4 ms·

Forgive my ignorance and bluntness, but reading the above, it sounds more like an anxiety disorder than like depression. Both are serious, but I'm not sure if i

by swombat 12y ago

Forgive my ignorance and bluntness, but reading the above, it sounds more like an anxiety disorder than like depression. Both are serious, but I'm not sure if it helps to confuse the two? I've not experienced either seriously, but I know people who have. Depression seems to be more about things not mattering anymore, everything being pointless, the world seeming drab and just not fun anymore, rather than feeling that everything is going to go to shit. Anxiety, though, (and I'm speaking from experience here, having had some light anxiety attacks caused by too much regular caffeine usage) seems to be characterised by a feeling of impending doom, that everything is wrong, it can't be fixed, it's all hopeless, etc. But in my (mild) anxiety attacks, like Rand, I still cared about the outcome. I just felt like there were too many problems to solve, overwhelmed, ready to say "fuck this", give up the entire thing, and start again from scratch with something completely different. PS: Otherwise, props for the very honest and open article. Running a business is a lot of responsibility and very stressful and it can be comforting to know you're not the only who seems surrounded by world-ending scenarios.

rbinv 12y ago
Could you please elaborate on your caffeine-related anxiety attacks?
- flavor8 12y ago
  I can speak from my experience. I was for a long time drinking 2-3 cups of coffee in the morning. During the morning, generally things were good and I could crank out code. However, during early-mid afternoon I'd often get overwhelmed, tired, and unfocused, especially when multitasking, and often would lapse into a browse-reddit/agh-i'm-not-being-productive/browse-more-reddit cycle. Cutting down to one 1 cup in the morning has made a real difference - I no longer get the early afternoon slump, and can stay focused for longer in the afternoon without being overwhelmed by a long task list.
- swombat 12y ago
  Sure. I've found that when I drink coffee regularly over a long period, my intake invariably increases. Eventually, it reaches 2 cups of double-espresso-with-milk or equivalent a day, and goes past that too... after a few weeks or something months of that, I start getting strange episodes at random times that I describe as "light anxiety attacks". The way they feel is that I get an impression that something, SOMETHING is wrong. I'm not sure quite what, but I don't realise that I'm not sure what until I realise I'm having one of these attacks. There's an unpleasant feeling of tension that starts in the chest and radiates out to the rest of the body - all the way to fingers and feet, through shoulders, knees, etc. That's the physiological aspects. Mentally, I feel like everything is going wrong. Nothing looks like it's going to work out. I tend to be more aggressive and curt with people, and extremely negative of course, since nothing seems like a good idea. In one of these episodes, I could easily find myself thinking that this business that I run, that employs 17 people and turns over over a million pounds, is doomed and that I should just leave it and run away from it and do something else. When I think something so ridiculous, usually some part of me wakes up and says "hey, that's not quite right", and then I realise I am having an anxiety attack. If awake, once I realise that's what's going on I can deal with it fairly effectively. Get rid of any physical discomforts (e.g. go pee if I need to pee), have some water, take some deep breaths, and refocus on positive things. It used to take longer, but by now, once I realise it's happening, I can get out of it in a couple of minutes, even while I'm in the middle of conversation with others, so it's not noticeable to others. If I'm asleep, it's more bothersome, because I'm unlikely to notice it in a half-dream state... so I'll lie in bed half-awake and half into some kind of mild nightmare where everything keeps going wrong and I feel stressed. Eventually, 30-60 minutes later, I'll actually realise what's going on, and go and open the window, take some deep breaths, go to the loo, have some water, etc... then once it's calmed away, I can go back to sleep. I would not call this an "anxiety attack" in the full sense because usually people who suffer anxiety attacks can't get out of them so easily... but it definitely seems to overlap with the general understanding of what an anxiety attack is meant to be like. So I call this a "very mild anxiety attack". I've noticed that when those are happening more regularly (e.g. once or twice a day), if I reduce my caffeine intake to zero, they go away almost entirely within a couple of days. So I'm pretty sure it's caffeine-induced.
- kaitai 12y ago
