Severe Anxiety

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Dan_1981

Original Poster:

17,493 posts

204 months

Thursday 5th May 2022
quotequote all
After some advice please folks.

A little background.

My wife has for several years been what you'd describe as a bit of a worrier - it all seemed to start after we got broken into about 10 years ago.

This has ebbed and flowed over the years - things out of the ordinary, going away on holiday / breaks, changes to the norm, things like getting a new car, would cause her to become very very nervous, upset stomach, not eating etc but it'd pass as soon as the event was over.

She also suffers intermittently with migraines - these usually cause severe interruption to her vision - flashing lights, blurring etc - usually only fixed by going to bed for several hours.

Last week she had a migraine attack, went to bed to sleep it off & thought nothing more of it. However in the days after it became apparent that she was still suffering to an extent - a feeling of being spaced out, & not herself.

Then last Wednesday she woke up with a very severe case of the nervousness - literally couldn't get herself out of bed to take the kids to school. Upset stomach, chest pains, floods of tears, racing heart etc.

Since then we got her in at the doctors who took bloods and prescribed propranolol (40mg / day) both for the migraines and the anxiety.

Through my work we have private health so she had a call with the mental health team who have set up a session of CBT next week.

Since this, mornings are still really bad for her, the school run is off, appetite is poor & she's sleeping poorly.


I guess other than just getting thoughts down on paper the thread is just really to ask if anyone has any experience of this type of anxiety & the impacts.

Is propranolol a sensible prescription, what about the level? Is this a 'forever' thing?

What else can we do that's sensible?

How long will CBT take to have an impact?





Edited by Dan_1981 on Thursday 5th May 11:13

popeyewhite

20,942 posts

125 months

Thursday 5th May 2022
quotequote all
CBT may have an effect quite quickly, but will be a 'sticking plaster' that does not look into the root of your wife's issue. Whether CBT is enough... .

PositronicRay

27,351 posts

188 months

Thursday 5th May 2022
quotequote all
Mrs PR has suffered for yrs with this, not quite as bad as you describe though.

She won't seek help, so we try to manage trigger points, ie relinquishing control. Sometimes stuff just happens and it knocks her for a six.

It's debilitating.




Edited by PositronicRay on Thursday 5th May 13:56

Hoofy

77,341 posts

287 months

Thursday 5th May 2022
quotequote all
About to pop into a meeting so in short: learn to filter the world differently. It takes practice. Safer and more long lasting than drugs. I can send you something. Message me if you're interested.

super7

2,000 posts

213 months

Thursday 5th May 2022
quotequote all
I've had this for a decades now......

Used to take Propanolol and still take Citalopram. Have had a number of sessions of CBT but this doesn't work either as it's a sticking patch and I can see through it. Also Propanolol removes the symptoms not the cause.

I think once you have been 'touched' by Anxiety. it will be there for ever, and it's more down to recognising it for what it is and just pushing through it, but that is really difficult and is what CBT is based around.

The arse thing about it, is that it breeds and festers of itself. Once you have something in your head it's difficult to remove and you really have to confront it and ridicule it for what it is it.

I've had panic attacks in Shops, in the car, in work, at home, in the pub, everywhere. You always go about life looking for an escape route. It's not unusual for me to just turn to the misses and say 'I'm out of here' and leg it.

My anxiety mostly manifests itself as an irrational fear of puking everywhere. I get indigestion, guts start swirling, light headed, racing heart, sweaty hands and every symptom of impending involuntary puking. But.... and here's the point, i've NEVER been sick in the last 20years!! So it's all just in my head.... you need to use that reality, that the worst NEVER happens to alter your mindset for the present.

It's not nice!!

mcelliott

8,853 posts

186 months

Thursday 5th May 2022
quotequote all
First off Propranolol is totally safe, in time she can reduce the dose if she wants, she feels super jittery in the morning because of high levels of cortisol which occur on awaking, I find a magnesium tablet before bed, and something like a banana or porridge for breakfast can help take the edge off things.

