tired of panic attacks

I had a panic attack tonight during what was supposed to be a five minute trip to the grocery store. It was pretty shocking to me, and I don't really know why. There has been so much going on over the past month - the panic attack I had at the movies that I talked about in my last post, Thanksgiving, people visiting, holiday parties to attend, holiday gifts to buy, etc. I know I've been stressing more than usual, so it's not that surprising that this would happen.

Still, it seemed like it came out of nowhere. I left my house feeling absolutely fine. When I walked into the store, I noticed I was beginning to feel kind of weird and unwell, and I thought "well, that sucks, but oh well, I'll only be here about five minutes, no big deal." I only needed to get five things. I got the first item and was on my way to get the second when I started feeling what I interpreted as waves of nausea, although they might have been waves of panic. They were really intense, and after the third or fourth one, I was convinced I had gotten sick and was going to vomit in the store. Sometimes I think about how if this ever actually happened to me, I would have to explain to the people around me, "I know I should have noticed what was happening, but I have this phobia, so I try to ignore sick feelings" and how they wouldn't get it at all. Which is a terrible thought and only makes me more panicked, but whenever I get to that point where I really start to believe what's happening is real and not anxiety, it pops into my head.

Anyway, I immediately walked out of the store, leaving my basket with my one item in it on the floor somewhere along the way. I went back to the car and sat in it, trying to calm down enough to go back inside. I was determined not to leave. I sat there for probably ten to fifteen minutes, thinking things like, "you are going to go back inside. If you don't go back inside, I will be so pissed."

(By the way, word of advice: don't be as hard on yourself as I am. It's definitely not helpful.)

I wasn't feeling much better though, and I couldn't convince myself to get out of the car again. I finally gave up and drove back home. I took my temperature, even though I knew what the outcome would be - as usual, no fever, nothing wrong with me, all in my head. I knew because of how much better I felt as soon as I walked in the house. It restored my confidence, and I then drove back to the store and had the quick uneventful shopping trip I had originally been expecting.

Well, that's not entirely true. When I got in the checkout line, the person in front of me was buying a green pepper, and the cashier couldn't figure out how much it cost. The confusion went on for a while, and I was on edge and wanting to get out of there as soon as possible to avoid anything else bad happening. Not knowing exactly how much longer I was going to have to stand there, I experienced another wave of panic/nausea. But there was no way I could leave the store then without having people notice and question me, because I had already put my items on the belt. So I mustered up every bit of thought-control ability I have and willed myself not to think anything related to being trapped there or possibly being sick or anxiety or how much longer it would be. I stared at magazines and tried to clear my mind as much as possible. I wasn't entirely successful at doing so, but I kept myself calm enough to get through the next few minutes until I could leave.

As awful as it all was, I did feel very proud walking out of the store with my bags of food, almost deliriously victorious. It was like anxiety was an external opponent I had beaten, and I felt like laughing (in its face) or shouting "HA!" or something like that. "I got what I needed, what are you gonna do about it now?"

I'm tired of this though, really tired. It might be time to start doing daily meditation again, at least for a while.         

high-anxiety week

I am having a high-anxiety week, and it's been pretty unpleasant. Yesterday I went to a movie and had a panic attack during it. I wanted to get through it without leaving the theater, but it got to be more than I felt like I could handle. So I went to the bathroom and stood in a stall until I stopped shaking and feeling so "sick."

It was the movie itself that actually set off the attack. Since the events of 2010, I have had a hard time distancing myself from stories the way I used to be able to. Especially during times when my (baseline) anxiety is high for whatever reason. An emotionally charged scene of a movie (or part of a book) can then make my anxiety spike. Of course, that almost always manifests as feeling, or imagining I feel, nauseous.

I had also felt "sick"/anxious the day before the movie. Today was better, at least the morning. In the evening, I again felt "nauseous" and freaked out a little about it.

I hope this bad period ends soon. I think I must sometimes come across as the Pollyanna of emetophobia, because I try so hard to be positive/upbeat in this blog. In my experience, that's what helps the most - negativity leads to me feeling much worse. But that positivity doesn't always come right away. It takes effort, and sometimes I need a few days. Sometimes I don't even believe what I'm saying as I'm saying it, but it still helps to write it and have that positive viewpoint to go back to later.

I walked out of that movie so angry at myself and at the situation that I had to fight to keep from crying. I knew that by retreating to the bathroom temporarily, I had let the anxiety win a battle, and even though I still believe I am winning the overall war, I hated that.

So I am still pulling myself together right now, trying to get some perspective on this incident. I wish I could figure out a way to get back to having normal reactions to books/movies. It bothers me to be unable to tap into my emotions without the risk of them becoming out of control.

