Why don't they get it!!!

[IWillBeFineSomeday]

It's hard to even explain to the family what's going on with you when you're depressed!! Today I literally had to find posts related to depression and anxiety and explain each and everything I feel in order to justify my behavior!! It's tiresome...

[linuxusr]

Sorry to hear this. It's hard to explain anxiety to anyone. Really, there are no words for these things. But you should try. For me, when I am depressed, it is the opposite of anxiety or an anxiety attack. In an anxiety attack I am filled with terror, feeling like I could die or lose my mind. When I am depressed, I feel safe! I don't feel terror at all. But the suffering is intense, much worse than the terror associated with anxiety. So try and describe it. The better we understand our suffering the better off we are. On the other hand, when you are suffering badly, gotta have that support network set up in advance, a family member or a friend, who can talk with you live or be by your side. And in that case you're probably not thinking about describing your depression, you just want help!

[IWillBeFineSomeday in reply to linuxusr]

Even I have anxiety.. I recently had panic attack.. and lashed out.. even then I had to explain myself.. I hope you also keep on trying to heal!! I think it's a long journey for us. I hope you also can ease the pain you feel with someone who understands or at least tries to understand!

[linuxusr in reply to IWillBeFineSomeday]

Thank you very much. Hit me up anytime you want to chat! Um, I don't remember if I talked to you about this but there is a science based solution for panic attacks that, if applied correctly, works 100% of the time. You will NOT have an anxiety attack. Do you know this already or do you want me to explain more? BTW, this technique will NOT resolve anxiety that is < than an anxiety attack but it may diminish it. This technique comes directly from my psychoanalyst, M.D. from a major university in the U.S.

[IWillBeFineSomeday in reply to linuxusr]

Oh I don't know the technique. If you could explain a little more it'll be a great help!!

[linuxusr in reply to IWillBeFineSomeday]

From my psychoanalyst, M.D., professor in a school of medicine, in a major university in the United States, I learned that the breathing technique “pursed lip breathing,” if applied correctly, will prevent an anxiety attack. The basic reason why it succeeds is because the mechanism that produces an anxiety attack is biochemical and can be reversed in minutes. (Note: There are other triggers which may produce an anxiety attack ). That biochemical pathway is complex but it is not necessary to understand it and the technique will work fine. However, I’m going explain the basic idea so that you can see that the mechanism is science based. The anxiety attack begins with hyperventilation. In hyperventilation there is a shift from long and slow breathing to rapid and shallow breathing. When this shift occurs excess carbon dioxide is exhaled. Although carbon dioxide is a respiratory waste product, it also performs a critical function. That function is to buffer and maintain the blood pH in equilibrium. The range of that equilibrium is very narrow, and if it is exceeded, it produces a condition known as respiratory alkalosis, where the blood pH is now too basic (alkaline) and in disequilibrium. It is this disequilibrium that is the cause of the anxiety attack and its symptoms. This disequilibrium can be reversed in about one minute, using “pursed lip” breathing, which increases carbon dioxide saturation in the blood and restoring normal equilibrium.

[If you want more detail, here it is: (ChatGPT Plus, 4o)

What Happens in Respiratory Alkalosis?

1. Hyperventilation:

o Rapid breathing causes excessive exhalation of carbon dioxide (CO2\text{CO}_2CO2).

o This decreases the concentration of CO2\text{CO}_2CO2 in the blood.

2. Impact on pH:

o CO2\text{CO}_2CO2 is in equilibrium with carbonic acid (H2CO3\text{H}_2\text{CO}_3H2CO3) in the blood: CO2+H2O⇌H2CO3⇌H++HCO3−\text{CO}_2 + \text{H}_2\text{O} \rightleftharpoons \text{H}_2\text{CO}_3 \rightleftharpoons \text{H}^+ + \text{HCO}_3^-CO2+H2O⇌H2CO3⇌H++HCO3−

o Less CO2\text{CO}_2CO2 shifts the equilibrium, reducing H+\text{H}^+H+ concen-tration and raising blood pH.

3. Result:

o The blood pH increases above the normal range (7.35–7.45), leading to alkalosis.

