Anxiety – Frantic Shanti

Mindfulness 101: Noticing the Qualities

The main reason why I started a meditation practice was because I had been diagnosed with breast cancer and was, to put it mildly, freaking out.

As a naturally anxious person, the diagnosis blew the roof off my ability to cope and plunged me into a nightmarish situation. Anyone who’s ever dealt with severe anxiety will tell you that nothing is more important than making it stop.

Over the years, my anxiety gathered enough power that it was able to blindside me. Cancer anxiety practically wrecked me.

When my radiation oncologist recommended mindfulness meditation, I felt empowered by the thought of gaining control of my runaway anxiety without the need for medication.

I was hoping meditation would enable me to sit in peace in the midst of chaos. But I imagined that as feeling no stress, as in, being numb to anxiety-provoking stimuli.

That simply doesn’t exist. I wanted to not experience any stressful situations, but there is always stress. We can’t change that. Mindfulness meditation was only going to help me change the way I reacted to it.

So here I am, more than six years after initally starting a daily meditation practice and guess what? I still have stress, I still feel anxiety.

However, what did change is that I can define it now. When I become aware of agitation and anxiety, I know to pause and bring attention to how it manifests in my body.

What does it feel like? Tightness, heat, rapid breath?

Where does it show up? Face, temples, chest, stomach?

Is there a color or sound or smell associated with it? Does it have a “texture”?

Does anxiety have an odor? Next time stop and take a whiff.

I can relax my muscles, sink into the earth, breathe deeply and notice the qualities of anxiety. By pulling apart what is happening, I slow time down. Instead of being hit by a locomotive full force, I walk around the train cars. I can notice how I feel as I pass through the experience.

Is it pleasant? No. Does it always work immediately? No. However, I can see it coming, and as a result, I relax into it. It is the awareness of the anxiety that helps me through it, not a numbness to it. This leads me to acceptance of the situation instead of bracing against it.

On one level, it’s a little discouraging to still be dealing with the unsettling nature of stressors. But I am heartened by the empowerment that mindfulness offers. I have evolved enough that I know I don’t have to go back to being thrashed by the whirlwind. I can sit inside it and watch it swirl and pass through. Every time I do this, it gives me more confidence for the next time.

Is this something that might help you too?

Things I Wish I’d Known About Breast Cancer, Part 2

This post continues what I started in the last post…a few things about breast cancer that I wasn’t aware of at the time of my diagnosis. Knowing the following would have made things a little less stressful:

1. Lumpectomy is a relatively uncomplicated surgery. I wish someone had explained this to me because I was a total wreck going into surgery (which happened to be the only surgery that I had ever had up to that point, making everything 10 times worse). Although I had decided against a full mastectomy, I was still so afraid of what a lumpectomy would entail, what I’d look like and how long it would take me to recover from losing a chunk of flesh.

The reality was…I was back at work the next week. No drainage tubes, no need for heavy analgesics — just a couple of ibuprofin the night after surgery because skipping coffee that morning resulted in a headache, but that was it. It was even hard to tell that I’d had my lump excised. Wish I could go back to my earlier self and tell her not to worry.

Stethoscopes are emotionless. Oncologists can seem to be too, but that’s by design.

2. Doctors are not in a hurry to give you good news. I think there’s a general feeling among medical professionals that there’s so much that can go poorly during cancer treatment that your doc isn’t going to go out of their way to pump you full of optimism. They probably practice keeping an emotionless face as they deliver all sorts of news, both good and bad. As a patient, however, I watched every flicker on my oncologist’s face for an indication of how things were “really” going. I feared that there was something he wasn’t telling me.

It wasn’t until perhaps a year or so later when I was expressing my fears to him about possible abnormalities inside my body that he uttered the phrase, “but you have your health”…and I was taken aback because I had never heard him sound so positive. It was almost a shock to hear him confirm that I was actually considered healthy.

3. Don’t expect things to be the same as before. Accepting that part of your life has changed will make it much easier to go on. This took me a while to appreciate because I was expecting to get back to doing and feeling everything the same as before my diagnosis.

