Are We Talking Ourselves Into Panicking?

Photo by Cernicalo-e
This morning when my eyes opened and the knots in my stomach started I thought, "Its ok. I am going to have the whole day to myself with no pressure from anyone to eat this or that. I will just eat when I want to." Then as I got up still not feeling well I thought, "I'll just get some breakfast and then go to the store." Then my anxiety got worse. I sat on the chair all alone with the symptoms of my anxiety rising and I couldn't believe I was getting so upset about eating breakfast and why I didn't want to. I started to have a pity party. Without realizing it, I was telling myself things like, "I have to stop feeling this way. I have to eat so I can gain weight. I have to gain weight. I shouldn't be so worked up all the time."

Other thoughts that raced through my head just from a feeling or an image that appeared in my mind were "What if I eat while I am feeling anxious already and I get sick and throw up? What if eating makes me panic more?"

Then I ran into my room and threw myself on the bed and as the tears came I thought, "I'm never going to get over this. There is something very wrong with me. I'm only getting worse, its hopeless, why bother."

I am in no position to be giving help or telling anyone how to be cured. I highly recommend getting the book mentioned below and in my list and use the directions and guidance provided there. I am only listing a brief overview for an understanding of what I am going through and maybe give some ideas on things that might work for you.

So, as I have learned from The Anxiety and Phobia Workbook by Edmund J. Bourne, all of what happened this morning was anxiety escalated by what is called Negative Self-Talk. A few pointers from the book to quickly explain what it is and how it works:

• It is so automatic and subtle you don't notice it or the effect it has on your moods and feelings.
• It appears in telegraphic form- one short word or image ("Oh no!) contains a whole series of thoughts, memories, or associations.
• Anxious self-talk is typically irrational but almost always sounds like the truth.
• Negative self-talk perpetuates avoidance.
• Self-talk can initiate or aggravate a panic attack.
• Negative self-talk is a series of negative bad habits. (You have to reprogram your brain to say helpful uplifting confident talk to remove the negative thoughts)

There are different kinds of negative self-talk and I listed examples of every kind I had this morning. The Worrier often promotes "what if..." thoughts and promotes anxiety. My biggest what if thought is always, "What if I get sick and throw up?" The other kinds of sub personalities are the Perfectionist ("I should, or I have to" thoughts) which promotes chronic stress and burnout, the victim ("I can't. I'll never be able to) promotes depression, and the Critic ("Can't you ever get it right?") which promotes low self esteem.

The important thing to do is be able to recognize when you are promoting this behavior and what you are telling yourself. Then you counter your negative self-talk with positive counterstatements that you believe in or want to try to believe in. The book goes into more detail about questioning your thoughts and working through them rationally to prove they aren't true. It also helps you to create the positive counterstatements so that when you are in a situation where you are anxious and start to worry and promote the negative thoughts you can replace them and prevent your anxiety from going out of control, and giving yourself the confidence and respect you deserve.

So I sat down and wrote down all my negative self talk that I mentioned at the beginning and came up with the following positive counterstatements for myself that I am listing here so I can look them up quickly if needed.

Subpersonality: The Worrier
Negative Self Talk	Positive Counterstatement
What if I get sick and throw up?	A panic attack, however uncomfortable is not dangerous. If I get sick and throw up, I will learn from it and move on.
What if people around me see my anxiety and judge me?	I am willing to go forward with my life and try to better myself regardless of what others think. I respect and believe in myself apart from other's opinions.
What if I can't eat very much?	I am competent to listen to my body and follow it as opposed to other people's opinions about when I should be full.

