Wednesday, February 18, 2015

Finding Happiness as a Writer: MANAGE YOUR PANIC

If you’re new to the series, you can check out all the posts here. (Start at the bottom.) If you’re not a writer but struggle with anxiety, this is a post that you might still find helpful.

Let’s talk panic. Welcome to your crisis post, the one that coaxes you down from the ledge. [Small print: I am a licensed RN but nothing in this post should be considered official medical advice. If you believe you are ill, you should consult a medical professional in your area or 911 for emergency transport.]

Today's musical selection: ANXIETY by The Black Eyed Peas. For whatever reason, there's no licensed Youtube clip [I hate when that happens] so if you're hankering for readalong music, pop in your Elephunk CD or check it out on Spotify (track 12). Basically, if your train of thoughts is more like a runaway train, if your anxiety is worse than bullets from Uzis, that's a problem.

I’m not going to lie guys—sometimes I get stressed—like trembling fingers, racing thoughts, chest tightness kind of stressed. Usually it’s when I’m looking at my to-do list and thinking “Ahahahahahaha. Why did I agree to write fifty-six guest blog posts and teach a class and edit two full manuscripts while I'm trying to draft, revise, and promote three different books? OMG, I wish Fiona Paul was real so she could help me with all this work.” But then I do some push-ups and the shaking stops, and I attack the list a bite at a time. I make to-do lists and a plan. [Plans help me a lot. Monthly, weekly, hourly--I make lots of plans.] And then my breathing returns to normal and slowly everything starts to feel manageable.

Panic attacks come in many types. If you’re having chest pain or are unable to function, please call 911 or have someone take you to the emergency room. I used to date a paramedic and some of his calls involved going out to the same house once a week to prop up an elderly man who slipped down in his wheelchair. The man's wife wasn’t strong enough to do it and they couldn’t afford home health so she called 911. I am telling you this because most of us think of paramedics like we see them on TV, always responding to gruesome car wrecks and shootings, much too busy to deal with our piddly little issues. NO. JUST NO. That is not real life. Your issues are part of their job. You are not doing anyone a favor by trying to drive yourself to the ER if you are shaking and losing it. And if there is even a tiny part of you that thinks “I might need the ER” then go to the ER. Sometimes a panic attack is a heart attack. People die every year because they don’t get a $25 EKG or $175 in bloodwork that can definitively diagnose a heart attack. Don’t be these people. Your life is worth more than 200 bucks.

But what if you’re stressing but not quite at that level?

If you’re hyperventilating, you’re blowing off too much carbon dioxide which can mess you up internally. Try these hyperventilation tips from Web MD.

If you’re not hyperventilating, but you’re breathing rapidly or you feel physically anxious—like you’re in “fight or flight mode”—try square breathing.
  1. Breathe in for 4 seconds
  2. Hold air in for four seconds
  3. Exhale for four seconds
  4. Hold lungs “empty” for four seconds 
This type of breathing is taught in emergency response classes as a way to calm your whole body. It’s also used by military snipers to calm their minds and reduce trembling of extremities. At least that’s what Parvati [my LIARS book-girlfriend] told me. I square breathe a lot. A lot. It can also just help you learn to use your lungs more efficiently.

Okay, but what if you’re feeling stressed but it’s not necessarily manifesting in your vital signs? 

I also sometimes do what I call the DESTRUCTIVE THOUGHT SPIRAL. Here’s an example: Editor likes option manuscript but tells agent she has to pass because the book is too similar to something else on publisher list. Do I have anything else she can read? I immediately do something like:

1. OMG, everyone hated my submission.
2. Passing on the sub was a nice way of telling me I’m finished at publisher.
3. My editor doesn’t really want to look at another project.
4. She won’t buy more books from me ever.
5. No one will buy more books from me ever.
6. Publisher probably won’t even do much for current book there since they passed on sub.
7. Basically, my career is over.
8. Which means I will be miserable FOREVER.

That’s a slight exaggeration of my spiral, but not as much as I wish it was >_< Let's all agree this is serious drama queen action. It’s one thing to be aware of the worst case scenario. It’s another thing to assume it’s inevitable every time things don’t go your way. I mean, what if you got caught in traffic and arrived home two hours late to find your husband packing his things because he assumed that your traffic jam was an affair and you were obviously going to leave him so he was packing to get out of your life forever since clearly you don’t love him anymore. Not okay, right? Rule of thumb: Try not to behave in a way that you wouldn't tolerate from other people. You might run across a lot of ledges in your writing career. Don't crawl out on the ones you have no business being on. [The reality of that spiral is that the editor bought other books from me and the book she didn't buy sold to someone else. Oops, don't I feel silly!]