Then she needs to really get into the mindfulness side of things, please look at something called The Dare response, it will teach her how not to run from or fight her anxiety but to actually form a relationship with it so that in time feeling anxious will become normal and boring rather than what it is now which can be very very frightening indeed.

Also take citalopram which I found to give a really good base from which to work from, worth talking to your GP.

twing

5,139 posts

136 months

Thursday 5th May 2022
quotequote all
I've suffered since very young, now 46.Propranolol does help in that it slows the crazy heart rate so stops me panicking more than I already am but doesn't stop it altogether. I'm reluctant to take anything else so I stay away from the doctors.
As said above I have formed a relationship with my anxiety, I do try to tell it to "fk off" and sometimes that works. Other times I just grin and bear it and remind myself that today is just a bad day and there will be better ones around the corner.
I had to take ten days off work last month because, like your wife, I just couldn't face the world, I couldn't even bring myself to ring in sick, I just wen AWOL.
I've found walking each night really helps, fresh air, natural colours an smell are really calming. There are lots of sensory techniques on the web which may help but they need to be used consistently not just now and again.
Breathing techniques help me hugely but I'm rubbish and don't practice them anywhere near often enough.
Sorry for the long post and good luck to both of you

Drew106

1,471 posts

150 months

Thursday 5th May 2022
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I've always had quite bad anxiety, mostly social anxiety, I'm not as bad when alone.

I've taken various legal and illegal drugs over the years, but wouldn't recommend it as a treatment. By far the biggest improvement for me has been learning to meditate. It took a long time for me before it clicked, but when it did it's been really freeing. Anxiety is still present in my life, but doesn't rule it or dictate my actions, it's just another emotion to recognise.

Propranolol is a beta-blocker, so an help the racing heartbeat etc. It only treats the physical symptoms so does little to alleviate the negative thought patterns. It's not something that helped me much, but is safe to take long term.

I've had issues with panic attacks, mostly in socially demanding situations, job interviews, public speaking, big parties with unfamiliar people, that sort of thing. Diazepam is something which can help in this situation. It can help to relax you and take you out of a 'fight or flight' situation. Definitely not something that can be taken long term, it's very addictive and withdrawal can kill. I keep this as a back up. A "in case of panic attack, break glass" sort of item.

Meditation is 100% the way forward IMO. There's a few good apps out there. I personally use Sam Harris's Waking Up app. Sam's a no nonsense sort of guy, which drew me to it. Meditation can get lumped in with airy fairy rubbish, quite unfairly. Sam's a neuroscientist and comes at it without appeals to higher powers/ spirituality etc.

Get to know your mind. Realise there is really is no thinker of thoughts, we can merely witness them as they appear. Once you see this, the half life of any emotion can be drastically reduced.


Bullybutt

211 posts

45 months

Thursday 5th May 2022
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I’ve had a couple of nervous breakdowns and it’s left me with depression and anxiety. I would change the drug to a proper antidepressant as the one she is on is working to reduce the heart rate, which can make you faint or dizzy etc if she is having a better day. Cbt didn’t work for me but a mindfulness course did a lot and some sessions of hypnotherapy. An antidepressant is more about supporting the body and mind whilst you figure out a better coping strategy. Mornings were always the worst part of any day for me, the pressure of what lay ahead etc. If she can start with setting an alarm very early, say 5am, spend a good 45 minutes on a guided meditation (quiet mind cafe on YouTube are ace) then go for a shower or bath. Go slowly but always aim to do the basics each day of get up, bathe and move. Moving helps use the adrenaline building up from the anxiety. Don’t worry about appetite for now. Drink is more important. Stay away from napping so that she is tired at bedtime.
It may take a few attempts to find the right tablets, most start you on citalopram as it’s the cheapest. Push for something else, duloxetine is a much better option for no side effects.
Start with small stuff like her doing the school run with you, even if she stays in the car. Anything to keep the usual chores a normality in her life, the longer she doesn’t do some tasks like this, the harder they can be to get back to.
Good luck and pm if you need anything