I will say, in the spirit of positivity, that I am sure this is just an off week and not a sign that I have stopped progressing or am getting worse. It also really drove home how well I have been doing, and I was reminded that it's been a long time since my anxiety problems led me to feelings of complete despair and hopelessness. Comparatively, a few days of frustration and self-criticism don't seem so bad.      

must check temperature now

I had a dentist appointment today and wasn't feeling well in the hours leading up to it. I actually drove to the pharmacy down the street just to buy some of those disposable covers for thermometers so that I could take my temperature and reassure myself I wasn't sick.

As I got out of the car and walked up to the store, it hit me how ridiculous I was being. Would someone who was sick with a fever really have the energy to run a quick errand and remember to grab a CD before they left and be singing along with the music on the way? Even if they did, they'd certainly feel worse by the time they got there, and I felt much better (I'm assuming because I was taking action to solve my non-existent problem).

On top of that, my car's "check tire pressure" light was on, and it probably would have been a better use of my time if I had added some minutes to my for-emergencies cell phone in case I had a tire problem on the very long drive to the dentist. Because let's face it, that was much more likely to happen than me getting sick during my dentist appointment.

Not my most rational moment. Luckily, I did not have any car trouble. Or a fever.

Anyway, aside from minor crazy behaviors like the above, I have been doing well. Very little anxiety. Life is good.

Hope everyone else is doing good too!    

two years

Today's the anniversary of my "breakdown." Actually, I guess it really started the night before with the first of the panic attacks, but this was the date where I was in the hospital all day, so I consider this to be The Infamous Day.

I never thought I would feel like myself again, but I do. I can now say I feel like my anxiety is under control, at least as much as it can be while still having a phobia. It's just exhilarating to know that. Two years ago I was such a mess, and I had never imagined that things could get that bad. And then I couldn't imagine that they would ever get this good again either.

In celebration of this, I'm posting the timeline of my improvement. This is pretty much how the last two years went:

September 10, 2010: I was in the hospital most of the day discussing my non-stop panic attacks with various people. Then they gave me Ativan, and I went home and took that immediately, and then one or two other times in the next few days.

September 11-19: I went to the doctor three times. The first time I was given Lexapro, which made me feel sick, so I only took it once. The second time I got my thyroid tested (problems with it can cause anxiety issues), and nothing was wrong with it. The third time I was given Cymbalta, and I only took that once too. It didn't make me feel sick, but it did have minor side effects that bothered me (like restless legs).

I missed a lot of work. I couldn't eat or drink much. Everything I ate made me feel nauseous; I was taking a lot of Zofran during this time. I couldn't sleep and basically spent every night in the living room, dozing with the TV on.

I started seeing a therapist and doing breathing exercises, and I listened to a guided meditation CD every day and tried to meditate as much as possible. It was not something I had done much in the past, but it helped immensely anyway. Just made me feel temporarily calmer.

September 26: I started working through The Anxiety & Phobia Workbook. I know I've talked about it a lot, but I'll say it again. It's an amazing book. It helped me so much.

October 5: I joined a gym and started exercising more to see if that would help. It does help, but I still have a hard time sticking with the habit, even now.

October 8: By this point I was doing word searches almost constantly, especially when I woke up in the middle of the night (which was almost every night). They really helped me calm down when I was anxious.

October 16: I wouldn't let myself watch anything (on TV or in movies), read anything, think about anything upsetting or anxiety-producing. I felt frustrated by having to hide from negativity, but now I think it was the right thing to do. It helped me get better faster, and obviously I no longer have to do it. But I still don't watch horror movies. I used to watch them all the time and now don't let myself, because they have too much of an effect on me.

October 20: I had gotten a little notebook and was writing out affirmations in it every day. I would pick one from The Anxiety & Phobia Workbook and write it out five to ten times in a row, pausing in between to reflect on what it was saying and really try to believe it. I did this at least once a day, but more if I was really anxious. It was another activity that calmed me down.

December 4: I started noticing that PMS always made my anxiety issues much worse. I began reminding myself of this every month around that time so that I wouldn't take my thoughts and feelings so seriously.

February 3, 2011: I started doing yoga. I don't do it much anymore, but it was helpful and calming at the time. 

April 30: I printed out some of my favorite affirmations and would tape one to the wall above my desk so that I'd be reminded of it frequently throughout the day. Every so often, I'd switch to a new one. 

May 9: I was still seeing that my anxiety got significantly worse and hard to deal with during PMS, so I started taking 100mg of B6 daily (on top of a multivitamin) to help with that. It seemed to work wonders (after a couple months I think). I still take it. 

July 23 - 26: I started having bad panic attacks again. It felt like a repeat of the initial "breakdown" only to a much lesser degree. But again, it was extremely difficult to eat or drink for a few days, and I felt horrible all the time. I'm not sure what caused this relapse, but I got it under control much faster than I had the first time, mostly through forcing myself to eat as much as possible, which kept me somewhat stable. This gave me hope that I was moving in the right direction. 

August 29: I started taking a class at a college nearby. This forced me out of the house on a regular basis, forced me to interact with the world again, which was something I really needed. I had gotten pretty homebound. 

