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I haven't had another panic attack since that one at the grocery store last month, but my anxiety levels have still been all over the place. Some days have been perfectly fine, others not so good. I have been meditating and doing deep-breathing exercises more. I have been looking through my affirmation flashcards. Hopefully this is helping me even out, but I haven't noticed a significant change yet. That might be because I am still not doing these relaxation exercises consistently enough. I should be doing them every night, but right now it's more like twice a week.

Another change I made that I do think is really helping me is that I stopped going to emetophobia forums. Up until maybe a year or two ago, I never went to these forums. I mean, I can remember popping into them a handful of times during my teen years, but they bored me. I really had no interest in putting more effort into handling my phobia then. I felt like I did well enough. But when things got worse, I started visiting them, thinking they might be helpful.

It's been just the opposite for me. I feel like they have made me worse. And they were somewhat addicting too. I couldn't stop logging in for a while, reading everything, leaving comments with advice occasionally. I tried to avoid threads that looked like they might contain information I didn't want to have in my head. For example, I try not to read anything anyone posts anywhere ever about norovirus. I don't care if it's facts about it, helpful tips on avoiding it, how it's spread, good news about it, whatever. I know I have the potential to get so unbelievably obsessive about it. The information gets stuck in my head, and I find myself changing my behavior.

But it wasn't always easy to tell what might be in a thread, and I still kept coming across this negative information. I remember one night I had just eaten Pizza Hut for dinner. Then I logged into one of the forums, and the very first thing I saw was a thread titled something like "Pizza Hut food poisoning" or something like that. So I didn't even have to click on that one for it to make me anxious!

That is what annoys me so much about groups of people with emetophobia getting together. Inevitably, 90% of what is discussed will be things like that. People asking which foods or restaurants are best to avoid. People posting in a panic asking for someone to give them a safe/benign reason why they feel sick. I wish there was more discussion of how to deal with the anxiety/phobia itself. But I notice that when people bring up this point on the forums, they usually end up getting attacked by people who are "anti-recovery" I guess, that stress they would rather it be a "support" group than a "recovery" group. I find it odd. I think the best support is encouraging someone to recover. If someone had encouraged me to work on recovery when I was younger, I'm sure I would have ignored them, so yes, I agree that no one can/will recover before they're ready. But at the same time, during those years that I was technically "anti-recovery" I wasn't "pro-support" or at least not that kind of support that seems like a merry-go-round of scaring each other. I don't see how that helps anyone.

I have become very afraid of eating out at restaurants during the winter, and I know that is a direct consequence of hanging out on these forums and seeing other people constantly post about being worried about this. It's something I never thought about before. I have eaten out at restaurants year round my entire life, and I have never gotten sick from doing so. My method of eating out whenever I wanted to did no damage, and there was no need for anything to change. But I have changed and am now extremely reluctant to eat out anywhere until it's spring/summer again.

I feel frustrated with myself for letting myself be influenced like this. It seems I can't read the fears of other emetophobics on a regular basis without being affected by them. So I have stopped going to these forums, and now I'm hoping that as time passes these extra thoughts/fears I've acquired will drift out of my head again.

It's a little disappointing, because, first of all, it is exhilarating to be in contact with so many people who understand the way you think. And also, every so often, I would come across something that was uplifting or helpful. But it was so rare, and it's just not worth digging through all that negativity for those few positive gems. 

I think I'm much better off sticking with blogs. I've always found they tend to be more recovery-focused and positive, since they are more about sharing information than getting support. I've never seen a blogger post while having a panic attack and expect someone to immediately show up to talk them through it (maybe because bloggers know they're addressing a smaller audience). I really like that. I'm looking for less agitation in my life and more understanding of the fact that anxiety is really something you have to handle on your own. Not that I don't sometimes rely on my wife to calm me down, but I like to see those times as times where I have failed myself. Any time I can fix a situation on my own, I know I've just done something that is so much better for me in the long run.         

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.