Babber101

90 posts

123 months

Thursday 5th May 2022
quotequote all
Bullybutt said:
I’ve had a couple of nervous breakdowns and it’s left me with depression and anxiety. I would change the drug to a proper antidepressant as the one she is on is working to reduce the heart rate, which can make you faint or dizzy etc if she is having a better day. Cbt didn’t work for me but a mindfulness course did a lot and some sessions of hypnotherapy. An antidepressant is more about supporting the body and mind whilst you figure out a better coping strategy. Mornings were always the worst part of any day for me, the pressure of what lay ahead etc. If she can start with setting an alarm very early, say 5am, spend a good 45 minutes on a guided meditation (quiet mind cafe on YouTube are ace) then go for a shower or bath. Go slowly but always aim to do the basics each day of get up, bathe and move. Moving helps use the adrenaline building up from the anxiety. Don’t worry about appetite for now. Drink is more important. Stay away from napping so that she is tired at bedtime.
It may take a few attempts to find the right tablets, most start you on citalopram as it’s the cheapest. Push for something else, duloxetine is a much better option for no side effects.
Start with small stuff like her doing the school run with you, even if she stays in the car. Anything to keep the usual chores a normality in her life, the longer she doesn’t do some tasks like this, the harder they can be to get back to.
Good luck and pm if you need anything
How did you recognise that you had a nervous breakdown?

Babber101

90 posts

123 months

Thursday 5th May 2022
quotequote all
Bullybutt said:
I’ve had a couple of nervous breakdowns and it’s left me with depression and anxiety. I would change the drug to a proper antidepressant as the one she is on is working to reduce the heart rate, which can make you faint or dizzy etc if she is having a better day. Cbt didn’t work for me but a mindfulness course did a lot and some sessions of hypnotherapy. An antidepressant is more about supporting the body and mind whilst you figure out a better coping strategy. Mornings were always the worst part of any day for me, the pressure of what lay ahead etc. If she can start with setting an alarm very early, say 5am, spend a good 45 minutes on a guided meditation (quiet mind cafe on YouTube are ace) then go for a shower or bath. Go slowly but always aim to do the basics each day of get up, bathe and move. Moving helps use the adrenaline building up from the anxiety. Don’t worry about appetite for now. Drink is more important. Stay away from napping so that she is tired at bedtime.
It may take a few attempts to find the right tablets, most start you on citalopram as it’s the cheapest. Push for something else, duloxetine is a much better option for no side effects.
Start with small stuff like her doing the school run with you, even if she stays in the car. Anything to keep the usual chores a normality in her life, the longer she doesn’t do some tasks like this, the harder they can be to get back to.
Good luck and pm if you need anything
How did you recognise that you had a nervous breakdown?

PH.sausages

64 posts

101 months

Thursday 5th May 2022
quotequote all
Sorry to hear she is struggling recently. I've had similar symptoms (not quite as severe) on and off for the last 6 years. I can't help with the medication side (I've not seen my GP about it for years). However I can recommend some tips I find useful for day to day;

- Get outside for few hours once or twice a week (ideally nice green / quiet area
- make life as easy as you can (admittedly I don't have kids so this is significantly easier for me). However just simple things like getting clothes ready, keys & money in a bag, whatever is needed the next day, sorted out the night before really helps. Rushing around stressed out in the morning will worsen any nausea felt upon waking up.
- Drink plenty of water via small sips (I carry a bottle everywhere)
- Eat smaller meals more frequently (or snacks in between small meals). Sitting in front of a huge plate of food in certain environments sometimes make me nausious and anxious.
- Wear comfortable clothes. I find a tight trousers or restrictive tops add to my anxiety and certainly don't help with stomach pains/nausea/bloating.
- Allow extra time going places. If you know you can stop for a few minutes if required this can help with peace of mind.
- avoid excessive amounts of caffeine, citrus, sugar, glucose etc
- eating plain foods (rice, potato based) the day before a big journey, busy/hectic day.
- try and avoid worrying about things you just can't change.

Hope this and above posts are useful.