September 10: I tried hypnosis for the first (and only) time. I felt slightly better for a few days after it, but I have no idea if it was the hypnosis that caused this. Or the placebo effect. Or coincidence. 

November 22: I took a trip to see my family for Thanksgiving. This was very stressful and didn't go as well as I had hoped. Again, I had problems eating, drinking, and sleeping. I felt sick almost constantly. But I did manage to get through it without any medication (psychiatric or anti-emetic). I used affirmations that I had written out on index cards and the EmWave2 I had just gotten.

February 19, 2012: I did an online emetophobia study which started around this time. It involved a lot of CBT and exposure work that was helpful.

May 1: I stopped going to therapy, because I felt pretty confident that I knew what to do when I was anxious. Most of the time I could calm myself down by countering my negative thoughts and focusing on more positive ones.

That's about it. I've been doing really well this year. Basically, the Thanksgiving trip was the last "crisis" period I had, and I am sure that if I took that trip again this November, it would go a lot better.

Speaking of trips, I am taking a small one later this month. I won't even be leaving the state, but I will be staying in a hotel in another city. I'm excited. For the first time in a long time, I feel excited about a trip. I'm not dreading it! I think it's going to go really well and be loads of fun.

doctor

I went to the doctor for a check-up last week. And survived! I was extremely nervous before and during it, but it all turned out fine. I even got a vaccination that I needed, one that supposedly can cause nausea or vomiting (a 1 in 10 chance). No problems with that either.

I was anxious that I would be part of the 10%, but I know there was no reason to be. I have never had any issues with vaccinations or medications in the past (being allergic to them, having bad reactions). Not to mention the fact that probably most of the 10% felt nauseous but didn't vomit (since the stats combined the two side effects), or they allowed themselves to vomit when they felt nauseous because they aren't afraid of it.

I'm super proud of myself for forcing myself to do this. And the best part is that now I won't have to do it again for one to two years! I'm leaning towards two. 

self-healing rituals

Most people have heard of the placebo effect. A person is given a fake cure for some ailment, but it actually does make them feel better, because they believe it will work. Usually the person receiving the placebo doesn't know it's a placebo. They think they are getting real medicine (or surgery).

But some studies have shown that placebos can work even on people who know they are taking a placebo. This article from NPR gives more information. The theory as to why this works is that taking the medicine or having the surgery creates a "self-healing ritual" - which is just another way of saying that you're taking action to fix the problem. Your mind is aware of that, and then both your mind and body "expect" that this action will have good results. So it does.

A.J. Jacobs talks about this effect in his book Drop Dead Healthy:

"You could view placebos as depressing, I suppose. So much of medicine is a sham. Your brain is a three-card monte dealer running cons on the rest of your body. But I don't see it that way. I find placebos uplifting and exhilarating. It means that taking action - no matter what that action is - might help you feel better. The key is just to get your aching butt off the couch."

I'm not saying placebos are all you ever need to be healthy. When it comes to more serious illnesses, actual medicine would be necessary (although optimism - believing you will get better - is always a good thing). But for something like emetophobia, or any other kind of health anxiety, or even problems like IBS or chronic pain syndrome (that have been shown to improve using psychological treatment), I think self-healing rituals are extremely important.

I remember that when I started having those horrible panic attacks two years ago, I felt anxious almost constantly. It was like my brain was full of it, like I was always on the verge of hysteria - except when:

• I went to the hospital. On the drive there, in the waiting room, explaining how I felt to various doctors. I felt calmer this entire time - still not normal, but much better. I trusted that they would make me feel better. (It's been said that even seeing the usual attire of a doctor creates a placebo effect.)
• I went to the doctor to discuss trying psychiatric medication.
• I went to the pharmacy to pick up the medication. This one I remember the most. Even now, whenever I drive by that particular pharmacy, I feel my spirits lift a little, remembering how it was a beacon of hope for me at that moment. Even though I hated the medication and didn't continue taking it, I was so relieved at that time to have it as an option. I can see why many people believe medication is a quick fix. I told myself over and over that this wasn't true, but your desperation overshadows what you know.

Once all this was behind me, I realized there would be no quick fix, and I would need to keep working very hard on my own. I kept creating my own self-healing rituals: meditating every day for a certain amount of time, writing out affirmations over and over in a little notebook, and (my favorite, in terms of making me feel more hopeful) flipping through The Anxiety & Phobia Workbook and reminding myself that there were more things to try if what I was doing didn't work - that there was even the possibility that combining certain approaches would work best, which meant there were almost unlimited options.

