Anxiety Disorders and the Fear of Insanity (Episode 137)

SPEAKER_02 0:01

We hit the sensitized state. When there's no actual threat, we can land on the fear of insanity. And it's something that I absolutely wrestled with a lot. Not helped with the symptoms of anxiety that kind of play into that kind of narrative.

SPEAKER_01 0:15

Derealization and depersonalization. My personality is disintegrating. I'm losing my sanity somehow.

SPEAKER_02 0:21

You combine that with a threat response, a load of adrenaline, a load of cortisol, makes sense why people would jump to that conclusion.

SPEAKER_01 0:28

All your brain needs to do is find a believable story. Doesn't have to be accurate, it just has to be believable, and insanity feels believable if you're experiencing those things. Only experience will change the prediction. You can't just decide to believe. Oh, Josh and Drees said I'm not going insane. I'm cured. Yay. Let go and just let that feeling be there. Welcome to Disordered. This is episode 137 of the podcast. We are talking about anxiety and the fear of insanity, otherwise known as dementiophobia, very common fear among people that suffer with anxiety disorders. I am Drew Linsolata. I am a therapist that specializes in the treatment of anxiety and anxiety disorders in New York, uh, former sufferer of the stuff we talk about here on Disordered, now a four-time author on this topic. We just got a new book out. We'll talk about that. And uh yeah, like guy with expensive microphones that likes to talk about anxiety.

SPEAKER_02 1:23

And I am joined by the other half of Disordered, that would be I'm Joshua Fletcher, also known as Anxiety Josh, therapist, author, podcaster. I can really relate to today's subject. Um, and if I had a quid or a pound or a dollar or a ruple for every time I heard the phrase I went to Amsterdam and took an edible, or I smoked weed, or I did something, and I had a panic attack, uh, and then it leads to the fear of insanity. Uh I'd be a very rich man. Um, but not just that, it's when we're really anxious and panicking, we don't know where we come from, we hit the sensitized state. When there's no actual threat, we can land on the fear of insanity, and it's something that I absolutely wrestled with a lot.

SPEAKER_01 2:15

It's terrifying, isn't it? I think uh the fear of insanity is one of those. So there's two things. There's the in the moment I'm so anxious I feel like I'm gonna snap, and then there's the lingering fear of insanity, like uh always checking to see if your memory's intact, do I remember my kids' names? So it's a little different, but like that is one of the top three fears, I think. Death, incapacitation, uh death, insanity, and then there's the whole like making a scene or just generally losing control. But like, yeah, really scary, very scary.

SPEAKER_02 2:45

Yeah, it is, and it's like it's the only thing that you can kind of bear in mind, you know, you when you're panicking or when you're anxious, the whole job of the of the threat response is to find uh a threat. And when there is no threat, it just goes, well, if it's not around you, then maybe it's you.

SPEAKER_01 3:06

Right. That's exactly right. What's that smell? Well, maybe it's you, like it'll literally do that. Yeah, you're right.

SPEAKER_02 3:15

Yeah, there's no like there's no lions, tigers, thieves, bandits, rival tribes, um, no snakes, no poisonous rats, no spiders. Um but there must be a reason as to why we feel like there's imminent disaster and death. Uh maybe it's you. Now, for some people it's cardiophobia, for some people it's yeah, the fear of fainting, some people it's whatever. And for a lot of people, for me, I remember my brain would often suggest well, obviously you're going insane, not helped with the symptoms of anxiety that kind of play into that kind of narrative. And what's some of the what are some of those symptoms, Drew?

SPEAKER_01 3:59

For me, the biggest one that that spoke to that was the feeling of derealization and depersonalization that was linked instantly to like my personality is disintegrating, I'm losing my sanity somehow. Because I didn't know what that was.

SPEAKER_02 4:14

Yeah, it makes sense though, because you stood in the room, you're like, everything looks weird, I sound weird, my place in the room is distorted. Yeah, well, if my reality doesn't look familiar, then my brain might be going crazy. And to be honest, it's okay to kind of assume that I look back and be like, well, yeah, that's the that's the that's what I deduced from that. But actually, there's a load of other stuff going on that people don't really tell you. So, you know, like you're anxious, you're on edge, your peripheral visions shut down, everything, your depth perception changes, you're letting more light in, everything looks weird. Then when you dissociate, you know, things like your temporal parietal lobe shuts down, your prefrontal cortex prioritizes other things, depth consumption, your spatial awareness to everything is different, just like what would happen if you drank three beers. But you combine that with a threat response, a load of adrenaline, a load of cortisol, a load of oh my god, worse, something bad's gonna happen. Makes sense actually why people would jump to that conclusion, and they're not stupid for doing that. I certainly looking back, not stupid for thinking I was going crazy, yeah, not helped by going to the doctor and then him saying, try these meds, have this, and I'm just feeling worse. Yeah, I'm like, oh my god, I it must be me. What's the problem? Fear of going crazy, uh, and then OCD can latch onto that too. Yeah, so then I would avoid things like, Oh, you know, I want to watch Shutter Island, great movie, nope, but I wouldn't be watching that in that state because even seeing anything related, news topics, yeah, you know, like oh, oh, he was he was a quiet family man in the rural town, yeah. But one day he snapped. Yeah, but my anxiety would be through the roof. Um, but I was just having panic disorder, OCD.

