Anxiety discussion

[MajorSky1]

Hey guys,

I just wanted to open up a side discussion about anxiety, first because there aren't any recent discussions on the forum about it, and also, it's becoming a problem of its own for me, and I'm trying to find effective ways to fight it.

I don't know if there's any point in trying to figure out which causes which: does the anxiety cause the pain, or does the pain cause the anxiety? I think more often for me, the pain causes the anxiety to leap up. However, I've also noticed that in stressful situations, it has attacked me too when I don't seem to be having overt pain symptoms. I would guess once the nervous system is switched into hyper mode, it doesn't matter which comes first. Just about any over-stimulation can bring on anxiety.

I'm wondering what symptoms others get, and if any are like mine. For me, there seem to be different variations of it. I used to get panic attacks that would come on quickly, and suddenly I felt like I was dying, like my world was done. I'd get nauseous, and my brain seemed to be on overdrive, noticing more sensations than I wanted it to, which only added to my nausea.

As I learned to do deep breathing, and came to understand that it wasn't death itself grabbing me, and that it was a panic attack and would go through its cycle and be done, I started to feel less threatened by them, and they started to reduce in frequency.

However, now, instead of getting a quick attack, I seem to wake up into a day of feeling crappy, and it will last for a few days. I'll get mild nausea, and my thoughts seem scrambled, and sometimes I feel like a fever-dream where my mind will go off on a tangent thinking about something too much. I also get a strange feeling in my throat, and when I swallow, it feels weaker than normal. Sometimes the neck muscles on both sides of the windpipe will feel very tight, and strange. It's very annoying, and scary. This usually happens when I have a deeper pain flare up - like recently, it's been a TP in the levator ani on both side of the tailbone. A couple weeks ago, it felt like testicular pain on the left side, but it seemed like it could also be a TP since I couldn't pinpoint the epicenter of pain. But within a short time of these deeper onsets of pain, over 3 or more on a scale of 1 to 10, this less spiking, longer duration anxiety would follow, and sometimes lasts longer than the pain flare up itself.

Recently, I've had some stressful phone calls from my kids, and one from my ex, and within 24 hours, the anxiety kicked in. From Sunday to Wednesday, I was VERY tired, and I slept a lot during the day, and had a hard time getting out and doing much of anything. My energy was gone, and my thoughts were not their normal lighter mode. My mental state seemed off - and noticing that only added to the anxiety. Also, my mind seems to get into this way of thinking that I'm never going to get over this - and this usually happens while there's pain. Last week, I had a good week, felt good, enough that I had forgotten how the anxiety messes with you. It's so strange how when you feel good, it's hard to remember what it's like to feel bad, and vice versa.

I do relaxation, and I'm reading about meditation. Yesterday evening, I took a half of a Xanax. The days before I took half a hydroxyzine, which at that dose does not usually make me drowsy, but for some reason this time, maybe it did.

I'm considering trying some sort of anti-anxiety medication, but I oscillate so much on getting on one of those, I'm just not sure it's worth it.

My questions are:

1. Has anyone found a reliable method for reducing their anxiety and keeping a clear head?
2. What are your anxiety attacks like?
3. How long do your durations of NOT feeling anxious go on for?
4. As your CPPS symptoms diminished, did your anxiety eventually stay away?
5. Has anyone noticed a difference drinking coffee? Does it affect your anxiety if you have a cup? What about decaf?

Please feel free to add anything else.

[Caedar]

does the anxiety cause the pain, or does the pain cause the anxiety?

Both. This is fairly well documented.

However, now, instead of getting a quick attack, I seem to wake up into a day of feeling crappy, and it will last for a few days. I'll get mild nausea, and my thoughts seem scrambled, and sometimes I feel like a fever-dream where my mind will go off on a tangent thinking about something too much.

Over-activation of the sympathetic nervous system (fight-or-flight response) diverts blood from digestive system, which could cause nausea. Scrambled thoughts or foggy thinking (similar to "fibro-fog" in fibromyalgia) might be caused by bodywide sub-inflammation (some studies have shown elevated levels of inflammatory markers in CPPS and other chronic pain conditions).

I also get a strange feeling in my throat, and when I swallow, it feels weaker than normal. Sometimes the neck muscles on both sides of the windpipe will feel very tight, and strange.

Sounds like you have trigger points in the SCM muscle, which is a common case in computer users. These can also cause pretty bad headaches. Thankfully it's pretty easy to treat with your hands; just look up SCM trigger point release on YouTube.

Recently, I've had some stressful phone calls from my kids, and one from my ex, and within 24 hours, the anxiety kicked in. From Sunday to Wednesday, I was VERY tired, and I slept a lot during the day, and had a hard time getting out and doing much of anything.

Sounds like your stress is interfering with your sleep. Try to improve your sleep hygiene, which often means not napping during the day.

It's so strange how when you feel good, it's hard to remember what it's like to feel bad, and vice versa.

It is strange, indeed. I find that keeping an anxiety or mood log is helpful, as it helps put in perspective how you're doing.

I do relaxation, and I'm reading about meditation. Yesterday evening, I took a half of a Xanax. The days before I took half a hydroxyzine, which at that dose does not usually make me drowsy, but for some reason this time, maybe it did.

If you can stand it, I'd recommend taking hydroxyzine daily, working up to one tablet in the evening. If you take it sporadically, the side effects might not go away and you might not get the full effect.

I'm considering trying some sort of anti-anxiety medication, but I oscillate so much on getting on one of those, I'm just not sure it's worth it.

