Please help with reoccurrence of anxiety

@yanks950 You've had quite a week or two, between Covid, your daily tech training program (kudos to you on that!) and managing depression and anxiety. A few things to note:

* Just as the Covid virus can cause fatigue, it can also trigger some brain changes contributing to feelings of anxiety. You stated you tested positive a week ago Monday - since today is Monday, I'm unclear if that was last week or two weeks ago. It may take at least two weeks, sometimes more, for the virus to get out of your system. It's generally advisable to retest for Covid after symptoms have resolved, particularly if you're returning to settings where you're coming in close contact with others.

*I may not be following if you've been going out to bars and having 3 bars since you've had heightened anxiety (and after Covid) or if this was before, but in any event you stated you know about alcohol and anxiety. I take this to mean you're aware of the depressive effect alcohol has -after the initial sensation of feeling relaxed and sociable, many people feel the inevitable crash. While socializing can certainly help with feelings of depression, you may want to explore if it's worth the increased anxiety that may accompany after indulging. As you've likely experienced it becomes a negative cycle.

*The meds you've mentioned, Propanolol in particular, has a synergistic effect with alcohol and is generally not recommended to combine the two. Additionally, drinking with these medications can lead to drowsiness, poor coordination and slowed reaction times. So this can have a negative physical impact as well, resulting in compromised safety.

**I saw in the past, a concerned commenter suggested taking a break from your meds. I highly advise against doing so as medications such as these need to be slowly tapered, ideally under the guidance and supervision of a prescribing provider. As you've probably found, medications for depression and anxiety frequently require adjustments to remain feeling as well as you can.

You've asked an important question, but let me ask some in return: Have you retested for Covid after the initial positive test? Have you attempted socializing with a substitute for these beers or sought any intervention for the potential reliance on them? And have you discussed these increased feelings with the provider who is prescribing the meds?

@yanks950: Anxiety is awful… leads to insomnia, poor nutrition and generally just not taking care of yourself.
My 2cents are to DISTRACT your selfish mind and keep busy- whether at school/work or home. You need to find some accomplishment and positive thoughts - clean/organize the garage or your closet, paint your bedroom a soothing color, etc. - just get off the couch or fetal position and DO Something! The more time you spend wallowing in self-pitty the worse the anxiety will get. With positive action you will realize better self-worth and be able to make best decisions for tomorrow. Next - encourage your empathy for others and find a way to demonstrate by doing something for someone. You will gain more self-worth by voluntarily helping others.
I know you are hurting, you feel alone and feel you are worthless right now. Believe it or not ALL of us have bouts of anxiety/depression but only YOU can decide to make changes in your thought and action. You can decide tomorrow to be happy, be productive, be successful! Don’t make another excuse why you are miserable… you have the strength and power to change your tomorrow! I know you can do this!

So I had Covid a week ago from yesterday. But I have had Covid before and it’s just like a head cold that comes and goes quickly. I have not retested but I have been symptom free for multiple days which is what I told I need to be. I hope what your saying about Covid is true and that it is the cause of my severe increase in anxiety.

As far as the drinking I’m 36 so that is where me and my friends spend a lot of time. I understand I have to drink less but while I’m going through this I have been having 3 beers a night as a way to just get out of the house and be with people. I can’t come home from clinical all day and then be home all night feeling like crap. I normally go home from clinical and maybe take a nap which I wake up feeling horrible from and then try to go out for a little so I don’t go crazy.

I did talk to my psych but he said it was alcohol withdrawal when I first got Covid but it is 100% not as I have gone times without drinking. I need to talk to him again and possibly increase the propanol. I just know every night by 8ish I cry due to how crappy I feel all day for what seems like everyday.

@yanks950 I have been where you are in your clinical education. Clinicals are incredibly important, of course, in your training. Clinicals are also incredibly stressful and while you are learning the skills you will need for your future your whole being is overloaded with trying to keep up. Just when you experience a success a few minutes later a doubt creeps into your head. You're being evaluated by your supervisors at every step who are there to mentor you but they also have their own jobs to do.

