Ask a Psychiatrist and Get Answers to Mental Health Questions ASAP
Hi, Brian! You know, to give you the best answer, I think I should ask you a few questions first that will help define the problem and the situation.
This started 6 months ago. What was happening in your life then that might have triggered this sudden rise in anxiety?
Was there trauma or abuse in your childhood? What about alcohol or dysfunction in your family when you were growing up?
Have you never had anxiety or panic attacks before 6 months ago?
Have you had any other mental health issues?
Are you getting any treatment right now? If so, what type? How is it going?
If not, when was the last treatment? What type of treatment was it? Was it helpful?
Any extra information that will help, feel free to share.
I see you are offline at this time and I may be logged off for the night before you reply, but go ahead and reply to these questions and I’ll answer as soon as I log on tomorrow. Okay?
Brian, thank you for the added information. It helps a lot. I believe I can now be of help with this issue.
First let me say that I can imagine how worrisome and frustrating this situation must be for you. The sense I get from your further information is this: you're a normal guy with a normal history except in the area of "pushing to be perfect". And it bit you. Rather than backing out of some of the successful bids and staying on the "normal" path of life, you chose the push to perfection and of course, you made it. At the cost of your health. And now it's telling you that you have to pay.
The good news is that you're used to natural methods and so you're not rushing to medications. So let's use a behavioral program to treat the anxiety. I'll at the end of the answer give you a behavioral technique to get started with this. You can use this technique throughout the day when you are having anxiety. It is not a cure; it is something you can use to help yourself.
Let's work on four ways you can begin to build a behavioral program for yourself: herbal remedies, diet, exercise, and psychotherapy. The first two are to help you feel more involved and in control of yourself and what's going on inside. The psychotherapy can actually teach you skills and give you tools for managing your symptoms.
I'm going to make two herbal recommendations. This is because I know there is SOME research evidence for these two herbs. However, it is not that conclusive or even impressive. But it is some and they have the following going for them: in the cultures they come from, they are traditionally used for anxiety. That's encouraging. The first is Black Cohosh, the root of which was used by Indians in our country. The second is Kava, sometimes called Kava Kava, which is from the Pacific Islands.
Not directly for anxiety but useful for moods is Omega 3 fatty acids, either in fish oil or capsules. Buy good quality. The clinical dosage is 2-3,000 mg daily. All these things you should get at the biggest and most frequented health food store and ask them for the best brands they trust in terms of quality. Because these are all unregulated supplements.
So give those a try. But please remember: they are not going to be the kind of powerful drug that the medications would be. That's why medications take years to develop: they are very powerful!
Diet: cut out coffee, sugar, white flour. That may be tough. But you will see results as some of the newer research shows. And lean meats only. No fast food restaurants, no fatty foods. See what I mean about getting involved in controlling what's happening? With diet changes you are treating your problem with respect: you are acknowledging you need to make changes to get your body feeling better. Omegas are important.
Exercise: 5 days a week moderate exercise, to include 3 days of strength training as you get more used to it. Pretty amazing isn't it? I told you it would require work, but what you put in to it you will get out of it. Your doctor will verify the research results showing the benefit.
Which brings us to psychotherapy. If you find the symptoms last even as you begin to regain your focus on "normal" living with the above work, you need to find a psychologist or psychotherapist to help manage the anxiety. Fortunately, anxiety, phobias, and panic 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 (CBT) to learn skills. Here is the Amazon web page address for the classic workbook for anxiety and phobias by Edmund Bourne: http://www.amazon.com/Anxiety-Phobia-Workbook-Fourth/dp/1572244135/ref=sr_1_1?s=books&ie=UTF8&qid=1286170992&sr=1-1
Ask your doctor to refer you to a psychologist that he/she feels would help you with CBT work on the anxiety. If your doctor isn't able to refer to anyone, here 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. If you want someone who isn't as structured as CBT therapists can be, then seek someone who also practices psychodynamic therapy so that you can focus on insight into your "self". http://therapists.psychologytoday.com/rms/
Okay, that should help you get working on these symptoms and get her some relief.
I wish you the very best!
Now, I want to give you a tool to use for when the anxiety is present for you. It is quite easy to do almost anywhere. My patients suffering from 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 so that you will be familiar with it. I want you to practice the PMR at least 5-6 times before 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?
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.
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