SPEAKER_01 6:12

Well, I mean, remember that, like you're right. We you know, we've talked about this before, like, why do we use the word disorder? Well, it's out of order. The fear comes before the threat. It's legitimately literally in the reverse order that it should be. Usually there's a threat, and then we get fear. Like, no, we experience fear, and then we have to look for what's the purpose of this fear. Okay, can't find it outside of me, so I must be the source of the threat. And all your brain needs to do is find a believable story. It doesn't need to be accurate, it just needs to be easily accessible. Insanity. This must mean insanity. For me, I interpreted my panic symptoms as death because it was a very easy to arrive at conclusion. And my brain was like, yep, this seems about right. That's we're going with death. And like, doesn't have to be accurate. It just knows it has to be believable. And insanity feels believable if you're experiencing those things. And when you talk about those movies, like things like Shutter Island or what was it, Memento? Like that was another movie that a lot of people could watch. Like it feeds into that. See, this does happen. Oh my goodness, that person snapped and like, you know, uh uh killed his whole family. It does happen. He went insane. Yeah, I know that confirms that that story is even more believable now. So yeah, yeah.

SPEAKER_02 7:19

It happens, so therefore it's happening to you.

SPEAKER_01 7:22

Correct. You're right. Unfortunately, it does happen in the world, but that does not equal the story being accurate, it only feels believable. That's it.

SPEAKER_02 7:29

And you know, yeah, it's important as well to bring attention to the fact that like your threat response will use recent memories and experiences or anything tenuous. Yeah, so for example, and I'm not being insensitive here, I've just been very sensitive. Like I have good friends and stuff, but people who have the frit fear of insanity or dementiaphobia, what they're also saying is it's a fear of Alzheimer's and dementia, it's a fear of bipolar schizophrenia, paranoid schizophrenia, stuff like that. And we'll get onto the main compulsions that that prop this up. Uh, but then the brain will be like, yeah, but your second cousin struggle that, or even your parent, you know, with a way, it will just try to gather evidence in air quotes um to keep your attention, you know. It does happen in the world, it happens quite close to you, so therefore, it might happen to you. But actually, what's happening is you're misinterpreting panic attacks, and the threat response is just trying to find a threat. And the weird thing is when you're anxious and in panic and in threat, all your senses change. So you compulsively try and find like discrepancies in your in your in your senses when they've fundamentally changed. I used to do this all the time. I used to lie in the bathroom and be like, Did I hear something then? Was that in my head? Oh boy, yeah. Or as you're nodding off to sleep, you naturally have hallucinations. I love them now, by the way. I fall asleep, I get excited to have the hallucinations. Yeah, like when you're dreaming, I'm still awake, but I can see things like oh, this is awesome. Back then, oh hell no. Like, no, no, diazepam, benzo, knock me out. I don't want to see that. Yeah, but yeah.

SPEAKER_01 9:12

Uh the you know, it would trigger me back in the day was the I'm falling asleep, and what do they call a hypnagogic jerk? You know, that thing where like like suddenly for I don't know why my mind connected that to DPDR and like for me, I always use the word disintegrating. Like my version of insanity was my personality was disintegrating.

SPEAKER_02 9:31

And for some reason that happened ages ago.

SPEAKER_01 9:33

Oh, yeah, and it's never come back. Like, this is what you're left with. That's it's sad, right? It's really sad. Thanks for listening to my disintegrate.

SPEAKER_02 9:39

I remember when you were fun.

SPEAKER_01 9:41

Uh but uh for some reason that hypnagogic jerk, which like I was so everybody experienced with time to time, my mind just connected that instantly to that's part of that process happening, and then I would be up for two hours in a panic, like trying to hang on to my so I don't disintegrate. Like, like I guess it didn't work. I don't know, according to Josh.

SPEAKER_02 10:00

What what about like when you catch yourself happy?

unknown 10:05

Yeah.

SPEAKER_02 10:06

Like I was like that, that's the best one. Like, whoa, I'm actually happy. I'm out with my family, I'm having a really nice day. Yeah, but what if that means you're having a mood spike and you're actually going insane? I'm like, you absolute.

SPEAKER_01 10:20

You're absolutely right. Because the disorder will do that, and that that hypersensitive, I better be on the lookout for something. This thing I fear, I always have to be looking for it. I have people who will ask me when they start to feel better. Like, hey, they're doing, you know, whatever. They're they're they're putting in the work, they're doing this stuff, and they're becoming desensitized and they have moments of calm. And then the dementophobia will ask, will drive them to ask me, Am I bipolar? And I'll be like, where's this coming from? Like, where would bipolar have ever entered the chat in your life? Well, because isn't this is this the down part of bipolar? They're really worried that not feeling agitated. Well, we talked about this in the panicogenic relaxation episode.

SPEAKER_02 11:00

Yeah, I was just thinking that. Right.

SPEAKER_01 11:02

Means that they've developed like a serious mental problem like bipolar and their sanity is in jeopardy. Like, no, you're just neutral. You're just like everybody else around you right now. That's normal. But no, no, I I hear you. So yeah, it'll latch onto all kinds of stuff and suggest the craziest stuff that it doesn't even have to prove, just has to suggest it, and that's it.

SPEAKER_02 11:20

It's very akin to OCDs as well, isn't it? The obsession is the fear of insanity and the compulsion list with this, which we'll go on to in a bit. Sure. Is an is enormous, but I think let's hear from our insane community.

SPEAKER_01 11:35

Let's yeah, this is a good one. Let's listen to this did it anyway.