Does any of the above sound familiar to you? If you have a history of anxiety and depression (as I did when I went to clinical internship) all of the "old stuff" is dragged up again.

When I was in school I also relied on my friends for support. We did not live close to one another so at night I was mostly on my own and spent much of time reading or writing. What helped? My parents lived closeby in those days so I often went to my parents' home for dinner or just to be in the presence of my mother which I found calming.

When I changed professional careers many years later I had more wisdom on how to take care of myself. I had a group of friends I made plans with, I learned that exercise was helpful (running or walking in the summer, x-country skiing in the winter), and I distanced myself from nay-sayers or anyone who brought me down. When I experienced insomnia which was most nights I taught myself some self-soothing techniques that helped. One of these I still do. I loved the neighborhood where I grew up and so I take a mental walk through the neighborhood "seeing" the houses and remembering the families who lived in those houses. I mentally walk through the house where I grew up. In minutes I drift off and I'm sleeping.

Happiness is not something we choose. We also do not choose to feel anxious or depressed. I have learned that we can practice acceptance and take the anxiety and depression along with us as move forward in our lives. I no longer try to distract myself from anxiety which I still experience at times. I've been anxious and felt panicky enough over the years that I have learned I won't feel that way forever. I ride the anxious wave up and wait for it to smooth out.

One of my friends who is a nurse told me that feeling anxious and depressed when I'm ill is a normal response to the virus. No one is happy, she says, when they don't feel well. It's very possible that COVID this time - and it's la different variant of the virus then the last time you had COVID - may indeed be affecting your mood and your emotions. Please allow yourself the rest you need and give yourself the gift of compassion.

Do you see a mental health therapist?

Everything you said about Clinical's is true. It has me worried about the future and if this is truly the field I wanna be in because of all the pressure.

My problem is I live a very sedentary lifestyle and know I need to change it but have no drive to change it. I feel like the more I do the more I have a chance of having another problem with anxiety or depression even tho I’m here now.

I’m really hoping it’s because of the Covid but the thing that always gets me is there is no definite answer or cure and the length of time to get back to where I was always varies.

I just am upset and always asking why me. The only time I feel totally relieved is later at night when I cry and pity myself.

I am seeing a psych doc but need to get a therapist. It’s hard to do that now because I just don’t feel like I have the fight in me to call around and figure out which one is right for me.

@yanks950 While it's hard to say with 100% certainty what has led to your uptick in anxiety, as @naturegirl5 also indicated, Covid is likely contributing to your current situation at least in part.

You may hear the advice to "pull yourself up by the bootstraps" but while you're in the midst of a depressive episode, that's hard to do. As pointed out, it can be okay to lean into those feelings rather than try to suppress them and explore your rationale for what may be keeping you in this troth now for which you've asked for some guidance. Exercise, activity and healthy socialization can definitely help, although it may all sound overwhelming at this time. Would it help to make a list of some short term and long term goals?

That list may very well help, keeping in mind motivation for change needs to come from within. You've recognized you need to rest after a long day of clinical; that's a positive step to restoring your physical and mental fatigue. So score one in that step! You then recognize the need for socializing with people - another step forward. Then there's that fuzzy part of acknowledging the consequences of having those 3 beers but being aware of the negative implications of doing so, while perhaps attempting to rationalize it. Yet you've seen that complete withdrawal is hard way to go about breaking a habit.

Perhaps explore some things you may have the tools yourself to answer about how to alleviate the increased anxiety and depression you're feeling and ways to go about implementing change:

*Is increasing medication the most ideal way in this situation to cope with this cycle?
* Have you discussed with your psych that you're taking the meds while having these 3 or so beers as frequently as 5 nights/week?
*Would you consider addressing alternatives to having or craving alcohol? There are many such ways to seek and obtain such intervention, whether it's guidance with detox/withdrawal, devising a treatment plan with an appropriate provider, engaging in directed therapy.

