looking for help with anxiety, panic attacks

[pitt82marino]

I'm a 44 year-old male and I've always struggled with anxiety. I feel very socially awkward and have trouble interacting with people sometimes--even with some of my longtime friends, if I haven't seen them in awhile, I feel nervous beforehand or if I randomly run into them (most of them anyway).

My anxiety is most powerful related to work, and that's always been the case regardless of where I've worked. I currently work in a call center and feel overwhelmingly worried/scared/anxious/fearful every day before work, on the drive in, and almost the entire time I'm actually at work. Some days it'll subside after a few hours at work, other days it's crippling pretty much the entire day. My blood pressure is high, my hands will get clammy, my heart will race, my stomach will be very irritable and I'll have pretty much no appetite from the time I wake up until the conclusion of my work day--normally during that 11 hours or so I'll consume a banana and maybe half a sandwich, at most.

Lately it's taken everything I have to even get out of bed, on a day I have to work, and in fact today I called in for the first time (I've only been there a couple months.) because I just couldn't handle the idea of going in and feeling that way. And while I felt guilty calling in, I immediately felt more comfortable and relaxed after I did, knowing I wasn't going to have to face the typical workday.

I've tried deep breathing, meditation, prayer, seeing various counselors, certain mindsets, words of affirmation, you name it.....I've tried pills like Abilify in the past, and currently my dr. has me on Zoloft. I've been on it for about 16 days and while I know it's still early, it's yet to help me in any way. The anxiety/fears/overwhelming sense of general doom haven't gotten any better at all.

My wife is supportive but really doesn't know what to say or do and hates seeing me like this. I feel like joy is just robbed from my life before work, at work.....the only times I'm able to relax are after work or on days off. Life has to be about more than feeling this way--I'm not suicidal or anything but I honestly don't know how much longer I can take feeling these ways and not finding any relief or peace. I'd appreciate any suggestions/well-meaning words of advice.

[Ritch]

Hey Pitt,

I'm unsure of the opportunities in your area, but with the social difficulties you are experiencing I think the type of work you are currently doing may not be the best choice at the moment. I imagine the call centre is a very busy place and for someone with social anxiety it sounds like you are actually flooding yourself (http://www.psychologistworld.com/behavior/flooding.php) without actually receiving any benefit from it. Also you said it is taking a lot of effort just get out of bed and couldn't face going in because of how it made you feel etc so if it is a viable option I would look for a quieter workplace for the time being.

When you say worried/scared/anxious/fearful could you elaborate a little more, are you worried about interaction with others..... scared of feeling the way you do when you are there or is everything basically overwhelming you?

When you tried deep breathing, meditation these types of things how long did you actually stick at them for? I only ask because a lot of people become frustrated with meditation etc because it can sometimes take a while to feel any benefit so people abandon the idea's but often when people persevere they do begin to feel benefits. I'm personally a big advocate of mindfulness which is a combination of a particular mindset/meditation (little bit more complicated but you get the idea). For example mindfulness encourages us to live in the present moment, so for example when you are having breakfast at home before work you should be focusing on your breakfast, the hot drink you have with it. How it feels in your mouth/how it tastes and basically focusing on things we would usually do without thinking about. If you are concentrating on these things it is very difficult to think about anything else.

At the moment what you are doing is living in the future, you are anticipating going to work..... you are predicting that situations will occur that will increase you levels of anxiety and basically getting the adrenaline pumping around your body before you even get to work. Mindfulness if persevered with would help this.

If possible I would also advise exercise before work..... this could be anything walking/running/weights or even sex just basically anything to burn of some of the adrenaline to take the edge off before going to work.

Give the Zoloft a chance to give you some benefit it can take between a 2-8 weeks before any positive effects are noticed. It also may be possible to add a beta blocker in to the equation as it could help with the physical side effects of anxiety (clammy hands/heart racing) but this is something you would need to speak your doctor about. I would also advise getting some therapy from a clinical psychologist, I appreciate you have seen counsellor but it appears it hasn't yielded the results you would have hoped for.

Has your sleep been affected at all?