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TherapistMarryAnn, Therapist
Category: Mental Health
Satisfied Customers: 5810
Experience:  Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
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I had a reply to my previous question in May this year from

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I had a reply to my previous question in May this year from Dr Mark - thank you very much, and now I have another question.
Since May things have got much worse. Just before the summer school break my anxiety got really bad, so much so that I virtually stopped leaving the house. I've become a complete wreck, just sitting at home with no energy for anything, scared of going out, scared of being in without either my mum or husband, not enjoying anything, not even able to play with the children. My mum would take my daughter to school, I'd do online shopping, and my two little boys would have to play by themselves or watch TV because I just didn't have the energy (as a result they are having some behavioural problems for which I know I am to blame). I've been asking my family doctor for help but nothing much happened: he tried me on Paroxetine (I had awful side effects and stopped it after 5 days), then Propranolol 40mg (my pulse dropped to below 50 after just one and didn't take that anymore and the doctor decided that perhaps medication is not for me); then he suggested therapy/CBT which I had around 10 sessions of with a trainee, and that's done nothing at all for me, in fact I was still getting worse; the doctor then tried Propranolol 10mg and Diazepam 2mg (not simultaneously) after I virtually begged him for something again, but they don't really help either, other than making me even weaker (I feel very weak physiclly a lot, exhausted you could say despite not doing much). I finally decided that enough is enough (after having what felt like a near-breakdown again), and went to see a psychiatrist privately, and amazingly after just a few minutes of talking he was able to tell me exactly what was wrong and what I needed - I seem to suffer from a mixture of GAD, health anxiety, panic disorder, agoraphobia, a little OCD, and now also depression (what a list!). He's given me Imipramine 25mg (to increase to 75mg, but at 50mg I had side effects in the form of bad "shakes", so stayed on 25mg on his advice, which seems to work-slowly-I've been on it for just over 4 weeks and my family are noticing a small difference in my mood and general basic day-to-day activity), he also suggested an experienced psychologist for CBT (I've had 2 sessions so far). I now understand my problems (I have also read up about it, I understand the mechanism, the triggers, the processes, but obviously am unable to put them into practice) and see a light at the end of a (very long) tunnel. I know this is a long road and I'll have to do a lot of work...I am very impatient though and have been getting very teary the last few days again. I want to be a mum, a wife, and a normal human being again. I want to wake up in the morning and not feel anxious, nervous, pins and needles all over, I want to be able to take my daughter to school and not be scared of going into the school playground, or take the children for a walk to the park or a playground... I don't want my children to see me like this and have to worry about me, I want to be a part of their life!
Let me just say here that my husband is extremely supportive, he is happy to feed the kids, bathe them, put them to bed and then tidy up the kitchen after having a stressful day at work himself, he's there for me no matter what, patient and loving... And my mum comes here every day to help me (but it's getting her down too, physically and mentally, and my family are blaming me for that...) - takes my daughter to school and just sits here with me so that I'm not alone (I am scared of being at home with the children without another adult, in case something happens to me there is someone to look after them - illogical, I know, but so is the rest of this illness).
My main problems are more of the physical nature - caused I assume by the anxiety: I feel constantly exhausted, my arms and legs feel like they are made of lead, and worst of all, I constantly feel like I am shaking on the inside, from the moment I wake up, and this is causing me to worry quite a bit - is this normal? What can I do to stop it/make it less noticeable? And how can I speed up the process of getting better? My biggest problem and also biggest wish is to be able to take my daughter to school again. How do I break the vicious circle of fear of fear? I know I am already getting help, but I am DESPERATE to get better and am clutching at straws. Do you have any comments / advice please?

Hi, I'd like to help you with your question.

Anxiety and panic occurs when your body reacts to your thoughts. Your mind tells your body that you are in danger even if you may not be. Your body then reacts by releasing adrenaline into your system. Adrenaline causes your body to experience symptoms such as racing heart, shortness of breath, pins and needles, and shaking. Since you are feeling anxious most of the time, your body is always on alert. This causes the feelings of heaviness and exhaustion you are experiencing because you have depleted your energy reserves.

