How I Overcame Generalized Anxiety Disorder
Describing anxiety is difficult. It’s like every nerve is activated all at once in a fight or flight response against something that isn’t even there. Imagine what it must feel like to fight a bear, the fear, the pressure to survive, the adrenaline…that’s what it’s like when anxiety strikes.
Except there is no bear. It’s just you and…nothing. If there was a reason to be afraid, it wouldn’t be Generalized Anxiety Disorder. Preparing to survive a real ordeal isn’t a disorder, it’s how we’re supposed to function. When you have an anxiety disorder, the brain has been rewired with the wrong response to situations that are not actually dangerous.
When you have an anxiety disorder, the brain has been rewired with the wrong response to situations that are not actually dangerous.
Of course, the other side of the coin is coming down from that intense emotional and physiological response: depression. People without a disorder have responses to situations throughout their day, but under normal conditions, these responses are little bumps of highs and lows. Anxiety takes you so far up that when you come down, you plummet.
The fall can be just as bad as the initial anxiety.
Turning 30 Sucks
Not for everyone, but that’s when my anxiety struck me the hardest. It was there once before turning 30, when I was driving to meet my wife after eating a large plate of spaghetti and suddenly thought I was having a heart attack. The thought of getting to see her before I dropped dead was what got me to my destination. My mother happened to be there and said:
“Welcome to anxiety. We all have it.”
My depression after wasn’t solely from the anxiety attack.
I didn’t want anxiety. I saw how my grandmother needed medication for it. I never wanted to rely on any medication, much less meds to control fear. To my mind, at the time, anxiety wasn’t even a physical problem. Just get over it!
To my mind, at the time, anxiety wasn’t even a physical problem.
A few years later, I turned 30 and the anxiety hit me, hard. When I was younger, I kept my body in excellent physical condition by training three hours a day in martial arts and accompanying physical fitness activities, like running and weight lifting, that made me a better fighter. I had never experienced anything like severe acid reflux or gas.
After I got married, I slowed down my training and started eating bad food more often. Eventually, ice cream, Del Taco, and skipping training to watch movies became my norm, and with that, all the fun of gas and reflux. I didn’t know what these symptoms were and my brain immediately went to a heart attack.
It started with a panic attack at work. A full-blown, fall on the floor, limbs curled up from a loss of oxygen panic attack. At the time, it felt like the panic attack was happening to me. Looking back from my recovery, I can see how it was something I had created. This is not the case for everyone, but it was for me. I was creating my own personal level of hell.
When you have a problem, everyone has a solution for you. They don’t always think them through or know what they’re talking about, but they usually come from a place of genuine concern. The problem with other people’s solutions is that they are not in the arena — most people don’t know what it’s like to have an anxiety disorder.
When my anxiety became more regular and limited the sorts of activities I could do for fear of anxiety (fear of having fear, can you think of anything more debilitating?), my friends didn’t understand. I told them that I felt like I was going have a heart attack at any time, even though the many doctors I had gone to see, often while in the throes of a heartburn-induced panic attack, told me that I was healthy. They all said I was just too afraid of something that wasn’t there.
A few even went so far as to say “stop it!” Seriously, just stop doing something that had become my natural response. If it were only that easy.
The Moment that Led to My Recovery
September 14th, 2014. That was the day I was officially prescribed Xanax to cope with my panic attacks, along with Wellbutrin to “feel better.” This from a hack doctor who didn’t even know my name. He walked into the room, saw a ball of stress sitting on the bed, and wrote medication that I would likely depend on for the rest of my life.
Whether I needed it or not, I had my biases about meds and I didn’t want them. I didn’t want to need them.
At this point in my life, I didn’t understand the nature of automatic thoughts. You know those thoughts that pop into your head, like the various options you could take in a situation? They usually go unnoticed until the option they present would be life-changing in a way you could never imagine choosing, such as walking out on your spouse and living a new life, even though you love them and would never dream of doing something like that. You’re often left wondering why you thought that at all.