But chemo (and eventually, age) pushed me through menopause, and I had to come to grips with, say, a high-intensity interval workout requiring more recovery time and that I had trouble remembering people’s names. Once I got to that point of acceptance, life after cancer treatment became easier, although it did take a number of years to get there.

4. Hair takes a while to grow back in. The reason I created posts with photographs that illustrated the cancer journey that my hair went through (here and here) was because I could not find good photos on the internet documenting the process. I did see images of a woman a few weeks after stopping chemo with little stubs already visible, but that was not my experience and it made my anxiety over my slow regrowth even worse.

Walking around with no hair was getting old and I was getting more desperate by the day to see evidence of sprouts!

If you’ve ever googled your chemo drug name + “hair loss”, you understand the fear: the first search result is usually a law office gathering info on behalf of cancer patients whose hair never grew back!

It took a number of months before my folicles woke up and actually started growing. I remember the moment that I finally saw growth on the front of my head and it was as if the heavens had opened up and divine light poured out onto me. Seriously. I would have avoided a lot of stress if someone had just told me that it’s gonna be a while.

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Ok, ok, to be fair, my oncologist did urge patience with the regrowth but I was a jumbled mess of nerves and was feeling overwhelmed. All the internet propaganda about both (1) other women having much faster regrowth, or (2) other women never getting their hair back terrified me. Note to self: when feeling desperate, stay off the internet!

“Detached”: Time-Out in Third-Person

As an addendum to my post where I wrote about using third-person language in meditation to help keep distance between yourself and your thoughts, I wanted to revisit this method for everyday life.

While in that post I alluded to using third-person descriptions on stressful days, it’s really worth emphasizing the utility of creating space throughout the day.

To sum up that post, I mentioned a mindfulness technique suggested by meditation teacher Jeff Warren in which when we find ourselves being swept away in thought, we describe what’s happening in “third-person” language and play the role of an observer.

But as I said in that post, why limit that to meditation sessions? In fact, you could argue that it is even more important to bring that type of gentle detachment to the things that ordinarily set us off in our daily lives, whether it be with family, at work or anywhere.

I would say that so much of my anxiety has stemmed from an inability to maintain perspective about the trigger. Noticing when I’m getting carried away and then describing the situation as something that is happening to another person — similar to the way a newcaster might report on an event in a calm, informative manner — helps loosen its grip on me.

The ability to step back and detach from the situation is kind of the name of the game in terms of reducing stress levels, isn’t it?

By narrating the circumstances around your stressors, we make space: “FranticShanti felt a little ill when she saw that the letter in her mailbox was from her landlady. She expected this to be about a rent increase…and she was right. Another $200 per month.”

Third-person language gives us the space we need to tackle our stressors without getting pulled into them.

That telling offers some space. It doesn’t change the situation, simply presents what’s happening in an unemotional manner. Then following up with some trouble-shooting helps soothe my agitation: “This will require a review of her finances, but as she calculated with last year’s rent increase, she can still absorb this additional amount. Things will probably be okay. She takes some deep breaths and feels into her hands and feet.”

Not only can you calmly describe the situation, but you can describe yourself engaging in self-soothing techniques as you work out your next steps.

It is quite effective in slowing down racing thoughts, particularly if you’re in a place where you can speak out load, as hearing yourself describing things can be even more grounding.

As with other simple grounding techniques, this may seem a little contrived or simplistic, but it might be just enough to bring you out of your head and into the here and now — cool, calm and collected.

Creating Space with Third-Person Language

I’ve had some up-and-down weeks this year and have been working on making space in my head to lessen the impact of anxious thoughts.

I recently heard a wonderful suggestion by meditation teacher Jeff Warren (via his Daily Trip on the Calm app) about creating more mental room for yourself. He encourages describing what’s happening in the third person when thoughts come up during meditation.

Like many suggestions to help with mindfulness, this seems surprisingly simple, but so far I and everyone else I’ve recommended it to have found it to be very effective.

Making space is good for more than avoiding viruses…

It goes like this: I am sitting in meditation focused on my breath (or any other chosen anchor) and a thought pops into my mind. I say to myself, “There goes FranticShanti thinking about X topic again”.