So I am in total agreement with A.J. Jacobs when he says that taking any action can help - and that this concept is extremely uplifting. Anxiety can feel like it is paralyzing you, but taking steps, even small steps, to conquer it can be a powerful "weapon" in itself.

movie scenes

I didn't write about it at the time, but a few months ago, I finally decided to sit down and force myself to watch some movie vomit scenes I usually avoid. I had seen most of them, but I tend to hide even from those I've already seen by covering my face or leaving the room, just because they make me uncomfortable. But two scenes I saw for the first time, the scene from Drop Dead Gorgeous and the scene from Bridesmaids. I had heard about how graphic these scenes were from other people before seeing the movies, so I made sure to always leave during them.

The Bridesmaids one in particular has already become a frequent mention on emetophobia forums. I've seen a bunch of threads talking about how awful it is, other people disagreeing and saying it's funny, debates starting about whether vomit should ever be shown on TV or in movies.

Of course it should. I may sit around at home and complain about it and get really angry and say it's completely unnecessary. But so is everything else in shows/movies. I'm choosing to watch, and I know what I'm getting myself into. There's no way of knowing what will pop up. I also don't particularly like excessive gore. And I hate how movies about babies almost always include some disgusting poop-related scene. Oh well. Other people like those things and think they add to the drama and/or comedy. Vomit is a somewhat extreme act that can be used for either purpose. Of course they're going to keep taking advantage of that. It's up to me to desensitize myself as much as possible.

I was pretty surprised at how nervous I was. I watched the scenes without any volume at first. Which I would highly recommend, because that made them totally manageable. Once I had seen everything that happened without having heard any of it, I watched them again with a little volume, and then a few more times with normal volume. They were definitely unpleasant. I can't say I ever enjoyed them (even the Bridesmaids one - I didn't think it was that funny), but it was easy to get to the point where I could tolerate them.

With new movies/shows, I won't be prepared. I won't know when the scene is, and I may not have heard the basics of what happens. And a lot of times they like to surprise you when it comes to vomit, to have it come out of nowhere. But I feel like this desensitization exercise has a broader effect than you would think. I haven't been flinching as much when I encounter new TV/movie vomit.

It also helps (with vomit, gore, any gross thing in movies) to remind yourself every time that it's fake. Of course you already know that, but actually thinking about how they did it takes away much of the ickiness. I don't know what they use to make movie vomit, but I'm guessing it's usually some mixture of food. This website talks about how they use a vomit machine to project tomato soup in one movie.

Plus with Drop Dead Gorgeous, Denise Richards is in it, and knowing that she has emetophobia makes me feel oddly comforted about the scene in that movie. I guess it's knowing that someone is involved who understands how I feel (although I don't think she is actually in the vomit scene). Who knows? This may be true of other actors/actresses as well, and they just haven't come forward about it yet. 

"it's different this time"

This is usually how one of my emetophobic anxiety attacks plays out.

I notice something happening in my stomach. This leads me to think/say "I don't feel well."

I try to pinpoint the cause. In fact, I want to know the exact cause, which then leads to frustration, because that's almost always impossible. If I ate three different things an hour ago, I might spend way too much time and brainpower arguing with myself about which of the three things would be the most likely to make my stomach hurt.

I start assessing how bad the unpleasant feeling is. This is where things can quickly spin out of control. It doesn't really matter how bad the feeling is - what matters is how anxious I am. If I'm not careful, if I don't do something to try to calm down, I will soon arrive at the conclusion that this feeling is somehow different than any stomach-related feeling I have ever had before in my life. It's more severe, or it's in a different part of the stomach, or it feels like there's more _____ this time (churning, bubbling, flipping, whatever).

"It's different this time" - four words that I should never say, but I say them far too frequently. Other variations: "this feels different" or "what if this is something different?"

Sometimes it's not even the feeling itself that leads me to this "conclusion." Sometimes it's that I feel I was exposed to some illness a couple days ago, so this feeling MUST be related to that and therefore, it's different, where "different" really means "the moment I'm finally going to get sick."

From looking around at emetophobia blogs and forums, I can tell this thought is not unique to me. It seems like most, if not all, emetophobics get hung up on this idea of stomach pain being "different this time."

Maybe it's not only emetophobics, but all people with anxiety. One of the main cognitive distortions an anxious person will struggle with is catastrophizing, and if you are telling yourself "it's different this time" you are catastrophizing. Instantly you have changed something that is benign/harmless to something huge and scary. You have taken something you can handle, something you are familiar with (stomach pain for emetophobics, a panic attack for those with panic disorder, etc.) and made yourself believe it is unfamiliar and unmanageable.

You're basically saying "though every other time has been fine, this time I am clearly in great danger." Even if you don't fully believe that, that's the message you are reinforcing with your words, and it will only lead to more anxiety.

It seems like emetophobics have a kind of amnesia when it comes to their stomachs. With all the times in my life I have felt "sick," and all the times I have thought or said that what I was feeling was different than anything I had felt before, it's impossible that I could be right all those times. There isn't an unlimited number of unpleasant stomach sensations. If I am able to calm down some and then reassess, it's rare that I still believe it is a brand new feeling.

I think this irrational thought is one of the most harmful for me, so I have been putting a lot of effort into correcting myself whenever I catch myself thinking or saying it.