  I'll throw in a personal experience with caffeine. I was feeling really bad (anxiety-attack-ish, according to Google) whenever I sat down to work on my thesis, a few years back. I'd use nice coffee to bribe myself to work on the thing. One day I went to work on the thesis after going to the gym and left my heart-rate monitor on. I noticed that this bad feeling coincided with a seated heart rate of 110 bpm, long enough after exercise that it should have been around 68. Investigation and experimentation ensued. Short version: caffeine + hard thinking about something scary launched me into a real physical anxiety attack; just switching to green tea allowed me to continue my work ritual without the panic.
zentiggr 12y ago
This suddenly feels way too familiar. Thanks for writing this - and I think I'm going to try going decaf for a couple of weeks and see whether or not my anxiety eases.
- swombat 12y ago
  See also my reply to rbinv below, for more details on what it feels like for me, if you're curious.
- wbhart 12y ago
  You need something like 14 days for caffeine withdrawal to cease (during which anxiety may temporarily increase). And any effect from changing things about might take weeks to have an effect on anxiety (perhaps up to 6-12 weeks). Exercise (if tolerated) can have an effect in about two hours, and I've read papers which suggest some prescribed (and indicated) medications can have an effect in around 3 hours. But withdrawing stimulants such as caffeine, although essential to long term recovery, generally doesn't have a sudden effect. Similarly, some standard treatments for anxiety actually increase symptoms in the short term (e.g. patients who were given sedative antihistamines in the past, which are no longer recommended as a treatment, used to be advised that their symptoms may initially increase).
bhouston 12y ago
> Forgive my ignorance and bluntness, but reading the above, it sounds more like an anxiety disorder than like depression. Both are serious, but I'm not sure if it helps to confuse the two? I disagree. It could easily be case of chronic significant stress/anxiety that lead to depression. It happens a lot. Tons of reputable articles on it: http://www.webmd.com/depression/features/stress-depression http://www.webmd.com/depression/features/stress-depression The reason why I say that it probably isn't just anxiety was this statement in particular from the story (and there are others): > Depressed Rand is weird. Don’t get me wrong, regular Rand is weird, too. But depressed Rand magnifies the bad 10X and minimizes the good. He refuses to even acknowledge good news and, because he’s a pretty smart guy, he can usually argue for why that good news is actually just temporary and will turn to shit any minute. The weird part is, I think depressed Rand is actually a very authentic version of myself. When I felt depressed, I upheld TAGFEE – particularly the values of transparency and authenticity – as the reasons why I could and should be such a raging, all-consuming, negative naysayer.
- swombat 12y ago
  Yeah, that paragraph sounds like anxiety to me - why does it sound like depression to you?
  - bhouston 12y ago
    This is classic depression: > But depressed Rand magnifies the bad 10X and minimizes the good. You find that in descriptions of depression: http://www.helpguide.org/mental/depression_signs_types_diagnosis_treatment.htm http://www.helpguide.org/mental/depression_signs_types_diagn... (e.g. "you feel hopeless and helpless." "you can’t control your negative thoughts, no matter how much you try.") You do not find that in descriptions of anxiety: http://www.webmd.com/anxiety-panic/guide/mental-health-anxiety-disorders http://www.webmd.com/anxiety-panic/guide/mental-health-anxie... My concern is that you are mixing together the definitions of anxiety and depression so that there is no difference between them, but they are in fact different things. Anxiety is generally does not consist of a feeling of constant doom/dread, but rather a feeling of anxiety/nervousness (which is a type of excitability, shortness of breath, tightness, flight or flight response, etc.) Anxiety is more in the moment (whether that trigger is drugs/caffiene, or a situation that provokes it), where as depression is a constant (you wake up with it and it stays with you all day.) It is useful to think of anxiety as a form of excitability (which provokes action, or at least that is the psychology point of anxiety), whereas depression is sort of the opposite (it reduces motivation for action.)
marklittlewood 12y ago
Swombat, that is both ignorant and blunt. Please don't try to imagine what goes on in someone else's mind.
pdpi 12y ago
Indeed. Compare the PHQ-9 and the GAD-7: http://www.patient.co.uk/doctor/patient-health-questionnaire-phq-9# http://www.patient.co.uk/doctor/patient-health-questionnaire... http://www.patient.co.uk/doctor/generalised-anxiety-disorder-assessment-gad-7 http://www.patient.co.uk/doctor/generalised-anxiety-disorder...
Rakathos 12y ago