SPEAKER_04 11:39

Hi, Drew and Josh. Um, my name's Callie. Feel free to use my real name. I'm 35 years old and I'm from Leicester in the UK, and I was wanting to share my Did It Anyway with you. So I've been having panic attacks for the past three or four months, um, largely centred around health anxiety and OCD. A big part of it for me is cardiophobia, which I know you've both covered in your respective podcasts, which I've been listening to. And I've also read Drew's fantastic book, The Anxious Truth. So, anyway, I decided I needed to expose myself to things that make me afraid. So I started running. I was a total beginner. It was very slow going at first. I'm running a bit further now, and it really got my heart rate up and my breathing up. And I did it to prove to myself that nothing bad was gonna happen, and nothing bad has happened. And aside from the benefits on my, you know, my mental well-being, I'm also reaping the benefits physically, like my body as well. So, thank you so much for all the information that you put out there. It's really, really helped me turn my mindset and my life around, and it's only getting better. So, thank you so much.

SPEAKER_01 12:57

Yeah, that's for more than that.

SPEAKER_02 12:59

That's amazing. Yeah, well done. That's willful tolerance, showing the brain, uh that you know, nothing bad's gonna happen. Yeah, interoceptive exposure. You know, let's get that. The thing I fear, well, um, let's just go and get my heart rate up and and and run around. I love it. Well done, well done.

SPEAKER_01 13:15

Uh-huh. Someone with cardiophobia that decides to run. I can't ask for any more than that. That's really good job, Callie. Thanks for sharing that. You know, if we tie it to today's topic and dementophobia, what did Callie do? Well, I have to show my brain that the bad thing doesn't happen. You're right. Because even though we can tell you on this podcast, uh, it's just uh misfiring, it's an overactive threat response. It's your brain just finding a believable story. It doesn't mean it's accurate. Only experience will change the prediction. You can't just decide to believe. Oh, Josh and Drew said I'm not going insane. I'm cured. Yay. We would love it, but it never happens. Callie had to actually run and risk the thing she feared. And the experience taught her brain, oh, I'm I'm telling the wrong story. Imagine that.

SPEAKER_02 13:59

Experiential learning. Well done.

SPEAKER_01 14:02

It's how we did that.

SPEAKER_02 14:03

And for demenophobia, that is like you know what? Go sit down and watch that movie where the yeah, they they they they they turn. Split's another one as well. Oh, it's actually not really a great movie, but it's triggering for people where he has 13 split personalities.

SPEAKER_01 14:19

Ooh, okay, that would be scary as hell right.

SPEAKER_02 14:22

Yeah, it's good. I have set that homework over the years. They're like, no, no, I couldn't possibly watch that. I was like, you're watching it all in 4K in surround sound. Let's go.

SPEAKER_01 14:31

Let's do it. Yeah, let's run with it. I have been known in sessions to say, people will say, like, but yeah, but it feels like I'm going crazy. And I'd be like, all right, let's just wait. Go ahead, go crazy. I'll wait with you while you do it. Go ahead, like, go crazy. So, like, yeah, yeah, yeah. Yeah, I'm I'll wait. It's okay. We got all time, we got an hour. Let's wait while you go crazy. Go ahead, do it. And I think it's it's really weird. So, how do I how do I face what I fear in demetophobia? Either go directly toward it, like Josh is saying, watch these movies intentionally get triggered, or I had to learn when I would get depersonalized to let go and just let that feeling be there. It was so hard to stop compulsing against it, because that felt right. That felt like it was saving me.

SPEAKER_02 15:10

So, yeah, yeah. And we'll we'll talk a bit about the compulsions, but uh just us while it's in my mind, but Dave Carbonel, like as part of his formulation process, would say, like, almost in like a condescending way, but I find it brilliant. He's like, All right, yeah, yeah. So you're gonna lose control, right? Yeah, yeah, cool. Um, so when you've lost control in the past, what did that look like?

SPEAKER_01 15:31

I love it. Yeah, I'll wait.

SPEAKER_02 15:33

Well, I've I've not.

SPEAKER_01 15:35

Yeah.

SPEAKER_02 15:36

Okay, okay, all right. So yeah, okay. So well, what does it look like when you lose control? Oh, um, I'm going crazy, I have to be restrained, I have to all right, okay, okay. And and that, but that's not happened before. No, okay, but now it is gonna happen, is it right? And I just love it, I love it. I would I wish I had had that from my therapist. It's like, yeah, but but what if it happens?

SPEAKER_01 15:58

And then all right. Okay. I will usually add the next question, like, oh, okay, so it hasn't happened. So why hasn't it happened? What what saved you? And uh, you know, you'll get the usual answers, like, oh, my partner was with me. I call my you know, my friend and they talk me through. I'm like, your friend is that magical that they somehow preserve your sanity. Like, is that it? That did it, like, can I can you introduce me to that person? Because I need that person in my life. So, like, yeah.

SPEAKER_02 16:24

You are you are to me true. You are magical to me, and you preserve my sanity.

SPEAKER_01 16:28

Oh he's lying. Wait, this is the dude that was that was last year since I were playing the video game. Like, hey, dude, I think I'm having a panic attack. And he's like, believe every thought you have. Worst friend ever.

SPEAKER_03 16:45

Yeah, yeah, right.

SPEAKER_02 16:46

So good. You're having a you're having a panic attack, Drew. Uh so here's what you need to do. All those what ifs are real. Yeah, all the sensations are dangerous.

SPEAKER_01 16:56

Didn't even take a breath, just literally said, like, you should just believe everything you're thinking right now. And I'm like, fuck you. So good. I mean, I had a laugh. So yeah.

SPEAKER_02 17:05

Uh no, no, no, no. Anyway, main compulsions with dementophobia and fear of going crazy. Let's list them. Let's see how many we can get okay.