Suddenly I feel a *whoosh* as I’m pulled back out of that scenario. And instead, I’m observing myself having that thought. Hearing myself describe the situation as a bystander has a calming effect and creates a sensation of safety and distance.

I’m still staying present and noticing what’s going on around me, but recognizing that this thought is happening to the person who is known as me — instead of allowing myself to get sucked into it, along with all the associated emotions — expands the amount of mental space I have.

It’s kind of like looking through a window at a situation instead of being there in the room with it. Not nearly as scary or immersive.

Looking at things through a protective buffer makes even scary situations less threatening.

Likewise, throughout the day, describing a stressful situation in third person helps us remember that there is always space around us that can serve as a buffer from unsettling thoughts. It can even help us handle anxiety-provoking situations as it also provides an opportunity to describe a potential ‘solution’, as if you were to give a friend some advice on how to deal with it.

Imagine saying, “[Your name] just realized that there’s a deadline they forgot about, so they’re reshuffling their schedule to accommodate the task.” That’s much more productive and grounding than screaming, “AAAAAAAAIIIIIIIEEEEE!!!” in your head.

So, I’ve started using this in everyday interactions when I feel myself getting swept away by worries. It’s been an effective way of bringing myself back into the present, to what is real and actually here, and it serves to reframe what is going on in my life.

This sort of method brings stressors down to a manageable level, allowing for perspective. And we can all use a bit of that.

Just One Day

If you had one day to live, how would you live it?

I pondered this question last week as I was trying to calm myself down before teaching my first official public yoga class, while also juggling emotions about certain events at home over which I had no control. Read that as: anxiety.

And in the midst of this all-too-familiar emotional turmoil I felt myself being consumed by my thoughts. And yet, if I had only one day left on this earth, I can’t image that I’d let myself get mired in everyday worries. My perspective would immediately snap into a megawide view of everything that exists in the world.

Never was I so aware of every palm tree…

It would be easier to see the beauty everywhere. Consider this: when I returned to Southern California after four bitterly cold years in a Northern climate, I noticed every.single.palm tree. I was so aware of everything that I had missed during my years away and appreciated every ray of warm sunshine. Other cares temporarily fell away as I was filled with gratitude to be back.

If I had only one day to enjoy the world, I hope that I wouldn’t spend it lamenting over little things. I would sit with my face to the sun, smell the breeze, take deep breaths and appreciate the here and now. Accepting that I had only 24 hours, I imagine that I wouldn’t be ruminating about something a co-worker said to me in passing or how I really should be cleaning the bathroom more often.

So interesting that it would take facing the end of my days to begin truly appreciating them.

So how about this (and this was what I meditated on last week in the midst of nervous feelings), why not imagine the feelings of that last precious day every single day? Stop and feel into my feet on the ground and the air in my lungs. There is so much wonder all around us and what a pity that it takes a drastic event to experience a perspective shift.

It feels so glorious to be alive.

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Don’t get me wrong, the shock of knowing that your end is near could be devastating. So if you’d like to use this idea as a meditation prompt, perhaps consider if you were on vacation in a paradise-like location and if your plane were leaving in a day, how would you enjoy your remaining time there?

Finally Normal: My Six-Year Oncological Visit

I hit another cancer journey milestone this past week: my six-year oncology appointment.

Like my last few appointments, this one felt commonplace and unintimidating…and if the nurse had let me sit down for a couple of minutes after coming into the exam room, my blood pressure would have been lower. As it was, the reading was not that far from normal.

For the first time since cancer, my bloodwork is all normal!!!

One other thing that was strikingly normal: for the first time in six years, since all the cancer madness began, all my bloodwork, both Complete Blood Count (CBC) and Comprehensive Metabolic Profile (CMP), was completely normal. Nothing that would suggest a year’s worth of cancer treatment in the past.

This is so curious because for years, nothing felt normal.

Now everything is.

Ironically, it was my oncologist who was experiencing illness and I had to switch my appointment time so that he could get to his doctor.

I was hit by the realization that everything that had felt out-of-control and hopeless six years ago no longer existed. I was the one who had kept the idea of cancer alive in myself. I still defined myself as a cancer survivor because perhaps I needed some way to justify what I considered to be my shortcomings, as in, “I used to be able to do this, but…”.