Subpersonality: The Perfectionist
Negative Self Talk	Positive Counterstatement
I have to stop feeling this way.	I can let my body do its thing. I accept these feelings and know that they will eventually pass.
I have to eat because thats whats expected. I have to eat so I can gain weight.	I can eat when I want to, not when someone else thinks I should. I am ok the way I am RIGHT NOW
I have to gain weight.	I don't always have to be trying to gain weight. Life is too short to be taken so seriously.
I shouldn't feel so scared about eating.
I shouldn’t get so worked up all the time.
Subpersonality: The Critic
Negative Self Talk	Positive Counterstatement
I'm so weak, the moment I feel sick I break down	I am ok the way I am.
I can't believe I am feeling like this, I am such a loser	I am worthy of the respect of others, but especially of myself.
Everyone else is eating and enjoying themselves- I'm so weird and have so many problems	I am worthy of the respect of others. I'm a unique and creative person with many loveable qualities.
Subpersonality: The Victim
Negative Self Talk	Positive Counterstatement
I'm never going to get over this, there is something very wrong with me.	I have seen progress before and I can do it again, one step at a time. I don't have to be all better tomorrow. Its never too late to change.
Its hopeless, why bother?	My condition isn't hopeless. I can overcome it by establishing and committing myself to a program for recovery. I deserve to be happy and healthy.

Fear of Being Who I Am

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Fear: "the unreasonable overestimation of some threat, coupled with an underestimation of your ability to cope." -The Anxiety and Phobia Workbook, Fourth Edition by Bourne

I am trying to stay positive and optimistic and say life right now is very "interesting" instead of many more ugly words that come to mind. It is true after all, that everything I am experiencing has some degree of growth and learning potential. But here I am back at the beginning where food in general is a problem because I am anxious all the time and I have no appetite. Any heavy meals sounds awful just like it would if you were nauseas from food poisoning. But I know I need to eat something and slowly get my appetite back. So I do this with snacks. I eat small amounts of high calorie foods such as tapioca puddings, crackers, cheese sticks, high calorie drinks, etc. as often as I comfortably can. Its important to go at my own pace otherwise I run the risk of re sensitizing myself and I'll have to start over again. Eventually when I become more comfortable and less anxious on a constant basis, I will upgrade to larger amounts of food.

Here is an interesting article I came across today: http://www.newstarget.com/001976.html

With my fear of eating around others, it works very similar. I am usually just fine with snack foods and small casual meals around people I am comfortable with. The worst extreme situation is a fancy sit down meal like Thanksgiving for example. Sitting in a restaurant, even fast food place can be too much to where I can't handle it unless I properly prepare myself in advance. This explains all the birthday meals growing up where I ended up sick at the end of the night. All the attention was on me while I was eating and I couldn't handle it. Why my body reacts by throwing up I have no idea. I wish I knew why it was that and not passing out or hyperventilating. Its just how my body deals with it I guess.

So now I know and you know. You know how I feel and why I might act awkward at family gatherings and why I feel sick a lot- usually because any family function revolves around food. I know that my fear is irrational and there is no reason for it, however its a fight or flight response that my body has grown accustomed to and now I am trying to deal with the unpleasantries of my mind and body screaming for an escape anytime I am faced with that kind of situation.

Be Your Own Kind of Beautiful

“The Lord seeth not as man seeth; for man looketh on the outward appearance, but the Lord looketh on the heart” (1 Sam. 16:7).

Yesterday was a really tough day for me as I explained earlier. At one point of the day I called my sister who lives in Georgia to cry and talk to her since I was feeling down. When I got back from my initial visit with my new counselor, my neighbor stopped me in the driveway to give me a boquet of flowers that someone had delivered. It is a beautiful full boquet of red roses with one white daisy sticking out. The card said, "Be your own kind of beautiful! I love you! -Lisa" Just like the picture shows, I don't have to be one of the roses to have my own unique beauty shine through. It was a good reminder that I shouldn't care where other people think I should be. Its my life and no matter how people think I should behave or look or feel, it doesn't matter. I can't worry or care about the judgments. That is the hardest lesson I will have to learn. I know right now I still do care and thats what spawns my attacks.

It turned the rest of my day around. It was nice to know that I had someone cheering me on and was supporting me not just making progress, but was there to support me when I didn't, when I went backwards.