PositronicRay

27,351 posts

188 months

Friday 6th May 2022
quotequote all
Being a partner of someone with anxiety is a tough call too. If I'd known about it in the early stages of our relationship I'm not sure I'd have had the guts to go through with it.

I'm still learning after 30yrs, this thread helps give me some extra insight too.

I don't pretend to understand the triggers, just avoid them where possible. Despite being physically fit, able to fling herself around in exercise and dance classes, fear of missing her footing (uneven footpath, long grass or dark drive) will trigger an attack.

When confronted with a situation my reaction is to try to work around it, rationalise , adjust strategy, baby steps, etc. Hers is red mist, declare it impossible and back out.

Edited by PositronicRay on Friday 6th May 07:19

Bullybutt

211 posts

45 months

Friday 6th May 2022
quotequote all
How did I recognise the nervous breakdown? The second time I ended up in hospital in a bad way and when they went through my history, they could tell that I’d had one 18 months previous, but hadn’t received the help that I needed. Hence having a second one. Basically they class it as your nervous system completely flooded and unable to carry out basic tasks without monumental struggles. My first task after starting therapy was to go in a shop and buy something. My mum would be doing my shopping before that as it was before online stuff was available. Took me a very long time to manage that and only then in a Tesco express type place, others were too large to even contemplate. After six months I managed to take the kids to the park myself. Fifteen years ago now but thinking back it’s incredibly painful that I ended up that way.

Dan_1981

Original Poster:

17,493 posts

204 months

Friday 6th May 2022
quotequote all
Thanks guys, some really useful info in here.

Appreciate the invites to PM too.

No real update from this side yet, she's still struggling massively.

Managed to join me on the school walk on Wed morning but couldn't face it yesterday, but the rest of the day was much improved.

However this morning I knew I had to come into the office after i'd done the school runs so she wasn't in a good place at first but seems a bit better now i've spoken to her.


Dan_1981

Original Poster:

17,493 posts

204 months

Tuesday 17th May 2022
quotequote all
Bit of an update.... not a particularly good one.

Last week was a bit better - convinced her to try getting up in the morning and going for a solo walk which was helping i think.

At the weekend she had another 'episode' on Saturday which really knocked her for 6.

Sunday & yesterday were complete write offs... she barely came out of the bedroom yesterday, isn't eating and sleeping really poorly. She literally has no energy, no desire to do anything, can't face time with the kids etc.

Today she's had another phone session with the doctor, who's now prescribed her sertraline but cautioned it'll take a couple of weeks to take any sort of effect.

frown


xx99xx

2,167 posts

78 months

Tuesday 17th May 2022
quotequote all
PositronicRay said:
Being a partner of someone with anxiety is a tough call too. If I'd known about it in the early stages of our relationship I'm not sure I'd have had the guts to go through with it.

I'm still learning after 30yrs, this thread helps give me some extra insight too.

I don't pretend to understand the triggers, just avoid them where possible. Despite being physically fit, able to fling herself around in exercise and dance classes, fear of missing her footing (uneven footpath, long grass or dark drive) will trigger an attack.

When confronted with a situation my reaction is to try to work around it, rationalise , adjust strategy, baby steps, etc. Hers is red mist, declare it impossible and back out.

Edited by PositronicRay on Friday 6th May 07:19
Seems I'm in the same situation, although I would definitely not have stuck around in the first few months if I'd have known about it.

It basically ruins her life and the knock on effect is that it ruins my life. Interestingly, she thinks it's ok to vent her anxieties to me, but not to her friends (who might understand them better) because 'they won't want to hear it' or 'they'll get annoyed if I'm constantly telling them about my latest worry'. But it's ok to get me annoyed apparently!

She's had counseling and tried ADs but stopped them both because she thinks she fine. But a fully grown adult crying several times a week isn't fine. Obviously it's all my fault though so that's ok.

mcelliott

8,853 posts

186 months

Tuesday 17th May 2022
quotequote all
Dan_1981 said:
Bit of an update.... not a particularly good one.

Last week was a bit better - convinced her to try getting up in the morning and going for a solo walk which was helping i think.