This was a battle I fought in but only memories remain. In the present moment, there’s only silence.

Returning to the cancer center for this appointment felt like I was visiting a battlefield from a war that I had fought long ago. The echoes of battle cries…just the wind. The clashing weapons and falling bodies…not there anymore. This may sound like such an overly theatrical description, but that’s exactly what it seemed like.

This doesn’t mean that I’ve got the rest of my life figured out. There are still so many unknowns, including an increased chance of cancer recurrence — and I still need to schedule this year’s mammogram, something else that slipped my mind as I was basking in the idea of being “normal”.

But that tortured soul who, on top of all the other stressful things going on in her life, was hit with a cancer diagnosis…she doesn’t exist anymore. If I’m so unfortunate as to have the cancer come back, she won’t be experiencing the aftermath.

I will. And I feel like I’m so much better equipped to handle all that uncertainty than she ever was.

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I still call myself a cancer survivor. But it’s only one of a long list of “skills” that I have on my resume.

What Is Self-Talk Telling You?

Last week we had a guest come visit. This was preceded by a flurry of preparation on my part as I caught up on all the cleaning and organizing that I’d been putting off.

And as I was planning out what I was going to tackle on which day, I berated myself for waiting this long to start, thinking that if I’d done more the previous week, I wouldn’t feel so rushed.

So as I pushed through late day fatigue, I realized that there was a soundtrack running through my head. In it, I’m explaining to our guest why there’s still clutter and dust, and what issues I have with where we live that we get a lot of road gunk coming in through the windows. Excuses, explanations…

I always imagine my home as being dirtier than it really is, and it continues that inner narrative in my head that I’m never going to be good enough.

I actually went as far as to text our guest an apology that we didn’t have a nicer place to offer them to sleep. I felt that they should know in advance.

I was getting quite stressed about the whole thing, so I took a moment to ponder what was actually going on.

Yes, keeping a very tidy apartment is difficult when I’m the only one working actively towards maintaining it. Particularly now that my plate feels even fuller as I try to incorporate teaching yoga into my current work schedule…

But that’s not the real issue.

Problem is, I was raised to believe that my home is a reflection of me. My abilities as a housekeeper were practically a moral issue, as allowing in clutter and not keeping up on scrubbing things meant that there was something wrong with me. I was shown examples of other women who seemed to have no problem giving cleaning the priority that it required.

I felt like a failure.

With a guest coming to visit, I realized that no matter what the apartment looked like, I would still fear being judged. And it is that fear of judgement that has followed me through my life, throughout all the ups and downs, cancer and anxiety.

What did I hear from my inner critic? That no matter what I do, it’s still not good enough.

In fact, I have taken a liking to getting things clean and organized, standing back and surveying the work that I’ve accomplished. But that feeling of not being good enough still haunts me, and it’s not like this is a new revelation.

Frankly, I’ve been aware of this for years, especially when I realized that deep down I had viewed getting cancer as a failing, like I had brought it on myself, even though I was doing everything imaginable to live a fit life. So it wasn’t until I turned my attention to my inner critic and listened to what it was telling me that I realized, ah, maybe I wasn’t over all of this just quite yet.

Mindfully allowing that voice in my head to express itself, but without getting sucked into the negativity, offered me insight into those old fears and worries that encrust my mind like mineral deposits on a bathroom faucet. They’re tough and really stuck on there.

Bringing awareness to that negative soundtrack takes some of its punch away, kind of like identifying the monster under the bed and making it sit on the living room couch where I can keep an eye on it.

Yes, it’s still there. But now it’s tamer and eventually I’ll be able to show it out the door.

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Undoubtedly, negative self-talk can be harmful, but it’s also quite difficult to stop. However, being able to allow yourself the space to examine it and understand its roots is one of the best ways to free yourself of it.

Tall Like a Mountain: A Meditative Visualization

In dealing with anxiety, I’ve come to accept that while fearful thoughts come and go, I remain the same.

