Ask HN: How to break anxiety/fear-avoidance cycle?
For years anxiety/fear-avoidance cycle defined my life. I tend to procrastinate to a such extent that causes problems in my day to day functioning, and generally my life.
For example, i have to submit 2 fairly simple assignments, in 2 and 3 days respectively. If i don't pass the next 4 assignments i will fail the lab, but i keep avoiding sitting down with all of my power. I feel pure fear and a sense of "i will certainly fail if i try".
The above example is with these assignments, but this type of behavior extends to everything in my life.
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[ 3.3 ms ] story [ 273 ms ] threadWhen the fear pattern arises again, realize as quickly as possible that it has come back. Stop it, i.e., do not walk down a road in imagination related to the fears, imagining painful outcomes or whatever. In other words, gently stop the thought and drop it. Relax tension in the body, especially in the head. Smile. And bring up the wholesome feeling, however is appropriate for you. This dampens the fear echo. Each time you do these steps, you are taking energy away from this habit of your brain. Every time you do it correctly, you're taking a step toward not being bothered by this concern.
This technique will work, but please just try it and try to do it diligently, giving it provisional belief. In the meantime, try to do your assignments, watching for your fear to decrease.
* This message pre-censored by HN, allegedly to preserve curiosity.
Realize that if you fail, your life is not going to end.
Internalize that even after you fail, you are not worth less than what you think you are if you succeeded.
Perhaps they say they do, but they are always totally full and also really low quality
The biggest problem is it needs to be quite well customized for each user.
I believe talking to anyone/anything helps a lot, and hearing feedback helps even more.
A "personal medical assistant" like that could help manage medication intake, serious episodes, moments when you feel very bad.
I have a prototype for myself, it's just a bunch of cobbled software running on a dedicated smartphone. The voice triggers and replies are prewritten based on my own self-analysis. But I know it all already, so the best part is medication reminders and letting me know what I live for.
However it needs to always be on me, and right now it uses too much custom software to just install on anything. I can't build such an app myself, but it should be possible.
I am single btw, so of course I have no one to talk to.
The therapists I tried were just public ones, so they're more interested in showing up and getting their cut out of the mandatory insurance system.
"We don't take on new clients" or "we only speak German" is a valid reply, and what's a depressed person calling for help gonna do?
Just hang up and give up or best case, call others. It's a shit system.
I gave up on it all and am trying to make/find a "system" that is truly personal, custom, free as in freedom, independent of the gargantuan public and for profit healthcare machines, which are too big to accommodate everyone, plus the disinterest in actual help is obvious in places where insurance is mandatory.
Not knocking on emergency services, surgeons, anyone fixing obvious physical problems, those people are worth it. Mostly mental healthcare, where it's easy for unscrupulous people to fudge numbers and make money for doing nothing.
It's like my hypothyroidism, took me years to get that diagnosis, it's stupid.
But of course, when you say "I'm depressed and I drink a lot', that's not the first thing anyone would think to check for. Or maybe my luck is terrible.
Either way, universal healthcare systems are just huge machines like the justice system, they work for most, but many slip through the cracks and get zero help, being left to self-medicate and self-help, which is hard when said machines gatekeep anything that can actually work.
That's how you get a huge popularity of homeopathy, religion, diets, illegal drugs, and anything desperate people can cling to and believe in.
I hope you can find yourself proper counseling though, I didn't know things were so dismal in Germany (I am assuming you are in Germany based on the contents of you comment).
Treat finding a therapist like dating or considering a friendship with someone. A therapist can be a very good therapist (objectively) but not click with you.
It's okay to say "I'm trying out multiple therapists right now to see who fits best. Can we just do introductions with each other?"
Find someone who you respect, shares some beliefs with you, and generally has a compatible outlook on life.
Also sometimes when you procrastinate it's an indication that what you're doing is not really what you want to do, so you might want to consider doing something else that you can be passionate about (not saying that's easy and you talk about assignments, so you probably don't want to drop your degree out of the blue).
