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Anxiety: Nothing to Do but Embrace the Dread (nytimes.com)
69 points by wikiburner on July 15, 2013 | hide | past | favorite | 46 comments



Personal history for anyone suffering from serious anxiety:

Anxiety destroyed my 20s. It kept me home-bound. I rarely went out and would have attacks at the grocery store all of the time. Early on I hoped that things would come to a head and that I would eventually be immune to it, and stronger for it. But that never happened. I was afraid to seek help because I assumed they'd put me on meds that would dull my thinking. Looking back, that probably would have been fine. At every turn anxiety held me back. A stupider but freer me would have been welcome.

After a lot of self-analysis and experimentation I discovered that about 70% of the problem was the Pepsi I was slugging down every day. For my body, sugar and caffeine together are like crack. I switched to diet and dropped about half of my daily anxiety in a few months. I eventually cut the caffeine out altogether. Daily anxiety almost entirely dropped, with occasional spikes for stressful situations. A friend told me to look into choline. I'm not a supplements guy, but it turns out eggs have plenty so I started eating eggs every morning. I also started running which has had a huge impact on my mood. After a while I rarely had anxiety. In fact most of the anxiety was from worrying that I was going to have an anxiety attack. I'm not cured - I don't like certain situations and those can still bring out an attack. The good news is that it's now at a point where I can fight back and "be brave", which I always though would fix it but never did. That actually works most of the time now. That was just impossible in the past.

I used to think that caffeine was making me smarter. It was definitely giving me bursts of ideas, but ultimately it didn't give me anything I wasn't going to have already. I was abusing a drug, not thoughtfully taking a medication.

I basically had to become enraged at how my life was going in order to do something about it.

The bottom line is to never stop trying to solve it. Try the meds, exercise, diet, meditation, electroshock, whatever. Try everything until you figure it out.


"The value and necessity of anxiety mean that it will persist until the last breath. It is impossible to extinguish, no matter the level at which it affects you."

In contrast to your post, I found it interesting that the author of the article has pretty much reached a hopeless conclusion after many years of wear and tear, basically resigning himself to the conclusion that anxiety is beyond his control... (i.e. learned helplessness)

I fully agree with you though... I think everyone needs to come to that point of emotional awareness where they understand anxiety to the point of not fearing it, but using it as a gauge in their "life wellbeing" checklist.

I personally find that when anxiety hits for an extended period of time, that's a caution flag for me to step back and take a look at the last "X time period" and do some reflection. Anxiety for me is generally one of those indicators that life has been going in a wrong direction (physically/mentally/spiritually/emotionally) for a little bit too long... It tends to be more of a symptom of larger life issues and in that case you're right, it's always better to find the root rather than hack at the weeds.


I've had some intense anxiety issues, though not as intense as the thread parent.

I too found that changing my diet and exercising helped.

One of the most effective methods for me is meditation.

Ironically, during meditation, you also accept the anxiety. Or to be precise, you accept the experience of anxiety. The thing is, I also know that all things are transient. That includes anxiety. If you mindfully observe anxiety as it arises, you can literally see it created, come into full force ... and then start fading away.

When the mind starts avoiding the experience of anxiety, it tends to get stronger. Further, the avoidance itself triggers secondary waves of anxiety, so you enter this feedback loop of anxiety.

Ultimately, anxiety is the feeling of avoidance. If you've gained the skill where you direct your awareness at the anxiety itself, you start being able to see things more clearly.

You can learn about this through http://www.urbandharma.org/udharma4/mpe.html or participating in a Vipassana retreat.

There is also the method described by this book: http://www.amazon.com/Feeding-Your-Demons-Resolving-Conflict...

There are also carefully conducted entheogen sessions that can help treat this.


> After a lot of self-analysis and experimentation I discovered that about 70% of the problem was the Pepsi I was slugging down every day. For my body, sugar and caffeine together are like crack. I switched to diet and dropped about half of my daily anxiety in a few months. I eventually cut the caffeine out altogether.

This, so many times over. When someone comes into /r/adhd and asks "I'm having troubles with anxiety, help!" my first response is "cut out caffeine then come back in a few weeks."

People do not realize, caffeine is a drug, it has side effects. One of those side effects is anxiety.


Sounds like me as well. My 20s really sucked. Most of my friends were dating and travelling, but I had too much anxiety to do either. I lived an hour from a big city, but had too much anxiety on the freeways to go there. Most of my friends were always going to the city to museums, concerts, and to have a good time. My panic attacks on the freeways and around members of the opposite sex were rough, I see my 20s as the Dark Ages. Cutting my caffeine intake over half helped out a lot.