Visualizations have been helpful in realizing this. One of my favorites, the one made famous by Jon Kabat-Zinn, PhD — creator of the Mindfulness-Based Stress Reduction (MBSR) program — is the Mountain Meditation, and I value this visualization particularly because it is so meaningful in its description.

For this meditation, you settle into your seat and bring your attention to your body. Scanning your different parts, from your feet to your head. Feeling yourself breathe as you go. No need to change anything; you’re simply noticing sensations.

Imagine your ideal mountain…and then become it.

As you sit with eyes closed, shift your thoughts to a beautiful mountain, tall and stately. Imagine the details about it, it can be whatever kind of mountain you choose. Steep or gently sloping, rocky or carpeted with greenery. Allow the image to form itself: the mountain is stable, majestic and unperturbed regardless of the season or weather.

Then, once you have a clear picture of your mountain…allow yourself to become the mountain, settling into its form and taking on its characteristics. Feel yourself grounded in its stillness.

Sitting as the mountain, imagine the seasonal changes and the different weather that each brings. Through the snow of winter that blankets everything, the spring thaw as nature awakens and buds burst open, the summer teeming with life under the warmth of the sun, and autumn with its changing colors and cooler breezes that move you into a quieter state in preparation for the coming winter again.

All these bring wind, precipitation and occasionally harsh conditions whether they be cold or heat. But the mountain still sits as it always has, unmoving and unbothered.

And so you, as the mountain, also sit in the midst of different conditions. When you take on the garb of the mountain, you link with its strength and stability and unchanging nature from day to month to year. This meditation encourages us to see through the chaos of our everyday lives and find the persistent calm behind it.

This is one of my favorite meditations because it carries so much meaning. Below is a YouTube video of Dr. Kabat-Zinn leading a 20-minute Mountain Meditation:

Jon Kabat-Zinn’s Mountain Meditation

If you would like to read a version of it, PalouseMindfulness.com has provided their own adapted transcript of Kabat-Zinn’s Mountain Meditation in a pdf file. Alternatively, googling “mountain meditation” will also bring up a nice variety of recordings.

I encourage you to try this when you feel you need extra grounding.

“My Eyelids Are Heavy, But My Thoughts Are Heavier” – Anxiety At Night

I have a full toolbox of techniques for handling anxiety during the day, but nighttime is a little trickier. If you’ve had the same experience, you’re not just imagining things.

A Live Science article by Louise Bond examines this issue. According to Clinical Psychologist Charissa Chamorro, PhD, at night our brains have fewer distractions, leaving us more vulnerable to worries that creep in. This makes sense as we can redirect our attention during the day to activities that are not available when we’re in bed.

Darkness can be unsettling enough, but researchers feel that the circadian rhythmn is also involved in the accentuation of nighttime fear.

And you don’t need to be suffering from horrible anxiety for this to be the case. Research (Li et al., 2015, Int J Psychophysiol) showed that even among women without anxiety, fear was enhanced at nighttime, and not simply because of darkness, suggesting the involvement of the circadian rhythm. At the same time, as diurnal beings, humans naturally evolved to have stronger fear responses at night. This is partly due to the fact that we don’t see well in the absence of light and therefore are more vulnerable to nighttime predators.

Furthermore, while there is a natural ebb and flow of cortisol throughout the circadian cycle with cortisol levels peaking in the morning and being lowest at midnight, when anxiety keeps cortisol levels high during the day, that affects nighttime hormone release and therefore your ability to rest (Hirotsu et al., 2015, Sleep Sci).

To make matters worse, once your sleep is disrupted, worrying about your inability to get a good night’s sleep can result in being unable to sleep, and a vicious cycle develops.

Establishing calming practices during the day can have a positive effect on nighttime anxiety.

You’ve probably heard the suggestions for improving sleep: turning the lights down in the evening, avoiding electronics (or using blue-light blockers), keeping your bedroom cool and dark, using a sound machine to mask noises, avoiding stressful or polarizing conversations in the evening, and the like.

To that I would add that what you do during the day itself can affect what kind of sleep you have at night. Meditation, practicing mindfulness, doing deep breathing exercises all put us into a calmer state. If you wake up in the middle of the night with a racing mind, having practiced and become adept at self-grounding techniques in daytime can help you soothe yourself at night.