It is not different this time.
The truth is, I have been through this many, many times before.
I have had this same feeling at some point in the past and lived through it.
I know I can handle this. I'm practically an expert.
This feeling will pass.

regressing

The person I was going to meet for dinner cancelled, as they ended up not having enough time during their vacation to make the long drive over to my area. I can't say I wasn't partially relieved. I had been stressing about it every day. But at the same time, it would have been nice to prove to myself that I could get through a situation like that.

Then last weekend a friend came to visit and stayed with us. I had so much fun hanging out with him, but my anxiety spiked. Which was both surprising (because I'm close to and comfortable with this friend) and annoying.

We went on nature walks, and because it was hot, I worried I would get heat stroke and throw up. Or I worried I was overexerting myself, and that would make me sick. We went out to eat twice. The first time (breakfast) was absolutely fine, but the second time (dinner) I wasn't hungry, probably due to anxiety, and I was anxious that this meant I was getting sick and would throw up. We did a bunch of other things too. By the end of the day I was exhausted - it was more activity than I am used to - and then I worried I was sick because I felt tired! I had to repeat affirmations in my head in order to fall asleep and then woke up in a half-asleep panic at around 2 in the morning, feeling "sick" and trying to figure out where I could go to be sick in private, if it was going to happen.

I hardly ever wake up feeling like this anymore.

I feel like I've hit some kind of wall. I don't experience much anxiety anymore, but I guess it's only because I feel safe, because I'm only hanging out on a "narrow strip" of my room, as Rilke would say. I don't expect these (pretty minor) challenges to throw me so much, because I'm feeling so great most of the time. I really need to find more things to do around here that put me in situations where I am uncomfortable. I hate to think this is as good as it gets. I want to be able to go into any situation without returning to the mess I used to be.

making plans

I've been noticing that I'm afraid of making plans. I've pretty much always been that way. I hate telling someone days or weeks in advance that I'll meet them at [insert time] at [insert place], preferring to either have more casual (non-)plans or to make plans at the last minute. I think this is a result of the anxiety I've always had and knowing that if I make set-in-stone decisions it's harder to undo them later when I become too anxious to follow through. This has happened several times, and it's difficult and embarrassing to get yourself out of something you've already committed to. At a certain point I just started thinking 'I'll probably end up chickening out anyway, why bother?' and I still have that mentality.

It's clearly not leading me anywhere good. For one thing, most of the time I immediately decline invitations, not even wanting to get into the whole back-and-forth 'should I, should I not, what if' cycle of thinking. Then I end up missing out on a lot of potentially fun and/or rewarding experiences, sometimes even beating myself up about it or feeling plagued with regret. It's not even usually regret about any one specific outing, more a cumulative regret at this point, a feeling that I am missing out on almost everything.

Also, not-making-the-decisions becomes a strong habit. When I do agree to hang out with someone, I hem and haw about the specifics, asking them what they want to do, where they want to go, etc. until they have made all the plans and I end up in a situation even more unpleasant. Until recently, it never even occurred to me that I could take matters into my own hands and suggest times/places that would be more comfortable for me. Just the idea of doing so still makes me feel guilty, like it's wrong for me to be allowed to make choices.

I've been trying to stay aware of all this, and today a situation presented itself that gave me the perfect opportunity to break my habit. Someone I know (although not that well) is taking a vacation next week and will be close to where I live. So they emailed me and asked if we could get together one evening.

My first thought was 'there's no way I could handle that, I've got to think of some way out of it.' After I talked myself past that, I wrote her back saying yes and asking what she wanted to do (the habit takes control yet again). Finally, I sent a second response with a specific restaurant where we could meet. It's a place I've been many times, so I know how to get there, what I could eat there, and that I'll feel more relaxed in general being in a familiar setting. Better able to handle any anxiety brought on by the food or socializing.

This seems like such an effective strategy, I don't know why it took me so long to realize it and start taking advantage of it. Now I won't have to spend the next week looking up directions, taking practice drives, or obsessing over an online menu, trying to find the perfect "safe" dish. Not that I should be doing any of those things anyway, but it's nice to be able to take something extremely stressful and overwhelming and turn it into something slightly more manageable, even if it will still be a challenge.     

accomplishments

I finally did it. I made a doctor's appointment for a check-up. It's at the end of August, and I'm already really worried about it. I can't even put my finger on why exactly, but I guess it's a fear that I'll find out I have some horrible health problem. Or that I have one, but it won't be identified, because I will forget to bring something up or describe something incorrectly. I feel like I should make some long list of all my concerns to take with me, so I don't forget anything. But that would probably be annoying, huh?

