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Anxious Insomnia

My anxiety keeps me awake all night.

(this is raw unedited text, computer transcribed directly from the audio)

Here's a question that I received from Joey. Hi, Dr. Kenner. About twice a year I have a bad anxiety, attack due to stress. I can't sleep that night, I can't eat. And I usually don't feel better until I've thrown up. I don't want to be on regular medication or med. But since that this rarely happens, the effects of not sleeping that night and not eating stay with me for days. Is there a medication I can take only when this happens? Thank you for your time, Joey.

Okay, I'm going to just address the medication briefly, that you can talk with your medical doctor, there are asleep medications that you can take as needed. Maybe, and maybe sometimes even an over the counter sleep medication can help. You know, they have Advil, they have Excedrin with some sleep aids in them and some other sleep aids. But you want to definitely get that information through your medical doctor.

And you also want to make sure that whatever is happening, this bad anxiety is not masking a biological problem. Because sometimes when we have anxiety, rarely, but sometimes it's actually not due to psychological issues. Sometimes it can be and what they even call caffeine ism, say too much caffeine or some other biological problem in your body.

But let's get back to your situation you have bad anxiety attacks due to stress, I'm going to take you face value, then let's just assume it's not medical, it's not biological. And if you're having bad anxiety attacks that make it so you can't sleep, you don't feel better, you can't eat and then you throw up. One of the things that you want to think about is that pills don't teach skills. So you want to do some introspective work become a detective, become a curious about yourself. Why twice a year, what is happening to me, you want to learn about yourself.

So you can ask yourself some questions. What type of stress was I under? That triggered this anxiety attack? Was it problems with your parents or siblings or in a romantic relationship? Maybe you had some difficulty at work or in your career or with finances or friends? Or maybe you're upset with yourself, you're on overload you took on too much you procrastinate. Or maybe it's with a new situation. Maybe you have to do public speaking twice a year and that triggers it. So you want to see is it the same sort of thing that triggers my stress these panic attacks or bad anxiety attacks twice a year? You want to be a detective? Why only twice a year? Is it what's called in quotes an anniversary event? Well, what's an anniversary event?

Well, sometimes if you have a trauma that happened at a certain time of year, perhaps brother died in a car accident in the spring, then when that time rolls around, even if he died a decade ago, you might feel down in the dumps. And until you do some introspective work and see that it's still some grief work that you need to do. You may not recognize it. Or you may have had some trauma as a child that happened at a certain time of year and it kicks back in and unless you ask your own mind, Hey, bud, what's up, you're not going to be able to identify it. So cognitive therapy is very good to give you some skills to identify what's going on.

So Joey, anxiety means uncertainty about something important in the future. And the key words are uncertainty. That's what makes the shaky about something important enough. It's not important if I lost my dirty toothpick, I'm not going to feel shaky and uncertain, and it has to do as anxiety is a future oriented emotion. Depression is more of oh, I'm bummed out something bad happened or nothing ever goes well, but anxiety is future focused. I have a test tomorrow. I'm I'm afraid I'll fail it. I have to go to the doctor's tomorrow. I'm worried about what he'll say. That's where we get that's when we get anxious. So you can use a uncertainty in important and future as key words, and you think about it, what am I uncertain about what is important that's going on in my life, what hangs in the balance in the future. And if it's difficulty with your kids, you can learn some parenting skills. If it's problems, thinking, maybe that's the cause of your anxiety, then you can learn thinking skills and cognitive therapy. If you're on overload, you will, you can learn a skill of scaling back. If it's some grief work, you can do some grieving that maybe it's complicated grieving or your your normal grieving. You know, another milestone is past and somebody wasn't around that you love. You can grieve.

So you want to really listen to yourself, be a detective, figure out what you say to yourself when you feel the first glimmers of anxiety.

Now, here's the second point. Another point, many times we have an emotion about having a bad anxiety attack, a panic attack, we say, oh my god, it's not that anxiety again. Now we have two problems, we have the original problem that triggered our anxiety. And now we have a second problem. We're anxious about the panic attack or the anxiety attack, about feeling out of control of our own minds. And that's called a secondary emotion. And it goes along the lines of, oh, no, not again. Why does this always happen to me? I'm not going to sleep, I won't eat, I'll have to throw up again. It will mess me up for days. Well notice, if you're saying that to yourself, you're sending down those messages to your subconscious. And you're anticipating those were the worst. And your own body is going to release cortisol and adrenaline into your system and it's going to make the anxiety worse.

So if instead you said to yourself something along the lines of Joey, oh, it's just this again, I can handle it. I'll write down what's on my mind and look for the core of what's causing me to feel uncertain then I'll work on a plan to deal with the sad situation you can learn some relaxation techniques and and roll with it more.

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