Hi, Chrissy! I believe I can be of help with this issue.
First let me say that I can imagine how scary and frustrating this situation must be for you. You are clearly an intelligent, competent, loving and caring woman. And you have had extreme anxiety
verging on panic
attacks along with depression (possibly post partum). Your worry seems to have internalized to such an extent that it is now pure anxiety and panic.
And this is actually the key to my answer to you that you need to think about and consider and act on. Your symptoms are severe enough that I think we need to discuss serious interventions. I will also at the end of the posting give you a technique you can use on your own as well for when you are in the throes of anxiety and panicky fear and worries.
Chrissy, I don't want you to rule out psychotherapy. You need to find a psychologist or psychotherapist who will work on a sliding scale. I assume you don't have insurance and your income is too large for Medicaid. If not, get Medicaid and see if you can find someone who's good and makes you feel confident who accepts it. Not many do because it pays so little. But try. Otherwise, we'll focus on ones who accept a sliding scale. You need therapy to help you manage the anxiety as well as to gain some insight into yourself in relationship to this extreme anxiety that has been increasing. Fortunately, anxiety and panicky worry and racing thoughts and depression are among the most researched disorders in terms of effective treatments. And the therapies today are very effective. The preferred form of treatment today is Cognitive Behavioral Therapy to learn skills. Here is the Amazon web page address for the classic workbook for anxiety by Edmund Bourne:
H ere is the web address for Psychology Today's therapist directory. You can sort by zip codes and when you see someone who seems like they might be helpful (they show you a photo of the therapist!) look at the listing and see if they list CBT therapy in their orientations and anxiety disorders as one of the areas they work with. Also look to see if they list that they accept a sliding fee. Don't be embarrassed to call if they do and let them know honestly your situation and what you can afford.
If you want someone who isn't as structured as a pure CBT therapist, consider seeing if the therapist also lists humanistic and/or psychodynamic
therapy in their orientation. The idea here isn't that these types of therapy are magic. It's that you may want to find a therapist who will form a strong therapeutic alliance with you and will help you look at the sources of your emotions and social phobia
That you're losing weight is an incredibly important sign of success. There are wonderful websites now with tips and recipes and tracking information. Here are two:
Spark People is free and has great resources.
Weight Watchers charges but has wonderful online groups that offer real support.
The point is that I want you to remember that what is happening to you is workable. That each small success you have is going to lead to greater confidence and lessening of the panicky feelings. So get the workbook, keep losing weight by eating right and exercising. Consider going back on the medications for another 3 months to give you a boost. I waited till now to bring it up because you are not a "pill pusher" kind of person. Good. But consider it. If you don't want to, then be very faithful to do the exercises in the workbook. Consider calling the therapist as I recommend. Because all these steps will produce the successes that will let you breathe more deeply and be more confident and be the Chrissy you want to be.
Okay, that should help you get working on these symptoms and get some relief. I wish you the very best!
Now, I want to give you a tool to use for when the depression is overwhelming or you need to actually do something with people that is raising your anxiety level and worry. Here are instructions on a therapeutic protocol called Progressive Muscle Relaxation (PMR). It's really quite easy to do almost anywhere. My patients suffering from depression or anxiety, when I teach them PMR at first are amazed how simple it is and that it is a psychological protocol. It was first used in the 1920s! Since then, of course, it has been refined and many studies have been done showing its effectiveness. You will practice PMR at first when you don't wake up with an attack so that you will be familiar with it. I want you to practice the PMR at least 5-6 times before an attack or feeling acute anxiety. Why? Because when you're in the throes of anxiety, you will only remember to do something you are very familiar with it. So practicing 5-6 times is really a minimum.
I want to stress
the importance of breathing as well. Part of the physiology of what is happening to you in anxiety states is that your breathing is getting shallower. This reduces the oxygen in your blood to your brain. That increases the anxiety reaction, which strengthens the attack and you are in a vicious cycle! Not good. So breathing is the primary tool. I have found in my practice that learning breathing techniques can be helpful. But some of my patients are not interested in learning more than one thing at the beginning, so I have found that just reminding you to BREATHE deeply at the same time you are doing PMR is almost as good. If you are willing to take a yoga class and learn breathing techniques, that's the best. But, breathing deeply with your PMR will help.
So, we're ready for learning PMR. I want you to print my instructions below my signature and have a copy in each of the rooms of your home where you may be when you have an attack. And again, you need to practice this easy technique at least 5-6 times as soon as you can. It needs to become as natural to you as breathing. Ah, remember breathing?
Please remember to click the green accept button. Feel free to continue the discussion; my goal is to get you the best answers possible. Bonuses are always appreciated! If I can be of further help with any issue, just put "for Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, Dr. Mark INSTRUCTIONS:
- After finding a quiet place and several free minutes to practice progressive muscle relaxation, sit or lie down and make yourself comfortable.
- Begin by tensing all the muscles in your face. Make a tight grimace, close your eyes as tightly as possible, clench your teeth, even move your ears up if you can. Hold this for the count of eight as you inhale.
- Now exhale and relax completely. Let your face go completely lax, as though you were sleeping. Feel the tension seep from your facial muscles, and enjoy the feeling.
- Next, completely tense your neck and shoulders, again inhaling and counting to eight. Then exhale and relax.
- Continue down your body, repeating the procedure with the following muscle groups:
- entire right arm
- right forearm and hand (making a fist)
- right hand
- entire left arm
- left forearm and hand (again, making a fist)
- left hand
- entire right leg
- lower right leg and foot
- right foot
- entire left leg
- lower left leg and foot
- left foot
- for the shortened version, which includes just four main muscle groups:
- neck, shoulders and arms
- abdomen and chest
- buttocks, legs and feet
Quickly focusing on each group one after the other, with practice you can relax your body like ‘liquid relaxation' poured on your head and it flowed down and completely covered you. You can use progressive muscle relaxation to quickly de-stress any time.
What You Need:
- A comfortable place.
- Some privacy.
- A few minutes.
Please remember to click the green accept button. Feel free to continue the discussion; my goal is to get you the best answers possible. Bonuses are always appreciated! If I can be of further help with any issue, just put "for Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, Dr. Mark