I also have been trying to take better care of myself physically - exercising and eating healthy. I wouldn't say I'm doing either enough, but I'm keeping it in mind as a constant goal, and I have been doing better than usual. Last Friday I took the day off work and dedicated the day to relaxation. I didn't speak all day (just thought it'd be nice to have an atmosphere of absolute quiet). I tried to eat all my meals mindfully. I took a long walk around town (it was a gorgeous sunny day) and then did about 45 minutes of yoga. I worked on some writing projects and then later that evening, I listened to my meditation CD. It was the perfect vacation day.

Then over the weekend, I went to see the new Pixar movie Brave. There were of course children in the theater, and as a general rule, I try to stay away from them. They scare me quite a bit, because I see them as being constantly sick. Seriously, it seems like my (almost 2 year old) nephew is sick with something different every single week, sometimes things I have never heard of. But I was able to handle the movie without feeling much extra anxiety. I tensed up slightly every time one of the children walked by me and kind of leaned away from them. That was about it. The movie was incredible, by the way. It was the best kids' movie I've seen in a long time.

After the movie, I went out to eat at a restaurant I've only been to once before. I was really hungry and ate a lot, including dessert. I only had a little anxiety, and it was in the car after leaving, when I realized how full I felt. But it (the anxiety) passed quickly.

I'm so happy with all of this. I feel like I'm doing really well, other than freaking out about the doctor's appointment. It's not for a while, which could either mean I have plenty of time to calm down about it or that I have plenty of time to get more and more anxious. Of course, that's up to me and what I choose to think, so... time for affirmations! 

blah

I haven't had that much emetophobic anxiety lately. I even went out to dinner recently and ate until I was overly full and didn't feel the slightest bit worried about it. I can't remember the last time that happened. So there's the good news.

But I've been having tons of anxiety about my health in general. I keep noticing little aches and pains and feeling like there is something wrong with me. Plus I feel low-energy. All of this could, of course, be caused by anxiety and anxiety alone. But how can I know for sure? I can't. I can't know anything for sure, and my refusal to accept this is basically the root of all my problems.

My only option really is to start up an anxiety-fighting regimen again to see if that makes me feel any better physically. I think the main area I need to focus on is exercise. But I also bought a CD player for the bedroom so that I can listen to guided meditation CDs in there, away from distractions (naughty cat, TV, noisy air conditioner).

And I'm trying to work up the courage to make a doctor's appointment. This was one of my New Year's resolutions, to get a check-up this summer, and now it's summer, but I've yet to make the appointment. It'd be nice to be officially told there is nothing wrong with me, and then I'll have that as ammunition against all these irrational thoughts.

signs of emetophobia as a child

I haven't ever known someone else with emetophobia in my "real life" (offline). I did have a strange indirect encounter with it several years ago when I happened to hear one of my bosses talking on the phone about her seven year old niece being hospitalized for refusing to eat while sick, because she was terrified of vomiting.

I don't really like telling people about my phobia in detail, and it especially seemed weird to tell my boss, but after hearing that, I couldn't resist emailing her and attaching some websites with more information. She thanked me for the information and said she would pass it on to the girl's mother. We never talked about it after that (which was a relief to me), so I don't know what happened with the girl, but I hope that if she did have the phobia, she got help for it early on. I know from experience that it only gets worse and more ingrained as you get older - you keep developing more and more avoidance behaviors.

I can think of so many obvious red flags from when I was younger that I'm sometimes shocked my family missed them:

• The biggest one, of course, being that whenever someone around me vomited, I would become upset or panicked. When I was very young, this usually bordered on hysteria. I can remember one time in a restaurant where I catapulted over a chair and ran out of the building to escape (and refused to go back in). As I got older, I tried to hide the response more, but I still would usually walk away quickly, avoid looking at the person, and then get extremely upset if I had to be in a confined space with them. I would try not to breathe or would bury my face in something thinking that might protect me from the germs. I would cry or sulk. Sometimes I would get really angry and be hostile to everyone around me.
• There was a time period (not sure how long it lasted) where I decided it was not safe to touch my food at all and would lift my plate or bowl to my mouth and eat like an animal.
• If anyone in the house was sick, I stayed in my room as much as possible. I tried to eat very little. I would sneak "safe food" into my room like individually wrapped packs of crackers. I was afraid to use the bathroom where someone had vomited, which usually meant I would start using my parents' bathroom, because the sick person was almost always one of my sisters.
• I can remember at least a couple freak-outs over me getting a little food stuck in my throat. It wasn't even enough to make me cough, but I still feared it meant I was choking, and that could lead to vomiting. One day my mom explained to me that I wouldn't be able to breathe or talk if I was choking, so then those panics stopped.
• I became extremely opposed to taking vacations with my family, because someone would usually get sick on them. When I vomited last, I was on one of these vacations. I also once had to spend eight hours in a car with my family after one of my sisters had almost vomited that morning.
• I would miss school because of my stomach hurting. From second to fourth grade, this happened rarely, about twice a year. In fifth grade, I had a period of about two weeks where I went home or stayed home every day. Each time I tried to go back, my stomach would hurt again as soon as I got into class, and I would have to leave. Since I was perfectly healthy, people were all over me asking what was "really" wrong, but I didn't know what to tell them, because I had no knowledge of anxiety at that point. In the years after that, I still sometimes went home "sick" because of panicking about something I imagined I felt, but never that many days in a row. I would say it was probably about seven days a year, spread out.