SPEAKER_01 17:14

Um, I'll start. Uh checking to see if you remember everybody's birthday.

SPEAKER_02 17:20

Oh, yeah. Going on, everyone. Um, yeah. Avoiding stimulants and alcohol.

SPEAKER_01 17:26

Oh, uh freaking out over getting enough sleep because tired could mean snap.

SPEAKER_02 17:32

Yeah. Um testing your and comparing emotions in the same place to see if there's any discrepancy in your mood, if that's the first sign of like going crazy.

SPEAKER_01 17:47

Yeah, it's always like kind of looking for the signs, right? Along the lines of trying to remember everybody's birthday, is I had people who would recite all of their relatives' names over and over compulsively. So they knew they weren't fairly.

SPEAKER_02 17:56

Very OCD, very OCD, like exactly.

SPEAKER_01 17:58

Yeah, kind of to testing.

SPEAKER_02 18:00

Yeah, um, looking at the ingredients on packets to see if there's any psychoactive substances.

SPEAKER_01 18:07

Oh, that's a really good one. Uh, or the other one would be like res getting the antibiotic for your sinus infection and like refusing to take it for two weeks because I heard that antibiotics could like bad side of bad psychological side effects. I don't this is gonna make me crazy. I I've seen that. Yeah, seen that.

SPEAKER_02 18:25

Yeah, those um again of just avoiding any, like avoiding the news, movies, TV shows, the anything to do with that might mention someone losing control.

SPEAKER_01 18:35

Yeah. I think one of them that is uh we have to honor this one a little bit because it it is based on a real event. It's true, people who have had that history in their family who will then consistently just keep telling them the story again and again and again because it happened to grandma or to mom. It's going to happen to me, and I'm gonna act like it's happening right now. So it's weird. It's almost like a compulsive catastrophizing over and over and over every day.

SPEAKER_02 18:59

Yeah, yeah. Uh, can I do another carbonyl? Like right. So you'll go, oh, it sounds like everyone in your family goes crazy. Yeah, like a no, just just just just my cousin did. Oh, right. Oh, sorry, the way you were describing it was that it sounds like everyone in your family goes crazy and it's gonna happen to you. Yeah. That's a good point.

SPEAKER_01 19:20

Well, I mean, he's doing a good job of calling out a distortion, right? You know, old school CBD cognitive distortion. Like, you made it sound like you should have been crazy 10 years ago. Is that what you're saying? No, not really.

SPEAKER_02 19:29

Oh, okay, just clarifying I love it because it's like you're it's making your anxiety smaller. Yeah, it's like it's this very loud voice that's always screaming, this is gonna happen, and then you just get some guys casually sat there going, oh right, yeah, just calling out all the logical fallacies that feel so real. Yep, and then you're like, actually, now, you know, it's okay. And all that's a good one.

SPEAKER_01 19:51

Yeah, I think so. And all in the end, all that's going to do is give you ammunition for letting yourself have experiences to learn from. Like Dave's great, love Dave, but like he never cured anybody just pointing out the logical fallacy. It just says, Oh, I guess it is safe for me to do that exposure, to watch the movie, to tell the story, to not not compulse. Like, it's safe for me to do that so I can learn really that this is not. Oh, yeah.

SPEAKER_02 20:15

And he would he would do that though. He encourages people to just do the exposure.

SPEAKER_01 20:18

Oh, 100%. Yeah.

SPEAKER_02 20:19

Yeah, I love that.

SPEAKER_01 20:20

Yeah.

SPEAKER_02 20:21

Um, another re uh reassurance seeking. Did you hear that same noise?

SPEAKER_01 20:26

Oh, that's oh, this is interesting. Uh, I don't know why I did this, but one of the things that was really interesting was I was on Reddit over the weekend and I'm rarely on Reddit. And remember on Reddit. I was on Reddit. There was a purpose for Reddit, I promise. And I'm like, now we just released a book on health anxiety, the disordered guide to health anxiety. So I'm like, is there a health anxiety subreddit? Uh I still haven't recovered from scrolling for three minutes to the health anxiety subreddit. I cannot tell you how many has anybody else ever experienced and lengthy, lengthy discussions where people try to help each other believe that they either don't have health problems or are not losing their minds. There were so many dementophobia threads. And I'm I just wanted to chime in and say, y'all got to stop talking to each other because all you're doing is trying to convince each other in the moment that you're safe, and then you'll be back tomorrow.

SPEAKER_02 21:16

But yeah, yeah, and that's so there was a lot of. So, yeah, Reddit reassurance seeking from people, forums, Reddit. 100% obviously the big one, AI straight away. You know, like how do I know I'm going crazy?

SPEAKER_03 21:28

Yeah.

SPEAKER_02 21:28

Um, which is really funny because I I I worked with someone recently who had dementephobia, was using AI, and then one day they came and said, I've stopped using AI. And I said, Well, well done. That's really good. You know, you stopped compulsing. And they said, No, it wasn't good. Actually, it's now avoidance because I read that there was this huge onset of AI induced psychosis, and now I'm too afraid to use it.

SPEAKER_01 21:53

Yeah, yeah. I have heard that once in the last couple of weeks. Like, yeah, what are these stories about AI induced psychosis? I'm like, Why, you know, what brings that up? Well, I I use ChatGPT for everything. Well, okay, if you want like, you know, like spaghetti recipes, it's fine. You're it's not gonna lead you into, you know, a dark place. But this was a person who wasn't even talking about their mental health, they just use it for just general information. But they got really nervous when they heard the word psychosis. Really nervous.

