Anxiety Really Sucks!

Promote better sleep hygiene to cut down on the sleepless nights.

I think I was born to be an insomniac. Starting in my preteen years, I developed a complete aversion to falling asleep before midnight. I also developed this amazing talent where I feel sleepy all day and perk up as soon as I should be going to sleep. I can spend hours upon hours on Facebook, but only after the sun sets. I also tend to discover new passions when the rest of the world is asleep – it’s 2 am and I just have to learn to speak Japanese by tomorrow morning!

So how does a guy like me get any sleep? Well, the answer to that question is still in the makings. But I can offer you some tips that I’ve found helpful over the years in my quest to overcome my nocturnal nature and embrace the wonders of sleep hygiene.

How to avoid BAD sleep hygiene 

1. Do NOT consume caffeine close to bedtime. Obvious, right? Well, I bet you’re still doing it. I’ve spent many a night lying in bed with my eyes glued open, staring at the ceiling fan as I count the number of pages I have to read in the next week because of that extra cup of coffee I just had to have at 10 pm. There are many alternatives to caffeine to give you a little energy boost – I recommend that you become familiar with them. 

2. Do NOT go to bed after drinking copious amounts of alcohol. This is another common tip, but you’ve probably ignored it because it sounds paradoxical. Alcohol makes you sleepy, right? Sure, in the short term. But if you’re looking to get a good night of sleep, don’t turn to alcohol. It may put you to sleep faster, but once it is metabolized from your system, it will disrupt your sleep. Alcohol has a pretty complex relationship with sleep, so it’s best to just not mix the two.

3. Do NOT spend hours on the computer right before sleep. You’ve been told a million times before – don’t surf the web before bedtime. But how often do you listen? It’s tough, because often, our computers are what keep us entertained. Shut off the computer at least two hours before bed, and pick up a book or take a bath or something. Life goes on even when you’re not constantly checking your email.

4. Do NOT spend time in bed when you’re not sleeping. As much as we love watching TV, surfing the web, and playing Skyrim while lying in our comfy beds, these behaviors perpetuate sleep problems. You should keep your bed for two things: sleeping and sex. That way, you will develop a stronger association between lying in bed and falling asleep.

5. Absolutely, whatever you do, do NOT plan for the future right before bed. This is often my biggest downfall. I’m up late, worrying about something, and so I decide to make a plan. Sounds reasonable, right? WRONG. Planning for the future is very stimulating and will keep you up all night obsessing over details. “Maybe I should read that chapter Tuesday instead of Wednesday, and then that will leave Wednesday open for finishing my essay, oh but wait, I also have to start my proposal outline, so maybe I should finish my essay Tuesday, and oh….damn it, I’ll just get out of bed and start now!” Insomnia: 1. Justin: 0.

How to promote GOOD sleep hygiene

6. Stay physically active throughout the day. While the exact relationship between sleep and exercise is not really clear, years of research have shown that physically active people do sleep better, on average. Whatever the real cause, I find that I sleep much better when I’ve been going for regular runs or hitting the gym at least 3 times a week. If you’re not an exercise fanatic, don’t worry. Physical activity can be as simple as walking briskly with your dog or doing 20 crunches before a meal.

7. Stay mentally active throughout the day. Part of the reason some of us can’t sleep at night is because we’re just not active enough during the day. Yes, physical activity is a big part of that, but something that often goes overlooked is mental activity. Activities that require intense concentration or problem solving skills wear down your energy reserves just as much as exercise. Instead of watching three hours of TV in your free time, try playing a video game, writing poetry, or whatever you enjoy doing that requires brain power.

8. Try to have a regular sleep-wake cycle. I always want to scream when someone shares this tip with me. Get up and go to bed at the same time EVERY DAY? Are you delusional? But alas, from personal experimentation (and I use the word “experimentation” in the loosest sense for you science buffs), I’ve found that I do in fact sleep better when I stick to a fairly regular sleep-wake cycle. Go to bed at 12, wake up at 9. Repeat. Repeat again. And so on. Eventually, your brain starts learning when you should be falling asleep and when you should wake up. It sucks, I know. But give it a try.

9. Practice relaxation techniques. My last post was about practicing mindfulness in conversations. Well, lo and behold, I will argue again for the benefits of mindfulness – one of which is better sleep. Practicing some form of mindfulness (meditation, Tai Chi, yoga, eating without distractions, etc.) every day will help you sleep better.

10. Get lots of natural light throughout the day. If you weren’t aware, your entire body works on a close-to-24-hour cycle. This is called your circadian rhythm. It’s partially controlled by your suprachiasmatic nucleus (SCN), a part of your hypothalamus that is directly connected to your eyes and thus senses light. Your SCN controls the release of the hormone melatonin, which you may know is involved in sleep. To make a long story short, get lots of natural light throughout the day and avoid getting any bright light for a couple hours leading up to bedtime in order to keep your circadian rhythm in check. This is a simple way to listen to take advantage of your body’s natural sleeping mechanisms to overcome insomnia.

