Please help with reoccurrence of anxiety

@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?

I feel overwhelmed sometimes from the program I’m in and especially right now with the constant anxiety I have been feeling for almost 2 weeks. My thing about drinking is that I want to cut back but I don’t want to quit. Not because I crave the alcohol but because it’s something I enjoy doing with my friends not feel forced to do.

I plan on looking for support from a therapist.

@yanks950: Anxiety does compound any type of learning and/or work experience to the point of feeling overwhelmed. There are definitely tools in addition to help you through this and you're definitely right to be looking for a therapist to provide some of those valuable techniques. You're also taking a major step on wanting to cut down on drinking. Sounds like you're ready to start on some of those short term goals!

Over the course of the next week, see if you can you try to check a couple off:
1) ask your psychiatrist - if you've not already - to recommend at least 2-3 therapists to contact and follow up with reaching out to them to see about scheduling appointments
2) practice deep, slow breaths to calm your nervous system at various times of the day and/or when feeling particularly anxious
3) practice drinking your beer slower so it takes longer to finish, alternate with drinking water in between to add to your sensation of fullness
4) consider speaking to your clinical advisor about your health issues so they nay be able to provide you with any additional accommodations during this time

How do you feel about the items on this list?

I find that when I am filled with anxiety, my thoughts are usually projecting into the future. I am constantly playing out possible scenarios that have not happened and may never happen. It helps me to practice just staying the present. I do what I have to do today. Today is all I have anyway. I also find that putting my hand on my stomach (usually sitting down) and breathing in through my nose and out through my mouth, paying attention to just breathing is also a way to calm myself down. I am in therapy, have long COVID (3 years now) in an online grad school program and a recovering alcoholic of 7 years. I also take propanolol and it does ease that fight/flight reaction that raises my cortisol. Those are just some suggestions. Breathing and staying in the present can really help. Also, remember that today is it. The past is just a memory and the future is not here yet (at least that we know about in this dimension of space time) 🙂