Ask HN: Are there techniques to cope with acute anxiety? | Hacker News Reader

Ask HN: Are there techniques to cope with acute anxiety?

21 pointsFreeHugs23 comments

I often feel anxiety for a specific reason. For example, when I have an appointment with a dentist, it will negatively impact my quality of life for several days. The days before the appointment. During these days, I cannot really focus on other things as much as I like.

It is not as if I feel terribly anxious. Just kinda constantly restless. And not really able to enjoy life. I constantly think "Ok, I need to get over this appointment first. Then I can live my life again.".

Are there techniques to deal with this?

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Step 1: Notice that you're anxious. Personally, I find that when I have that feeling of restlessness, it's because I'm avoiding thinking about it/avoiding my feelings.

Step 2: Acknowledge that you're anxious, without judgement. It's perfectly fine to be anxious; it's normal. Notice it and make space for it. I literally say in my head "I'm anxious about going to the dentist." It sounds silly, but it helps.

Step 3: Pinpoint EXACTLY what it is that makes you anxious. For me, the part about the dentist that makes me anxious is when they clean my teeth and poke me in the gums, and it hurts. (Also, I try to do the same thing if I'm procrastinating: EXACTLY what is it that I don't want to do?) Identify the thing and give it a name so describe it. It may be helpful to say this out loud.

Repeat steps 1-3 multiple times until you're more comfortable with the situation.

Step 4: Figure out if there's something you can do to make the root cause of your anxiety easier. When I go to the dentist, I'm upfront and tell them that I get anxious, and I ask them to play music to distract me. They're happy to do that, and it helps. As another example, if I'm anxious about traveling to a new place, I look it up on Google Maps or Yelp ahead of time. That helps me.

    When I go to the dentist, I'm upfront and tell 
    them that I get anxious, and I ask them to play 
    music to distract me.

This works for me too!

In my case, it's not music that helps. I let them know that I'm afraid of the unexpected in a medical setting. I ask them to tell me what they're going to do, before they do it.

Telling them exactly what we need is so good. If we just say "I get anxious" they may be sympathetic but how would they know what to do for us? I feel like a lot of people just state the problem and not their needs.

Even if a dentist is not particularly compassionate, 99.99% of the time human beings just want to get through their work day. And so they're more than happy to make an accommodation (music, whatever) if it helps everybody get through their day more easily. Anxious patients aren't fun for them, either...

Even better, bring your own tunes and headphones. Tell your dentist to tap your right shoulder if they need you to adjust or spit into something. No effort on their part (if anything you just made their job easier) and you get to jam out and relax (to the extent that's possible when getting your teeth poked and drilled).

That's interesting. That wouldn't work for me at all and would probably make me just associate those particular songs with an unpleasant experience.

But, I bet that would work for some people?

    It is not as if I feel terribly anxious. Just kinda constantly 
    restless. And not really able to enjoy life. I constantly think 
    "Ok, I need to get over this appointment first. Then I can live 
    my life again.".

Yeah, this is totally me.

As other posters have noted, just noticing it without judgement is a thing that helps too. Practice noticing it without beating yourself up for it. (Mindfulness, essentially)

I think for me it's more of an "executive functioning thing" than an "anxiety" thing?

Like, I'm not even worried or scared or dreading. I'll just keep thinking about it. It feels very adjacent to ADHD.

Part of why I'm sometimes hyperfocused is because my mind can't stop thinking about the unknowns. Where will I park? Or should I Uber? How will traffic be? Is my neighbor available to dogsit? what will I wear? etc.

So often, resolving those things is the biggest boost. If I can't answer the unknowns, I can sometimes cope by coming up with a Plan B ("I'll take a spare outfit in the car, in case I'm overdressed") or just resolving to leave early ("Traffic is too hard to predict, so I'll just leave a full hour early and have a drink at the bar while I'm waiting for the event if I get there way too soon.")

Standard disclaimer that I’m not a doctor and this shouldn’t be taken as medical advice, but you might find cognitive Behavorial therapy interesting.

The gist is that there’s a common set of cognitive distortions that we fall into. Things like, “fortune telling,” where we assume some bad outcome is going to happen even if we can’t really say that for certain.

You basically write down all the things that are troubling you, and then see if you can call-out those cognitive distortions.

This is just a 10,000 foot perspective, but it’s actually pretty straightforward.

The book “Feeling Good” popularized it.

Agree on this. My therapist had the list printed out and laminated. During sessions where I'd describe an anxious situation, they'd hand me the sheet and a dry-erase marker to check off all the distortions in play in that situation.

CBT does not work for everyone. It's "pretty straightforward" for sure, almost laughbly so. It's a culturally-insenstitive framework for mental illness that, as you exlicitly state, is about "calling out those cognitive distortions".