That night I had the scariest of automatic thoughts. I was laying in my bed looking at my closet. For whatever reason, my brain started taking inventory of what was in there: clothes, shoes, my gun… Then I had the automatic thought of putting my gun in my mouth and pulling the trigger.
What the fuck?! Why did I think that?! I’m not, and never have been, the sort of person to consider suicide under any circumstance. The vividness of the thought scared the shit out of me.
The thing about automatic thoughts is that they’re just vapors of the brain, here one moment and gone the next, unless you act upon them.
I was convinced that my thought meant more. The thought of The Joker just snapping and going crazy, because Batman stories told me that was a thing, kept flying through my mind. Was I snapping?
I needed to figure out what was wrong with me, why I was reacting to situations like this.
It was time to get some help.
Going to a Therapist
My family used to run a psychiatric office, so the idea of seeing a therapist wasn’t something prideful that I had to overcome. But I knew that most therapists were just sounding boards for my problems, looking forward to taking my money every week for years to come.
The first thing I told my therapist is that I wasn’t there to discuss the problem — I was there to fix it. He agreed. He said therapists are like milk, good for you until they expire, at which point they become toxic. You learn to lean on them, using them as a crutch until you can’t make a decision without their approval.
Therapists are like milk, good for you until they expire, at which point they become toxic.
That won my confidence.
“You Might Need Medication”
Those were words I didn’t want to hear. He said it after I told him what I was prescribed earlier that week. I told him how much I did not want to take medication.
He asked me if I had read or watched any Batman stories. After my thought about The Joker, I was beginning to regret that I ever did. He said:
Batman uses the tools on his utility belt to solve various problems. Not all tools are needed for every problem, but they’re all there if he needs them. The medication…that’s one tool on our belt. We’re going to hang onto it in case we need it. Okay?
After I agreed, he told me that only about 2% of people who are prescribed anxiety medication actually have a biological need for lifetime medication regimens to keep their anxiety in check. When you have anxiety, though, you catastrophize everything. So no matter how small a chance, you think you’re part of that 2%. He was preparing me for the idea that I might need the meds, but that the chances were that I could get over my anxiety without them.
That said, medication is a tool on the belt of many people dealing with Generalized Anxiety Disorder, and different members of our nerve-wracked Bat-Family need to reach into that pouch more than others. Batman likes his fists, Nightwing favors his batons. We all approach our problems with different tools.
Building My Utility Belt
My therapist explained the concept of what we were going to do. He didn’t give it a name, but I learned later that it was Cognitive Behavioral Therapy.
The way he described it to me was with a description of neuroplasticity, which is the concept that the brain’s neurons are malleable. As we learn to react to new things, like hitting a baseball being thrown our way, our brain’s neurons move to create pathways to reinforce the new reaction, making it faster and more efficient the next time we need it.
Unfortunately, my brain had created pathways between feeling heartburn and believing it to be a heart attack. The pathway had grown so strong over a number of years that I had a superhighway of neurons heading, quickly and efficiently, in the direction of an inappropriate response: panic!
We’re going to make new pathways for your brain by giving you new ways to respond. You’ve been using the same tool — panic — for too long. If you were fighting a bear, that tool would be reasonable. We need to learn to use some new tools.
The initial tools were to control the problem of panic attacks. They included snapping a rubber band on my wrist (because your body can’t think about two things at once, and physical pain gets priority) and concocting a fictional antagonist who was the author of my panic (because a house divided cannot stand, and I needed someone external to fight).
Neither of these tools worked very well for me. As mentioned before, we all approach problems with different tools.
Since our brains are wired to use tunnel vision in survival scenarios, forcing your peripheral vision to activate snaps us out of survival mode…
My most effective tool to overcome panic attacks was engaging my peripheral vision. Your brain gets tunnel vision when in survival mode. You need to focus on that bear you need to fight and ignore things that don’t matter to your immediate survival. You can’t engage your tunnel vision and peripheral vision at the same time. And since our brains are wired to use tunnel vision in survival scenarios, forcing your peripheral vision to activate snaps us out of survival mode, and for me, because my anxiety was based on a fear of immediate death, suppresses the panic.
