Situational Anxiety

[scotty]

This is my first time posting here. I hope that this is a place I can find some help and hopefully solutions. Well I'm about to spill my guts so here it goes...

I am a 24 year old male. I went to a psychiatrist for about a year about two years ago. I was treated for anxiety and PTSD. It was recommended that I talk to my doctor as well and went on a small dosage of Lexapro (10mg/day). I went off of it after about 9 months. It seemed to have helped with the PTSD but not the anxiety (I still suffer from both). My questions here is a little different from what I was treated for before.

I experience extreme anxiety in specific situations. For example, one situation is when I am in an unfamiliar location with people other than my immediate family and have to spend the night there. I feel like something medically and life threatening will happen to me (as it has in the past a couple of times). I feel as if these other people wont help me or will see me as “weak” because of the medial emergency. I feel overwhelming anxiety about the thought of having to ask them for help in the event of a problem. I feel that in that new environment I wouldn't know it well enough to get help for myself and the thought of being able to help myself is comforting. I also feel that the new city I am in wouldn't be equipped to help me medically (even though most cities are as good or better than the one I live in). It has caused me to lose jobs where I had to travel. I had to go to college in my home town because I feel secure with my family close by. It has caused me to disconnect with friends. This situation caused anxiety has been with me since elementary school. I thought I would grow out of it as people often told me I would but I never did. Anytime I know that I am going to have to spend the night outside of my “comfort area” I turn into someone thats not my normal self and I do everything I can to get out of the situation. I don't like living like that, its frustrating. But the second I know I don't have to be outside of my comfort area, I feel immediate relief.

Another situation is being intimate with a girl. I don't have anxiety during the day but as soon as I feel the possibility of us spending the night together I get extreme anxiety. One reason is I feel as though I would be letting my parents down if they knew about it. I feel like its wrong and they would think that too. But I have only had one girlfriend (the rest I was able to run from when it got to that point) and I know in actuality my parents want me to date and wouldn't be disappointed in me. I feel that if I got an STD I would regret that particular night for the rest of my life even though sex isn't going to happen for sure. With these thoughts I don't feel like a normal guy. I don't think normal guys get anxiety over this stuff as bad if at all. All these thoughts race through my head at once and uncontrollably. I fall into the thoughts and dwell on the them making them worse and worse. Even though I want to be with her, I again try to get away from the situation and as soon as I know I am, I feel instant relief.

My anxiety consists of sever incapacitating stomach aches. I feel as if I need to throw up. My jaw muscles tingle and my mouth waters uncontrollably in preparation of throwing up. I do everything I can to not throw up for two reasons. First I'm generally in a place with other people and second, I worry that if I throw up my body would get used to that and do it every time just as it is used to becoming anxious. Also, I begin to worry excessively about all of the negative possibilities of the situation and spiral down into those thought so that I can't stop thinking about them. I always have a bottle of tums, pepcid complete, and pepto-bismol on hand to take. Non of these do anything to stop the stomach pains. However, as soon as I know I'm out of the situation causing the anxiety, the symptoms vanish instantly. This mostly happens at evening/night.

I have plans to travel, maybe move and I don't want to stay single for the rest of my life. What can I do to stop this?

Thank you.

[kim robin]

I know how you feel but you are not alone about 40 million Americans are suffering from situational anxiety. Try to consider these five ways to calm situational anxiety:

1. Break The Situation Down Into Small Steps: Most times, it's the size of the situation that overwhelms us. Break it down into small pieces/tasks and tackle those one by one - telling yourself you can certainly tackle this small piece of the puzzle. Anxious about the mountain of work on your desk with a looming deadline? Break up the mountain into small, manageable hills and give yourself reasonable deadlines for each one. As you tackle each, move towards the next until the whole project is done. You can use this technique for anything that causes situational anxiety.