Today has been rough as well but in a different way. I am back at work and struggling to get through the day with this constant nausea feeling in my stomach. I have no appetite whatsoever but I am not going to push myself cause that will only make things worse. The hardest thing about today is that I am back at square 1. Starting completely over. I can't keep thinking about where I was cause it just gets me down. So what if its 1:40 pm and I have only taken in 269 calories. A few weeks ago I was in the 2550 range at the end of the day and thats how I was gaining weight, but I didn't start there. I think I started at 500 originally, and thats when I was feeling good. So I will take it one step at a time, one day at a time, at my own pace. Positive Affirmation Alert: "I can take as small a step forward as I choose. There's no need to push myself." This is the first time in my life where I completely understand that phrase, "One day at a time."

Stop the World I Wanna Get Off

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Setbacks are extremely hard for me. It takes me days to a week to get over them. Sometimes I feel so over my head- there is too much to do and I can't remember it all, I can't control my body. I feel like sometimes I can handle my anxiety, and then many days I can not. So this morning when I woke up and anxiety hit my stomach the moment my eyes opened as it has for the last several weeks, I broke down. I sat shaking in the shower, balling, not sure how I would ever make it to work feeling such a loss of control over my own body. Something needed to be done. I was worried about how taking another sick day off of work would effect my job, but I knew I couldn't go to work in the emotional state I was in.

So I faced the facts. I am in over my head. My health is more important than my job. I spent the day working with my insurance company to find a counselor that I could talk to. I was able to catch an appointment that afternoon. I was so excited to speak with someone that could help me. I left my house 20 minutes early just in case I got lost because I am extremely directionally challeged. Just my luck, not enough time. I have never gotten more lost in my life. I finally showed up- only 45 minutes late! I was soo frazzled after almost getting into 2 car accidents and one pull off to cry I could hardly make it up the steps without tripping over myself. I'm sure the Counselor thought I was a mess.

Since I was so late we only got to chat for about 15 minutes, but it was nice. She was a little older and very calm and relaxing to talk to- very motherly. I have great hopes that she will be able to help me where I can't seem to keep up.

Anxiety Scale

Photo by j.kolo
One of the most important things I have learned is to detach yourself from a panic/anxiety attack and observe your symptoms. You do this by flowing with the feeling you have, not fighting them. There are certain degrees of anxiety and if you can maintain control before you get to level 4, you can prevent a full blown attack. Here is my anxiety scale (the symptoms will be different for everyone):

7-10 Major Panic Attack: All of the symptoms in level 6 exaggerated; loss of control ofmy body and throwing up; compulsion to escape.

6 Moderate Panic Attack: Palpitations, difficulty breathing, feeling disoriented or detached (feeling of unreality); panic in response to perceived loss of control.

5 Early Panic: Heart pounding or beating irregularly, constricted breathing, definite fear of losing control, unable to think clearly, compulsion to escape.

4 Marked Anxiety: Feeling uncomfortable, heart beating fast, beginning to wonder about maintaining control, feeling nauseas, burning in the back of my neck or face, trembling body o shaking hands.

3 Moderate Anxiety: Feeling uncomfortable but still in control, heart starting to beat faster, more rapid breathing, trembling hands.

2 Mild Anxiety: Butterflies in stomach, definately nervous, negative self talk starts.

1 Slight anxiety: Passing twinge of anxiety, feeling slightly nervous.

0 Relaxation: Calm; a feeling of being undistracted and at peace.

The coping strategies in summary to enact when you start to detect your early symptoms are:

• Practice Abdominal Breathing
• Repeat Positive Coping Statements
• Use Abdominal Breathing in Combination with Coping Statements
• Talk to Supportive Person on the Phone
• Move around or Engage in Physical Activity
• Stay in the Present
• Use Simple Distraction Techniques
• Get Angry with Anxiety
• Experience something Immediately Pleasurable

I will go into more detail about some of these that help me the most later, and will link them to this blog, but for now I wanted to get this down so I can use it at work as a quick reminder.

The Weight of the Matter

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Trying to gain weight is one of the hardest things I have ever had to do. A website that I started using religiously that really helped me keep track of how many calories I was taking in and let me see my progress is www.fitday.com It would be just as great for losing weight, whatever your goals are. It takes a lot of commitment but it’s what has helped me so it is a miracle website.