Start with the smallest steps possible. Maybe that means opening the assignment and saving it to your computer. Then put it down and walk away. Come back in a little while and take another small step, such as reading over the assignment or making an outline of what you need to do to get it done. Often once you've done something you will often start to feel a lot different than if you've done nothing.
Keep track of how you're feeling. It's okay to feel more anxiety at first because you're doing something instead of nothing. Those feelings tend to subside over time as you take action, but the point is not to reduce your anxiety, the point is that you are making a commitment to do something in your life, to live your life, rather than to remain paralyzed in fear. Your goal is not to get rid of the anxiety but to live the kind of life you want to live.
This is the model for Acceptance and Commitment Therapy. A great book on this is "Get Out of Your Mind and into Your Life."
I call it the foot-in-the-door method, it makes wonders.
The other piece of advice I'd give is break tasks down. Write a paper is hard. Open a document is easy. Title the document is easy. Write a thesis is harder than those two but easier than writing an entire paper. Writing the first paragraph based on your thesis statement is easier than writing a paper.
If you have things broken down into steps its much easier to have a clear step by step plan on how to move forward.
One thing that's helped me is self talk. You should assure yourself that you're the man and that these challenges are easy for you to overcome. Don't be afraid to go over the top with this and when you do it, give yourself a pat on the back before you take the next step.
It can be also combined with a couple of neat tricks: talking with somebody about it & making a list about it.
Avoidance/procrastination is still an ongoing struggle for me, and I suspect it always will be.
But breaking things down into steps is my best weapon. Nothing comes close.
(Second place is probably "getting good sleep" which has positive benefits for well, just about any challenge your mind faces)
I actually extend this concept to life in general. I make lists of daily tasks. This even includes "getting out of bed", "taking vitamins", etc. Sometimes it's useful to give yourself "credit" for doing all of the little things. Gets you rolling. Sounds silly but it is often effective for me.
I implemented a system of 9+ hours of sleep the night before an exam; this means I'll be in bed an hour and a half (maybe 3 hours) before my usual bed time. This provides a noticeable buff to my speed, accuracy, and recall on test day.
I'll typically try making a list of the small steps I need to take, though I recognize that for some people seeing that list might make the anxiety worse. But for me it's a tangible step that allows me to cross off items and visualize the progress as I go which ends up reducing my anxiety about the task at hand. I do it for everything from work related projects to general "cleaning up the house" type work.
Conceptually, they know they just need to put one thing away at a time, but often their emotions kick in first and short circuits rational thought. I help them through this by sitting in the room with them and just calling out 3 things that can easily be put away and tell them to just do those 3 things. Then we will do it again, and again, and again, and ....., until the room is close to being clean and they can finally take care of themselves.
I also point out the phenomenon to them - I call it their "monkey brain" impulse, which I use to describe any impulsive or avoidant behavior. I also use "lizard brain" when they go into a blind rage against their sibling at some perceived slight or injustice, and %kid_name% brain for when rational thought and morality are piloting their actions. The framework seems to work for them, and helps them think about their thoughts (which is a concept I had to introduce to them, they'd literally never thought about doing that - I guess kids don't develop that until later?).
Seems like an excellent skill to practice so early. Love that.
Good parenting in place.
When I don't start a scheduled task, it just keeps pushing it down further and further. If I procrastinate too long, tasks at the end get moved to tomorrow automatically. Which sucks. Small steps, click start.
I have struggled with anxiety and fear-avoidance for a long time. Probably most of my adult life. It got to the point where I had to find external help in the form of a therapist. She specialises in cognitive behavioural therapy, which helped me take those first couple of steps. I got better after about 12 months of therapy, but felt like there was something missing in the CBT solution to the anxiety problem.
What really put things in a totally different gear was realising that the voice telling you to avoid, to put off, to cower and run from things, is just a voice. That voice feels like _you_, but it's not you. The voice is sometimes correct. Sometimes it's not. A part of CBT is questioning the unproductive thoughts and feelings, which helps, but it doesn't take this idea of "the voice being just a voice" to its conclusion. Just because you have a thought or a feeling does not mean you should take it literally, as the truth.