The fear cycle comes when you feel there is danger where there is none. Your mind associates these things and automatically puts your body on alert when you are faced with situations or thoughts that upset you. You begin to feel overwhelmed and constantly anxious because there is no real source of danger except how you feel. You literally become fearful of the fear itself. This is what causes anxiety.

The good news is that anxiety and panic are easy to treat. Anxiety is very common and therefore there are numerous resources to help you. And the fact that you have already sought out treatment and are motivated to get better makes your chances of recovery very high.

Besides therapy, there are many ways you can help yourself get better and do it more quickly. Books, on line links and support groups are all ways to help yourself at home and supplement your therapy. Here are some resources to help get you started:

When Panic Attacks: The New, Drug-Free Anxiety Therapy That Can Change Your Life by David D. Burns

Pass Through Panic: Freeing Yourself from Anxiety and Fear by Claire Weekes

A Life Less Anxious: Freedom from panic attacks and social anxiety without drugs or therapy by Steve Pavilanis and Patricia Alma Lee

The Anxiety and Phobia Workbook (Anxiety & Phobia Workbook) by Edmund J. Bourne

The Cognitive Behavioral Workbook for Anxiety: A Step-by-Step Program by Bill Knaus Ed.D. and Jon Carlson Psy.D. Ed.D.

Coping with Anxiety: 10 Simple Ways to Relieve Anxiety, Fear & Worry by Edmund J. Bourne and Lorna Garano

You can find these books on or your local library may have them for you.

As you begin to understand how anxiety works and how your own thoughts affect your body's reaction, you will find that it is easier to control your anxiety. The key is to let go. I know that sounds odd! But allowing the anxiety to flow through your body and not fighting it helps it dissipate faster. It is when you fight against it that your body tenses, your adrenaline pumps out faster and you feel the odd sensations and feel scared. You can practice letting go slowly. Take one step at a time and expect setbacks. That is ok. Every effort you make no matter how successful or frustrating is still a step closer to getting better.

If you have any more questions, please let me know. And if you want to start a new post and work with me, put my name in front of your question so I can answer it for you.

I hope this has helped you,

TherapistMarryAnn and other Mental Health Specialists are ready to help you
Customer: replied 5 years ago.
Hello Kate
Thank you for your reply. It was what I expected, I already had some knowledge of the theory of how anxiety and panic works, but just trouble with putting the advice it into real life situations. I will look at the links you suggested - thank you.
Just one thing that bothers me that I have not been able to get an answer to - it's this constant feeling of internal shaking/tremor/vibration that just never goes away; there are no external movements, just this feeling inside, which is driving me crazy and is quite worrying. Is this something quite usual for anxiety sufferers? Is there anything I can do to make it go away or at least less noticeable? I would be very grateful if you would be able to just briefly answer that. Thank you so much for all your help!

Hi Olga,

No, what you are feeling with the trembling and shaking is normal. Many anxiety experience at least one symptom that bothers them more than others. It is common for it to be something that seems unusual, such as the tremor and shaking you experience. It is also usually something that keeps you questioning whether or not you are ok and keeps your anxiety fueled.

For your symptoms, try deep breathing exercises. It should help calm you and in turn, affect the internal sensations. I believe that you are experiencing fear in your body through this symptom and learning to relax will help you control the feeling. Also, keep telling yourself you are ok and this feeling will not hurt you. Allow it to be. Accept it as part of your experience. Know that this too will pass.

Deep breathing and learning to relax sounds too simple to work. But most people with anxiety don't realize how keyed up they really are. It is why you are experiencing the exhaustion you feel. It's your body giving out after experiencing being keyed up all the time. So learning to relax can help you get back in touch with what it is like to be under control of your body again. This should help the tremors go away.

I am glad to help you anytime. Feel free to contact me with any other questions or concerns you have. I understand anxiety very well and know how it can seem to take over your life. Support and answers can help a lot when you are trying to recover.


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