SPEAKER_02 22:17

Yeah. Yeah. Well, two of my very good friends have psychosis, but they don't have anxiety disorders. It's really interesting. Funny how that works, right? Yeah, just like just like, yeah, whatever. You know, there's a there's there's a dude that chats away in my head sometimes, but whatever. You know, and they're more calm than the people that are like, oh, what if that's me? Because you're afraid of what, Drew?

SPEAKER_01 22:39

Uh, you're afraid of going crazy, yes.

SPEAKER_02 22:42

And panicking.

SPEAKER_01 22:42

Oh, you're afraid of panicking.

SPEAKER_02 22:44

You're afraid of the anxiety. I'm sorry. Yeah.

SPEAKER_01 22:46

Um, I was I was distracted because to this morning I asked my Instagram audience to say the word that they fear. Say the word, it's okay. You can start. Oh, that's a good one. Right? And I thought, hey, let me look. And I am just scrolling, and I cannot tell you how many psychosis, insanity, crazy over and over and over and over. Definitely, I mean, it's not scientific or anything, but there they are for for all to see. It's one of the most common fears that people like Josh and I deal with every day.

SPEAKER_02 23:13

The fear of the yeah. Yeah, the word I fear. Yeah. Sean Kasam. I've said that out loud. Is that me doing an exposure?

SPEAKER_01 23:21

Yes, just let the feeling come and go. Just stay with it. Stay with it. You'll be okay.

SPEAKER_02 23:25

Uh I'm dissociating already.

SPEAKER_01 23:28

Um, so but what about the part we should talk a little bit, and then maybe we'll do a little more community stuff. About one of the arguments that I hear is, but what about people who develop, like I will often hear, but what about the combat veterans? I've had people literally go back to World War One and stories of like men who lost their minds in the trenches, like in there's mustard gas and all stuff is going on, and they see in their friends is like limbs being blown off. But they did, they did go crazy, and like it, you know, it's really hard because then you have to try and feed good psychoeducation. They're like, we don't have a path from anxious, like anxious to crazy. We just don't have that path, it doesn't exist. But that's often a very common argument. Like, but can't you get so afraid that you will go insane? How do you answer that question?

SPEAKER_02 24:21

Well, no. I mean, right. Is it theoretically possible? Maybe, but no, and not with anxiety disorders, and not where I've in all the years I've been working.

SPEAKER_03 24:33

Yeah.

SPEAKER_02 24:33

Um, but then again, that's the brain, the threat response trying to justify your attention.

SPEAKER_03 24:37

Yeah.

SPEAKER_02 24:37

No, I mean, if you're exposed to the most horrendous trauma in the most horrendous conditions where you're not eating properly, you're not sleeping, you're living in acute fear of being shot, blown up for years in trench warfare, pushed to the very limits of what you can tolerate, yeah, then yeah, you might have a psychotic break. You know, I wouldn't say that's very surprising. But no, pacing around your house or having intrusive thoughts and having panic attacks. No, you're not going to go crazy from that.

SPEAKER_01 25:08

Well, I mean, and people will tend to argue, yeah, but I'm afraid just like the guy in the trench was in 1918. Like, I know you're afraid, but in that situation, you're afraid that something might be wrong, which is a is very different than oh no, something is a hundred percent wrong that may lead to my demise and everybody I care about. And there is nothing I could do about that. Those are two very different experiences.

SPEAKER_02 25:30

And we can look at like I've not heard that. I don't hear that often though from people. Do you hear that?

SPEAKER_01 25:34

Oh, I hear that. Yeah, that's one of the arguments I hear as to why, like, are you sure about that? Because I'm scared too. I'm I feel like I'm so overwhelmed, and we talk about this all the time. Common theme, right? It's too much. The fear it's this is it's going to be too much, and one of the outcomes people fear of out of too much is it will break my brain. My brain will break.

SPEAKER_02 25:53

Yeah, I can relate to that as well, though. I I do it's really scary, like sure, but but you never do, right? That's why I love, I love, I even just take my and this is a tip. Here's a tip on disordered. Who thought? Rather than two guys just being self-righteous.

SPEAKER_01 26:10

This may be the first tip we've ever given. You know what it needs? All right, what's your tip, Josh? Bring it. It needed some fan there.

SPEAKER_02 26:22

Uh I think I've forgot what it even totally direct. No, the the tip is uh for me, and you can just use mine if you want. What I used to use back then was um, it's not a brain thing, it's a it's adrenaline in my blood thing. Yeah, so I would just visualize like, oh wow, I've got a lot of adrenaline and cortisol in my blood, and it's just making its way around. I can't get rid of that unless I suddenly have a dialysis machine that I can wire myself up to and use compulsively every time I have a panic attack. You know, I wouldn't recommend putting yourself through dialysis as a safety behavior response to a panic attack. But I used to when I'm in the dementiophobia, like, oh, it's all in my brain, my brain's on fire, it's everything's happening. But actually, I kind of reshifted the visualization. Just a tip, you don't have to use it, but just like a yeah, I feel like this because I've got an adrenaline surgeon. It just has to do the it's lap of my body, and only my visualization, I'm not quoting, you know, science and physics, and and you know, actually it happens. No, just that's how I used to do. I'm like, and once it goes around my body, it's fine. It's a body thing, it's a it's a healthy chemical thing, let it go through. But when you think about it all in like all the racing thoughts in my brain, and it's becoming the supercharged, super hot battery that's gonna explode. No, that's that's not a healthy visualization.

