Hi folks - I understand that a lot of us have generalized anxiety related to (or due to) MAV. I’ve been told by my migraine doctor (otolaryngologist) that my anxiety is greater than what he generally sees with his other patients, and as such he made the reasonable recommendation that I see a psychiatrist and they communicate and collaborate on treatment decisions. While I’ve started to see a psychiatrist, my anxiety has not yet lessened (I take partial responsibility as I’ve yet to try the lorezepam prescribed to me due to fears of side effects and how it may impact my MAV). That all being said, I’m genuinely curious if anyone has developmed similar anxieties as me, and if so, how it’s been managed or addressed, if at all. Here are a couple of anxieties I have which my doctor found particularly unusual (and which my psychiatrist has also found unique):
I think about how we’re on this rotating sphere in the middle of an ever-expanding universe that we don’t understand, and how small we are. I also think about how if we’re a sphere, if I were to travel to the other side of the earth I’d be on the bottom (or the top) and it frightens the hell out of me to think about it. I have a very, very rudimentary and superficial understanding of science, but it’s enough to scare me when I think about it. While pre-MAV I may have thought about this quickly (or discussed it with a friend or in a class) and then moved on (or maybe even researched more because I would find it somewhat interesting and it wouldn’t lead to anxiety at all), it’s now much harder for me to go from thinking thoughts like this without feeling anxious.
Related, but a little different - I feel sometimes like I’m falling off the the earth. I believe that the motion I feel plays a huge role in this, as while I try to put these thoughts out of my mind I’m battling this constant swaying feeling which perpetuates thoughts and with it the anxiety. Even though I rationally know that I’m not going anywhere, it’s still very very uncomfortable.
I think greatly about the mystery of existence. Again, it’s not as if I would never have a thought like this prior to MAV, but it was something I’d maybe think about but be done with in a reasonably short period of time. I could go about living my life without issue. Now, it’s harder for me to conceive of doing mundane human tasks with my mind so occupied with this other stuff.
When I think about driving or flying north or south I have a hard time understanding how this happens with everything sticking close to the earth. I associate north with “up” and south with “down” and I can only think of the car or plane going up or down (not to the ground, but to the universe) Looking at maps can be tough for me because everything is just “up” and “down”. I wish I was living during a time period when a flat-earth was still the common belief. Not that I wouldn’t still have anxiety, but I truly do believe that’d help.
Large bodies of water. The expanse of the sea frightens me and makes me think of the universe and spatial relations, etc.
Open tracts of land or scenery. I’m much better off in a city where there’s activity (I understand that activity can trigger migraines for some but I actually prefer the atmosphere - aside from lighting I tend not to be as affected by environmental triggers as much as others.)
There’s more, but to be honest with you it was tough writing this post at certain points because it was bringing up anxiety. I’m just very curious to see if anyone else has experienced similar anxieties. I understand that anxiety related to bridges and abnormally large objects (eg major statues) is relatively common for migraneurs and I do believe there to be a connection between the cause of both those anxieties and my own more unique set.
Very interesting post. Sounds like we are in a similar boat. I have a life long history of GAD, depression, phobias, and OCD. I too, spend an unhealthy amount of time worrying about some of those things you mentioned. I have had several diagnoses in the last year regarding my dizziness, even though all test results were normal. (I was told BPPV, cervicogenic, Mal de debarquement syndrome, and anxiety/Chronic Subjective Dizziness). Although my Dix-Hallpike was normal, I must have some positional vertigo because I often get dizzy when I flex my neck in a downward position…sometimes it happens immediately, other times, the response can be quite delayed. The cervicogenic and MDDS thing make no sense in my case. My dizz. started very gradually in 2009 and has been more chronic since early last year. I am always dizzier when I leave my apartment, and sometimes feel like I’m gonna pass out but never do. If I am 100% distracted by something enjoyable OR by another worry, the dizziness is nearly absent. I’m sure I’m forgetting a few points, but I’m starting to wonder if I just have a mild inner ear disturbance (too mild for the VNG to show up anything?) coupled with Chronic Subj Dizziness. Could be the same for you as well?
Oh, Lorazepam works great for dizziness because it is a vestibular suppressant. I take 0.5mg about once a week with no problems. During high stress and anxiety, I get the falling off the earth feeling too. There was a girl who posted on the anxiety forum I visit, who said she instantly became dizzy thinking about things like space and vast oceans because it just “freaked her out.” Were you ever diagnosed with agoraphobia? My dr. suspects I have a mild case of that, myself.