Those are all the signs I see looking back, and I imagine they'd be similar for any child developing this phobia. Not that I'm in a position to give parenting advice, but I would hope that any parent who saw their child exhibiting such irrational and anxious behavior would sit down with them and try to talk to them about it. And then if it does turn out that they fear vomiting, get them some counseling. I'm sure it's much easier to get something like this under control at a young age, maybe even cure it completely.     

dentist anxiety

I had to go to the dentist today to get some filling work done. They gave me a tiny partial filling in one tooth, and they also removed a filling I got when I was a child (one of those old mercury ones) and replaced it with the upgraded version.

I'm surprised at how anxious I was. This procedure was nothing compared to the wisdom teeth extraction, but for some reason I had lower anxiety during that one. Maybe just because I had lower anxiety in general back then.

I wish I was more comfortable talking to people (like dentists, doctors) about my phobia. I always think to myself that maybe I should give some brief explanation before they do whatever they're going to do, but I usually chicken out. They see I'm anxious, but they assume it's because of the pain, so that's what they reassure me about. I don't worry about the pain that much. I worry about all the objects and substances being shoved in my mouth, especially the substances. I worry about my mouth being numb. I also don't like being horizontal while they're doing all this, and I really hate it when they adjust the chair to the point where my head is lower than the rest of my body. It's awful to feel like you're upside down when you're anxious.

There were all these nasty tastes in my mouth after a while, and I could feel myself getting very scared. I was starting to feel "sick" and could feel my heart pounding in my stomach. Sometimes (here being a good example) I'm almost grateful for my social anxiety, because I fear that without it I would be much more likely to escape situations, to sit up right in the middle of my filling and say "okay, I'm done here." But I don't want to embarrass myself, so I search around desperately for things to tell myself to make myself stay, like:

• They do this procedure all the time. They can't possibly expect that whatever they are putting in my mouth would cause nausea/vomiting. If they did, they would have something ready in case of that happening. They would have warned me.
• My heart is pounding. This is clearly anxiety. Don't forget to keep breathing, slowly and calmly.
• Even if I did vomit, it's not as though this is a normal public place, like a mall. It's like a doctor's office. I wouldn't have to feel as humiliated about it here.

If I can visualize my mouth as disconnected from the rest of my body, it's easier. All the numbness and drilling and other stuff is going on there, not anywhere else. I can use my nose for breathing. I don't have to swallow. I just pretend it's not a part of me, or at least not a part that I need for the moment.

The procedure only took about fifteen minutes. When I sat up at the end, I discovered I was really shaky, so walking out to the car felt weird. Also, once I started driving, I started feeling even more "sick" and had to pull into a parking lot and sit for ten minutes to calm down. I had a bottle of water and probably would have felt better if I had rinsed out my mouth, but there's the downside of the social anxiety. I couldn't talk myself into doing that where other people could possibly see me. So I just took sips of the water instead, which helped a lot. Every time I swallowed a little water, the sick feeling went away temporarily, so I started driving again and kept taking sips all the way home. By the time I got there, I was feeling better.

I know I should be proud of myself for getting through it. I won't have to worry about it anymore, and it's nice to know I no longer have mercury in my mouth. But man. Right now I just feel wiped out. Anxiety is exhausting.

defeating the health anxiety (again)

Last week I noticed a dull pain/ache in my stomach/abdomen area. My first response to something like that is always to try to ignore it. But it persisted for a couple days, and then I started getting really worried about it. I broke all my rules. I did an online search for my symptoms (not at first - I think I held out for at least two or three days, which admittedly is kind of pitiful). I found websites that made me think it was cancer. One of the websites even had a note advising that it was much more likely it was another smaller problem and that only 5% of cases would be cancer, but of course I kept thinking "I could be part of that 5%!"

I then spent a few more days thinking about all this information and my possible impending death, which made me into a semi-mess crying frequently over minor things. I kept mentioning the pain to my wife, and she kept making efforts to downplay it (since I was making no effort to do so myself), but I kept arguing with her about it.

I've read many articles about people who developed some serious health problem. I don't know why. I don't seek them out, but they seem to be everywhere, trying to scare people into taking better care of themselves or going to the doctor more often. I think the only effect they actually have is making anxious people more anxious. It's like those commercials for aspirin where there is a guy saying something like "I'm in great physical shape and run marathons all the time. Imagine my surprise when I had a heart attack completely out of the blue." You could be next! Buy aspirin!