This has been very much so my experience. I've had anxiety problems for about a year now. (I'm 23). I cut out caffeine and quit smoking. Working out and taking vitamin supplements have helped a ton too.

More importantly though you're right. I was in a really bad place and it finally pissed me off enough to do something about it.


> I switched to diet and dropped about half of my daily anxiety in a few months.

My wife had panic attacks for years until she was persuaded, for other reasons, to stop using caffeine and artificial sweeteners. A couple of months later, her panic attacks stopped, and they haven't returned. She's convinced one of the sweeteners -- she mostly used cyclamates, but also some sucralose -- screwed with her brain chemistry. (She's always avoided aspartame as it gave her a splitting headache, so it wasn't that.)

There are plenty of reasons to avoid artificial sweeteners, so I wouldn't necessarily weight this anecdatum too heavily, but I thought it worth passing on anyway.


Definitely agree with this. My girlfriend suffers from anxiety and her nutrionist told her to immediately cut out the artifical sweeteners and she's already noticed a difference.


-stops consuming caffeine, a drug known to exacerbate anxiety, and artificial sweeteners

-stops having anxiety attacks

-blames artificial sweeteners for anxiety attacks

???????


Sorry, I left out an important detail: she had quit caffeine several times before without experiencing this benefit.


The only thing on that list that I have not tried is the electroshock :-(


Don't give up anyway! It's may be weak to say this, but it's the best I've got. Also, consider that "whatever" includes a whole lot of things.. it includes everything but giving up :)

edit: I don't remember where I have this idea from, and it may be stupid, but it kinda stuck with me: if you can't find out how to solve a problem, try to find a way to make it worse, as that can give you hints how to overcome it. I have no idea how this could be applied to anxiety, not in general and of course not to yours; or wether that's a good idea even (surely might not be without friends or professional care around). But since you said you're all out of clues I thought I'd mention it anyway, even if it's just to bring people "out of the woodworks" which will tell me why exactly this is a bad idea (I really have the feeling it might be). I'll simply trust you'll not go off and do something dangerous with it; but maybe you can reverse engineer it a little that way.


this might not be what you are describing, but it sounds like exposure therapy: http://en.wikipedia.org/wiki/Exposure_therapy


I may have been joking about electroshock. :)


Have you tried things like wearing a rubber band around your wrist, and when you feel a panic attack coming on you can use it to slap your wrist and kind of derail your current train of thought? Like the parent poster, I often would have panic attacks while worrying about whether or not I was about to have a panic attack. Like, if I could make it to to wherever I was trying to go I knew I'd be fine, but getting there was hard because my mind would race while driving there and I'd have an anxiety attack usually. My dad told me to try the rubber band thing and it actually kind of worked. Sort of a placebo effect maybe, but anything is good if it gets you past that moment. I also got into the habit of telling myself that I was going to be alright. I knew panic attacks only lasted a few minutes and I knew I always got through them, so I had to tell myself that I'd get through the current one and be fine in a few minutes - even though it'd feel like hours. It really took me about a full year of giving it 100% effort to get over my anxiety, to a point where I could at least sense an attack coming on and I could kind of prepare myself to calm down. A lot of mine was proper breathing. It sounds really weird, but I think I realized that I would basically slow my breathing down to almost not breathing when I got nervous, and that would make me light headed or something which would trigger a panic attack.

Some other things that helped me a lot were to just tell my friends up front that I felt like I was having a panic attack. You'd be surprised how little amount of other people will judge you for saying it. Most people offer up advice and feel sympathetic, so telling them usually helped me calm down. I also went out and bought a bicycle and a basketball hoop. When I was feeling like I might have an anxiety attack, I'd just go outside and shoot a few hoops (I suck at sports, it was just something to do), or I'd go ride my bike around.

I did try herbs. I never took prescriptions. I don't think herbs every actually did anything, but sometimes it felt good to just be "taking action" and they had a placebo effect in that sense, I guess. That's just me, though.

Also, I take stuff really personal usually, and I'd bottle stuff up. I used to get very frustrated when something I'd been programming on for awhile hits a snag or I can't figure out how to do something, despite weeks of Googling and stuff. It may sound lame, but sometimes it felt really good to just let it all out. Whether it was crying or yelling or whatever. I had one time driving home from work, having a panic attack, that I couldn't handle it and I just started crying for some reason. It felt great after. I had other times where I'd just yell in my car and that'd be enough to kind of derail an anxiety attack.

I don't know man, I don't think there's really a 1 size fits all solution to anxiety. It's just finding something that you can use as a tool to help yourself get through that 1 moment in time. Don't look at solving the whole thing, just look at solving each panic attack, and then use those tools to get you through 1 day, 1 week, 1 month, etc.