________________________________________

Symptoms of Respiratory Alkalosis:

• Lightheadedness

• Dizziness

• Tingling in the fingers or toes

• Muscle spasms]

The technique (introduction): For the technique to work ideally it is best to initiate "pursed lip" breathing during hyperventilation before the anxiety attack ensues. If you miss this opportunity and initiate it during an anxiety attack, you will likely get relief. Personally, I have not evaluated this. I have never had an anxiety attack since I began using this technique, so I cannot speak from personal experience here. You must learn to pay attention to your breathing patterns and to know when there is a shift to hyperventilation. If you are so agitated that you cannot pay attention to your breathing and you do not know that you are hyperventilating, then you may not be able to fully prevent the anxiety attack in advance. Ideally, you should try to arrest the process of pH disequilibrium early on, near the beginning of hyperventilation when excess CO2 is leaving the system. If you are NOT SURE if you are hyperventilating, apply the technique anyway, no harm, no foul.

The technique itself: “Pursed lip” breathing has been around for many years. It is the main strategy used for sufferers of COPD but the mechanism for COPD patients is different from the mechanism for us who suffer anxiety attacks: different mechanism but same technique. The idea of the lips being “pursed” is that when you press your lips together, this slows the rate of the exhale which means that the exhale is prolonged. I recommend that you search YouTube videos for pursed lip breathing instruction and that you select videos by health professionals such as nurse practitioners. Practice the technique when you are NOT anxious until it is easy to do. I experience a little dizziness, which is uncomfortable, but it passes quickly. YMMV. Since my doctor explained this technique to me about two years ago, I have not had a single anxiety attack. But I have successfully aborted 20+ anxiety attacks with 100% success. Note that this technique does NOT resolve GAD when the magnitude of the anxiety is < that of an anxiety attack. Can you guess why?

For members who learn and use this technique, it is very important that you report your results here for further tweaking and discussion. Critically, I would like to know if there is anyone for whom this technique does NOT work. That would need to be investigated. Given the mechanism involved, it seems to me that, if pursed lip breathing is done correctly AND at the ideal time (beginning of hyperventilation), that failure is highly unlikely. That is because the mechanism is hard-wired.

I input into ChatGPT Plus (4o), my summary to evaluate for error and misleading statements. There are errors in the above summary related to overgeneralizations, clarifications and qualifications that I have left out. However, these problems are nuanced. On the whole, the above summary is essentially correct. I think we should proceed “as is” and tweak and clarify as we go along. If anyone is interested in these criticisms of my summary, I’ll be happy to share them. However, I think that overcomplicating this presentation at this time would muddy the waters.

N.B. Some of the chemical equations above did not render correctly.

[IWillBeFineSomeday in reply to linuxusr]

This is very interesting! I'm gonna try it. I've tried slow breathing while in the state of panic but never tried this one.

[linuxusr in reply to IWillBeFineSomeday]

Hello IWillBeFineSomeday! One thing you say concerns me. Possibly you are not understanding something about the technique and why it is so effective or maybe it is a vocabulary misunderstanding. Anyway, when you say, "I've tried slow breathing while in a state of panic, but never tried this one, " It is critical to note that pursed lip breathing will NOT resolve "a state of panic" as in GAD. What pursed lip breathing will resolve, and completely prevent, is an anxiety attack IF you apply this breathing method during hyperventilation. There is one reason and one reason only why the method works: The restoration of pH equilibrium in the blood by virtue of the input of carbon dioxide. If you are in a "state of panic" (GAD) where you are NOT hyperventilating, then excess carbon dioxide is NOT leaving the system and you can be in proper pH equilibrium AND STILL BE ANXIOUS. Hope this is clarifying. However, there is another method, completely different, which can help with GAD and that is vagus nerve stimulation via diagphragmatic breathing. If you want to know about that, let me know. In this case, the mechanism is completely different from above.

[IWillBeFineSomeday in reply to linuxusr]

Oh! I now understand how I have to go about pursed lip breathing! Earlier I thought this would help me through the episode but I think I didn't understand well enough.

[IWillBeFineSomeday in reply to linuxusr]

Thanks a lot!!

[linuxusr in reply to IWillBeFineSomeday]

If things don't work out like you expect, get back to me and we'll try to sort it.

[RS1974]

Sorry you're struggling right now. When I was young I cared what my parents thought now that I'm 50 I don't care what others think now

[IWillBeFineSomeday in reply to RS1974]

It's just great to know you're able to overcome this feeling!

[RS1974 in reply to IWillBeFineSomeday]

It took a lot of work and tons of therapy. You'll get there sweetie 😊

[Beavis2022]

If only you could not give a shit what anyone thinks, it would be great. Hard to do for anybody. Then you could be more relaxed with dealing with your depression. Most people are too wrapped up with their own stuff to even care. Sounds like you need some caring and support to ease the tension.