As far as treatment goes, I will be perfectly honest. The best I ever felt in my life, mentally and physically, was on antidepressants, be it SSRI, SSNRI, or the atypical ADs. The natural remedies, incl cognitive behavior therapy, do not cut it for me. This is up to each individual, but for me, the side effects of those things are not worth feeling better. I see my dr. soon and we are going to discuss something off-label like Neurontin, Lyrica, beta-blockers, etc…just SOMETHING to treat the physiological components of my anxiety, and hopefully the dizziness too, whether or not that turns out to be organic. Thanks for hearing me out as well!
Wow, thank you for your response. I’m very sorry to hear about the difficulties you’ve been facing.
I’ll respond in greater detail later, but here is one answer and one question:
I have not been diagnosed with agoraphobia. I’m actually able to leave the house and don’t mind large crowds or bustling atmospheres - in fact, I actually thrive in them. I actually quite like malls because there’s some security to me in having so many people around. The stimulation, while troubling to many, actually helps me cope by keeping my mind off of other thoughts, I think. The only piece that frightens me is wide open spaces where there’s no one around. Where many people love beautiful mountain scenery, for example, I have to look away even from pictures sometimes. For this reason, I’m lucky I live right outside Boston where there is a lot of activity.
Regarding lorezepam, I’m glad to hear of the recommendation. May I ask why you take it only weekly? Do you take it as-needed, when you feel the symptoms coming on or when you expect you’ll need it? Have you ever taken it more regularly than weekly? My psychiatrist is recommending I try taking it at regular times on a daily basis prophylactically.
One thing I should add is that to all but the people closest to me (my wife, parents and sister, really), people generally don’t know that there’s anything wrong with me. Or rather, some close friends and co-workers understand that I battle certain issues, but they don’t understand anywhere near the full extent of what I go through. While in some ways this is a blessing, in others its a real curse because people are too quick to write off some of my behaviors (eg making my wife drive!) as personal idiosyncracies as opposed to something larger. Even my wife and family, who are wonderful, just can’t appreciate what I go through because I show no outward signs of struggle or issue. Everything, it seems, is internal! No one can understand how I can feel like I’m walking at an angle yet be able to walk perfectly straight, even with my eyes closed, for example!
Again, thank you for your post. I look forward to furthering our discussion.
I personally find xanax to be better than lorazepam (ativan) as the xanax works faster and I need less of it to help with the anxiety. For more long term, slower acting relief of anxiety and the dizziness I use valium - I split a 5mg tablet in half and wait a while to see if I need more.
With xanax too I am prescribed 1/2mg tabs (very low dose) and I break them in half. I like to use the lowest dose possible. At some point when I was using lorazepam, it started to make me feel ill I think it was because of other Rxs like prozac I was taking at the same time. When I’ve taken it alone, 1 or 1/2 mg a day was great.
Interesting story you have! Would it help if you had a better understanding of the science to settle the fear or is the fear just completely irrational whether you had a new way to frame it or not?
Hi Scott - I’ve often wondered this myself. I’ve gotten better at talking myself out of irrational fears that I have a better understanding of, so I do think that understanding the science how we move around the earth may help. I know that traveling to China will not mean that I’m suddenly “upside down”, but it may be helpful to understand why that is, and how a plane traveling south is not going “down” (except when looking on a map!), but I do think that a greater understanding of the science would be helpful as I cope with the anxiety. (As an aside, I’m quite sure that I could fight these anxieties if I did not have the feelings of motion to deal with - if the anxieties even presented themselves at all - but it’s the fact that I often feel “slanted” (or that the floor is “slanted”) that I have difficulty putting these thoughts out of my head.) Once the topic goes beyond our relationship with the earth, however, and we start talking about the expanse of the universe and such, all such bets are off.
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Hi Hektisk,
Interesting story you have! Would it help if you had a better understanding of the science to settle the fear or is the fear just completely irrational whether you had a new way to frame it or not?
I have had panic disorder with agoraphobia for the past 30 years! In the depths of my worst anxiety I would have the thoughts that you describe…“what is the meaning of existence?”, “what is the whole space/time thing?”, etc. Once I got the anxiety in better control those thoughts hit the road completely. If you are thinking about them constantly then it could be an OCD component with just the obsessive part. I take Paxil, Xanax and Neurontin for my panic. When this started I had to take Ami and that wasn’t good, gave me a rapid heartbeat, etc but there were no SSRI’s at that time. I graduated to Prozac and in 93 that just completely stopped and sent me into the pit of hell with panic. I take the Xanax regularly and PRN every day and it not only helps with the panic but also makes me feel more balanced. I couldn’t take the Nadolol the neuro prescribed so we decided to try upping my Neurontin does and I’m in the process of doing that. I worry about side effects too, but I tell you what…I’d rather find out than feel so miserable. You may want to think about taking an anti-anxiety as it sounds like you really need it. Even my CBT therapist agrees I am one of those people with a familial/chemical need for anti-depressant medication for the remainder of my life. If nothing else the anti-anxiety would help you get some much needed sleep.