ACT, which I discovered by accident shortly after my epiphany, gets to the heart of it with defusion (de-fusing the internal chatter from your rational self) and five other core ideas. For me personally, the idea and practise of defusion was a core component in helping me deal with crippling anxiety. It requires work, but it's possible to feel great in the presence of _some_ anxiety and fear. It's possible to look forward to things which would normally make you anxious and avoidant.
Another book recommendation "A Liberated Mind" by Steven Hayes. I suggest reading a book or two and try to internalise these ideas through practise. No HN comment can provide the nuance and context you'll find in a book and through practise.
I found ACT to be a bit like relying on willpower. There were only so many times I was “willing” to move forward with my feelings when my thoughts and feelings are working against the task, before I give in and give up.
They eventually win out.
I had not noticed the pattern of "avoid negative feelings" -> "negative feelings increase over time", and I actually thought problems like my anxiety had gotten better just because I had found more and more elaborate ways to try to avoid feeling it. In fact, it got worse and I became more and more avoidant of things that might trigger it.
Now the anxiety is still there, it still sucks, but I feel it without flinching and carry it with me without getting lost in the stories it tells. And by doing that, I have enough space in my mind to do the things I was avoiding and be more present.
So again, thank you for writing this comment. Know that you have really helped at least one person.
Long term, I found success in changing my association to the stressor. For over twenty years,I used to feel dread and panic anytime I had to write more than two paragraphs. Last year, I decided I would write one page a week about anything. It was for ME this time. After two months, I completely changed my relationship to writing through this process. I also got a lot better at writing.
This helps me to silence the critics in me and to just get on with it.
The cushion is that you didn't apply yourself to the maximum because you procrastinated and ergo it isn't you who failed, but a you who did not apply themselves.
Why do we do it? Out of self preservation. Confronting the fact that the reality does not match our idealized self is a very difficult process as it leaves us vulnerable and exposed. We feel that our lack of skills will be exposed and everyone will see that we are failures.
In reality, there is only one self, you that is choosing not to do what you have to because you are trying to protect a fragile ego.
I don't mean to sound harsh, all humans do it in one way or the other.
But eventually reality catches up to us and forces us to confront our situation. In the expectation you will do as you always did. However, if you condition the future on taking failure as an indicator for growth rather than an indicator of danger, you will be able to overcome the situation.
Take what you fear the most and tame it by actively trying, and instead of thinking you will fail, think and accept that it is an indicator of all the new things you will learn.
NB: Speaking from experience.
PS. Radical acceptance is a powerful tool in getting out of these situations.
This is something that when I was growing up, we learned to deal with through sports. Sports teach kids to confront winning and losing early on and how to better handle their egos.
I wonder if these issues are becoming more common as sports participation has dropped?
I too played sports competitively as a child and that eventually fueled interest in PvP games. It was about proving one's self.
In contrast, when one is limited to just academia/school, they have a poor understanding of where they stack up as they are essentially in a microcosm of reality. I take it that OP is in advanced studies and did well in their prior years. With high probability they did too well in school for their own good and didn't have to learn how to be consistent and do the work.
Again speaking from experience on the latter.
Interesting thought about global leaderboards. I wonder if they are so big, that it's easy to dismiss though. I feel like there is an optimal size in between, sort of like what's happened in sports in the past. As a kid got better, they would get moved to higher levels.
A friend of mine was top 100 in a region with 10 million players, and I could barely get to top 10% without help. Granted my friend is absolutely brilliant and has played competitively in all the games he played (e.g. WoW, League of legends, hearthstone, and so on). I wish he could find something in real life that gave him the same rush as "being one of the best".
The idea of radical honesty is to avoid all forms of "dishonesty" which also includes omission. If you are feeling or experiencing something, you have to accept it and articulate it even that entails becoming vulnerable and losing some of the metaphorical shield that protects you.
