Anxiety, Panic, and the Fear Center

Beyond Blue reader Kay e-mailed me just before Christmas to ask me to address panic and anxiety.

I feel blessed to have had a few months now without that dreadful knot in your stomach—actually I think of it as more of a croissant (it’s French and has attitude).

But, oh, I know that feeling all too well.

About ten months ago I visited a good college friend over St. Patrick’s Day weekend. The day after I got back, I experienced bouts of anxiety just like the kind I did very early in my recovery (like the weeks after I was in the hospital). I was so scared that I was going there again.

I thought I’d share with you the post that I wrote then, because it holds true for today. When I experience bouts of anxiety I like to pretend that I'm a newspaper reporter and figure out what, exactly, it is that is baking the croissant, and see if I can throw it away or hurl it at somebody.

I analyze my recovery program: Am I eating healthy? (HA!) Am I sleeping 8 hours consistently? Is my schedule off? Have I been exercising? Am I worried about something, or reacting to a recent conversation?

If the clues point to a source, then I go to that source and tell it off, or do something about it. But many times I can’t figure out why, all of a sudden, I’m hit in the face with the croissant.

Either way, I remember my FEAR CENTER. That’s the amygdala—the cluster of cells in the brain responsible for worrying. It has just posted signs for a toga party. I simply have to go there, to my amygdala, and tell it that parties aren’t allowed. I do that in a variety of ways (which I get to in the following piece).

Here’s my post from last March. I hope this helps, Kay!

I have ten topics in mind that I want to write about right now: the value of humor, not taking things personally, the relationship between food and mood. But those are just ways to avoid what I'm really feeling at this moment: anxiety and the fear of returning to the black hole.

Today is the first time in over six months that I woke up with that horrible knot in my stomach--the kind that, I suspect, a priest or sister might feel after robbing a bank. It's like guilt in that I'm convinced it's the result of a recent action, something bad I did. Yet, after searching my conscience, I fail to arrive at any major crime or sin (though there are plenty of little ones).

Early in my recovery I would take a sedative (or ten) on mornings like these, because a tiny seed of agitation was enough to turn and twist my thoughts into layers and layers of distortions, totally disabling me. Before long I'd be shaking nervously, unable to drive my car or load the dishwasher without holding onto something for balance.

Now I try to catch the anxiety in its birth, before it persuades my mind, body, and spirit to collaborate with it. I remember what positive psychologists like Dan Baker and Martin Seligman and neuroscientists like Joseph LeDoux say about a human being's "fear system," generated by that delinquent cluster of brain tissue called the amygdala, which sends messages of panic from my left toenail to my right eyebrow.

I put both index fingers into my ears and shout, "Liar, Liar, Pants on Fire." And I wait for the more nuanced, intellectual part of my brain to help me sort out the issue.

So that's what I'm doing right now. Having a conversation with the Harvard-educated part of my brain, which is assisting me in analyzing what is triggering such angst, and which instruments in my recovery toolbox I need to pull out in order to whack the sucker over the top of the head so he doesn't start pulling me into that deep, dark abyss.

I have plenty of suspects:

• The argument I had with my best friend right before I left to visit her for the weekend: I regret what I said even though expressing my frustration seemed the right thing to do. Still, I absolutely despise all confrontation and the awkwardness that accompanies it. I'm wondering if this is just a natural stage in the progression of a close friendship, or if we have issues we need to work out. (Do friends go to therapy together like couples do? Why does every single part of my life require therapy? Enough of therapy!)

• Without kids for the first time in a year this weekend, I slept through the night. Twice in a row. Which could have clued my body in on the fact that it's getting way ripped off in the sleep category and should demand more.

• The two and a half weeks before my weekend away, I stayed up past midnight almost every night to work because the sitters were on spring break. Thus, my current depression might be a kind of physiological meltdown once my body was allowed to rest. (This morning I didn't want to get out of bed.)

• Any breaks in my routine--even good ones--and traveling always cause me anxiety.

• I returned after a small break to my usual load of responsibilities, and am feeling somewhat overwhelmed by it (two weeks of newspapers to read, days of e-mails to return, extra attention to give the kids).

• My diet is off. I pigged out over the last three days because I was feeling bad about the fight. I broke my sweets rule, and munched as many cookies as were available.

• I got on the scale and saw I gained five pounds. (That causes panic in itself.)

Okay, now that I have identified the anxiety manufacturers--the likely contributors to my nervousness right now--here is my game plan:

• Continue with my day as if I'm not feeling any angst. Write my blog (this post) with the confidence of a woman not scared to death of a breakdown.

• Work out extra hard today--giving my brain an extra squirt of endorphins, and burning off some of the extra calories consumed this weekend.

• Go to the grocery store--buy plenty of fruits, veggies, whole grains, and protein. Eliminate sweets today and tomorrow. (Sugar highs always crash in depression or irritability. Like knowing that will really help me skip the cookies....)

• Get back to a regular sleep pattern--aiming for eight hours at night. Call a few more sitters to get extra hours if I don't have enough to cover my work so that I don't have to stay up this week. I'm in fragile land, which means I can't push it.

• Cut back on caffeine. Limit myself to two or three cups of coffee this week. Try to get down to two cups a day next week.

• Decompress for at least fifteen minutes today--time reserved for reading or journaling or sitting by the water, or zoning out.

• Don't try to meditate today.

• Check in with a fellow depressive or friend (Call Mike. Tell him I'm starting to freak out. He will set me straight. As always.)

• Take out my medal of St. Therese--my security object--and finger it every time my breath gets shallow.

• Remember what my doctor said: It is normal to be scared when experiencing anxiety or depression in the months that follow a severe depression--that the more days of recovery I get, the more confident I will become that periods of unease aren't necessarily signaling a major relapse.

Aah. That feels good. I'm already feeling better.

And I will feel even better after I finish visualizing smashing the almond-shaped brain tissue (the amygdala) responsible for my present panic with my medal of St. Therese. Because my faith is ultimately the best weapon against that fear-inducing scoundrel.

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