Things NEVER to do when you are seriously anxious or caught in a destructive thought spiral:
  • Email your editor
  • Post on social media
  • Make huge life/career decisions

Instead you might try:
  • Talking to a friend or your agent [Note: a friend is not a 285-person writer message board. Groups like this can be great, but I caution you from getting too venty with them, and I'll tell you more about why next week.]
  • Yoga or stretching
  • Push-ups
  • Walking
  • Running
  • Music
  • Inhaling lavender or rosemary
  • Writing therapy
  • Complete distraction [movie with friend, drive to the beach etc.]
  • Emotional freedom techniques [sort of like self-hypnosis]
  • Licensed cognitive or behavioral therapy

Butterfly is soothing, yes? Perhaps you need a therapeutic trip to Costa Rica.

I did my Master’s project on reducing test anxiety in nursing students, and there’s empirical evidence that music can not only reduce blood pressure and heart rate, but also cause people to report lower levels of anxiety. For some people loud angry music works best and for other soothing classical music helps. The deciding factor seems to be the kind of music you like.

Inhaling lavender or rosemary also resulted in lower heart rates and lower reported anxiety scores. Writing therapy [If you haven’t figured it out, this whole blog series is writing therapy for me], in which anxious students spent ten minutes journaling about their anxiety prior to taking a test, not only resulted in lower reported anxiety, but also in higher test scores. [Hey, maybe this blog series will make me a better writer!] Other things that work according to the research I did include emotional freedom techniques and licensed therapy.

Speaking of therapy...When I was in nursing school, I was that kid who got all As on the tests but was scared to touch the patients. I had particular anxiety about inserting IVs because when I get nervous, I shake, and no one wants a shaky IV inserter, right? I talked to a LCSW through our student assistance program. That’s the only therapy I’ve ever had and I went because I was really suffering and because it was free. And it helped me. And I got to do my senior practicum in the Cardiothoracic ICU, one of the scariest places to work. I later graduated with an “Award in Clinical Excellence.” Me—the girl who was afraid to put in IVs. 

My insurance is crap now and I can’t afford any kind of counseling, but if I could, I would probably go. I mean, why not? Who among us couldn't use an unbiased listener to help us navigate the stresses of life? I would say probably 30% of the writers I know have told me they take antidepressants, anxiolytics (anti-anxiety meds), and/or see a therapist regularly. And that's lower than the real number because not everyone feels comfortable talking about their mental health. YOU ARE NOT WEAK IF YOU NEED TO TALK TO SOMEONE. You are not even unusual. I’m betting plenty of your writer pals are also seeing someone and/or taking meds too. Just because they don’t tell you doesn’t mean it’s not happening. It goes back to the introductory post: We writers are a sensitive bunch and writing can be really unpredictable and scary. Get help if you need it.

As far as meds go, I don’t take antidepressants or anxiolytics, but it's not because I'm the picture of mental health >_> Mental health is a fluid thing and I definitely have days where I feel emotionally labile or frail. I'm only telling you all that because it feels disingenuous to say there's no shame in taking medication and then not be straightforward about myself. I can say as an RN that these meds work really well for a lot of people, and if you have a side effect from one (weight gain, cloudy thoughts, etc.) there are lots of other options. Finding what works for you might take a couple tries.

If you have situational or social anxiety that only bothers you occasionally, you should know there are pharmaceutical options that aren’t psychotropic that you can take on an as-needed basis. Beta blockers are cardiac meds sometimes prescribed off label to lower your heart rate and blood pressure if you’re like me and shake/sweat when you’re anxious. Beta blockers are used a lot by classical musicians and stage performers, and I have taken them to survive school visits and store events because these things are really hard for me. [Note: hopefully this doesn't need to be said, but taking any kind of prescription drugs while not under the care of a healthcare provider is illegal and dangerous. Don't do it.]

Okay, so to recap:
1. Get help if you need it.
2. If you're doing okay, try some things on your own, but then
3. Get help if you need it.

Next week we're going to talk about building a support network, and yes that involves more than just joining one of those huge 285-person online writer forums. Depending on who you are, it might even involve reducing the time you spend on one of those. See you then :-)


  1. This is the post that I think will be the most helpful for writers and non-writers alike!
    The good thing of being a RN is that you can recognize things for what they are (unless we decide to ignore them and be in denial, of course) and try and find a way to stop the anxiety before it gets worse.
    I'm usually rather bad at letting myself feel things because I tend to push through things and go on, and then when I do BAM! it hits with a lot of bloody awful mental downward spiral... that I end up having a hard time controlling but music and some nice herbal tea have a soothing effect on me. Just going through the motions of preparing the tea, holding it in my hands and drinking it helps.
    I have a friend that has serious anxiety, and she was on medication for a while, and now through therapy she's off her meds, unless she's having a particular bad attack, and I'm her go-to person when she needs to talk to break her spiral.
    Having someone to talk to, to help you break that mental spiral and be there for support really is priceless.

    1. Having a support network is so helpful. Just the other night I was like, to my writer-friend:

      Me: Marcy! I'm so freaked out because [stupid thing that doesn't really matter.]

      Her: Well [awesome thing that is actually important and relevant and totally counteracts stupid thing.] I'm just saying.


      And then I got back to work, and I still feel better thanks to her kind words.


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