Which implicitly assumes that your cognition IS distorted.

- what if that creep who's stalking you actually IS a rapist? - what if your strained work situation actually IS a hostile takeover that's trying to sabatoge your company? - what if your family member's strange behavior actually IS a red light for suicide? - what if your investment in X IS actually going to tank and your family is going broke?

CBT is so focussed on the idea that anxieties are "cogntive distortions" that it completely alientates anyone for whom those worries are realized, regularly.

Anecdotal evidence around me suggest Cognitive Behavioural Therapy might be an approach that may help you on that front. Seek professional help.

There's also moodgym which is less focused on any particular issue than a dedicated CBT therapist, but might be better for someone having an issue going to appointments.

https://moodgym.com.au

For me, a combination of asking "why am I worried about this? what's the worst that can happen?" and propanolol. Propanolol is an easy prescription to get, it's a blood pressure medication, but it works VERY well for acute anxiety IMO because it takes away all the physical symptoms (fast pulse, shaky hands, nausea, dry mouth).

This.

Had an acquaintance with some anxiety. His doctor prescribed propanolol and it worked exceedingly well. His anxiety disappeared, his productivity went up and everything was copacetic.

He gave up the propanolol b/c it was causing him to ignore his wife's constant frivolous complaining. His cure use was driving her crazy.

The other suggestions here are great as well, I just wanted to add that you should avoid alcohol. It wasn’t until a psychiatrist suggested it that I realized “holy crap”, after I drink I am more anxious in general for 2-3 days.

For me at least it doesn’t seem to matter how much I drink, even a couple glasses of wine with dinner will make me more anxious the next day, but it does seem to scale up with intake. YMMV.

Edit: as another comment suggested, CBT would very likely help, particularly if you’re nervous about certain things and there’s no “real” reason for it.

If there’s a specific reason behind the anxiety (like worrying about a language barrier with the dentist), then CBT probably wouldn’t be my first priority.

The book Managing Your Mind [1] has an excellent chapter about dealing with anxiety and the thoughts you described. The approaches in this book are rooted in cognitive behavioral therapy. Helped me tremendously.

You might also profit from some mindfulness training in order to learn to live more in the present moment and let go of the future.

[1] https://www.goodreads.com/book/show/883834.Managing_Your_Min...

> Are there techniques to deal with this?

#1 = View it as a desire to change a fundamental part of your personality and all the trial and error and life long effort that will entail to find the coping mechanisms and actionable wisdom that will work for you.

https://bigfivepersonalitytraits.com/

https://www.psychologytoday.com/us/blog/psychiatry-the-peopl...

https://helloskills.org/blog/neuroticism-personality-trait/

Deep breathing and guided meditation audios or videos. For me, the guided meditation is especially effective for falling asleep.

The easiest thing you can do is go to YouTube and search for guided meditations. I've recently been listening to Jason Stephenson sleep meditations on YouTube to fall asleep.

You should also consider consulting a psychologist. A good psychologist should give you the tools and techniques to manage anxiety.

I’ve seen this book/method highly recommended:

https://www.goodreads.com/book/show/205913.When_Panic_Attack...

One point it makes is that avoidance actually increases anxiety about a thing.

I'd certainly recommend talking with your doctor and try an anxiolytic along with a therapist.

deep breathing - music (classical works well, but anything you like) - focus on your work/task to regain confidence and outside of a crisis: regularly go out - sun exposure - contact with nature - smile and laugh

don't participate actively in social media, try to avoid reading social media, avoid the news, and do something (hopefully productive) to occupy your idle thoughts.

This person is using social media as a tool for self-development and improving their mental health. The way to work on anxiety is to learn to focus on, recognize and ultimately let go of idle thoughts.

Your solution may be healthy for someone who is experiencing burnout or whose anxiety stems from internet overload. Certainly taking time away from these things and living a simple and focused life helped me for several years. Given OP's level of anxiety in the face of the mundane, I suspect this advice taken in isolation would be insufficient at best and damaging at worst. A habit of avoiding idle thoughts leaves one unpracticed and unskilled at handling them.

Edit for OP:

I find that a habit of exercise helps to redirect that restless energy. After a 3-mile run, I feel strong and healthy and ready to focus on the tasks at hand. If you distrust this but don't have that habit in your life, then prove it to yourself with a 30 day habit of cardio. It's worth knowing.

Beyond that learning a meditation practice helped me immensely. I don't keep up with that as I should, but it's in my toolbox now and I use it as needed.

This person's anxiety doesn't seem to stem from social media, but from regular day to day things. Unfortunately for people with anxiety, `do something (hopefully productive) to occupy your idle thoughts` doesn't work because they can't focus on anything else.

Just get prescription ansiolitics. They work like magic.

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