Slightly off-topic, but I wanted to expand on anxiety quick: > Anxiety, though, (and I'm speaking from experience here, having had some light anxiety attacks caused by too much regular caffeine usage) seems to be characterised by a feeling of impending doom, that everything is wrong, it can't be fixed, it's all hopeless, etc. I was diagnosed with Generalized Anxiety Disorder earlier this year, after some career-related stress gave me a panic attack. Your description, the feeling of impending doom, everything is wrong, etc. is spot on. For me, it feels like a broken fight-or-flight response. I feel like I have to physically do something right now, and if I don't then something very bad is going to happen. After my first panic attack, I immediately scheduled an appointment with a doctor. I was prescribed Xanax to take whenever I feel anxious, and then I was given a recommendation to see a therapist. The therapy has helped, but by far the biggest improvement has come from daily, rigorous exercise. Two months ago I started running twice each day, along with walking to/from work and walking our dog. My anxiety has been almost completely eradicated, excluding a couple random 5-minute bouts every other week, whereas before it was an every day, all day thing. I'm also happy to say that I have not had to use the Xanax at all since I began exercising. If you're feeling any of the symptoms of anxiety (feeling of impending doom, it's all hopeless, etc.) or depression, please, make an appointment and see a doctor. You can get help.
ufo 12y ago
Two things to keep in mind: 1) There is more than one kind of depression 2) Its actually common for Depression and Anxiety often go hand in hand.
wbhart 12y ago
I've read that anxiety and depression often present together, so much so that it's hard to tell which is the primary issue. I personally suffer from anxiety without depression, so it seems easy for me to tell the difference. An anxiety attack for me is something that comes on very suddenly, leaving me with an overwhelming sense of impending doom. Usually it's a feeling that I'm about to lose control or drop dead right then and there. The thought that often goes through my head is, "oh no, something isn't right, this can't be right, I have to call an ambulance" or "I have to get out of here, now!". When the attack passes, it is followed by feeling extremely jittery, weak and anxious for hours or even days. During the attack, any number of physiological symptoms present, including pounding heart, feeling like I might pass out, wind, diarrhea, feeling weak, etc. I did suffer from mild and occasional depression when younger. It seemed to be more of a feeling of disappointment with various things in life leading to an extended malaise, but with a chemical origin (brain chemistry). (I think of such episodes as "chemical depression" as opposed to "ordinary depression".) But because anxiety and depression can often go together, it is not usually so easy to distinguish them. I read that sunshine and aerobic exercise help with both depression and anxiety (in my case exercise helped more than normal since I used to be overweight; a contributor to my depression at the time). Treating either depression or anxiety seems to require a multi-pronged approach. Most important in my experience seems to be teaching yourself (or be taught) how to shut down unproductive thought patterns as soon as they occur. They are habits which apparently exacerbate both issues (not necessarily immediately, but cumulatively). For anxiety, ruthlessly removing sources of anxiety (especially initially) can be helpful in the long run. Being blunt with people and simply telling them what the issues are that are stressing you out, and how much of an impact that is having on you, can help. Bottling up those issues and being unassertive and endlessly constructing "what-if" scenarios before or after the fact, exacerbates the problem. For anxiety, cut out caffeine and other stimulants. Avoid intense anaerobic stress (e.g. heavy weightlifting or aerobic exercise past the point of exhaustion), which stresses the nervous system. Also keeping the system running smoothly (e.g. modifying your diet for smooth digestive transit and controlling any allergies with standard hayfever antihistamines) seems to substantially lower overall stress levels. And obviously there are pharmaceutical options if you consult people qualified to dispense them. At some point you begin to realise you haven't had any real attacks in a while and that you are recovering. That relief in itself helps in the recovery process for anxiety (which I have heard can take months or even years in some individuals).
neurotech1 12y ago
Anxiety and Depression often go together. There are neurophysiological reasons for this. I found that lack of quality sleep, energy drinks and prozac was a really bad combination. Note: I'm not a physician and this is not medical advice. I have experienced more than a few medical misadventures along the way.

