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What do you define as “extreme anxiety”

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Extreme is when I start to go non functioning. Usually when I get quickly overloaded. Not triggered but still, shutting down, back and neck tighter than a piano wire, and in "get home mode" as I call it.
I dislike medication as well. However the one thing I do know is that I tend to discount my symptoms - or more accurately I don't know how bad it is until its gone, if that makes sense. I popped the cartilage in my left SI long ago and suffered from low back pain, back spasms, and the same with my neck. Do therapy, find trauma and my back is 95% better. No chiropractor every two weeks, as a matter of fact last month was the first time I had seem him in over a year.

Just saying that sometimes, from where we are inside the sh*tstorm we don't know how affected we really are..
 
Is there part of you that feels like you don't deserve' to be diagnosed as having extreme anxiety?
Yes, absolutely. If I function, then that’s not extreme, or in my mind, often not even classified as anxiety.

Like @Freddyt describes, I also discount my symptoms. Prior to exploring my past I never noticed body pain like I do now. It’s daily, and I typically dismiss it as a fact of getting old. Even though, I’m still reasonably young, active, physically fairly healthy. So, when my stress is higher, of course certain parts of my body flair up to send me a message. But I keep functioning, ignore it, take Advil and carry on. So….nothing wrong with me.

So no, I don’t warrant a second glance or a description such as ‘extreme’ anything.

That’s one of the reasons why I’ve decided to return the prescription slip to my pdoc/T. The other compelling reason is that when he gets audited they question why a patient continues to receive that type of prescription and hasn’t ‘improved’. I refuse to let a stranger (paper-pusher) pass judgement on my T or on me. The only solution I can see is to stop filling that prescription.

I likely have not pushed myself hard enough to not use the medication when certain circumstances occur. If it’s the first thing I consider when managing specific issues, then I’m not doing it right.
 
Here's the thing, though - filling that Rx isn't a permanent thing. It could be that the Rx will help you. It's equally likely that the Rx will do nothing or not work in some way. But not trying the Rx has only one outcome: you continue to feel the way you do now.

My pdoc recently told me I should go on leave due to my own extreme anxiety. Because I trust my pdoc completely, I didn't dismiss her opinion out of hand. After some thought, I took the leave. But I could still go back to work tomorrow if I wanted to.
 
So no, I don’t warrant a second glance or a description such as ‘extreme’ anything.
What about this situation? When I had joint surgery last winter, they gave me pain meds to take after I went home. I was supposed to use them "as needed". Well, it hurt, of course, but it didn't hurt THAT bad. So I didn't really need the meds, right? And I started out not taking them. Because even though it hurt, I'd been in WAY worse pain than that, so I clearly didn't need them. Except that there were also a bunch of exercises I was supposed to do. And that was really important to a good recovery. And then I realized I could do the exercises better if I took the meds..... A dilemma. I took the pills for a week, did the exercises as perfectly as I could, and I think it was the right thing to do. Didn't use them as a way to do more than I was supposed to, just so I could do what was actually required. I find that to be a hard thing to sort out! Still is.

So, maybe talk to your PDoc about their definition of "extreme". Chances are they never really thought about it. That's probably just the word most commonly used when writing up a label.
 
So no, I don’t warrant a second glance or a description such as ‘extreme’ anything.
Except that PTSD is an extreme reaction to stress?

It’s not normal, having PTSD. As a baseline. Your normal and my normal? Send other people to the ER convinced they're about to die of a heart attack.

Just something that’s easy to forget, but important to remember.

***

It’s like when my kid was finally well enough to come home from the hospital? I had the direct number to the pulmonologist on call, no switchboard, because the YAY! Doing So. Much. Better! symptoms my son was sent home with after months inpatient? If I called the hospital switchboard & nurse line… rated immediate transport by ambulance, pulmonary called down, OR prepped, and surgeons scrubbing in. <<< Yeah. Same kid. Same symptoms. 2 wildly different expectations from those symptoms. >>> His normal, for the next few months? Was anyone else’s life threatening emergency. Because, yeah, his life was at very high risk… even doing Yay! So. Much. Better! We just happened to already have the supplemental o2, PICC line, and other interventions already in place. At home. With nursing shifts.

Just because it was his normal? Didn’t mean we could kick the medical equipment, interventions, experts, & medications to the curb. The opposite. He got to have a semblance of a normal life BECAUSE we had those things. Otherwise? It was back to living at the hospital.

Normal just means you’re used to it, and ideally, prepared for it. And it’s entirely relative.
 
Yes and don't discount how much quality of life you're actually loosing because of the anxiety. Not in the things you do, but the ones you don't, and the ones you screw up. It's a benefit risk balance and not a matter of judging your worth on the basis of your medication or disorder. PTSD is almost constant extreme stress and it causes a lot of impairment.

If I can function? More or less. But I function better with the meds than without. Would I thrive if PTSD wasn't there? You bet I would. But 85% of my hard drive is devoted in keeping shit together. If meds can reduce that to 60%, I'm taking it. Merely functioning and suffering isn't a life. We all deserve better, no matter if it's with meds, CBT or praying or all of this.