When you talk to your psychiatrist, would you feel comfortable discussing any of the above?

When I go to my docs I’m always an open book. I know they want me to cut back on my alcohol. The problem is that in the mental state I’m in I don’t feel capable or have the will to actually try to change it.

When I feel better I intend to work on it because I will have the energy and will to do it then. I enjoy drinking with friends. I just know I have to cut back on how often I do it.

Everyday is a struggle right now and I’m trying to do things that I used to do before this to try to feel somewhat normal even through though it doesn’t. If that makes sense

Don’t cut back-Quit. Best thing I ever did. There is nothing that a drink won’t make worse.

@yanks950 I am going to be very frank with you here as you have been open with us. I'm happy to hear that you are very open with your doctors.

I worked as a psychologist in a behavioral health facility for many years. I evaluated and treated clients with co-occurring disorders which includes substance use (alcohol is one of these) and mental health disorders such as anxiety and depression. From what you've described here - and please correct me if you think otherwise - you drink beer when socializing with friends. You don't drink beer when you're on your own. You feel very anxious and its these times with friends and with beer that you feel better. The problem with this scenario is that without you realizing it and never intending for it to happen the beer can exacerbate and contribute to anxiety. Then, you want to continue drinking alcohol and may feel better if you drink more. Then a cycle of drinking beer and feeling more and more anxious continues. This is how problems with alcohol often started for many of my clients.

Going to a pub to drink with friends? Just the pub alone surrounded by alcohol can be an impetus to drink. If you feel you can switch to soft drinks in that setting, please consider doing that. Some people are very able to do this and enjoy the socializing part. My clients could not do this and needed to find other ways to socialize with friends that did not involve alcohol.

Here is my question. What are you willing to do in order to feel better? This is not only about motivation because if we wait for motivation sometimes it's just not there. But willing to do what you know is best for you?

This is the quote I use for myself and for my clients when I don't feel motivated:

Yoda: "Do or do not. There is no try."

Yoda means this. You fully dedicate yourself to a task, rather than just giving it a half-hearted effort or waiting for motivation to spur you on. Yoda means that either you commit to something and give it your all, or you don't even bother attempting it.

What do you think about Yoda's quote and yourself?

@yanks950 I've read naturegirl15's response; what key points to hone in on! There's reflection of what I believe she and I have been hearing as expressed in your writing - and part of what I'm hearing is motivation vs. desperation.

Here's the difference between the two, and it circles back to one thing I mentioned earlier - as one is short term and the other longer. It sounds like you've been describing a cycle of negative, quick-release feelings brought on by a sense of having no options and hopelessness. That equates to desperation - a feeling of no way out so to self-soothe in any way possible right now. That's a short term management and can be cyclic if not broken as something always seems to come down the pike to reinforce it. Motivation, on the other hand, is an inner drive to achieve positive goals that will also lead to long term enjoyment. However, get that it's hard to feel motivated when you're not feeling positive.

So the first step may be in addressing how you -- and you alone - can take those steps to avoid the desperation, for lack of a better term. Perhaps it's hard to see from your perspective right now, but you've asked for recommendations so there is some part of you I'd guess that is open to considering those suggestions. I'm also wondering if you were hoping to hear some assurances that your plan of continuing the going out to the bar/pub and drinking alcohol while you're feeling like this is a safe, sound and logical idea. There has been a lot of rationale to indicate otherwise.

Yoda's quote to me underscores the need for commitment and does not allow for cop-outs. It's a way of convincing ourselves WE CAN DO THIS rather than a meeker I CAN TRY TO DO THIS. The latter allows for a pass when things get rough, the former requires fortitude, dedication, adherence and support. You've demonstrated those qualities by exploring a career path - even if it's not the one to last a lifetime (I can assure you that many of us have changed roles over time!) and maintaining your clinical efforts with the vital support of those providing training. There's also support for cessation of drinking. Therapeutic intervention, as suggested, is one such way to obtain that support. Another is a 12 step program. Is that something you would consider?