A friend of mine teaching trans-personal psychology told me once that there is a difference between anxiety and panic. When you are panicking, the feeling is so intense that you don't know you are panicking. If you have the presence of mind during the experience to know you are experiencing this feeling, this would be anxiety.

The rubber band thing works because it interrupts the usual pattern of feedback loop where the anxiety builds and feeds on itself.

You mentioned breathing. You are talking about deep, yogic breathing? This is where you engage the diaphragm, ribs, collar bones, breathing smoothly, deeply, and quietly.

In any case, I found that anxiety, like procrastination, is the symptom rather than the cause. Anxiety arises from deeper issues. Those deeper issues are addressable.


The only thing that has blunted my panic attacks are herbs - Ashwagandha and Holy Basil. These herbs bring me calm and help me stay relaxed when my mind is in the right place.

Our life in the creation of our minds....so the first thing to do is make sure you're eliminating toxic thoughts that can cause anxiety and spur panic attacks. After that, the herbs can be of tremendous helps without the harmful side effects of benzodiazepines.


What's anxiety like?


It's like being chased by a tiger, except there is no tiger, and you know it. So it's some of the worst fear you've ever felt in your life, coupled with feeling stupid because you know it is irrational and you should just "get over it". Except you can't.


Wow, that sounds excruciating.


Yikes.

>Toss aside the bath water of anxiety and you will also be tossing aside excitement, motivation, vigilance, ambition, exuberance and inspiration, to name just several of the inevitable sacrifices. Get rid of anxiety? Even if you could — and you can’t — why would you want to?

I would be extremely cautious with this train of thought. It is very dangerous, and by no means true.


I'd upvote this comment more if I could.

I've recently suffered from acute anxiety, and it was not pleasant. But I figured out what was causing it, changed my diet and exercise patterns, and it's not happening anymore. The rest of the good things in that list remain in place.

That said, the author is probably not intentionally misleading his audience; his personal experience points to the connection between those good attributes and anxiety, and he assumes that if you lose one you lose them all. It's an honest mistake, but a mistake nonetheless.


If anyone is looking to build technologies to help quantify, then diagnose and treat anxiety, stress, and depression, we're hiring at Neumitra. I'm a neuroscientist by training and a severe family history of mental illness led me down this path.

hello@neumitra.com


Or you can get high: http://www.scientificamerican.com/article.cfm?id=hallucinoge...

I've found that the best way to handle anxiety to stop talking about it all the time, and just fill your mind with living. When HN gets in a spate of depression/anxiety discussions, it drags my mental health down.

It's almost enough to get me in support of the concept of Trigger Warnings.


"When HN gets in a spate of depression/anxiety discussions, it drags my mental health down."

Psychedelic experiences and meditation are closely interrelated.

Filling your mind with one thing instead of the other is a temporary solution. It's another form of avoidance.

Anxiety arises from an underlying emotional issue that someone is avoiding.

In the psychedelic and meditative states, it is entirely possible to feel oneness and love for all that is. That's fine. For insight meditators, this is a peak experience that is itself transitory. We'd call this the first "flowering". There is still much work to reach the "fruit".

Think about it. You're given the gift of unity consciousness, of love and light. But, the tendency after that is then select only some of the experience as good, and to reject the rest as bad. The gift of the bliss and love is to teach you what it is like to be unconditionally accepting of all that is.

And unconditionally accepting includes the experiences of anxiety, depression, misery ... It's only when you accept the experiencing that you can become a complete person.

So HN gets in a spate of depression and anxiety discussion. "It drags my mental health down." The practice at this point is to disassociate the apparent cause and effect and focus on what you are experiencing at the moment. "I feel that my focus is breaking apart." "I feel my mood going down." And you go deeper, observing the sensations that make that up: where exactly, in your body, are you feeling it? What color is it? What texture? What temperature? Any sounds, smell, or taste? Then you note it and let it go, go back to focus on living and breathing.

Over time, you gain the ability to mindfully observe anxiety or any other sensation as they pass through your awareness, yet you are not moved. It is in this way, the mystics would call "finding your center". It no longer matters that HN gets in a spate of depression and anxiety discussions. You are OK with that.


This is an incredibly well written reply; it sums up the basics of mindfulness in a very short space. Have you written any more on the subject?


Huh, thanks.

Much of the language and frame I use comes from Daniel Ingram's "Mastering the Core Teachings of the Buddha". You can check that out if you want more. If you've got some meditative experience, that has some good stuff. If you're coming in from entheogens, that is a great book to read after a couple breakthrough experiences. One note though: Ingram is considered controversial by a number of people for some reason.

As for my own stuff, I have written a cheatsheet at some point: http://www.quora.com/Meditation/Whats-a-nice-little-cheat-sh...

