DEAR DR. NERDLOVE: What’s up, Doc? I’ll keep this one short and sweet: I’ve got anxiety and I hate it. It doesn’t matter how well things are going, there is a voice in the back of my mind that will tell me how it’s all a big mistake or that I’m at risk of messing everything up or I did something weird and now everyone’s got the ick.
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My anxiety means that I’m on high alert all the time like I’ve gone outside the wire in Iraq all the time and I’m always second-guessing every word I say and everything I do. When it’s not doing that, I’m going over everything people have said to me and trying to convince myself that they don’t secretly hate me.
I hate it and I want it to stop and I don’t know how. Please don’t say therapy, I’ve already got a therapist and they don’t seem to understand. What do I do?
Nervous Devonshire (W)rex
DEAR DEVONSHIRE (W)REX: I know you said don’t say “therapy”, but if your therapist isn’t helping, it’s probably time to find a new therapist. Therapy is a lot like dating; if you aren’t clicking with your therapist, if you don’t feel like you’re being understood or listened to and if their work isn’t helping after you’ve given it a good-faith try, then you may need to find someone who is a better fit. You might also want to talk to your GP or a psychiatrist about anti-anxiety medication. Even something like a beta-blocker to help control your heart rate might help you get things under control.
Yeah, I know: it can feel like you’re weak or can’t hack it because you need pills to not be a nervous nellie. F--k that noise; as someone who’s dealt with a few different mental health issues, I’m a big believer in better living through chemistry. Our brains are blobs of tapioca with electricity running through them until they hallucinate hard enough to invent calculus; of course changing the chem balances will have an effect. If you’re willing to use the right kind of oil to keep your car’s motor happy, then there’s really nothing significantly different than taking your meds when you need them.
Now with that out of the way, I think what may help here is to change your relationship to your anxiety. The key to understanding anxiety is that it’s not there to hurt you or make your life worse. Anxiety is one your brain’s attempts to keep you safe. Your brain doing its best to anticipate problems before they can happen so that you can navigate them smoothly and without issue.
Think about it: if you know that you’re entering the savannah and there’re saber-tooth tigers around, having plans and contingencies in case you encounter them makes sense. Being on the lookout for signs that they’re nearby is basic survival.
That’s what anxiety is doing; it’s looking for signs of trouble and trying to help you avoid it if possible and to deal with it when necessary. In this case, instead of helping you avoid predators in the tall grass, it’s being applied to your social life – helping you navigate the complex and frequently confusing morass of being a person in the world.
The problem, however, is that anxiety can be a bit like a working breed dog; if it doesn’t have a job, it can get rambunctious and destructive. When we had to be on the lookout for smilodons and cave bears and s--t, someone with a higher level of anxiety was a feature; they kept their crew alive. In a much safer world, there’re fewer things to be on alert for and so that anxiety kinda goes berserk trying to do its job and starts trying to find threats where there aren’t any. So someone like you ends up becoming hypervigilant in the name of safety, convinced that there’re threats lurking behind every smile, micro-expression or time that someone takes longer to reply to a text than they did before.
So, there’re three things to do here. The first is to give yourself a little breathing room. When you have those moments of being sure that something is wrong, actually look at the evidence and ask yourself what you would tell a friend who came to you with the same fears. Would you look at their concerns and say “oh yeah, you’re f--ked; pack your bags, change your name and get a new face, you gotta get out of here”, or would you say “hey, it’s ok, you’re making a lot out of nothing”? Or you might take a moment and think of times when you’ve been on the other end of the situation: a friend said something weird or you didn’t reply to a DM the instant you got one. Did you start to hate them because they misspoke, or did you intuit what they really meant and just took it in stride? Were you not answering their DM because you don’t like them or because you had other stuff to do?
You can’t logic yourself out of an emotion, but you can dial back the immediacy of the worry. If you can give yourself that space where it doesn’t feel like the world is coming down on you right this instant, then you’re giving yourself a chance for that moment of anxiety to pass. And it will pass, just as every feeling does. Nobody can be sad or happy or scared forever; it just feels that way in the moment.
The second thing you want to do is to pay attention to your feelings – note them when you’re having then and give them a name. When you have an anxiety attack about something, take a moment and observe that you’re having a feeling. Then you name it and describe its purpose “this is my anxiety about asking Sally out on a date”; “this is my anxiety about my connection with my friends, it’s telling me that I’m feeling insecure because I haven’t seen them in a while because I’ve been busy but they’ve all been hanging out and I worry that it means that they don’t have room for me anymore”.
Please note very carefully the way I phrased that: you’re having a feeling, not you are that feeling. You’re not anxious, you’re feeling anxious. Reminding yourself that you’re having a feeling is a reminder that this is a temporary issue, not a permanent, definitional state of being. Similarly, describing the why of it helps you figure out what the underlying issue is; the answer is often found there. If you’re worried about your closeness with your friends and you’ve been distant for a while, then perhaps it’s time to block out time to hang out with them. Maybe it’ll be easier to schedule one-on-one, rather than a big group outing; either way, that time with them will help reaffirm that no, things are fine.
The third is to gently redirect your anxiety away from these phantom problems. Remember what I said about how anxiety is like a working dog without a job? Well, just as with those dogs, sometimes the answer is to give it a job. If you’re getting anxious about something, ask yourself if that’s something that’s actually happening right now? Is it something that is, absolutely, positively going on, or is it theoretical, just the potential of a problem? If the answer is “no, it’s not happening right this instant, it just might”, then you want to gently redirect your attention to something that does need to be taken care of.
Is there a deadline for a project coming up? Maybe now’s a good time to figure out how to make progress on it. Is there a call you’re not looking forward to? This is the best time to start rehearsing what you’re going to say. Finding something else to focus on, something that you can accomplish and know that you’ve avoided a problem, helps settle things down.
Remember: anxiety is just your brain trying to keep you safe, not happy. It’s about smoothing the way forward and avoiding problems. By finding other things to do or problems to solve, you help keep it occupied and – importantly – allow it to do its job. Yeah, I know; it sounds like weird woo-woo s--t. But trust me: it works. The key isn’t to try to make the anxiety go away, it’s to give it a useful focus until the moment fades.
And by being more in tune with your feelings, being more mindful of what you’re feeling and why, you actually reduce the amount of anxiety you experience because you are giving yourself to address the underlying causes in a productive manner, instead of just freaking yourself out for no good reason.
Good luck.
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Please send your questions to Dr. NerdLove at his website (www.doctornerdlove.com/contact); or to his email, doc@doctornerdlove.com