2. Talk Yourself Through With Facts, Not Fears: One of the biggest causes of situational anxiety is allowing our fears to run out of control with "what ifs" or worst case scenarios. Although "worst case scenario" thinking is very common, the worst very rarely happens. When these out-of-control thoughts start, think about your past success. How many times have you really been ridiculed at an office presentation? Were you ever actually so tongue-tied you were laughed out of an interview? It's human nature for an audience to remember what went right, not what went wrong. Realize that most people are empathetic because they feel situational anxieties themselves and will overlook minor slip ups.

3. Be Certain You're Not Transferring The Anxiety From Another Situation: Anxiety-prone people generally strive to avoid unpleasant feelings and situations - so much so that they are masters of pushing down or putting aside any thing they find upsetting. Although it would seem this is a self-preservation technique that lessons anxiety, it actually does the
opposite. If you don't deal with the issues, feelings or situations, they will only come out somewhere else. For example, if you are feeling anxiety about a presentation at work when you've successfully given many, take inventory and make sure you're not avoiding another issue. Until you do, situational anxiety is likely to rear it's ugly head in places where you actually aren't feeling particularly anxious.

4. Take A Break From The Cycle Of Tension And Relax: Your body generally will have the same physiological response whether the stress is from an actual stressful situation or anxiety stemming from the mere thought of one. Your body tenses up either way and makes the anxiety worse. As soon as you feel your body's own signals of situational anxiety (racing heart, what-if thoughts, sweaty palms, etc.) take a break. Get up, even if it is only for five minutes, and take whatever steps you need to break this cycle. It may be talking a quick walk, turning on soothing music, or shooting a few hoops. Your body needs a break from the tension because if left unchecked, the tension will only feed on itself and make the situational anxiety worse.

5. If The Situational Anxiety Is Reoccurring Or Limited To One Fear, Face It Head-On: f you find yourself having a repeat of the same situational anxiety over and over again and these techniques are ineffective, then you have to face the repetitive anxiety head-on. Doing so is really the only way to take away the reoccurring power the situational anxiety has over you. For example, if you're absolutely mortified of public speaking, seek out small, doable opportunities to hone you skills. Gaining confidence is a sure way to decrease anxiety. You could begin by giving a dinner toast each night, volunteering to speak in small groups, or taking a community theater class. With each step, you'll gain more and more confidence and the situational anxiety will begin to weaken it's grip. Eventually, a situation that would've left you highly anxious will no longer even register any alarm.

We all face situational anxiety. But it is truly a burden that you don't have to carry. Break the task or situation into small steps. Remind yourself of rational facts and past successes. Take inventory of anxieties you may not be addressing. Take a break and relax. Face any reoccurring anxieties head-on. Know that all of these things will lessen the anxieties, so you don't need to worry another second.

[scotty]

Hi kim robin. Thanks for the tips.

I have tried these things in the past. Nothing seems to make it better other than avoidance which I know is the worst thing to do. I know that it is best to face these things head-on but in my case that is not very easy. First, using my two examples above, its not easy to just take off and go travel to a new and unfamiliar location and then to stay there long enough to become comfortable. Next its pretty rear for me to stay with a girl or for her to stay with me. I also know that it is good to repeat these stressful situations over and over to become comfortable in them. Again, this is tough to do in my case.

When the anxiety begins, the parts that are difficult is the downward spiral of thoughts of the negative possibilities of the situation which is joined by incapacitating stomach aches. Its very hard to distract myself from the thoughts once they begin. I have tried some of the steps you mentioned but nothing can pull those thoughts away. The stomach aches pretty much knock me off my feet. When they happen I can't move and just have to lay down.

I've had this for the last 15 years. So its pretty tough to change this cycle that I am so used to now. It would be nice to get ride of it though.

[scotty]

This stuff is very confusing to me. I often read that anxiety is successfully treated. But it seems that everywhere I go there is not an answer and everything I try doesn't work.

This leads me to wonder if I even have anxiety. I am wondering if there is a difference between anxiety and excessive worrying?