SPEAKER_01 27:46

Yeah, there's uh you know what I would be curious there's gotta be a way for Google to track this. The number of people who listen to this episode and then search dialysis near me. Like, what would that was the overlap there? Because I I I know you're all gonna do it. Do not search dialysis near me. Do not do that.

SPEAKER_02 28:02

I one they will not. I have more faith in our listeners. They will not be going to compulsively use a dialysis machine.

SPEAKER_01 28:09

Like, is that possible? Can I take the adrenaline out of my blood with dialysis? Um, I I think one of the things that's so interesting that I always find it's very meta about this, right? That a lot of this doesn't make sense. It's not intuitive. Like, yeah, but I'm so afraid. It is so intense. I know, but the intensity of the feeling, which is fear, only confirms that you are afraid. It's only reflective of what you believe to be the danger. It is does not confirm the danger, it only reflects what you are afraid of. That's it. So that's very circular reasoning, but it is true. But I get so afraid that my butt isn't that going to break me. No, you're only really afraid because you you are worried that you will break. That doesn't confirm that the break is going to happen. It only confirms that you're worried that it will. That's it. That's all it is. Yeah, I agree. Which is really hard to get your brain around a little bit, but again, all it does is give you a little ammo for sort of relaxing into it and trying to walk away from the compulsive response or the saving response, avoidance, whatever you want to call it. So should we do another didn't?

SPEAKER_02 29:09

No, it's time for Drew's question, and I would like the eagle sound, please. Sorry, white head thought.

SPEAKER_01 29:14

You know what? I don't have the eagle here. You have the eagle. What? Do I have the eagle? Yeah, hold on.

SPEAKER_02 29:19

Let me get it. Let me get him out of his cage.

SPEAKER_01 29:21

Yeah, I don't have the eagle. Let me see. Did I put it somewhere else? Why do you have the eagle? Yeah, I don't have it.

SPEAKER_02 29:28

It's time for Drew's questions. Um, this is where I pick a question for Drew, and he not don't tell him beforehand. And it fits really nicely with this episode. Uh, I don't think they've given us permission to use their name, but here we go. Yeah. Hi, I wanted to reach out because your podcast really resonated with me, but it also raised some questions about my own experience with DPDR. In most explanations of DPDR, it's described as something that comes from anxiety or stress and acts as a protective mechanism. I understand that, but my experience feels slightly different, and I struggle to find people who describe it this way. These are the people in Reddit. For me, the DPDR symptoms don't seem to come from ongoing stress or constant anxiety in daily life. They mainly appear when I focus inwards, when I start checking, monitoring, or analyzing my consciousness, my sense of presence, or whether I feel real. As soon as I direct attention to how I feel or try to confirm that I'm present, I immediately feel detached or unreal. When I'm focused outward or engaged in activities, I often feel more normal. Because of this, I find it hard to relate to the idea that DPDR is only driven by anxiety or stress. In my case, because it's a special case, it feels like the act of checking and monitoring itself creates the symptoms, even when I don't consciously feel anxious beforehand. People often say, just don't think about it and let it go. But that's incredibly difficult. I agree with that. I honestly can't think about DPDR without immediately experiencing it. Even talking or reflecting on it seems to trigger the symptoms. That's why I'm generously curious how you're able to talk about DPDR so openly on the podcast without being pulled back into the experience yourselves. For me, simply bringing attention to it seems to reactivate it straight away. Uh really good question. What do you think, Drew?

SPEAKER_01 31:25

Well, I'm gonna start by I'm gonna go all Dave Carbonel here. That's not a question. None of this is news, right? So okay, people describe it as a defense mechanism when there's a problem. But there's not a problem. But the problem for me is that I this is my unique, which uh we all hear this every day, this is my special version of DPDR that must be different than everybody else's, is when I go and scan and look for problems. I know. So just because you think that the problem comes inside from inside of you and you have to look for it doesn't mean that there's no problem that triggers it. So what's the difference between like, oh, I feel like my partner's about to go on a tirade and start breaking dishes and I and I dissociate? Okay, you would understand that. You you get that. That's how they describe it to you. Oh, but it only happens to me when I go in and check to see how I'm doing. Because I am worried that I'm not doing well and I'm looking for a threat. And sure enough, I find one. Like the act of looking for the threat finds a threat, and then you get the symptom of the threat. So I understand that it feels like, but that's different. There's no problem that triggers it, but there is a problem. You're worried about how you feel. You are the problem. Josh said it early in the episode, right? If there's no threat, then the threat is you. So yeah, it's okay.

SPEAKER_02 32:37

Also, also, I would challenge the question and your narratives. By the way, again, reiterate, great question.

SPEAKER_03 32:42

Thanks for letting it in.

SPEAKER_02 32:43

Um, it's you're saying that oh, a lot of DPDR is triggered by stress and anxiety. Mine's different, it's when I check. Well, why are you checking?

SPEAKER_01 32:54

Because you're stressed.

SPEAKER_02 32:55

Because you're stressed and you're anxious.

SPEAKER_01 32:56

Yeah, it's 100% right. So, like, I it it it's a you know, it doesn't make sense that you would argue that, like, but there's no stress and anxiety. Well, then why are you looking for problems inside of you?

