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[oseph]

Low dose of amitriptyline daily and massage therapy when extreme anxiety/panic strikes.  The massage therapy works wonders, and I no longer consider it a luxury (I found an inexpensive clinic).  I had an anxiety attack just yesterday over family health issues and how they were affecting my work, so I picked up the phone, scheduled an appointment, and a few hours later I was as calm as I could be.  Slept like a baby last night, woke up calm and ready to deal with the world.  It works wonders in lowering your cortisol level and raising levels of serotonin and dopamine.

[ucprof]

Anyone with a "type A" personality (and many of us in higher ed have that) goes through some version of this at some point.  So you need to realize that (a) this is actually somewhat "normal" to suffer anxiety at the TT level
(b) you need to relax about it because it is somewhat normal (c) exercise is incredibly important - think like an hour of cardio every morning - first thing in the morning - and I suggest swimming as part of the workout because it has a great calming effect that can last throughout the day and (d) please stay away from medication for anxiety because it will only give you worse problems longer term - most of it is not designed to be taken long term and it will mess up your central nervous system big time - and then you WILL have something to worry about.  

A life threatening illness will likely cure your anxiety over mundane things but you probably don't want that.  So given that your health seems fine, you need to RELAX, and take things one at a time.  CBT is a reasonable thing, and seeking help from a psychologist (not psychiatrist) who is trained in CBT is reasonable - in that they should be able to give you some exercises - both for the mind and physical exercises to help you relax.  

What you are going through is similar to what people go through with "test anxiety" or any major life event, except that your brain has somehow gone into overdrive and now you get anxious about everything.  This is not surprising because on the TT you are now getting lobbed with all sorts of new activities and expectations - you are being asked to multitask on many different fronts and this can be information and task overload which puts you in this mind set.  So you simultaneously have to learn to take things one at a time and relax about things, much like
an expert skiier would relax their body when going over a series of moguls - you take them in stride as bumps in the road - new courses, new committees, etc.  Nothing will be perfect but the point is to do each task as best as you can and then move on and not obsess about whether you did it right.  After a few years of this it will become routine and there will be less to worry about.  

You will do fine.

[grasshopper]

While waiting for an appointment with the CBT therapist (which has a great track record for helping people deal with anxiety), cut out the caffeine. It sounds like it's affecting how you deal with minor issues, which then escalate. Heightened caffeine intake is a big red flag, covered in sparkles, with fireworks all around it.

As people have said, the response becomes a sort of habit that your body gets into (and the body develops habits pretty darn quickly!) You've got to change your body's habitual response. Train your body to respond differently to minor stresses. But the first step is to cut the caffeine. It may not stop the anxiety attacks, but just cutting your caffeine will probably reduce them significantly.

[bhavani]

In my case taking regular yoga classes that include breath control exercises ("pranayama") has helped me a great deal. The yoga both strengthens and relaxes the physical body, and the breathing exercises seem to stabilize one's mental state while also positively affecting the body on a neurological level. I take 2-3  90min. classes per week and feel "straightened out" and robust. I think that my own anxiety stemmed from my nervous system being too enmeshed with external reality and feeling that I could not handle it all. By contrast, my physician (who is also a trained psychotherapist) recommended that I undergo a classical psychoanalysis for at least one year to work through my issues. She said that I was functioning just fine in everyday life and that she thought that I was not a candidate for CBT. I decided to try the Yoga path first, i.e., to work with body and mind, while also reflecting on my own personal situation etc pp. My impression is that the yoga somehow "regulates" me in a new way, and that by doing it, i.e., by assuming certain postures and moving through certain sequences, a certain "ideal" physical or mental state expresses itself through me. In this "newly ordered" state I feel quite normal and healthy, even joyous, i.e., I just look at myself without judging, knowing that I can recreate the effect by going back to doing more yoga. For me this was much more useful than the sense of pathology that I got when asking around in the medical establishment although I realize that there are a lot of good people/methods out there. I guess I wasn't able to trust, plus I absolutely believed in my body-mind's own healing power. My own insight: this vastly complex thing called life requires a sophisticated response system in order to keep up with it. My own anxiety had to do with finding a tool kit and knowing how to use it while also learning to "turn down the volume" of everyday life. When I reported back to my physician about two years later she was pleased to hear about my progress but couldn't at all relate to the story behind it. FWIW.