It sounds like there are some significant anxiety issues, and possibly panic disorder. Anxiety alone can cause dizziness since those two parts of the brain are connected and share similar chemical mechanisms. Its possible that migraine is playing a significant role too, but you did not mention whether you experience acute migraine. And from my understanding, patients who present with clinically significant anxiety plus dizziness generally have obsessive compulsive tenancies. I would suggest an SSRI for treatment since you have clinically significant anxiety presenting with dizziness, and little or no typical migraine activity. SSRI’s are very effective in the majority of patients with this presentation.
Hmm that is intriguing about the wide open spaces. Do you know if this fear came from anything, or is it just there? Do these spaces make you feel the dizziness worse?
Well, my GP said I COULD take the Ativan up to twice a day, 6+ hrs apart, but I rarely do. For one thing, I worry excessively about addiction, to anything. Also, I’ve read that if I were to take this drug everyday, my vestibular system may not learn to re-adapt. I am not positive this is true. That may only be the case for people who take it in high doses or abuse it. I definitely take it during a panic attack, or if I am soooo dizzy I find it hard to function with my day. When I tried Celexa a few months ago, I was taking the Ativan once or twice daily because i could not tolerate that anti-dep. for nothing! Made me super anxious, not to mention other horrible side effects, even at the lowest dose!
Yup, my symptoms are “invisible” too…I can still walk perfectly straight, do perfect on Tandem and Romberg tests, etc. Most people are already aware of my pre-existing mental health problems, so my vestib symptoms are usually chalked up to that.
A psychiatrist is definitely in your future, your fears will help them categorize your anxiety and hopefully lead to the right treatment, but you have to be willing to take their advise of which drugs to try…I only got a little relief from my neurologist , but after adding in the psychiatrist I am feeling much better.
Read your post with interest as I’m almost your diametric opposite. When feeling panicky, I actually manage to calm myself by thinking of my own insignificance in the universe and the tiny blue dot that is our Earth. I also like to remind myself that I am just an amalgamation of atoms that were formed in stars. I know I may sound bonkers but it sort of helps put MAV in its place for me.
I would have thought CBT would be good for your anxieties.
HI,
I just wanted to add that I believe these sort of thoughts and the accompanying phsiological symptoms have a lot to do with brain chemistry…namely low serotonin. A particular med, Luvox, is an SSRI and very good for ruminating thoughts. Also not bad on the side effect scale. When I was going through this in the begining, I thought if I indeed had a diagnosis like MS, I was fully prepared to fly to Switzerland and have myself euthanized. I was NOT going to watch myself decay and be a burden on my family. I was also suffering from very low serotonin, depression and anxiety that was exacerbated with the whole MAV thing. Today, with being treated approprately, I can see how it’s hard to have a “healthy” outlook when our brain chemistry is off. A good friend of mine was bipolar, and went off his meds. Unfortunately, he took a dive off one of the towers here in Las Vegas, leaving behind 2 children. I knew him medicated, and he seemed quite normal. Ran a multimilion dollar company, had a loving family, was handsome and smart. Having all those feelings and worries is not the way to go through life in my opinion. I’m sure you have many talents and abilities that would be a better place to put your energy. I hope that you get the proper care and medication to get things back on track…a great psychiatrist is a blessing.
Kelley
Read your post with interest as I’m almost your diametric opposite. When feeling panicky, I actually manage to calm myself by thinking of my own insignificance in the universe and the tiny blue dot that is our Earth. I also like to remind myself that I am just an amalgamation of atoms that were formed in stars. I know I may sound bonkers but it sort of helps put MAV in its place for me.
I would have thought CBT would be good for your anxieties.
Dizzy Lizzy
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Funny… I do nearly the same thing. I riddle about how it is possible for a collection of atoms (or chemicals, or matter, or elements, or whatever you want to call the things we are made up from) to be self aware, and to move and think and feel and react. If we mixed together a potion of the same ingredients, why isn’t it self aware? I also think about life and death, but from the angle of ‘one minute you’re alive, the next you’re dead, but all of the same chemicals and elements are still there… so why were you alive a minute ago, and not now’.
Strange stuff, but it occupies my mind, and helps calm things down. I also think about gravity. What is it, really? Why is matter attracted to other matter? Is it really just a curvature of space, or is there something else involved?
I see my dr. soon and we are going to discuss something off-label like Neurontin, Lyrica, beta-blockers, etc…just SOMETHING to treat the physiological components of my anxiety, and hopefully the dizziness too, whether or not that turns out to be organic. Thanks for hearing me out as well!