It sounds like there is a catastrophizing component of your anxiety. Have you tried cognitive behavioral therapy for that?

[MajorSky1]

Hey Caedar,
Thanks for the response, much appreciated.

I see a psychologist, but he doesn't offer any kind of "cognitive behavior therapy" - which is possibly something a psychologist doesn't do. I will look into that, and ask him tomorrow. Any suggestions?

What else can I do to calm, and keep calm the sympathetic nervous system? I do a relaxation CD, walks, read, working on learning how to meditate. I confess I don't like drugs, but I take them when I need to. I'm trying to get myself on a steady track of clearheadedness, where I don't have the over active SNS stuff going on. It's like falling in a hole. Then I finally climb out for a while until I fall back in. Don't want to fall back in anymore.

The hydroxyzine at a the 25mg dose does make me very sleepy. It says "as needed" on the bottle, so I figured if I was feeling either anxious, or having urethral pain I'd just take a half when needed. I'll see if my system can take it at half dose for a while, then maybe full at night.
Earlier on, when I tried it at full dose before bed, I'd wake up feeling very groggy. That was the main reason I cut it to half.

Probably my worst catastrophizing is when I have pain/anxiety and then feel really stuck, and unable to see a future of wellness, and normalcy for myself. I recognize it's catastrophizing, but man is it difficult to overcome. Xanax helps, but I will only take that two weeks apart per dose, or if I can avoid it, not at all.

[Caedar]

Psychologists provide cognitive behavioral therapy, but not all do. It is, however, one of the most common forms of psychotherapy nowadays. Cognitive behavioral therapy will teach you skills to use to avoid catastrophizing, which causes anxiety and thus involves the sympathetic nervous system.

Oh, you're at a 25mg dose for the hydroxyzine; didn't realize that. Yeah, half a tablet is fine. As far as the "as needed" prescription goes, hydroxyzine is an antihistamine, so its regular use is in allergies. Because people don't have allergic symptoms all the time, that's why it lists "as needed". In CPPS that's helped by hydroxyzine, however, the general idea is that the immune reaction (mast cells, etc.) is chronically upregulated by internal processes (central and peripheral nervous system dysfunctions) rather than being acutely upregulated by the environment (pollen, etc.). So the more consistently you can stay on the hydroxyzine, the more consisently you'll prevent the cycle of inflammation and pain and upregulation from continuing.

[MajorSky1]

Whoops, yeah, they're 10mg tablets. Sorry, got I confused it with something else.
I'll try to ramp up to a whole 10mg.
It's possible my sleep during anxiety is not as quality as I think it is, and that might be what's really causing the drained feeling during the day.

[Caedar]

It's certainly possible. Various factors can influence how much deep sleep (stage IV sleep) we get. Certain chronic conditions can mess with it, too, such as fibromyalgia. It's not entirely impossible that CPPS does some of the same stuff, and working to heal the CPPS could improve sleep (and vice versa).

[webslave]

I also get a strange feeling in my throat, and when I swallow, it feels weaker than normal. Sometimes the neck muscles on both sides of the windpipe will feel very tight, and strange. It's very annoying, and scary.

Stress or anxiety may cause some people to feel tightness in the throat, or feel as if something is stuck in the throat. This is called globus hystericus.

[MajorSky1]

Thanks for the responses, guys.

Geez, it's been a tough week for me with anxiety. Probably the worst stretch in a couple of months. Can't seem to find the doorway OUT of this stretch of anxiety I've been in since Sunday. Tried breathing, stretching, Xanax, hydroxizine, walking, reading, etc.

Ironically, my pelvic pain is low, and my therapist said yesterday that it's the best she's seen it so far and that I've made great progress. The tightness has seemed to move to the posterior to the muscles around the tailbone, and that sends a very distressful ache and pain up the spine. Therapist checked the sacro and said it seemed fine, just some tightness.

I used heat on it last night, and will today too - we'll see if it helps. Though the pain is low, there's some kind of weird sensation in the pelvic area, sort of a malaise, hard to explain. Might just be part of the anxiety?

I would like to get back to a clear head and get out of this place where I feel like I'm trapped in a box with racing or overanxious thoughts. It's a bad stretch this time, leaving me feeling hopeless. Trying to reorient my conscious thinking, but something is resisting.

Supposed to see a psychiatrist in October, because that's the soonest they can get me in. Ridiculous. Seeing my psychologist today, and will talk to him about cognitive strategies.

My apologies if my anxiety makes me appear difficult. I'm grateful for this forum and your advice, and have been doing a lot of reading. There's a lot to sift through because everyone's symptoms and such are a little different.
Thanks.

[SoothingSpaces]

I am suffering from these mind blowing panic attacks mostly in the morning. I do not want to keep popping valium. I know that is not the answer. I am on Lexapro. And nothing else. I try to settle my breathing -- but the pain in the perineum is virtually always present. I get the anxiety-pain connection, and am trying to tune into that. But it's hard.

[Caedar]

Are you seeing a therapist? Have you tried cognitive behavioral therapy or mindfulness meditation?

[SoothingSpaces]

I do have a therapist. Seeing her this week. Trying to breathe normally when in pain is difficult -- with all else going on. I mean it hurts to hop in my car to drive to the therapist. Ugh. Even sitting here with my legs up on the couch I am in discomfort. Two PT sessions this week. I look forward to those but not the drive there. Ha. I am just in constant discomfort except when I sleep.