At the weekend she had another 'episode' on Saturday which really knocked her for 6.

Sunday & yesterday were complete write offs... she barely came out of the bedroom yesterday, isn't eating and sleeping really poorly. She literally has no energy, no desire to do anything, can't face time with the kids etc.

Today she's had another phone session with the doctor, who's now prescribed her sertraline but cautioned it'll take a couple of weeks to take any sort of effect.

frown
Yes the first couple of weeks on ADs can make things worse for some people, stick with them cos they will give a her a sound base from which to work from.


Edited by mcelliott on Tuesday 17th May 22:16

Douglas Quaid

2,394 posts

90 months

Tuesday 17th May 2022
quotequote all
xx99xx said:
PositronicRay said:
Being a partner of someone with anxiety is a tough call too. If I'd known about it in the early stages of our relationship I'm not sure I'd have had the guts to go through with it.

I'm still learning after 30yrs, this thread helps give me some extra insight too.

I don't pretend to understand the triggers, just avoid them where possible. Despite being physically fit, able to fling herself around in exercise and dance classes, fear of missing her footing (uneven footpath, long grass or dark drive) will trigger an attack.

When confronted with a situation my reaction is to try to work around it, rationalise , adjust strategy, baby steps, etc. Hers is red mist, declare it impossible and back out.

Edited by PositronicRay on Friday 6th May 07:19
Seems I'm in the same situation, although I would definitely not have stuck around in the first few months if I'd have known about it.

It basically ruins her life and the knock on effect is that it ruins my life. Interestingly, she thinks it's ok to vent her anxieties to me, but not to her friends (who might understand them better) because 'they won't want to hear it' or 'they'll get annoyed if I'm constantly telling them about my latest worry'. But it's ok to get me annoyed apparently!

She's had counseling and tried ADs but stopped them both because she thinks she fine. But a fully grown adult crying several times a week isn't fine. Obviously it's all my fault though so that's ok.
Do you have kids? If not why not separate?

ben5575

6,566 posts

226 months

Tuesday 17th May 2022
quotequote all
I can't help on the meds as I never ended up on them, however I essentially lost 10yrs of my life through my 20's with chronic anxiety, 6 months of which was spent unable to leave the house.

20 years later and other than mourning the time that I lost and accepting that it has made me who I am today, it simply doesn't affect me any more. So if nothing else, have faith that you can get through it, though I never believed that at the time!!!

It's interesting reading people's crutches that they held onto (loose clothing etc). Mine was tubes of gaviscon pills. For ten fking years I wouldn't leave the house without a tube of gaviscon in my pocket. Of course that seems totally irrational now, but at the time it made perfect sense to me. Lansoprazole rid me of that...

There's so much to say but if I were to condense any advice/observations:

Don't pressure her to do anything she doesn't want to, she needs to find her own way out.
Avoid discussing triggers with her. It is very much a downward spiral, as soon as she hears a new one, she'll claim ownership of it. I could rattle off a load of things that triggered me, but I wouldn't want to give her or others reading the thread ideas
Understand that 1 in 10 suffer chronic anxiety. She is not a freak, she is not weak, even if she feel like it. A lot of people around you are suffering with the same feelings
I imagine she's intelligent. I really struggled with the utter irrationality of it. Why the fk do I feel like this? Again, 1 in 10 people do.
Loss of control. If I can't control my anxiety (don't even get me started on intrusive thoughts), what else can't I control? Who am I and what am I capable of? Loss of identity and self perception/worth is a very real thing.

Bottom line is that feeling anxious is as fundamental a sensation as feeling hungry or needing the loo. It is absolutely, 100%, completely normal. Every single person on this planet gets anxious just as every single person feels hungry. Your dna programmes you to feel this way, it is normal, you/she is not weird.

The difference is that in 2022 we don't have to run away from sabre toothed tigers. So there is no release from the build up, so it builds and becomes corrosive. I can't stress how important exercise is (the modern equivalent of escaping the tiger) is for dealing with anxiety/release.

It is a journey and there's no quick fix I'm afraid. But it will end, she will get better.