Noob here...greetings!
Gilkey,
I too do not suffer panic attacks but have more of a generalised anxiety problem. The fact is that all anxiety problems share common treatments and probably similar causes. So i am finding the forums and exersises here very helpful for my generalised anxiety- they are not only of use to panic sufferers.
I am no expert but i think that your case sounds roughly similar to my own, so i dont think its unique. I foudn that my flair ups were related to definate life events which i was very aware of each time. I think that you will find the CBT here very useful. My family doctor also prescribed medication but not the very treatment i needed to get better- which in my case is hopefully CBT and other related therapies. I finally found out about it through self help books and when i asked him he referred me. Just taking the medication is in my opinion only dealing with the symptoms, not treating the cause of why you suffer anxiety at these times.
It sounds like you put a lot of mental pressure on being able to sleep and im sure this may be related to your shift work affecting sleeping patterns. I have noticed that anything we put heaps of pressure on (for me its eating 4 meals a day) suddenly becomes a reason for our flight or fight response to kick in- i too can get extremely anxious if i dont think im falling asleep after say 2 or 3 hours.
Regarding the fears, almost all people who suffer from some form of anxiety develop some fears along the way, i think this might be because we are looking into the future way too much and not living in the moment. For example i have had fears of becoming depressed also but i have several others which are all not helpful and are unlikely ever to come to be. Try to think each day at a time and when you get these fears, try the exersises on challenging negative thoughts. You will probably find that your anxiety is closely related to your self-talk and attitudes. It will go away in time, and dont let your thoughts tell you otherwise. It may not happen overnight, but you are taking the right steps to recover fully this time.
By undertaking CBT and maybe other therapies and relaxation techniques to give your body some rest, you stand a good chance of being free from it for good, since perhaps if it ever does return in the future, you will have the skills and understanding to avoid it taking hold again. Its good to hear you are not taking too many sleep meds, as these can become counter-productive in the long term.
When i used to have an issue with sleep- this was early on in my anxiety and i beat it, i found these well published rules very useful to ensure a restful night.
1- Do not eat or drink for 3-4 hours before bed
2- Do not consume caffine or other stimulants at all and reduce your salt intake (not sure why salt but it is very well published)
3- Improve your diet to make it healthier as fatty foods can lead to sleep problems
4- Make sure you are fully hydrated with clean fresh water during the working day
3- Create the right bedroom environment (Very important) this means no electrical equipment (at least not anything on standby or with any LEDs etc.), no phones in the bedroom and absolute darkness and silence (these two are a must!).
4- If there is anything at all on your mind (such as thoughts about what has to be done tomorrow or other stressful thoughts) write these all down before going to bed, and then allow your mind to forget them, knowing that they are safely written down.
5- Light exersise (such as a breif walk) before bed can be very helpful to produce that naturally tired and relaxed feeling.
6- If you dont fall asleep within 30 minutes, dont stress about it, just get up and read or do something very tedious (like read a book you have already read) so that your mind begins to get the idea that it must now shut down for sleep. The key is a relaxed attitude towards sleep (easier said than done i know!) , if you're always on edge about it, your mind thinks it needs to stay awake and dutifully obliges you.
7- Consider using hypnosis tapes (i found these quite good) or progressive muscle relaxation techniques as an alternative to sleep meds. Another alternative is meditation or yoga about 30minutes before bed.
8- Good sleep requires adherence to natural circadian rythms. This means sleeping when the sun goes down and waking when it comes up. You might want to consider alternatives to shift work if you are not getting the sleep you need to feel normal. Our bodies are programed to want to sleep at certain times and not others. Check out the article on circadian rythms on wikipedia, it has a cool diagram that shows your biological clock.
I know thats a lot of information but it helped me overcome my sleep problems- and now i sleep fine most days. I think that since your anxiety is so closely related to your sleeping, then addressing the sleeping can only help your recovery. You do however need to complete the exersises here and then maybe you can be better at challenging negative thoughts and also better at dealing with the anxiety when it begins to interfere with your ability to get a restful night's sleep. You are not alone, there are millions of us dealing with anxiety and irrational fears which spring from it. Above all, full recovery is very likely once you have made the necessary adjustments and altered your thinking patterns for the better.
Hope some of this has been useful sorry its been a bit long winded, its nice to see someone else with a GAD issue on here, let me know how you get on.
Jamie