Phobias and Anxiety
Phobias and Anxiety: That which does not destroy us makes us stronger... but given the choice, I might opt for a little more weakness.
I learned a lot about phobias and anxiety the hard way. I was a precocious kid and early adult, and then something snapped. It helped me learn first hand what these things are, and are not. These are just my views, based on those experiences. I am not a psychologist but because of my experiences I've read quite a bit on the subject. I am hope that explaining some of these experiences will help others with "phobias" recognize what they are, or help those who know people with "phobias" to understand them a little better.
Contents
What is an anxiety or panic attack?
Many times Anxiety or Phobias are caused by a "broken" system. The fight or flight mechanism in some people breaks, and goes off at inappropriate times. You know the feeling you get when you've gotten in a fight, you just missed getting in a serious accident, or you came close to dying, etc. -- when your heart is racing, you are sweating, you are often dizzy or nauseous (throw in diarrhea, blood pressure, numbness, shakes, weakness, etc)? Magnify that feeling a few times, with no valid cause, and that is a panic attack.
It sucks, and is more unpleasant than most other kinds of pain. Remember, torture often breaks people not through the actual pain, but through the fear of what's coming -- that's how powerful that anxiety is.
What is a phobia?
Many people mistakenly think a phobia is a fear of something -- like acrophobics are afraid of heights, arachnophobics are afraid of spiders, and so on. Unfortunately this is an over-simplification that is as wrong as is it right. If you really talk to most people that are "phobic", you learn that many (most) are not "afraid" of those things - they are actually afraid of how they feel when they are put in those "situations" (perhaps dread or anxiety are more accurate descriptions).
Remember the panic attack? Imagine this system goes off for no reason (or wrong reasons). For some people it is when they are "too high", for some it is when they see a spider or a snake, for others it can be something like "being too far from home or being outside". These people's "anxiety" reaction (fight or flight mechanism) is a little "broken". When you put them in a situation that wouldn't bother most of us, this anxiety system goes off and triggers a panic attack. The "attack" is a horrible experience, and are so painful that people will often do anything to avoid those situations (because that avoids those attacks). People call this fear or a phobia, but that is like saying someone is "afraid" of dropping a bowling ball on their big toe, repeatedly, because they would rather avoid it. It is more than "fear", it is that sufferers really, really don't like the physiological responses of their body to those situations. I've broken my arm 4 times in my life, and had anxiety attacks. The physical pain lasted longer for the broken arm -- but the intensity or "pain" of a full on panic attack was far worse.
My Experiences (What's it like)
In the late 80's, I was a truly driven person; actually, I was all my life, but the symptoms didn't manifest until later. I did not have to be "the best" at everything, but I had to do "my best". Unfortunately I am pretty capable, and was pretty hard on myself, and so I really had to dedicate full effort to everything. I was working a full time job (consulting), and was teaching Karate for another 40 hours a week (literally), and I had to be really good at both. In my spare time I was writing a book on martial arts and trying to experience all of life at once (skydiving on the weekends, playing paint-ball wars, and always doing something new). It was obvious to many around me that I was pushing myself too hard, but I was doing it, and quite proud of my accomplishments (chugging on the beer-bong of life) - but something had to give. It did.
I used to sailboat race (occasionally), and once before the start of the race I started to get really sick. I had never been seasick before, but it was truly unpleasant. Dizzy, sickening, with waves of "ick" passing over me. I was ready to jump over the side and swim to shore (I could have made it, I used to swim for miles). It was so horribly unpleasant, and the thought of it going on for many hours (a race was about to begin and there was no way to get out of it) made it a very dreadful experience, and I think of it as one of my first, more mild, panic attacks. If not, it was close to what a very mild panic attack feels like (for me). People that have been seasick may be able to relate a little better to anxiety attacks. Many people that get seasick will never get on a boat again (or avoid them at all costs) - that is "boat-phobic", but for some reason society doesn't label them as such.
Eventually the race started, we got moving, I felt a bit better, and I survived the experience (barely) -- but since then I have been far more reluctant to get on boats (though I have a few times). We understand that they had a physical (and psychological) reaction to motion, and so we don't really blame seasickness sufferers -- but the phobia and anxiety sufferers are often just "loons".
What is happening?
A couple of months later, I was just basically unable to bring myself to work. Suddenly the hardest thing in the world for me to do was for me to force myself to go to my job (and I liked what I was doing and the people there). I just felt wrong, all over -- but I kept forcing myself anyway (mind over matter and all that). Finally, one day (a few days later) I just couldn't stay at work any longer, I just had to go home immediately -- I felt like I was going to die, if I didn't get home immediately. My heart was racing, sweat was literally pouring off of me, I didn't feel like I could breathe well, and my insides were all knotted up, I was shaking all over, my mouth was very dry (and all the saliva turned white and cottony), I was going to vomit. I made it home, after the longest 20 minute drive in my life. I crawled into my bed and just laid there trembling -- I figured if I was going to die (and that is literally what it felt like), then at least I was going to do it quietly in my house. Eventually it subsided, and I was as exhausted as I had ever been (years before I had gotten my black belt in a grueling ordeal that took 6+ hours, I was more tired than that), I slept. I thought I was losing my mind, and could not understand why I couldn't make myself work.