SPEAKER_02 33:06

Yeah, but also as well, uh to the second part of the question was how are you able to talk about DPDR without going inwards and it triggering? Because we no longer fear DPDR. Right. When you fear DPDR, you're gonna check for something you fear, don't you? See your threat response. You know, if I fear spiders, I'm gonna check for spiders. Just wood, you know. Uh, but when you fear for DPDR, you're gonna check for it. And when you check for something you fear, you're gonna find it and it's gonna trigger. It's a very, and this is where assurance comes in. This is very common, it's not special. You're checking for something you fear. You can overcome this when you teach the brain that DPDR is okay. So I would say, as a therapist, as an exposure, I would say, all right, step one, check for DPDR. Step two, be anxious. Step three, no more compulsions and do what non-anxious you would do.

SPEAKER_03 34:00

Right.

SPEAKER_02 34:00

That teaches the brain that DPDR is fine. But it's we're we're kind of checking, testing, is it there? Is it not? Oh no, mind special. I need to keep an eye on it. And the compulsions have got you there.

SPEAKER_01 34:11

But you'll get there.

SPEAKER_02 34:12

Um, you really will.

SPEAKER_01 34:13

I agree. I'll add to that, like, I I find it very people will say, don't think about it. Well, that's nonsense. That's bullshit in plain English. Like, of course you're gonna think about it. You can't ignore it.

SPEAKER_02 34:22

Of course you will. Even we will.

SPEAKER_01 34:23

Yeah, number one, you're really afraid, and that's okay. You're allowed to say this scares me. Like, let's acknowledge that experience. And like, of course, you're gonna notice that it's there. So the idea, like, oh, just don't think about it. That's ridiculous. It's but throw that advice away. But the point would be like, okay, we we actually it's not a bug, right? It's not a bug that you get triggered into a state you fear when you think about that. It for us, it's a feature. We I want that, I need you to be triggered so that you can practice moving through that situation. Like, so it's actually not a problem. The the the fact that you see it as a problem is part of the problem. Like, but I can't talk about it or it happens. I know we want it to happen, get used to it.

SPEAKER_02 35:00

Yeah, that would be step one. Yeah, yeah, 100%. So great question. Yes, yeah, yeah. The thing the the really good um you're halfway there conceptualizing it as well. You notice that you inwardsly compulse and check. Yeah, but I would say, all right, start then, purposely evoke it. Now what are we doing? Yeah, yeah, yeah.

SPEAKER_01 35:18

Very good. Great question. Uh that's the inward compulsion music. That I think we do have. Oh no, I don't have that. I have the other one.

SPEAKER_02 35:26

I've got the archives. Yeah, yeah.

SPEAKER_01 35:28

We get the whole soundboard. Um, okay, cool.

SPEAKER_02 35:31

Um, have we got anything else? We've got a couple more, haven't we?

SPEAKER_01 35:34

Yeah, we got a we got an audio did it anyway. And there's a question in this one too, which is gonna be kind of familiar based on what we just answered, but let's do it. Okay.

SPEAKER_05 35:42

Hi, Josh and Joe. Um, my name's Laura from the northeast of England. Um, feel free to use my name. So I've got a little bit of a did it anyway, and a bit of a question. Um, so last night uh I've suffered with panic solar for coming up to the air. Um, just came on quite suddenly, and then I've had it to take my so I sort of get used to it. Um just sitting last night watching TV and felt the um adrenaline rush start. And I must ended up in a bit of a panic attack. Now it's the first time I've had a panic attack for quite a long time. Um I get anxiety symptoms most days, but not a full-on attack. Um I felt quite happy with myself because I did just sort of sit there. I tried to finish watching the TV, um, and then I got up and did my normal tidy-up jobs before I went up to bed and watched TV in bed as well. So I was quite happy with myself. My question is when this happens, or if I have a really anxious day, it's normally no time, to be fair. I find it really hard to then the next day just get up and sort of forget about it. Um, it seems to like linger on a little bit. It takes us a little bit to kind of forget that it's happened and just get on with whatever I'm doing. It doesn't stop as doing anything. I'm not avoiding or anything like that, but it's always in the back of my head. Um, so that was no question anyway. Um, thanks for all your help. I really enjoy your podcasts. Thanks, bye.

SPEAKER_02 37:19

Well done. So that's really so many good things there. I love I love that bit. You're like, no, oh no, it's here. It's scary. No, I'm gonna keep trying to watch TV and then I'm gonna keep going and then I do my nighttime routine and go to bed. Yeah, okay, you're gonna feel a bit shaky and sensitized there, and you can't forget about it when whenever you're shaken up by something, it's hard to forget about something, you know. If a if a feral honey badger chased me through Manchester, not that they exist here, um, and that's gonna shake me up, and I'm probably not gonna forget that the day after, am I? Um the aim's not to forget about it. The aim is to be like, okay, I was shaken up yesterday, but I need to get up and do what I did magnificently yesterday. The focus isn't on what you're doing wrong, it's build on what you've just done. Yeah, that's amazing. I had a panicky moment watching TV, but then I carried on, and look what I learned there. I can tolerate anxiety at its worst, but now you keep checking back to see, you know, is it fixed, is it gone yet? No, it doesn't matter.

SPEAKER_03 38:27

Yeah.

SPEAKER_02 38:28

If you can tolerate anxiety at its worst, get up, crack on with your day. Well done.

SPEAKER_01 38:33

Yeah, yeah. I think the moment that you realized on the sofa what was going on and you softened into that and just let it happen, repeat that as often as you have to today or the next day. I don't know when Laura sent this in, but you know, presumably it's over now. But that's okay. It means that the the waves that come afterwards, because of the memory of a difficult experience, you got to soften into those the peak of each of those waves. Just repeat that. Uh, what if it happens again? Well, I see what's going on here. I'm nervous. Soften, surf, surf, like whatever you want to call it. Like just repeat it. You did it. You did it when it was much harder, so just keep doing it. It's okay. You got it.