[dr_evil]

A CBT therapist recommended the book Mind Over Mood to me.  It has some useful exercises, but sometimes I find it hard to keep up with them.  When I'm feeling down, motivation is greatly lacking, but it is a good book.

[t_r_b]

While waiting for an appointment with the CBT therapist (which has a great track record for helping people deal with anxiety), cut out the caffeine. It sounds like it's affecting how you deal with minor issues, which then escalate. Heightened caffeine intake is a big red flag, covered in sparkles, with fireworks all around it.

As people have said, the response becomes a sort of habit that your body gets into (and the body develops habits pretty darn quickly!) You've got to change your body's habitual response. Train your body to respond differently to minor stresses. But the first step is to cut the caffeine. It may not stop the anxiety attacks, but just cutting your caffeine will probably reduce them significantly.

Yes. Yes. Caffeine makes my entire nervous system go on high alert. Even in relatively small quantities, I take it for granted that caffeine will cause me to be anxious. It's just part of what it does.

[marginalia]

No caffeine today so far = nothing done

*tears hair*

[warehouse13]

I must have the body chemistry of a martian. When I'm feeling anxious, moderate doses of caffeine actually calm me down. It's also the case that a cup of coffee in the evening makes me sleepy.

I always feel mentally foggy when I am anxious, and I think the caffeine sharpens my thought processes so I can do the reality check that previous posters described.

[puella]

Agreed. Sometimes, a little caffeine is really helpful. The reason I had cut it entirely was that I wasn't really drinking a "moderate" amount of caffeinated beverages, and it seemed like a good idea to detox, so-to-speak. I didn't have any for about a month, and lasted for most of the spring semester and summer with just a coffee or a soda here or there. Of course, I'm back on the caffeine-wagon now...oops.

[dept_geek]

Low dose of amitriptyline daily

oooff. You are stronger than I. I tried that, and slept for nearly 3 days. Couldn't handle it.

[llanfair]

My psychologist told me about "negative inner dialogue" - that is, the panicky, pessimistic, what-if voice in my head that comes up with all sorts of awful scenarios.  He also gave me a thought to keep in mind, which is similar to what MsParticularity said - when you're worried about a situation's outcome, remind yourself that it could just as easily turn out well as not.  I've found that I'm able to put both of these bits of advice to good use, but only with the help of the Paxil.

Oseph's right about massage therapy, BTW - it's wonderful for stress.  Some health plans do cover it. 

[prephd]

Oseph's right about massage therapy, BTW - it's wonderful for stress. 

Unless you're like me and being touched makes you anxious. One of my best girlfriends is a massage therapist and I've never even let her give me one.

I've had good results with yoga and swimming, both of which encourage deep breathing and breath control. Can't be anxious when you're too busy breathing in and out.

[grasshopper]

No caffeine today so far = nothing done

*tears hair*

The body recovers from caffeine withdrawal pretty quickly. And you may very well be able to find a balance between a reasonable amount of coffee and maintaining productivity. But from what you said, it sounds like you've gone from 0 to 60 in no time, and that's a lot of caffeine for someone who never drank coffee before.

[t_r_b]

But from what you said, it sounds like you've gone from 0 to 60 in no time, and that's a lot of caffeine for someone who never drank coffee before.

That's the issue for me as well: I rarely drink much caffeine, so when I do it has a heightened effect. That is good for when I really need to stay awake. But it means that drinking it makes my anxiety level spike.

[bread_pirate_naan]

Lots of good posts.

Breathwork/pranayama

--Lengthen your exhalation.

--Simple counting exercise.  Inhale 2 counts, exhale 4 counts. Continue until you get results. 

Seek qualified teacher(s) and do not confuse CBT with meditation.  They have different goals.  Meditation is not a therapeutic modality, but an enlightenment practice. 

You can often learn a lot more about yourself from CBT than talk therapy, because there is no narrative, just observation.  Talk therapy is based on the story you tell yourself and others about your life and identity.  Your cognitive behavior is [what constitutes the mental aspects of]  "self."  It cuts closer to the quick.