In the example above: radical honesty is admitting that we are trying to protect our ego from being punctured by avoiding what is making us uncomfortable.
Radical acceptance calls for the acceptance of the current circumstances, i.e. expressing it is what it is, and trying to make the best of the situation. I can't change the fact that I am not as intelligent as Terrence Tao or Erik Demaine even though our childhoods up to a point were identical. The past can't change because the future wants it, so might as well try to create a future that doesn't want to change the past.
In the example above, radical acceptance for me was accepting that I can't just sit in the class and absorb the material as I did in undergrad, but instead I had to actively work for it to get the same grades.
I suggest you look into Dr. David Burns, the father of Cognitive Behavioral Therapy and the first person to seriously document and address this negative self conversation vicious cycle, and how to defeat it.
Insickness in this thread also pointed this out: start with the smallest step.
And when it comes to fear: become braver. What helped me a lot was to accept fear.
1. Regular written self-reflection, i.e., keeping a journal and
2. Re-framing "failures" as learning experiences; forgive yourself
helped me a lot.
The written part was important to me because it forced me to revisit my previous thoughts and reevaluate them in light of what had happened since last time I wrote.
(2) also helped me do things with the mind-set that "failure" wasn't actually failure. The goal was to try and learn from it.
I didn't get around to doing this until after school, but I wish I had. In your situation, I'd try to get myself to do the assignment with a quick pass early on leaving notes for things I wasn't sure about. Take a break, then revisit and revise. Afterwards, write in your journal what worked well and what didn't. Write about what you want to try next time differently if some things come to mind.
Hope you find a solution that works for you. E-mail is in my profile if you want to talk more about what's worked for me.
Before writing anything, I would read the previous entry.
Usually, I'd include a small goal I thought was achievable for the upcoming week.
That allowed me to slowly build up good habits. I'd reflect on how well my attempt over the past week went.
Beside the habit forming, I found value in just reading my thoughts from the past week. It was helpful to recognize negative thoughts that persisted week to week. And I spent time thinking about ways to improve the situation. It was also helpful to recognize desires I had that I wasn't making progress on and translating those into actionable steps.
The _key_ imho is the reviewing. That helps you set yourself up for improving instead of ignoring issues and stagnating.
For example, I once spend 2 weeks trying to decide on a startup name, for a startup that barely even exists anymore. It's funny now, and I think about that when I'm trying to pick names for things now. But in those 2 weeks it was not funny! I felt terribly guilty during that time.
Try to take it / treat it lightly. Joke about it. I know that's hard to do when you're in the middle of it though.
Keep in mind the point is to actually do the thing. Maybe my way doesn't work as well for and you find something else. I think it's worthwhile to experiment with different ideas here.
Therapy & mindfulness has been a huge help for me. It’s helped me be more aware of how I’m feeling, and to take steps when I’m feeling anxious. For example, I’ve got a regular reminder in my Phone to check in with how I’m feeling, to actively think about what I’m avoiding, and to consider what it is I’m afraid of that’s causing me to avoid. If I’m feeling anxious or avoidant, then I do something to help, like try to ”explore” why I’m feeling that way, and to do some mindful breathing / grounding exercises.
You’ve done really well to ask here for advice, being vulnerable and open is a huge first step. I’d recommend seeing a professional therapist or counsellor if you can, especially while you’re studying - your education institution should have some people who can help.
Same here. It took me 7 years. I would usually vomit before every exam.
The horrible thing was that my grades were 98th percentile and my study method was very effective for me. I've never had this problem until the end semester of the first year of University. I don't really know what happened given that that first semester ended perfectly: two exam with a 100% and one with a 93%; such are mental tribulations like anxiety
That being said both Anxiety and ADHD have the same exact dopamine problem which means that analogues of dopamine and serotonin treat anxiety if it's cause is genetic in nature.
I do not know if the poster has a genetic version of anxiety, however if they do here is what I take for my ADHD that works for anxiety:
L-theanine ashwagandha(its what is in Maca!) L-dopa
and my further twist is to take a tablespoon if raw Cacao powder in mornings as it has two ingredients caffiene and anandamide.