Were these tips helpful for you? Have you already heard all of them? Do you have any other tips? Leave me a comment; I’m interested to see your answers.

Why so angry?

I can be an incredibly irritable person from time to time. I get annoyed when people walk too slowly in front of me, when the fridge won’t close properly, and when I keep dying in Resident Evil at the same point. Usually, I’m able to control my anger and let it diffuse. But sometimes, I’m not. Like yesterday – when I tore off my running shoes and launched them with such force that they both left permanent dents in the wall, all while screaming obscenities at a volume that left my throat feeling raw.

There is a definite link between anger and anxiety. While they clearly feel different, they’re both states of heightened arousal. Both emotions often involve cognitive distortion and a biased evaluation of a situation. They both seem to involve the release of adrenaline and thus are manifestations of the fight-or-flight response. And from my personal experience, sometimes very acute anger can feel like a panic attack - the loss of control, the fear of going crazy, the shame that comes after you cool down.

Anger naturally would have us act aggressively. Perhaps our ancestors could lash out at a threatening foe, but our modern society does not grant us the outlets for acting aggressively (outside the realm of organized activities like sports). Instead, we have to learn to either suppress our rage or calm ourselves down. Suppressed rage can be a source of anxiety in itself, and sometimes it’s simply not possible to calm down (much as it’s impossible to calm down during a panic attack). Waiting until you lose control of your anger is probably not the best method. Instead, try thinking ahead.

How can you control your anger? There are no quick fixes, but here are some techniques I’ve picked up that help in the long run to deal with my anger and keep me more grounded and easygoing.

• Try relaxation. Whether it’s light stretching or mindfulness meditation, relaxation techniques are a good thing to pick up if you’re prone to anxiety or anger. From my experience with mindfulness, I can truthfully say that the more you practice being calm, the easier it gets. Learning the proper breathing techniques and tricks for keeping your mind focused on the present are great ways to keep yourself calm. Learn to do this while you’re feeling okay, and it will become easier to do when you’re not.
  
• Develop better communication skills. A passive-aggressive style of communication is a major source of anger and frustration for most anxious people. A common example of unhealthy passive-aggressive thinking is assuming that someone else should know what you want without actually telling them, and then feeling angry or cheated when they fail to meet your (silent) demands. Try to work on being more assertive – this way you will get your point across in a healthy way. I struggle immensely with being assertive, but I’ve been trying to work on it. It helps to start small: try buying a product and then returning it immediately. If you can master being assertive with strangers, move on to being assertive with your close friends and family. Getting your point across in a polite but direct fashion will save you hours of frustration.
• Use your journal. A great way to overcome your anger rationally is simply to document the things that make you upset and take a look at them once you’ve calmed down. Maybe you’ll be able to see patterns in the sorts of things that make you angry. Better yet, you may see that your anger is irrational and come up with a solution. Try restructuring the way you see the situation. For example, rather than honking and screaming at a driver who cuts you off, try asking yourself whether that person may be in some sort of emergency. Challenging your anger with rational thinking is a productive, healthy way to modulate your emotions.
• Exercise more often. Anger, like anxiety, is the product of pent-up emotional energy. Exercising is a great way to diffuse some of that energy. Go out for a jog or hop on your bike.

These are simply a few of the ways that you can learn to control your anger. Anger can strike out of the blue, sometimes in situations where you can’t easily diffuse it. Practice these techniques when you do have the ability to control your situation and it will get easier to handle situations that you can’t control.

How do you cope with anger? I would love to hear your own techniques.

[As a post-script, I just want to apologize for the sparse posting over the past week. My goal is to post at least twice a week, but I've been busy lately writing guest posts. You can read my guest post for Summer Beretsky's blog Panic About Anxiety here, and you can read my two guest posts for the Free Your Mind Projects here and here. I will resume posting more regularly! I hope you've all had a fantastic week.]

Today, I want to share a story. The year is 2012, and I’m back at school living a “normal” life. In order to move forward with my thesis project, I have to defend my thesis proposal in front of my professor and my fellow honors students. Like the procrastinator I am, I leave the presentation to put together the night before I’m scheduled to present. The following morning, I wake up and I instantly know it’s going to be a tough day. I gather all my stuff together, stuff a piece of toast in my mouth, and run out the door. In my bag is a little bottle filled with propranolol, a medication that calms me down and stops my physical anxiety symptoms from manifesting. I get to the psychology building forty minutes early, just to be sure I’m not late for my proposal defense. As my hands start to shake and my heart rate speeds up at the thought of speaking in front of my peers and professor, I pop one 20 mg dose of propranolol to calm down. Of course, unlike Xanax and other benzodiazepines, the propranolol does nothing to calm my racing thoughts and feelings, it just paralyzes my body a little bit so that other people can’t tell how out-of-control anxious I am.