That tool worked on my short-term problem: panic attacks. Then we started in on the big one: building the tool that would overcome my Generalized Anxiety Disorder for good.
My therapist said that when I felt anxious, he wanted me to hit the pause button on that. I almost walked out. It sounded like everyone else who told me to “just stop it.”
He then explained his meaning:
P.A.U.S.E. is an acronym. I want you to begin using each one, in order, when you feel anxiety coming on. Doing so will engage neuroplasticity and cause your brain to rework its pathways toward using P.A.U.S.E. instead of going into anxiety.
Okay. That sounded more reasonable. Here’s how he spelled it out for me:
P Is for ‘Predict’
You’re feeling that anxiety trigger (for me, it was chest pain). What is the absolute worst thing that it could be? (Heart attack.)
What is the absolute best thing it could be? And I want fireworks, dammit. (Umm…super soldier serum I was given as a child finally amping up my heart rate to make me superhuman?)
Cool. Now, what’s the most reasonable thing it could be? (Heartburn.)
Okay. Move on.
A Is for ‘Alternate’
Is there an alternative explanation for what this could be?
In my case, this step was the same answer as the more reasonable Predict response: heartburn instead of a heart attack.
U Is for ‘Understand’
What will happen if you buy into the illusion that the worst-case scenario is true?
For me, this was the understanding that I wouldn’t engage neuroplasticity, and in fact, would strengthen it toward the improper response. I had to buy into the alternative or I was going to go backward in my recovery.
S Is for ‘Suggest’
This one is powerful. If the anxiety got this far, this one usually blew it away.
If someone else was going through what you are going through, what would you suggest for them to do?
My suggestion was to take inventory of what I had been eating and doing. Ate some tomatoes? Probably heartburn, my guy.
E Is for ‘Evidence’
If you had to put your anxiety trigger on trial, what evidence would there be to prove it to be true? What evidence would there be to prove it false?
Since the symptoms of heartburn and a heart attack are not all that similar, my evidence was always “well, see, I have this feeling…” Sorry, sir, but feelings are inadmissible in court. We need facts! Evidence against? I ate tomatoes and, oh yeah, I have this anxiety disorder that… CASE CLOSED
Deploying My Utility Belt
It took about a month of therapy to get P.A.U.S.E. working in my favor (it wasn’t until week three that we had even discussed it). Every week was a review of the previous tool and then the learning of a new tool. Each tool was different, with varying results. I was told that some of those tools worked wonders for people with anxiety disorders. P.A.U.S.E. was that tool for me.
At first, it took several agonizing minutes to work through the whole acronym, sometimes having to write down each step so I could concentrate on it. After a few weeks, it took me right around a minute. By the time Christmas came around, all I needed to do was invoke the word ‘pause’ and my anxiety retreated like The Joker after a bad beatdown by The Caped Crusader.
Slowly but surely, I had rewired my brain to respond to my anxiety triggers with reasonable, evidence-based thinking rather than a panicked reaction. For me, that was what recovery looked like.
I never needed most of the other tools on my utility belt, including the medication. The peripheral vision tool helped if I wasn’t focused while invoking P.A.U.S.E., but then I would go back and work through the acronym again.
I finished therapy in February 2015. That year, I used P.A.U.S.E. quite a bit while I was getting back to my old life. Working out, road trips…getting on an airplane. Today, five years later, I keep my utility belt on me, just in case, but I haven’t had to reach for a tool in years.
My story is unique. Everyone who suffers through anxiety needs different tools on their belt. For me, medication wasn’t one that I had to rely on, but I am not anti-medication for all people suffering through depression or Generalized Anxiety Disorder. P.A.U.S.E. was my most useful tool, medication might be yours. No judgment.
When asked by friends and family who are going through anxiety about how I overcame it and what they should do, I always suggest a solution-focused therapist. Someone who, as part of their therapy plan, accounts for phasing themselves out at some point in the near future.
I hope my story helps someone. Anxiety and depression can make anyone feel alone in their suffering. But you are not alone. You are part of a larger Bat-Family.