by swombat 12y ago

rbinv 12y ago

Could you please elaborate on your caffeine-related anxiety attacks?

flavor8 12y ago
I can speak from my experience. I was for a long time drinking 2-3 cups of coffee in the morning. During the morning, generally things were good and I could crank out code. However, during early-mid afternoon I'd often get overwhelmed, tired, and unfocused, especially when multitasking, and often would lapse into a browse-reddit/agh-i'm-not-being-productive/browse-more-reddit cycle. Cutting down to one 1 cup in the morning has made a real difference - I no longer get the early afternoon slump, and can stay focused for longer in the afternoon without being overwhelmed by a long task list.
swombat 12y ago
Sure. I've found that when I drink coffee regularly over a long period, my intake invariably increases. Eventually, it reaches 2 cups of double-espresso-with-milk or equivalent a day, and goes past that too... after a few weeks or something months of that, I start getting strange episodes at random times that I describe as "light anxiety attacks". The way they feel is that I get an impression that something, SOMETHING is wrong. I'm not sure quite what, but I don't realise that I'm not sure what until I realise I'm having one of these attacks. There's an unpleasant feeling of tension that starts in the chest and radiates out to the rest of the body - all the way to fingers and feet, through shoulders, knees, etc. That's the physiological aspects. Mentally, I feel like everything is going wrong. Nothing looks like it's going to work out. I tend to be more aggressive and curt with people, and extremely negative of course, since nothing seems like a good idea. In one of these episodes, I could easily find myself thinking that this business that I run, that employs 17 people and turns over over a million pounds, is doomed and that I should just leave it and run away from it and do something else. When I think something so ridiculous, usually some part of me wakes up and says "hey, that's not quite right", and then I realise I am having an anxiety attack. If awake, once I realise that's what's going on I can deal with it fairly effectively. Get rid of any physical discomforts (e.g. go pee if I need to pee), have some water, take some deep breaths, and refocus on positive things. It used to take longer, but by now, once I realise it's happening, I can get out of it in a couple of minutes, even while I'm in the middle of conversation with others, so it's not noticeable to others. If I'm asleep, it's more bothersome, because I'm unlikely to notice it in a half-dream state... so I'll lie in bed half-awake and half into some kind of mild nightmare where everything keeps going wrong and I feel stressed. Eventually, 30-60 minutes later, I'll actually realise what's going on, and go and open the window, take some deep breaths, go to the loo, have some water, etc... then once it's calmed away, I can go back to sleep. I would not call this an "anxiety attack" in the full sense because usually people who suffer anxiety attacks can't get out of them so easily... but it definitely seems to overlap with the general understanding of what an anxiety attack is meant to be like. So I call this a "very mild anxiety attack". I've noticed that when those are happening more regularly (e.g. once or twice a day), if I reduce my caffeine intake to zero, they go away almost entirely within a couple of days. So I'm pretty sure it's caffeine-induced.
kaitai 12y ago
I'll throw in a personal experience with caffeine. I was feeling really bad (anxiety-attack-ish, according to Google) whenever I sat down to work on my thesis, a few years back. I'd use nice coffee to bribe myself to work on the thing. One day I went to work on the thesis after going to the gym and left my heart-rate monitor on. I noticed that this bad feeling coincided with a seated heart rate of 110 bpm, long enough after exercise that it should have been around 68. Investigation and experimentation ensued. Short version: caffeine + hard thinking about something scary launched me into a real physical anxiety attack; just switching to green tea allowed me to continue my work ritual without the panic.

