Can exposure exercises cause a relapse? Feeling more tensed up

[Sparkle1984]

Hi, I haven't posted on here much lately as I've been feeling better.

On Monday I decided to do an exposure exercise to test myself and to see how far I've come. Since then, I've been feeling a bit tense and I'm worried I might cause myself to relapse.

Backstory: Throughout my life, when I've had an anxiety episode it's mostly been to do with existential anxiety. Back in 2007 when I was 23, I started to get this feeling that time was speeding up, so I stupidly did some research on Google into why this might be. I came across a couple of websites which really scared me. Back then, it triggered a really bad anxiety episode which lasted 8 months, ie until early 2008. I didn't have any help back then as I didn't really understand what was wrong with me. I saw a doctor in 2007 and I explained that I was having a lot of trouble sleeping and a rapid heart beat and couldn't relax, but he just put it down to stress and said it would go away on its own, and he didn't do anything to help. It fizzled out by itself in March 2008, but it had been the worst time of my life so far.

Fast forward to July 2012, when I had my most recent anxiety episode. This was also existential anxiety, but the theme was slightly different - it was more about fear of death and dying than about time speeding up. It was really bad this time. Luckily this time I saw a doctor who really understood what was going on. I was diagnosed with anxiety disorder and she referred me to a CBT course and prescribed meds. I began to feel a lot better within a couple of weeks. The CBT course was very helpful too, and I felt more in control of my thoughts and feelings. So in January this year, with my doctor's approval, I weaned off my citalopram and I came off them completely at the end of February. I've been off them completely for 5 weeks now and have felt fine most of the time.

So, back to the original purpose of this thread: in order to test how far I've progressed, on Monday evening I went back to those websites which scared me in 2007 (the ones about the theory of time speeding up). While I was reading those websites, I didn't feel too bad - nowhere near as bad as I felt when I first discovered them in 2007. However, on Tuesday and Wednesday I noticed my underlying anxiety levels were higher than normal, and the things I'd read on these websites kept entering my mind. It reached a creschendo on Thursday, when I kept feeling this sicky feeling in the back of my throat and felt a bit nauseous. (When I first discovered the website in 2007, I panicked so much that I regurgitated my food, as I was eating something at the time!) The last couple of days haven't been quite so bad, but I still feel a bit more tense than usual and I regret going back to those websites.

Now I keep worrying that I might be causing myself to relapse by exposing myself to my worst fears. I think maybe I looked at too much on Monday night. On Monday night itself I didn't feel too bad, but even though I haven't looked at these websites since then, I'm still feeling a bit anxious about them. I have made so much progress in the last 7 months and I'd hate to think I've undone it all! :weep:

Is it possible for exposure exercises to cause a relapse? Should I carry on doing exposure exercises or should I stop for the time being? Should I be doing this in a more gradual way?

[Lost2010]

Hi sparkle,

Interesting question, would be good to hear from people that have gone through exposure therapy to see how they coped with it. I can understand that it might increase anxiety etc in the short term and in theory I suppose it could cause a relapse if you tried to do too much exposure at once. Perhaps seek the guidance of an exposure therapist or someone who could work through it with you at a recommended pace?

Do you feel exposure therapy is the answer for you? As an emetaphobe the only kind of exposure to it I get is unwanted nausea which I haven't found reduces the fear so don't really have any personal knowledge on it. Can understand why exposure therapy might help with specific phobias of things you must encounter regularly (e.g. birds or something) but with your anxiety triggers maybe avoiding the trigger would be an option? (Wow that goes against all the anxiety rules doesn't it?! lol)

I understand you were testing yourself so can see why you'd want to do it and ultimately it would be great to reduce the trigger to a non-trigger. Sounds like you've done really well though, although it triggered some anxiety it was nothing like as bad as it was before so that shows some really good progress, well done

[Edie]

I've never really tried anything like this, but it makes sense that if it caused you anxiety before it might do again.

However, your reaction is much less severe, which does show you have made a lot of progress. I don't think you've undone it all, you've just challenged yourself. Are there any techniques you learned in CBT that you can use at the moment? Something to help you look at this in a different way, or distract yourself, maybe?

Personally, I think you need to give yourself a break from the websites until the increased anxiety dies down, and then consider going back to them in a more gradual way. Perhaps restrict how many pages you read, or the amount of time you spend.

[ruthless]

Hi Sparkle

I was wondering the same thing as you a few weeks ago. My anxiety this year has been related to time, and it constantly passing, and everything we do being memories and in the past, so my fear is existential and very similar to yours.
I haven't seen a CBT specialist, but I did a lot of researching on line, and discovered a lot of information about exposure therapy for intrusive thoughts and phobias and pure O.
I decided to experiment by repeating specific sentences in my head related to my fears over and over, and my anxiety became much worse for a while - I had improved significantly over the previous 2 months due to my Sertraline kicking in. Now I know you are supposed to feel increased anxiety during exposure therapy otherwise it would be pointless, but I felt I was starting to go backwards again so I stopped it. The discomfort I felt after my improvement was disheartening.

My anxiety over my particular thoughts over the last 10-11 weeks has almost completely gone now. I still repeat things in my head at times to rationalise my way of thinking by telling myself it's only thoughts that have become embedded in my mind due to my paying far too much attention to them, and then I distract myself by doing something else. That helps me much more. I don't ignore the thoughts - they are still there at the back of my mind, but they don't frighten me anything like they did before.

I think exposure therapy does cause a relapse by it's very principal.
Whether or not it causes a significant improvement in existential fears, I don't know personally as I didn't keep it up long enough, although it is well documented on many trustworthy websites that it is a very effective therapy for fears, phobias and intrusive thoughts.

At the moment I am continuing with what I feel is best for me now, by taking Sertraline, and also rationalising my thoughts in a way that comforts me. It's the combination of these 2 things, and giving myself enough time to recover that has helped immensly.
Maybe more graduated exposure will help you without the same level of distress. It's a difficult one I think.
You can gradually expose yourself to fears of specific objects or situations, but I'm not sure how you gradually expose yourself to a fear of time speeding up, or passing, or ultimately the fear of death

[Sparkle1984]

Thanks for your replies. I have wondered in the past whether exposure exercises would be appropriate for this type of anxiety. Some people have said to me that I should just dismiss those websites and not bother with them. I can see their point, but there have been occasions where people (including friends and acquaintances in real life) have mentioned about time going so fast. This is often the case at the end of the year, when people say things like "I can't believe this year is almost over already, where has the time gone?!" When people say things like that, it sometimes does set me off thinking about the theory of time and existence. So it's not a subject I can easily avoid, as I never know when someone is going to bring it up in conversation. That is why I thought exposure might be appropriate, to desensitise myself to it.

As most of my anxiety episodes in the last decade have been existential in nature, I thought it would be good if I could be able to desensitise myself to it once and for all, to reduce the risk of future episodes.

I won't go back to those websites any more, I just don't think they're worth the distress.

How long will it take for this low-level anxiety to go away? Also, as it's been 5 weeks since I finished my meds, is it still possible that some of this anxiety could actually be due to withdrawal (even though I only started having these feelings a few days ago)?