While the roots of our anxiety may be complex, for those of us for whom it’s built up over time, so too will it take time to establish behaviors to help control it. Sometimes we need support of a therapist or medication, sometimes we can manage on our own, but setting aside time every day for even a short calming practice can help you improve management of anxiety no matter when it appears.

REFERENCES

Bond, Louise (2023) Can’t sleep? An expert reveals why anxiety may be worse at night. Live Science, https://www.livescience.com/anxiety-at-night

Li Y, Ma W, Kang Q, Qiao L, Tang D, Qiu J, Zhang Q, Li H (2015) Night or darkness, which intensifies the feeling of fear? Int J Psychophysiol, 97, 46-57. https://www.sciencedirect.com/science/article/abs/pii/S0167876015001713

Hirotsu, Tufik S, Anderson ML (2015) Interactions between sleep, stress, and metabolism: From physiological to pathological conditions. Sleep Sci, 8, 143-152. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4688585/pdf/main.pdf

Six Years and 2 Days Ago, Panic

On Feb 8, 2017, I finally went to see my nurse practitioner about a breast lump that I’d originally noticed six months before, the previous August.

From the split second that the expression on her face shifted as she felt the lump and sent me off with an order for a diagnostic mammogram, everything changed. I went from hemming and hawing about spending the money on a copay for a doc appointment for something that would obviously turn out to be nothing…to a downward spiral into despair like I’d never felt before.

Memories of this period in my life are not very pleasant, so instead of loading up images of frightened faces and horrible possibilities, I’ve decided to post only peaceful pictures here.

Looking back on that time, knowing all the self-calming techniques and meditation methods that I currently practice, if I were going through this now one thing is very clear: I would still have panicked.

It bears mentioning that on Feb 8, 2017, I did not get my diagnosis. That appointment simply opened the door for scans that I was hoping I wouldn’t have to go through, but it devastated me regardless. In the two weeks that it took before I could actually go in for the mammogram and ultrasound, I died many times over.

The fact is, nothing ever prepares you for a cancer diagnosis. No matter what sort of mental calisthenics you practice, cancer is still CANCER. And even the idea that cancer could be a reality is terrifying.

There is no “alternative wording” that makes this easier. Sooner or later, you’d still bump up against that six-letter word that, for someone in my generation, meant a distinct possibility for a very sad ending (which arguably is an outdated and potentially irrational view, but that’s what you get).

Yeah, nothing stressful here. Just a sleepy kitten.

So rest assured, if you ever find yourself in this situation, no matter how you’re handling it, you’re doing a good job. Because you don’t really “handle” the news, you just splash around and try to keep your head above water.

Doctors, I’m told, practice delivering the news in a calm but empathic manner. Trust me, that’s kind of lost on the patient. Since my lump was clearly cancerous on the diagnostic ultrasound, I actually got the news broken to me twice:

My radiologist (after the ultrasound): “I have two things to tell you. One, you have cancer. Two, you’re going to be okay.”

My general practitioner (after the biopsy): “It’s as we feared. It’s cancer.”

See, whether the delivery is kind of upbeat with an attempt at a positive ending or whether it’s more reserved, anticipating the patient’s fear at hearing this, it doesn’t matter. Because once you cross that threshhold, you can’t turn back to “it’s nothing, have a nice day”. You are literally propelled forward into the next steps, and there will be many of them.

Room for one more image? How about tulips? I love tulips.

But there are a few things to remember. Being thrust headfirst into the world of cancer means that at least you’re not standing still like you are when you’re worrying about a diagnosis. Recalling Churchill’s famous quote, “When you’re going through hell, keep going”. Of all the times in a cancer journey, the point right around the diagnosis is the most terrifying because you know you have cancer but not necessarily how “bad” your situation is or what the next steps are.

There is relief in the movement of information and the passage of time. If there is a way to focus on the next step, always the next step, without getting overwhelmed by the tidal wave brought on by the concept of having cancer, you will be able to gingerly find yourself a path through which to navigate the cancer journey, and there is peace in that.

And if there isn’t peace…you’re still very normal. ❤