There is a perception we have of medication making us weak while we've been strong. Or more exactly, knowing that if the medication is becoming important it's because we've been weaker, and in fact, not really functioning. As a patient you have the right to choose what seems the most adequate and good for you, but I'd say we shouldn't discount how bad we feel and ignore the pain. I didn't realize how much I was in pain until it stopped for a bit. It's as if I saw the colour of the sky for the first time in my life.
 
Here's the thing, though - filling that Rx isn't a permanent thing. It could be that the Rx will help you. It's equally likely that the Rx will do nothing or not work in some way. But not trying the Rx has only one outcome: you continue to feel the way you do now.
very good point. i have personally been off and back on the benzo's, I was reluctant to start the first time too. It was the first drug that had EFFECTS as well as side effects for me.
Anxiety to the extreme is when I cannot function in anything but a hypervigilant state. Beyond that I am no longer aware that I am suffering, it just doesn't matter how I got there, I AM there and the next thing that needs to be done is the most important thing there could ever be and I will do it or die trying. Great when I was getting away from adversaries or fire fighting, not so great when dealing with a jackass that was brought up by parents that left a few lessons out. Thats the extreme of the extreme, but the start of the extreme is in the rear view mirror by that point. Extreme is a place where I know how I got there and the trail back. Still reliably in situational awareness but in danger of developing the tunnel vision of the extreme extreme. Think code 1 and 2 and the reserved code 3, def con 5 through 1, same words different values.
Managing to hide the anxiety is tiresome and difficult isn't it? I remember the day I realized the benzo's worked for me, it was like all the energy being used to hide the stress was suddenly available for better purposes. Like stepping off a tight rope onto a level plane with honed balance skills still intact. It is still like that, as long as:
I can attempt to throw the breaks on it by taking benzos
Once the ability to brake has passed, I don't think anything really walks me back. I am looking for the trail of breadcrumbs I left and hopefully able to get down the trail back, and once there the benzo's would probably qualify as a recreational abuse because back is back and once there I wait until I catch myself going up that hill again.
 
It sounds like you've made up your mind, but it's always good to know you have options. it can help as thinking of a med as a tool you can use. We all use tools to make our life more manageable.

This is very interesting to me. One of my most prevalent reactions to a lot of things is an automatic flip to numb. As in, I dissociate quick. I’ve done a lot of work to improve that and prevent it, but it still needs work. I never considered that to be part of an anxiety response. I figured it needed to be panic or more dramatic.

I go from thinking "I can't think" to numb/dissociated. It can definitely be an anxiety reaction
 
Can I do things on the medication I couldn’t or wouldn’t do without it. That’s my go to.

Psych meds didn’t work for me. Cannabis has been good. Occasionally pain meds or Valium. Eventually I realised even drinking was a “medication” as far as I was concerned, because I was just trying to make myself feel a little better. But I definitely don’t recommend that for anyone here, particularly if you are depressed.
 
Once the ability to brake has passed, I don't think anything really walks me back. I am looking for the trail of breadcrumbs I left and hopefully able to get down the trail back, and once there the benzo's would probably qualify as a recreational abuse because back is back and once there I wait until I catch myself going up that hill again.
Same. Which is why if I would have to take them every day? I don’t take them at all. Either it works as a short sharp jerk on the leash, or it doesn’t.
 
Funny how a word can throw you in many different directions.
I don’t like medications, took me quite some time to even consider their use as a method to treat ptsd. But my train of thought has adapted somewhat. The rule I had against their use is only in reference to me. I don’t judge or see others using them in any way as a negative.
So, recently I renewed my prescription for Ativan and my Pdoc who is also my therapist wrote the prescription that it should be used for “extreme anxiety”.

I have trouble identifying my emotions, so extreme anything for me?? I don’t know.
Now I’m thinking that I can’t use this medication because what I experience as anxiety is not extreme. I can still function. People don’t notice I’m anxious (cuz I work reaaaaaally hard to hide it)

Looking for some perspectives….
Are you able to identify physical feelings when you feel at your worst? They tend to be my signal more than anything else, since it's what arrives first.

I find 'anxiety' a little difficult at the best of times... It means an awful lot of things for different people. If you stick with your diagnostic word of 'stress' in your problem, then it's easier. For some that's physical stress symptoms. For others, it's particular thoughts that they get used to having 'on repeat' when the stress rises That's a good time to pay attention to what else, since the repetitive stuff with PTSD can become a 'shorthand' version in your thoughts. By that I mean some people tend to focus on 'words in their heads' (thoughts) that they make sense of their PTSD with but if those words (particular thoughts) mean stress, as in 'PTSD stress', then that is what is extreme is.

As for medication used as and when required... It's when you're at your most scared. You will know when that is even if that is when the thoughts about not using any medication for it become most prominent. It can help to ask your doctor what particular alleviation they're wanting you to use it for. Otherwise the worrying kind of anxiety can creep in and confuse that. Your doctor will know best about the medication and its uses, you'll know best about what scenarios that then means for you.
 
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