zentiggr 12y ago

This suddenly feels way too familiar. Thanks for writing this - and I think I'm going to try going decaf for a couple of weeks and see whether or not my anxiety eases.

swombat 12y ago
See also my reply to rbinv below, for more details on what it feels like for me, if you're curious.
wbhart 12y ago
You need something like 14 days for caffeine withdrawal to cease (during which anxiety may temporarily increase). And any effect from changing things about might take weeks to have an effect on anxiety (perhaps up to 6-12 weeks). Exercise (if tolerated) can have an effect in about two hours, and I've read papers which suggest some prescribed (and indicated) medications can have an effect in around 3 hours. But withdrawing stimulants such as caffeine, although essential to long term recovery, generally doesn't have a sudden effect. Similarly, some standard treatments for anxiety actually increase symptoms in the short term (e.g. patients who were given sedative antihistamines in the past, which are no longer recommended as a treatment, used to be advised that their symptoms may initially increase).

bhouston 12y ago

> Forgive my ignorance and bluntness, but reading the above, it sounds more like an anxiety disorder than like depression. Both are serious, but I'm not sure if it helps to confuse the two? I disagree. It could easily be case of chronic significant stress/anxiety that lead to depression. It happens a lot. Tons of reputable articles on it: http://www.webmd.com/depression/features/stress-depression http://www.webmd.com/depression/features/stress-depression The reason why I say that it probably isn't just anxiety was this statement in particular from the story (and there are others): > Depressed Rand is weird. Don’t get me wrong, regular Rand is weird, too. But depressed Rand magnifies the bad 10X and minimizes the good. He refuses to even acknowledge good news and, because he’s a pretty smart guy, he can usually argue for why that good news is actually just temporary and will turn to shit any minute. The weird part is, I think depressed Rand is actually a very authentic version of myself. When I felt depressed, I upheld TAGFEE – particularly the values of transparency and authenticity – as the reasons why I could and should be such a raging, all-consuming, negative naysayer.

swombat 12y ago
Yeah, that paragraph sounds like anxiety to me - why does it sound like depression to you?
- bhouston 12y ago
  This is classic depression: > But depressed Rand magnifies the bad 10X and minimizes the good. You find that in descriptions of depression: http://www.helpguide.org/mental/depression_signs_types_diagnosis_treatment.htm http://www.helpguide.org/mental/depression_signs_types_diagn... (e.g. "you feel hopeless and helpless." "you can’t control your negative thoughts, no matter how much you try.") You do not find that in descriptions of anxiety: http://www.webmd.com/anxiety-panic/guide/mental-health-anxiety-disorders http://www.webmd.com/anxiety-panic/guide/mental-health-anxie... My concern is that you are mixing together the definitions of anxiety and depression so that there is no difference between them, but they are in fact different things. Anxiety is generally does not consist of a feeling of constant doom/dread, but rather a feeling of anxiety/nervousness (which is a type of excitability, shortness of breath, tightness, flight or flight response, etc.) Anxiety is more in the moment (whether that trigger is drugs/caffiene, or a situation that provokes it), where as depression is a constant (you wake up with it and it stays with you all day.) It is useful to think of anxiety as a form of excitability (which provokes action, or at least that is the psychology point of anxiety), whereas depression is sort of the opposite (it reduces motivation for action.)

marklittlewood 12y ago

Swombat, that is both ignorant and blunt. Please don't try to imagine what goes on in someone else's mind.

pdpi 12y ago

Indeed. Compare the PHQ-9 and the GAD-7: http://www.patient.co.uk/doctor/patient-health-questionnaire-phq-9# http://www.patient.co.uk/doctor/patient-health-questionnaire... http://www.patient.co.uk/doctor/generalised-anxiety-disorder-assessment-gad-7 http://www.patient.co.uk/doctor/generalised-anxiety-disorder...

