trying. They key – as always – is learning not to react in fear to your symptoms.  When you learn to truly accept your anxiety and panic symptoms as uncomfortable but harmless, when you learn to relax into them rather than bracing, fighting and fleeing, when you no longer fear them, then there’s no reason to be on alert 24×7. You’ll begin to come down from that hair-trigger over-sensitized state and not everything will be an anxiety trigger for you any more.

Lose the fear.  Win the war.

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Overcoming Anxiety Is An Active Process

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Recovery from anxiety, panic and agoraphobia is an ACTIVE process.

Nothing will improve if you just wait passively.

When we get sick (i.e. cold, sore throat, etc.), we retreat, rest and recover.

Retreat:  We take off from work or school. We cancel engagements and appointments.

Rest:  We lay in bed or on the sofa in our comfy clothing with our tissue box and asprin.

Recover:  We feel better after a few days and get back to the business of living.

Our bodies will fix things naturally through the magic of our immune systems. There’s no such mechanism for anxiety disorders. In fact, retreating and resting generally means avoiding, and that can actually make it HARDER to recover by making the disorder even worse.

YOU ARE NOT A HELPLESS VICTIM.  Everything you need to improve your situation is inside you right now. There are steps you can take – steps you NEED to take – to get better, and those steps should be taken right now.

STOP WAITING. 

  • Waiting for time to fix you won’t work. There’s no automatic background process going on that will get you your life back.
  • Waiting until you’re having a good day isn’t helpful. Anyone can accomplish stuff on a good day. You need to act on your worst days because progress happens when you actually experience panic and anxiety without avoiding or trying to escape.
  • Waiting until you find the right method is going to keep you stuck, because looking for the right method usually means looking for comfortable way out. None exists.
  • Finally, waiting for someone else to fix you is also not going to work. We all need support from other human beings, but support and encouragement won’t get you your life back. It helps, but by itself it doesn’t do anything. Its up to you to put in the work.

Before you can start to make real forward progress, you have to buy into the idea that there’s work to do, and that sometimes that work is going to be difficult.  If you’re ready, then lets go!

Start small.  Progress comes in small steps piled on top of each other.

Take a shower.  Get dressed.  Sit in your garden for a while.  Clean the house.  Take a short walk.  Drive down the street.  Do something you’re afraid to do.  Then do it again.  And again.  Then do something a bit harder.  Then do that again.  You get the idea.

Above all, once you stop waiting and start acting, keep acting.  Don’t stop.  No breaks.  No rest.  No vacations.  No rewarding yourself with a day under the covers.  At least not for the first few weeks. You need to build momentum, so be tenacious and be consistent in your action.

Understanding and accepting the concept of an active process can – by itself – change your outlook for the better.  Give it try!

 

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