I’m not a doctor, and this is not a good substitution for medical advice. I’m not saying that to cover my ass, I’m saying that because it’s true. If this is a problem for you, please talk to a professional. If you can’t find one, or can’t afford one, go to Nami.org or call the NAMI Helpline at 800-950-6264 and you’ll be able to talk with someone right away to help get you out of crisis. NAMI also has a lot of great resources on the various flavors of anxiety that I encourage you to look at.
Okay, so for me: I do a couple of different things. If it’s really, really, really bad, I’ll take some medication that helps calm me down. But that’s a last resort for me. The first step for me is to recognize that anxiety is rising up, and then work to identify what’s causing it. (I realize that, for some people, doing just that can cause the anxiety to increase into a feedback loop, so maybe meds are a better first step until the anxiety gets under control). If I’m able to identify the cause (maybe it’s upcoming travel, or a deadline, or I have to deal with a personal thing that I’d rather not deal with) I work to separate RATIONAL thoughts from IRRATIONAL thoughts. This is a real challenge, because the brain is responsible for that job, and when the brain is being controlled by anxiety or other mental health issues, it can be less than helpful. But, with practice and experience, I can separate rational from irrational thoughts. In the beginning, it helped me to write things down. For example: Rational: I may miss my flight and have to take another. That’ll be inconvenient. Irrational: I may miss my flight and not be able to get on another flight but if I do get on another flight it’s going to crash. Rational: This meeting is important, and I’m worried about doing my best. Irrational: This meeting is important and if I’m not perfect I’m going to fail at everything in life and lose my house and family.
You may think I’m joking or being deliberately hyperbolic, but these are real thoughts I’ve had in my life.
When I separate the IRRATIONAL from the RATIONAL, I put irrational thoughts into a space that’s like a mental trash can. They aren’t helpful, and I don’t need them. I focus on what I can do about the rational thoughts. The rational thoughts can be helpful, by making it clear to me that I need to work hard for something, or make sure that I’m ready to leave for an appointment, or whatever. Sometimes, the rational thoughts can feel irrational. For example: What if it rains and we can’t do the big thing outside that we’ve been planning for months? If we can’t do the thing outside, we’re doomed! So part of that is rational: I’m worried about not being able to do the thing outside. But if I can’t, it’s usually not the end of the world. We move inside, or we deal with some rain. But it is not the end of the world. The end of the world is when we do the thing outside on the same day that an asteroid crashes into the park. In this (and all of these circumstances,) the trick for me is to recognize when IRRATIONAL thoughts are beginning to overtake RATIONAL thoughts, before they can spiral out of control.
One more thing: sometimes anxiety isn’t about worrying about things that haven’t happened yet. Sometimes, anxiety is about being totally overwhelmed by what’s happening RIGHT NOW. For example: I’m having a great time at this convention or concert or party but HOLY CRAP I CAN’T DEAL WITH ALL THESE PEOPLE RIGHT NOW. That’s totally normal, by the way, and when that happens, I accept that I may need to take some time to myself to just get into a quiet, solitary space, and recharge. BUT THEN I’M MISSING OUT ON THE FUN! Really? Is it really fun to be spending all my energy and focus trying to maintain and not go into a panic attack?
Finally, I keep a pill in my pocket (usually in my wallet) at all times, so if I start to feel a panic attack coming on, I know that I have an escape hatch of sorts.
Oh, also: none of us have to do this alone. Our friends, family, partners all need to know that we have mental health issues. They need to be our support network, so when we are somewhere and are feeling the rising bile of anxiety, we can turn to whoever is with us and tell them that we need some help.
I hope this is helpful to you, or anyone reading this who struggles with the sort of thing people like us struggle with. It’s really important to know that we are not alone, there is nothing wrong with how we feel, and we can get through this, and have a good life.