Confused or maybe missing the obvious

[cokesmyth5]

I had my first look through the cbt4panic download last evening. I think it is excellent. I speak as someone already v familiar with cbt literature and I am lucky enough not to get panic attacks but there is plenty in it of great relevance to me.
Here is my confusion: in previous episodes of anx/dep, my psychiatrist (who I think is fantastic) reminds me all the time not to "over do" it, to listen carefully to my body and stop if I feel tired; to plough on regardless in early recovery can produce a setback etc. He has been proved right on this many times when I've taken a chance.

In cbt4panic we are told to carry on with normal activity, don't avoid situations/activities. I find long bouts of anxiety in any one day exhausting, my natural instinct is to do less/rest more even if I am working hard on trying to carry on as normal.
What does anyone else do? Do you react to the exhaustion from anxiety or treat it as just another anxiety symptom to observe?
looking forward to some thoughts

[robinhall]

Hi
Glad you are finding the programme helpful

I think the important thing to remember is that the programme is specifically targetted at Panic Disorder (although many people on the forum are saying it is very helpful with any anxiety)

With panic disorder people very often avoid situations not necessarily because they are fatigued but because they are frightened of triggering a panic attack. So the advice to carry on with normal activities as best one can (and only after a thorough understanding of the techniques and principles) is to help counteract avoidance.

Your psychiatrist is maybe cautioning you against pushing yourself further than your level of fatigue will allow you. I can understand that too. I agree that it is important to not 'overdo' anything - even for people who don't have anxiety.

But I hope you see the difference for people who are avoiding very normal activities like walking to the shop or vacuuming the house because they think the raised heart beat will trigger some panic. If we keep avoiding these normal activities we become more and more avoidant and avoidance plays a major role in the maintainance of panic disorder.

Hope that helps
Robin

[cokesmyth5]

Thank you very much, that answers my query perfectly.