Did you know it’s pretty common to have an increase in anxiety symptoms during and following the flu? In episode 255, I received a question from a listener struggling with poor sleep, anxiety and panic after recently being ill. In this post, I take a look at why this occurs and what you can do to help get yourself back on track.

The question

Thanks for writing in. I’m particularly proud of you for recognizing the need for mental health resources when you don’t have them readily available in your area. I think that it’s pretty common to have an increase in anxiety symptoms during and following a flu. I can imagine that it is probably even worse right now during the COVID-19 pandemic, which is still impacting parts of the world significantly.

It’s interesting that I came across this question this week because I’ve been working on my anxiety workbook and the part that I was working on this Monday was about what we call interoceptive cues. Funny enough, I bash this terminology in my TEDx talk, but a lot of anxiety is due to a process called misattribution of interoceptive cues. I’ll explain what it means, though.

What the heck are interoceptive cues?

If you think about how you felt the night before a very exciting day like a holiday or a birthday etc. The feelings that you had probably were things like jittery anticipation, you may have had predictions and thoughts about what might happen the next day, maybe your heart was racing… all of these things sound pretty similar to anxiety. The thing is, you don’t freak out and get scared of these feelings. You don’t interpret them as anxiety. When you have anxiety, it can be like a giant magnifying glass. Something happens inside your body that is odd, but not dangerous. But your anxiety latches on to it and convinces you that something is really wrong. So when we say interoceptive cues, we mean these signs from inside your body that signal that you are anxious. When we say misattribution, that means you are noticing cues that are normal, but think they are signs of danger or indications that you are having anxiety.

What can I do to help?

There are a few things you can do that might help. First is to build some tolerance for these internal cues. If you google “anxiety induction exercises” or check out my online course, you can find some ideas of ways to do this. For you, the one that comes to mind is breathing through a narrow straw for two minutes at a time. There is something really powerful about inviting anxiety in rather than avoiding it. Avoidance is what makes anxiety bigger. It wants to come in out of nowhere and run the show. If you can summon anxiety and prove to your body that you can actually endure it, you can gain mastery over it. It’s not just a simple once-and-done situation. But over time, if you can stop letting anxiety derail you and stop you, you will eventually become more tolerant to those cues and experience less anxiety overall. Anxiety itself cannot hurt you. Even if you have a full-blown panic attack in the middle of the night. It sucks. It feels terrible, but it won’t hurt you.

You may also want to work on your general sleep hygiene – I have a whole episode on that (episode 180). Things like having a consistent sleep and wake time, journaling before you go to sleep, having a consistent bedtime routine, and staying away from screens and the internet before sleep can help a lot. You may also need to take breaks from sleep sometimes. You can leave bed, engage in a relaxing activity (sudoku has been my go-to recently) and then try again in a few minutes. You may also want to focus on the fact that you have survived every night that felt like you couldn’t breathe so far. When the feeling of being smothered or choking happens, it shouldn’t be an indicator that you did something wrong or that you’re in danger. It’s simply what has been happening to you lately. You can expect it. You might even right a little note to your future self. A note that you can read the next time it happens. You can remind yourself that this has happened before. That you knew it was probably going to happen. And that you’ve been okay every other time.

Seek medical advice

Last thing I’ll say about this is that you said you don’t have access to mental health care in your area. But do you have access to general medical help? I ask because it might be worth it to cover your bases and make sure that you aren’t having any trouble that you need to be concerned about. If your doctor clears you and you aren’t having difficulties with breathing, sleep apnea, oxygen saturation or anything like that, then you can narrow your focus to just trying to work on the anxiety component. If there are physical issues, such as sleep apnea, maybe an adjustment to your sleeping position or bedding could make a big difference. There are also devices like nose-strips that could potentially help.

If you are new to me, I have TONS of resources about anxiety that you can check out as well. I hope this resolves for you. You deserve some rest.

You can listen to this on Episode 255 of the podcast! 

Thank you for the great question!

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