"Courage is the art of being the only one who knows you're scared to death." - Harold Wilson
Question #89568 posted on 05/01/2017 10:22 p.m.
Q:

Dear 100 Hour Board,

Those of you who struggle with anxiety -- how do you communicate about it to your spouse/loved ones? How do you explain your thought patterns and reactions to someone who is un-anxious?

I've figured out recently that I have a lot of anxiety, probably enough to be formally diagnosed, and I've also realized that my spouse has no idea what's going through my head. It's hard for me to explain, because to me, my thought patterns are normal. I don't have the means to do therapy right now (I am not in Utah, so the CCC won't help). Back when I was at BYU I did an online program for managing anxiety through the SilverCloud program, which helped some, but I still feel like I could progress in understanding my behavioral/thought patterns and helping my spouse understand them too.

Are there any good books you would recommend about anxiety, or any other resources? I keep thinking about how reading Come As You Are really helped my husband and I communicate about sex, and it was incredibly helpful for us in that area because it gave us language to explain things to each other. I'm hoping I can do something like that, but about anxiety instead.

Anything helps. Thanks. I love you guys.

-Fharya the Anxious

A:

Dear Fharya the Anxious,

I mean, the honest answer to your first question is, "...Carefully?" I can communicate all day about other people's anxiety, but mine is a lot more complicated for me to talk about. I am, therefore, not going to offer advice on that part. I was going to try, but it made me anxious and I'm just not going to get anxious over an anxiety post.

I came to offer advice on books. There's this therapeutic approach called CBT, cognitive behavioral therapy, which is the go to for anxiety. You might, therefore, look into a book called The Cognitive Behavioral Workbook for Anxiety by Dr. William Knaus. Me, I don't love CBT. I therefore recommend The Mindfulness and Acceptance Workbook for Anxiety. That book uses ACT, acceptance and commitment therapy, which can be interesting. Acceptance and commitment therapy is also used in a lot of couples therapy. I haven't read this book but I've read others in the series and they were good. While looking at these books, I also noticed that The Anxiety and Phobia Workbook has pretty good reviews, so maybe check out that one, too.

- The Black Sheep

A:

Dear Doctor,

You might want to try an online therapy program like Talkspace. I've been using it, and it's pretty awesome.

-Tally M.

A:

Dear Fharya,

This is a hard thing to deal with, and though I might not know your issues completely, I understand where you're coming from. I have pretty strong social anxiety but don't usually talk about it, which results in lots of miscommunication between friends and family. A couple days ago, a friend sent me this article on 81 mental health resources for when you don't have access to therapy. Maybe one of those could help. Here are a few in particular I thought might be useful, given what has helped in the past for you:

  • ACT Coach: App that teaches users how to handle negative thoughts by guiding them through mindfulness exercises.
     
  • ADAA: Offers extensive list of free or low-cost support groups for anxiety or depression in your area. 

  • AETAS: Mind balancing app that uses visual aids, meditation exercises, and inventories to eliminate obsessive or negative thought.

  • Happify: Designed by happiness and health experts as well as psychologists to lower worry and stress via games, activity suggestions, and gratitude prompts.

  • How Are You: Tracks your mood so you can recognize patterns in depression/anxiety flares. You can also see popular moods worldwide, see which emotions you most commonly feel, and export data to share with family member or mental health professional.

  • SAM: Monitors anxious thoughts, tracks your behavior, and suggests personalized self-help exercises.
     
  • Stop, Breathe, Think: I love this website. You select your mood and current stressors, and it suggests personal guided meditations.
     
  • Worry Watch: Allows users to track what causes them anxiety, observe when the outcomes were harmless, and record insights to remember in future anxiety flares.

As far as talking to your loved ones goes and helping them understand, I think communication is key. When we're feeling a strong emotion, it's easy to think that the other person understands exactly what we're feeling without telling them when they might not. The more open you can be with them (so long as you trust them), the better. For example, before I communicated with my coworkers, they would often think I was cold or aloof when in reality, I was just really, really nervous. I didn't realize that they thought this until they told me. After that, I tried to communicate more that I loved being around them but not to take offense if I'm a little quiet because I'm usually more comfortable observing or listening than talking.

In your situation, letting people know what makes you anxious and maybe why could help them understand where you're coming from (even if they can't relate). That way, they might be able to see your perspective and offer their support. Sometimes anxiety can be so strong or confusing that you might not know a source but even saying something like, "Hey, I'm feeling pretty nervous right now" could help your loved ones be more aware of your anxiety. Hope this helps and good luck!

-Van Goff

A:

Dear friend,

I think a really, really watered down definition of anxiety might be something like: wanting to do something well and feeling (intense) nervousness about the process of doing it. When felt in extremes doses, it can be debilitating. 

So can I give you some advice I've barely ever listened to that can maybe help? OK, I shall: Exercise. Run. Hit things (preferably things that want to be hit, like a punching bag). Anything to get the anxiety-causing energy out. At the same time, make sure you're giving your body the nutrients it needs to function well. 

The other writers have recommended some good resources, but don't forget about the biophysical/chemical approaches. That's exercise, meditation and mindfulness practices, medication, etc. For me, drugs were never ideal, but they were a good step in the healing process. 

Take care,

-Auto Surf

A:

Dear F,

I recommend Feeling Good by David Burns to my patients who are looking for a great self-help book. Like The Black Sheep's recommendations, it's focused on cognitive-behavioral therapy. Remember that the secret to cognitive-behavioral therapy is actually practicing all of the thought exercises, not just reading about them. This book focuses on depression as well as anxiety, so if there's a chapter that doesn't apply to you, just skip it.

- Eirene