Anyway, in a lot of these articles they will have a quote from the sick person talking about how they were fortunate enough to catch the problem early because they just "felt like something was wrong" and went to the doctor. No specific symptoms. They make it sound like it is just a vague sensation of something feeling different in your body. I think I even saw one article that said the sick person had dreamed about something being wrong with part of their body, which influenced them to go to the doctor, where they discovered it was true!

Do things like this actually happen, or is it just people being dramatic or trying to look like they have a special sense for detecting illness? I don't know. But, me being who I am, I got the idea in my head that it was of the utmost importance that I notice any changes in my body and take them seriously. SUPER seriously.

Well, that was a mistake. Maybe it is good advice, if you don't have anxiety. But it doesn't work for someone like me, because I am almost constantly noticing things about my body that seem "off" in some way or that I can't recall ever feeling before.

So basically, whether the advice is good or not, I need to let it go. I'm not going to be one of those "special-sense" people (if they even exist) - it's definitely not in the cards for me. All I'm going to end up doing is freaking myself out over and over and over again.

I finally managed to get past the autopilot anxiety and convince myself that worrying about the pain was in no way helpful. Worrying wasn't going to make me go to the doctor. If the pain was still there after a few weeks, I would, but not before then. I would only be making myself miserable until that point.

("I'm learning to let go of worrying. I can replace worrying with constructive action.")

So I forced myself to stop dwelling on it and distracted myself as much as possible. And a day or so after that, no more pain. Which means that not only was it not the 5% cancer, it wasn't even the 95% more benign problem. 100% nothing. Probably indigestion of some sort, made worse by my constant stress and attention to it.

It still shocks me that with all I know, I can go so wrong. Catastrophizing is a bitch.

tricks

I have been doing so well lately. I've been going out to restaurants and eating with little anxiety. I've been going other places without experiencing much anxiety. I've been eating at home even when I don't feel well, forcing myself to stick to a normal eating schedule.

I even decided to terminate therapy, because I feel like I have gotten to the point where I can handle situations on my own. Since then, I've had a few "oh god what have I done" moments of panic, but I just remind myself that I can go back if I ever need to, which brings me back to the realization that I'm doing okay without it. In fact, I think I could have stopped going a while ago, but I guess I had this fear that if I didn't show up on a regular basis and announce that I hadn't had a breakdown that month, I would jinx myself, and it would happen again. Like a fear that I was being too confident and would possibly miss signs that a professional wouldn't.

So far, so good.

I should be pushing myself more than I am, but I'm still happy with the way things are at the moment. I'm trying not to stress about any of it. In a rural area, there aren't exactly tons of ways to push yourself out of the house. I'm planning on going to a movie and lunch this weekend.

Life may not be super exciting, but I did start having an exciting new thought. I'm going to put it in the category of "positive mind tricks." By the time I hit middle school, I had come up with a bunch of thoughts I used to argue myself out of anxiety in public. They were really helpful, but I started thinking in the past couple years that maybe they weren't healthy. I don't care as much right now, because right now I'm more in the mentality of "living my life" than "step-by-step recovering." So I'm still using them. The main ones I have relied on are:

-- If I was home right now, would I still be feeling this way? When I was younger, I pretty much only felt "sick" if I was out in public, so most of the time, this question was all I needed.

-- If I was home right now, would feeling this way be bothering me as much? Kind of the same thing. It helped clue me in to what I was feeling specifically. If it was hunger, envisioning myself at home with the feeling would help me realize it was hunger.

-- Does the thought of leaving right now, immediately, make me feel any better? Why yes, it does. Look at that. Anxiety. Sometimes I would even test this by going outside or to the bathroom for a few minutes, and I would instantly feel much better, giving me the courage to go back.

-- Is anything else making me feel better? Sometimes I would notice that I was feeling "sick" and then something really funny or really scary would happen, shocking me out of it temporarily. Once the shock subsided, the "sick" feeling would come back, but the proof of being able to briefly feel better was still there.

-- How fast did this feeling come on? Usually leading me to the realization that ten, fifteen minutes ago, there hadn't been the slightest sign of anything being wrong. Actual sickness comes on more gradually.

There are probably more I'm not thinking of, but you get the idea.

I don't know where this new one came from. It just popped into my head maybe a couple months ago when I was sitting at home feeling "sick" and starting to get really anxious about it:

You would be damn lucky to only feel this bad right before vomiting.

I love it. I love how it's not a question. I love how it works at home. I love how it has gratitude built into it, something I'm trying to express more of. Though I've only thought about it during moments of anxiety and feeling mildly unwell, I have this idealistic hope that it would be comforting even if I was sick, even if I was about to throw up. Because nausea, even at its peak, is never going to be unbearable pain. At least that's what I gather from non-emetophobics. Unbearable pain by definition is a level of pain that would make you lose consciousness, but people don't lose consciousness because of nausea, even severe nausea.

Again, I know it's idealistic, and my new trick probably wouldn't hold up in the face of actual nausea and illness, but it is helping me quash a lot of budding anxiety attacks.