... though I will be updating it soon from the things I've been learning from practicing pranayama and yoga.


> I've found that the best way to handle anxiety to stop talking about it all the time, and just fill your mind with living.

Sometimes the solution to your problem is to un-ask the question.


For me, meditation beats anxiety. I meditate every day, more or less. I can skip a couple of days of meditation but then anxiety starts rising. Soon it's sitting on me 24-7. I get more and more upset and I start thinking crazy thoughts. So I meditate and the anxiety goes away.

I do samatha and vipassana.


From my own explorations, I've come to the conclusion that my anxious mind was a product from my parents. My dad is a fly off the handle, every small thing is a disaster. My mother is a chronic worrier.

It wasn't until I moved to CA where I had a chance to remove myself from it did it start to make sense.

Our emotional responses are learned and engrained from our earliest years. I see it in my parents when I go to visit but now that I'm aware of it I try to stay calm and grounded.


Actually, there's a lot to do with genetics and brain chemistry. Whether or not your fight-or-flight reaction (your amygdalae) kicks in has a lot to do with nature. Nurture is also important - meditation can help you regulate it.


It's like I wrote this. 3,000 miles disciplines even the craziest parents.


This book has not only helped me with back, neck, and shoulder pain but anxiety too.

http://www.amazon.com/The-Divided-Mind-ebook/dp/B000SEHJOI/r...

Turns out simple breathing exercises can lower most of my anxiety.

http://www.drweil.com/drw/u/ART00521/three-breathing-exercis...


I tend to think that anxiety is neither emotion nor reason. Rather, it's an indication that one or both of them is not being engaged in properly.


Anxiety is an emotion. It's an experience. It isn't reason, though one might come up with any number of reasons, rationalizations, and justifications to attempt to describe the experience.


I've found it helpful to learn not to fuel thought trains. ACT (Acceptance and Commitment Therapy)[1] is helpful for that: It's basically about developing an understanding that thoughts and feelings are not real, and that they are not dangerous. A thought is the voice in your head, feelings are sensations in the body. Nothing more. It also has techniques that makes it easier to detect them.

By the way: Gut flora may play a role in anxiety[2], at least for some. It seems to play a role in many different mental, as well as physical, illnesses.

[1] http://www.amazon.com/The-Happiness-Trap-Struggling-Living/d...

[2] http://www.apa.org/monitor/2012/09/gut-feeling.aspx


Anxiety is a naturally occurring process that has been essential to human survival. Some individuals have managed to place a completely different judgement on anxiety and we call those people thrill seekers while other individuals feel paralyzed with fear. Where one sees dread the other sees a potential for a state of euphoria. Conquering anxiety is not at all to do with removing it but with managing our perception of the experience. Embracing anxiety is not so much with accepting dread but to understand this naturally occurring system of defense and ultimately desensitizing ourselves to the dread associated with the experience.


Perhaps. Although, that is easier said than done.


Meditate. Breath. No one said this was easy.


I wasn't a normally anxious person before but 2 distinct traumatic events that happened in the last 2 years has now made me super anxious. The weird thing about anxiety is that it's like both sides of your brain are fighting for control of your body.


There's a fantastic book that may help with anxiety: Claire Weekes - Self Help For Your Nerves.

It teaches you how it's just a physiological response that feeds off itself.

Understanding this can help you to break the cycle.


Feel the fear, and do it anyways.


Unfortunately, during a panic attack, that may not seem like an option at the time. And, if you force yourself to do whatever it is you're trying to do at the moment, a panic attack could result in fainting or something, which may not be desirable. Anxiety, and "the fear", are both normal, but an attack is something hard to describe and triggers the flight response usually, for me.


Yep. Anxiety is literally the flight response, an avoidance.

It's less about doing and more about actually resting your awareness on the anxiety, and on what it is you are avoiding. The actual "doing" can come later; it is hard to do anything without presence of mind.


Guessing you've never experienced an anxiety-type disorder. Imagine feeling like the breath is being pushed from your body, like you're about to lose control of your mental faculties, but not having anything physical you can fight back against. Doesn't matter where you are, at home, at work, playing with your kids.

That's pretty much what it's like.


In some sense anxiety is an inability to one region of the brain to tame activities of the other(s). There could be a whole set of possible causation, but the idea is quite simple - a brain is a muscle, so it could be "changed" via exercises. This is the reason why meditation works is a grossly oversimplified, naive wording. So, yes, the way of out of chronic anxiety and anxiety disorders in general is not in medication or running away, but in contrary, go toward it and getting to know it by knowing oneself. This is how people survive on the war - by conquering extreme fear and anxiety.




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