SPEAKER_02 39:07

Yeah, you might have to do it a few more times, keep going. It's all good. You're desensitized. You you can't desensitize overnight. Right, exactly.

SPEAKER_01 39:15

And even somebody who is fully desensitized or recovered, or whatever word you want to use, we see it all the time. Like, oh, I haven't had a panic attack in two years, and I had one, and oh no, like square one, it's a big setback. And usually, like a few days later, that person will come back and say, uh, it really wasn't a setback at all. I was just a little bit shaky for a few days. Yeah, that's pretty normal. It's okay. You know, that's yeah.

SPEAKER_02 39:36

Really well done. Really good. Did it anyway? Uh, have we got time for what time are we? Yeah, we got where are we? I've got one. I've got one here.

SPEAKER_03 39:42

Yep.

SPEAKER_02 39:43

Uh, this is from Miri. Hi both. I'm Miri. You can use my name. Thank you both so much for all you do. I just wanted to share a did it anyway and ask a related question. This weekend I've been away on holiday with my family. Staying overnight away from home is my most difficult scenario, but I just knew I had to do it anyway. The first night I barely slept, but I didn't put any pressure on myself to get to sleep. I absolutely love that. Just listened to an audiobook and did some colouring. The second night was much better, and I got almost my usual amount of sleep. I had anxiety with me the whole weekend, but I was able to give most of my attention to what we were doing. Oddly enough, the biggest waves of panic hit on the way home. Something I hadn't expected, as returning home to my safe place usually makes me feel better. My question is, did my panic save itself up over the weekend, Drew? I added the Drew in there, because I didn't pay it attention and then hit me once I felt the danger was over. Thank you.

SPEAKER_01 40:49

That's a really good question.

SPEAKER_02 40:51

Applause first, though.

SPEAKER_01 40:52

That was That is true. Like, you know what? I didn't try to force myself to sleep.

SPEAKER_02 40:56

Good job, Mary. So Mary says, Did did my panic just save itself up to punish me when I when I get in?

SPEAKER_01 41:04

It's an interesting interpretation of it. I mean, I I could tell you that it's a really common experience. We here's what I would say is gonna be a bit of a meta answer. Don't spend that much time trying to figure that out. If you panic, you panicked. Why it happened? We don't know. You're afraid to panic, and it happened, and now you want to dig into it and explain the mechanism that caused it. You don't have to. I'm not sure why it happened. But it's a very common experience. I hear it all the time. The person with agoraphobia or panic disorder that rises to the occasion because they have to, you know, I have a sick kid or something, and you have to rise to the occasion and meet the thing that you're afraid of. And is always like so surprised, like, wow, I did so great. You know, I had to take my son to the hospital. We were there for three hours, had to get cast on his leg. I didn't panic at all. When I got home, I panicked. Very, very common. Makes sense.

SPEAKER_02 41:48

Good answer, but I think it makes sense as well. We've already mentioned today panicogenic relaxation. Yeah. You went away and you and you let your guard down, and often because of habits. Yes, home is a safe place, but I bet I bet you spent way more time anxious at home than you think. The old habits come out, and also you're feeling calm. You've enjoyed your holiday, you've done well, and then you relax, you're going back to your old place, panicogenic relaxation. Whoa, why, whoa, we we're not usually this calm when we're in the house. Yeah, yes, we're not panicking, but we're always on edge, we're always compulsing, we're always doing stuff. So I mean, it's no surprise that on your way back you started to feel panicky. Panic doesn't save itself up, and I know it does it's not this, it's not a little gremlin going, I'll get you later. It's just going, okay, well, you've taught me that that holiday was safe. Great, I'm not gonna fire off on holiday, but how often do we fire off at home? Probably for ages. So old habit, just in case, I'm firing off and protecting you, Miri. Yeah, no, and then we just carry on again.

SPEAKER_01 42:54

I think a lot of times that people will experience the whole, like, did I just do that? Like, I can't believe I did that. I went on holiday. Like, and that will create a checking state. Like, yes, I was okay. Am I okay now? And it's very subtle and it happens outside of our awareness, but okay, that's still going on. No problem. Just keep doing the work, keep doing it. I hate the work. I just said doing the work. You should kick me off this podcast.

SPEAKER_02 43:18

Checking state. I like that term, checking state.

SPEAKER_01 43:21

Yeah, it'll create a checking state. I can't believe I did that.

SPEAKER_02 43:23

It's pretty much the state that dictates most anxiety disorders, isn't it?

SPEAKER_01 43:30

Uh that was really cool. Anything else, Drew? No, I think that's probably it, other than I will extend a thank you not only to the people who are reviewing the podcast and leaving us five-star ratings and listening every week, but the people who are buying the disordered guide to health anxiety.

SPEAKER_02 43:42

Yeah, thank you for buying the health anxiety book. It's gone down really well. I've got mine here, it's really good. Um, if you struggle with health anxiety, we do talk a little bit about mental health anxiety in the book as well. Yeah, uh, touches on it because a lot of things overlap. But yeah, um, thank you for the really nice, what warm reception to the book as well. I'm glad it's in the hands of the listeners.

SPEAKER_03 44:02

Absolutely.

SPEAKER_02 44:02

Um, but yeah, thanks for the review stuff. Go to disorder.fm, leave your voice notes, leave your messages, and we'll, you know, we try our best to get through them all.

SPEAKER_01 44:12

And just thanks for listening. Yeah, we'll be back next week with some other random topic. So thanks for hanging out.