The next day I couldn't make myself go to work. Then my glands started swelling up. The gland under my right armpit got bigger than a golf-ball and I couldn't put my arm down, the ones under my jaw looked like I had the mumps (I had already had the mumps, so I knew that wasn't it), and glands in my left wrist and in right side of my groin enlarged as well. I also broke out in a fever, and it was most uncomfortable -- but was actually a relief, "something was wrong physically". I could deal with that. I went to Doctor, and learned that they are well educated, nice people, who are just making their best guesses at lots of things, and are not magicians. They still don't know what I had -- it was not dissimilar to mononucleosis, but it also messed with my liver enzymes (like hepatitis) -- yet I tested negative for both (though they said it seemed related to mono). Later I got names like "Ebstien Barr" or others, but it doesn't really matter. I definitely had a virus, and I just had to wait it out. I got over the worst of it in a week or three, but the residual physical effects lasted for probably 6 weeks. But it wasn't the illness that bothered me, it was the longer term effects.
After I was getting over the disease, it was still a great effort forcing myself to go out. I couldn't understand why. Even when I was at work, I would suddenly get this feeling of "bad", and all things would go out of whack. I would feel like my heart would leap through my chest and I would die immediately if I did not leave (I was dizzy, nauseous, would get diarrhea, and a few other things) - so I would go home. I still couldn't understand what was wrong with me, and I was I was sure I was "losing it".
I couldn't go out with friends or do anything that took me more than a few minutes away from "home". I learned this the hard way, by getting "trapped" somewhere tied to friends (and their cars), and I had an "attack" and had to leave. The friends weren't malicious, they just didn't understand how serious this was (to me), and I literally had to beg (practically crying) to get them to take me home - NOW! (Now meant within the hour to them). That experience, and me occasionally leaving events, made things worse (between me and my friends) -- my friends didn't understand what the problem was (I was just suddenly being weird), and I didn't understand anything -- but I could no longer trust them, and they couldn't comprehend what I was going through. I became more reclusive.
Finally after weeks of becoming more and more tied to the house, I was able to break-though and do OK, strictly going to and from work (and to teach Karate)-- I just had to allow myself to leave when I felt bad. I couldn't really go to many social events (for any length of time) -- or often had to leave early, and I couldn't travel more than a half and hour or so from home. It was the worst time in my life (or so I thought at the time).
Diagnosis
Finally, I went to see a psychologist. I was so house bound (on my free time) that it was really getting to me -- I couldn't even go out and watch a whole movie (in a theater) without having these "attacks", let alone grocery shopping or other things (if they took a long amount of time). I was suddenly cut off from humanity and doing almost Everything I enjoyed.
The psychologist talked to me for the first session, and then gave me a pamphlet on agoraphobia (known as the fear of "outside") and recommended some books on the subject. I thought that she was nuts. Of course I wasn't "afraid" of the outside, I just didn't like these attacks, and feeling sick in public -- but I read through the pamphlet and got her books (and many more) on phobias and read through them all. I was shocked, there were people that had experiences like I had-- and in many ways I was lucky. I was able to force through (on some occasions), I had learned my boundaries (I could go about 30 minutes from home, and I could handle about 45 minutes of any social event -- but all day for Karate and Work). I had sought help way sooner than many (many go YEARS or DECADES before they seek help).
It was enlightening and indescribable relief to read that I was not THAT abnormal, and that others had suffered these same "panic attacks". On the other hand it was seriously depressing getting the full weight of what was going on. At least I wasn't loosing it (or no more than many other had) -- and I wasn't going to die (just feel like it). I saw the psychologist a few more times, but basically kept reading on my own, and learning more, and dealing with my own problem. I had meditation (and had meditated for years because of martial art) and other tools that I already knew how to use. I had unusually good control of my mind and body (due to martial arts and years of self training). I have taught myself some strange "tricks", so learning to control anxiety (for me) was little more than a new "trick" -- though it turned out to be the toughest one I have ever had to learn. It took me years of serious "fighting" to ever get back from the abyss, and become "almost" normal -- and I had a far far easier time than most. You can read about how I did it in [link=/Thought/Dont Panic/RoadToRecovery.txt]. The meditation was the biggest aide, however acceptance was the first step -- I got a prescription for Valium that helped a little, but really only because it gave me some element of control (when I was starting to have an anxiety attack, I could take the Valium to help reduce the effects -- and if I had time, I could meditate and reduce the effects further). But you never really get completely "over it" because you can never forget your experiences -- it is like getting over a lost loved one, you go on, but you never forget.