Time is ticking by, and the other students in my seminar begin to show up. I laugh when they ask if I’m nervous, trying my best to avoid the question. I wouldn’t say I’m nervous – I’m freaking out! The metaphoric bell rings, and we all file in to the seminar room. The propranolol has slowed my heart, so I feel a little bit of relief, but my thoughts are racing and I have a crippling sense of dread. I stand up in front of the class and start talking. It feels like the room is narrowing in around me, as if the world is dissolving away and I’m left alone with my fear. My speech begins to feel automated, as if I’m on autopilot and the words are just spewing out on cue. I speak with adequate intonation, I have a good blend of hand gestures and eye contact; all in all, the presentation goes well enough. But inside my mind, a war is being waged.

After the presentation, I sit down and receive the usual reassurances – you did great, you spoke well, you seemed calm. (I laugh a little bit at the notion that I could ever “seem calm.”) As I sit back in my chair and listen to the next presentation, I can feel my chest burning up, and sure enough, I’ve developed a rash. It feels like I just ran a marathon. I can barely pay attention to what’s going on around me; my body is in recovery mode, trying to reach a state of equilibrium again.

On the surface, I wasn’t any more nervous to give that presentation than anyone else. In fact, I probably looked more calm than my peers thanks to the propranolol slowing my heart and calming my breathing. And that is the hardest part of living with a mental illness: the semblance of normalcy. The appearance of health. Mental illness isn’t something that you wear on your sleeve, it doesn’t come with canes or walkers, it leaves no blemishes or bruises. To the outside world, I’m no different than anyone else. But if there’s anything I’ve learned through this process, it’s that no one can tell me what I’m feeling. I know the difference between normal nervousness and crippling anxiety. For other people who can’t see inside my head, my illness is only as real as I say it is.

It comes as a surprise to most people when I tell them I have an anxiety disorder. Some are empathetic, some indifferent, and some would like to think they can cure me. If you’ve ever had to “come out” with a mental illness, then you know the interesting reactions you can get. Sometimes you hear things like…

“But you’ve never seemed anxious before.” Well, thanks. I’ve had anxiety for 8 years. It surely doesn’t take 8 years to learn how to hide something from other people.

“Everyone has anxiety.” Thank you, I wasn’t aware. I guess I’ll just have to stop being such a baby, right?

“Stop worrying about it so much and just get over it.” Great advice. I would be ecstatic if it were that easy. It’s not. I’ve tried.

To other people’s credit, it can be hard to hear that someone you know well is sick, especially if it’s not immediately apparent. Everyone loves giving advice – myself included – so it can be difficult to bite back the comments that spring to mind and listen. It is true that everyone experiences some level of anxiety (anxiety is normal, healthy even, in small doses), so of course everyone feels like an anxiety expert of sorts. Thanks to the laundry list of cognitive biases that plague our minds, everyone has their own take on how the world works and what people need most.

I spend a lot of my time pretending to be perfectly normal. It’s a choice I make, because I want to live a normal life without letting my disorder get the best of me. Sometimes, I’m forced to lie. From colds to stomach flus, I get a lot of mystery illnesses. It’s a lot easier to tell someone I can’t leave the house because I have a heavy fever than to admit I’m too scared of having a panic attack to sit through a meeting. I would rather say that I’m hungover from last night than admit the real reason I can’t go to brunch is that I’m too anxious to sit at a table with other people.

However, in the past couple months I’ve learned that sometimes, opening up and talking about how you’re feeling can do a lot more good than you’d think. Talking my anxiety out can sometimes help me get to the root of the problem and feel better much quicker than hiding it. It’s a tough route to go though; if you’re anything like me, you can fill entire conversations with how you’re feeling. It can be difficult to get across how you’re really feeling without being overly wordy. You might leave out some important parts of what’s going on in your head and give the wrong impression of your general state of being. Taking those first steps – admitting to someone that you suffer from anxiety – can be incredibly beneficial on its own. 

Yes, sometimes there are empty smiles. Sometimes I laugh when I really want to scream and throw things. Sometimes I respond with vague one-word answers when I’m not really listening because I’m fighting back the urge to race out of the room. But that isn’t to say I’m not really here. I’m me, just as I’m me when I’m not ill. Hiding your illness doesn’t make you a bad person. Neither does opening up about it. Those are just two of the options we have as sufferers of so-called “invisible” illnesses. You may choose to let some people know and not others. Some situations demand that you explain your erratic behavior, while other situations permit you to avoid the topic. In the end, you control how other people perceive you, and there is no right or wrong way to approach (or avoid) the subject of your illness.

How do you cope with your invisible illness? Are you open about it, or do you prefer to hide it? Leave me a comment; I would love to hear your answers.