Around 97 lbs. My wrists bug me in this picture.

Almost 10 pounds heavier- not too much of a difference but my Mom seems to think so!

When things were at their worst, I weighed about 97 pounds. I was doing really well gaining weight and was up to about 106.8 when I left for Hawaii. There I had the worst set back I have ever had. When I got back home, I weighed 102. So now my goal is to gain the weight again. My ultimate goal is to get to 110-115. I just weighed myself this morning before eating anything and I currently weigh 103.8. That makes me very happy and hopeful. This is the first time in my whole life that I have been able to pro actively gain weight. I know that my weight fluctuates a few pounds either way a lot, so in reality it doesn't mean very much. But it’s still a small step in the right direction. One of my positive affirmations that I tell myself all the time, "I recognize the progress I have made, and will continue to improve."

My Story

My name is Aimée. The spelling is French and it means “beloved” or "the loved one" which is ironic considering I spend much of my time worrying about others not loving me. I worry about it so much that I get anxiety and even panic attacks in many social situations.

Everyone who struggles with anxiety shows different symptoms when the panic sets in. I get a rapid heartbeat, a burning sensation in the back of my neck, a numbing tingling sensation in my arms, and shaky hands. Worst of all, I get nauseous. It starts out as butterflies and if I don’t use any coping strategies such as deep breathing or positive affirmations a full blown panic attack always ends up with me throwing up.

For years I thought I was allergic to certain foods, or that I had a a stomach condition like IBS. Several doctors never pinpointed my symptoms with social anxiety, but just considered it somehow stress related.

On a date in high school I had a panic attack that caused me to throw up in my date’s car on the way home. My date and all his friends called me “Bulimic” for the rest of the year. People would say “Is that all you’re going to eat?” or “You are skin and bones!” Even when I was pregnant people felt they needed to tell me to eat more for me and my growing baby. Several times in my life I have been approached by people that were concerned I had an eating disorder.

So I began to not enjoy eating around others. I got tired of the jokes and the constant worrying that if I didn’t eat enough or perform just right that people might think something was wrong with me or that I had an eating disorder. I started to worry about being judged way before going to any event where eating was required. I was walking into these situations already in a heightened state of anxiety and if something didn’t distract my thoughts, if I focused on it too much, I would end up hurling somewhere, which would only confirm people’s suspicions of me having an eating disorder. A vicious cycle started. 

In October of 2006 I was out to eat for my birthday lunch with my coworkers and in the middle of the meal I went to the bathroom and threw it all up. I clearly remember looking in the mirror and thinking “This is not normal. There is something very wrong with me.” That’s when I decided that I needed to do something. I didn’t want to have another birthday like that ever again. That’s when my research began and my diagnosis was made. 

After figuring out I had anxiety issues, my eating predicament got a lot worse before it got better. Knowing that anxiety made me throw up only caused me to worry more before any event.

I started losing weight. I knew I needed to eat more and gain weight, and that put pressure on me not just around others, but even when I was all alone. I felt nauseous when mealtime came and who likes to eat when they feel sick? I lost more weight. Each bite became a challenge. When things were at their worst, I weighed 97 pounds and could hardly eat at all and I felt sick with anxiety every day, from the minute I woke up. I knew I needed help outside of myself so I went to the doctor and got put on medication. And that was the turnaround that I needed.

My hard work payed off so now eating in public is no longer a trigger. However new triggers have popped up as my life changes. Using positive affirmations, deep breathing exercises, yoga, journaling, medication, and analyzing my negative thoughts have all played a roll in helping me to return to a healthy weight and to better manage my anxiety and panic attacks. I may not be cured from anxiety but it doesn’t consume my every thought in life like it used to. Occasionally I’ll have setbacks, but I believe any adversity has valuable lessons if we look for them. Anxiety is by far the hardest trial I have in my life, but because of it I know I am stronger, deeper, more compassionate, and a better person.

In 2006 I started this blog, The Reality of Anxiety, where I found that I love helping people cope and manage their anxiety by sharing tips that I have learned through my personal experiences. Please know that you are not alone and you can face your fears and live a happy life.