There are literally millions of people who suffer phobias or panic attacks who don't know what they are, or what is happening to them -- some of them are near suicidal because of the physical and mental anguish they suffer (suicide rates among those with phobias or anxiety attacks is far above the normal rates, and I suspect would be higher if we knew the cause of more suicides). Since the public is pretty ignorant of phobias, this isolates the sufferers even more (which isolates them and harms their self-esteem, and compounds the depression and other issues).
Lessons Learned
Like everything in life, you learn and go on. What you learn is up to the individual. I hope that others can learn from my experience -- but realistically, most people learn best from their own experiences (not from others).
The biggest lesson I learned was getting my priorities straight. I got near suicidal, and fortunately this made me realize what was (and was not) important in life. I've talked to many people that have had near death experience (even at their own hands) and it is amazing what clarity can be gotten from those experiences. Instant perspective. I was also somewhat self-righteous before, but facing death really reminds you to stand up for what you believe in (but also to let go of issues that don't really matter much in the bigger scheme). If you were to die tomorrow, what would you think of each decision you are making? Would you be proud that you are a compromiser, that is doing what is wrong for a paycheck or to please others -- or would you stand up for what is right, knowing that at least when you die you can look back and think "I tried to make a difference and stand up for what is right". (Obviously this has to be balanced with providing for your family and your other priorities). What things really matter? You quickly remember that the people in your life is what is important to you, and your behavior -- not things. Pain can be enlightening, so learn from others pain (as well as your own).
The last thing I learned was to believe in myself. It took me years of effort, and a lot of pain, to conquer what life had dealt me. But we ALL have crosses to bear -- many far worse than what I have (and mine are pretty tough). I don't pity myself for what I had, in fact the lessons learned actually made the torture worth while. That which does not destroy us, makes us strong. Well, I'm much stronger (and I thought I was pretty strong before). So I am proud that I overcame such a horrible experience, and know that others will as well.
It isn't just in your head!
There are many misperceptions I had about Phobias that made things worse (for me). Like thinking that a phobia was about the fear of something. I was never afraid of going outside (that would be irrational) -- I had a very rational "concern" about the anxiety attacks I got when I went out. Rightly so, considering the amount of physical and emotional pain they put me in.
Many people think it is "all in your head". This is about the same as saying that "ulcers" are all in your head. There are serious physiological things that happen, that sufferers do NOT like. I, like many phobia sufferers, had a physical disease that seems to have changed my brain chemistry and brought on the start of these "episodes" (or "broke" my fight or flight mechanism). We can use stress management and the mind to help us overcome the problems, and recognize them -- just like ulcer sufferers can use the same (and diet) to help with their symptoms -- but the phobia is a symptom of something else (a chemical disorder). Scientists can measure physiological changes in phobia sufferers, and they have found things "wrong" with the brain chemistry (or at least different) -- one study that was unusually fascinating (to me) showed that phobia suffers had a far greater intolerance for CO2 (or lack of oxygen) than "normal" people. Something is wrong, and just because you don't understand it, or can't see it, doesn't mean you should not be empathetic towards the sufferers.
It gets unusual (for the sufferers) in that the "attacks" are so random -- I would have totally different reactions depending on my bodies "mood". There were times when I put myself hours away from my home, was very stressed out (in life, work, etc.) and I would still have no episodes. There were other times when I would be AT home (or minutes away), having a relatively low-stress period in my life, and I would still get very bad attacks. So while a phobia is a psychological thing as well as psychological (it can be controlled through the mind), that is not all there is to them.
I believe that some thing are related to these "imbalances" that others may not think are related. From the descriptions of symptoms from Anorexia and Bulimia sufferers, I believe these are really just phobias (or at least a similar psychological/chemical disorder). These things make a lot more sense if you think of them as someone being afraid of the anxiety/panic attacks if they stop what they are doing (or they panic at the potential results).
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Conclusion
I had a very mild case of agoraphobia, or at least I handled it better than most -- it still took me years to get "over". Many have it for a lifetime. Luckily, I had martial arts, meditation, and other things which forced me (and enabled me) to deal with the situation. I still had a few tough years, but got through them, and am mostly normal today (I still infrequently get attacks, and am not a fan of travel -- but still go). If you know someone who has it, they can (slowly) conquer it; be patient.
The mind is an amazingly powerful tool, if you know how to use it. The attacks can be frustrating to all those around the sufferers (mostly because they don't understand). Remember, sufferers avoiding something that brings on an attacks needs to be thought of more as you would think of someone with an ulcer avoiding "bad" food, rather than thinking of the issue as "just in their head". Sadly, most people who have not had the an anxiety disorder will have a very tough time understanding them; hopefully, they will never have to learn -- I hope this article helps them understand a little more.
1997.12.31