Rakathos 12y ago

Slightly off-topic, but I wanted to expand on anxiety quick: > Anxiety, though, (and I'm speaking from experience here, having had some light anxiety attacks caused by too much regular caffeine usage) seems to be characterised by a feeling of impending doom, that everything is wrong, it can't be fixed, it's all hopeless, etc. I was diagnosed with Generalized Anxiety Disorder earlier this year, after some career-related stress gave me a panic attack. Your description, the feeling of impending doom, everything is wrong, etc. is spot on. For me, it feels like a broken fight-or-flight response. I feel like I have to physically do something right now, and if I don't then something very bad is going to happen. After my first panic attack, I immediately scheduled an appointment with a doctor. I was prescribed Xanax to take whenever I feel anxious, and then I was given a recommendation to see a therapist. The therapy has helped, but by far the biggest improvement has come from daily, rigorous exercise. Two months ago I started running twice each day, along with walking to/from work and walking our dog. My anxiety has been almost completely eradicated, excluding a couple random 5-minute bouts every other week, whereas before it was an every day, all day thing. I'm also happy to say that I have not had to use the Xanax at all since I began exercising. If you're feeling any of the symptoms of anxiety (feeling of impending doom, it's all hopeless, etc.) or depression, please, make an appointment and see a doctor. You can get help.

ufo 12y ago

Two things to keep in mind: 1) There is more than one kind of depression 2) Its actually common for Depression and Anxiety often go hand in hand.

wbhart 12y ago

I've read that anxiety and depression often present together, so much so that it's hard to tell which is the primary issue. I personally suffer from anxiety without depression, so it seems easy for me to tell the difference. An anxiety attack for me is something that comes on very suddenly, leaving me with an overwhelming sense of impending doom. Usually it's a feeling that I'm about to lose control or drop dead right then and there. The thought that often goes through my head is, "oh no, something isn't right, this can't be right, I have to call an ambulance" or "I have to get out of here, now!". When the attack passes, it is followed by feeling extremely jittery, weak and anxious for hours or even days. During the attack, any number of physiological symptoms present, including pounding heart, feeling like I might pass out, wind, diarrhea, feeling weak, etc. I did suffer from mild and occasional depression when younger. It seemed to be more of a feeling of disappointment with various things in life leading to an extended malaise, but with a chemical origin (brain chemistry). (I think of such episodes as "chemical depression" as opposed to "ordinary depression".) But because anxiety and depression can often go together, it is not usually so easy to distinguish them. I read that sunshine and aerobic exercise help with both depression and anxiety (in my case exercise helped more than normal since I used to be overweight; a contributor to my depression at the time). Treating either depression or anxiety seems to require a multi-pronged approach. Most important in my experience seems to be teaching yourself (or be taught) how to shut down unproductive thought patterns as soon as they occur. They are habits which apparently exacerbate both issues (not necessarily immediately, but cumulatively). For anxiety, ruthlessly removing sources of anxiety (especially initially) can be helpful in the long run. Being blunt with people and simply telling them what the issues are that are stressing you out, and how much of an impact that is having on you, can help. Bottling up those issues and being unassertive and endlessly constructing "what-if" scenarios before or after the fact, exacerbates the problem. For anxiety, cut out caffeine and other stimulants. Avoid intense anaerobic stress (e.g. heavy weightlifting or aerobic exercise past the point of exhaustion), which stresses the nervous system. Also keeping the system running smoothly (e.g. modifying your diet for smooth digestive transit and controlling any allergies with standard hayfever antihistamines) seems to substantially lower overall stress levels. And obviously there are pharmaceutical options if you consult people qualified to dispense them. At some point you begin to realise you haven't had any real attacks in a while and that you are recovering. That relief in itself helps in the recovery process for anxiety (which I have heard can take months or even years in some individuals).

neurotech1 12y ago

Anxiety and Depression often go together. There are neurophysiological reasons for this. I found that lack of quality sleep, energy drinks and prozac was a really bad combination. Note: I'm not a physician and this is not medical advice. I have experienced more than a few medical misadventures along the way.