Anandamine is what interacts with CBD receptors, i.e. if you want to get around the TCH in CBD oil this is the way to do it as anandamine obviously is not tested for i the THC tests and there are no addictions associated with anandamine.
Caution, it does not solve the emotional past obstacle you have set up for yourself. to solve that part you have to drastically change your life from consuming to doing in the form of making and creating and communicating. And yes, it is in fact a lot of work. But, I can tell if you make the honest effort towards this life-change you will be rewarded with the amazing stuff you can do once that life-change take hold. IMHO
I call it the ADD-anxiety-depression circle. Can't do what needs to be done -> anxiety about it and just everything -> depression because it's all too much -> can't do what needs to be done -> repeat ad infinitum.
I found that I must fix all three of them at the same time, because any of them can trigger the others very fast.
No anxiety? Skip straight to depression. No depression? Still can't do shit and am always anxious. No ADD (am doing everything)? Things are objectively great yet I feel anxious and depressed. It's a horrible cycle that only gets worse.
I’ve struggled with this as well and only doing things that interest me helped. Over time those things were profitable enough; took a long time to find.
good luck and hang in there
He talks about that the greatest fighters pick their battles very well, and they often get submitted in the gym because they intentionally put themselves in handicapped positions so that they can learn how to get out (and sometimes that doesn't work out, of course). So life situations where stakes are not high should be used to run high-risk experiments so that we can learn from them. He takes about risk taking a lot, and how confidence building is important for high performers. First, you learn how to recover from bad situations. You train this a lot. Then you need to learn and experience that even if you make a mistake you're good enough to recover from it. If you know that you can recover from your mistakes you're suddenly free to take large risks. As an extension: if you're new to a field and you're looking to acquire skills then learn how to recover from bad situations first, so that you can then keep exploring without the fear of getting into bad situations.
Your comment made me realize that every failure i considering it as high stakes...
As for John Danaher, he's seems an interested character. For a while now i want to listen his conversations with Lex Fridman, and also the 3hour long conversation he did with two other martial artists.
I love watching ragged edge hill climb segments or peak performance downhill mountain biking runs, they're this weird blend of composure and moments of recovery, and you can see them pushing through each small mistake fearlessly, as they're so familiar with them.
Also, pages and pages of advice here about anxiety and nobody mentions caffeine? Be aware that many people get a big increase in anxiety from just one small cup of coffee. Try a caffeine-free life for a couple months, if you have never tried it.
Finally, similar to the above advice, try doing some work in the morning before your "procrastination and anxiety" side has even woken up. In other words, roll right out of bed, still half asleep, and slouch over to your desk and do some work on your project.
Good luck!
You may choose medication to help you with that initial training, you may have a completely different diagnosis.
No one here should diagnose you, because a doctor wouldn't diagnose over the internet.
A helpful book: "Brain Lock" by Jeffrey Schwartz. It's about OCD but in my experience all these things are connected.
For me, I can see when I'm getting into that cycle (e.g. haven't checked my email in a few days) and one way to break it is to use medication. I don't like benzos, but I'm sure they work. Instead, I take a full dose of Benadryl and that can sometimes help me get rid of the anxiety long enough to get through the initial part.
Drinking alcohol works too, but obviously only works when you're at home. Shouting or high intensity dancing to loud music can help.
Basically, just knock yourself out of it just enough to actually start doing the work. Once you start, you'll realize it wasn't so bad.
Just picture Michael Burry having to read this emails in The Big Short during the most stressful scenes.
* be present, in the moment
* be mindful, of your anxiety, of your surroundings, of your self
* take action based on the above.
Maybe also take a ADHD diagnosis from somewhere like adhdonline.com. It takes an hour or so, longer if you're very introspective about the answers, and then you'll know if there are medical options to help you with this as well.
I would recommend therapy. They'll give you some similar advice as this thread, and also help you implement it, help keep you accountable, and help find if there's a further underlying cause.