Always Worrying

[aj2234]

As I'm sure you guys have gathered from my post history, I'm not very comfortable with cold sores. It makes me very anxious because of how easily transmissible they are, and I fear unknowingly spreading them to either my partner's or my own genitals. I realise, at this point, it's an irrational fear because I have never had a cold sore and tested negative for the virus a few years back.

I always try to calm the deep anxiety I get about them by telling myself that people with cold sores wouldn't deliberately spread them, or would be careful. Unfortunately, I've found this isn't the case. I've had friends who have shared drinks and are constantly touching it, unawares of whether or not people they're sharing things with have the virus. This really disappoints and unsettles me. Currently, my supervisor has a cold sore and is constantly touching her mouth and face. She's had it for over a week. Today, she was touching her mouth (either near or on the sore), then typed on her keyboard. I then had to use this keyboard not so long afterwards. I assume, unless I had cuts on my fingers, that this is no where near direct enough contact to spread the virus. I do a cut on my thumb, but not where it would touch a keyboard (i.e, it's facing upwards, opposite to where my thumb hits the space bar). I sanitised immediately afterwards. I assume this means I could not have caught the virus this way, but would love clarification on this.

What really bothers me is that I can't get over this. I understand a lot about disease and transmission and biology but something as simple as this really bothers me because other people have made me so uncomfortable about this and I just simply really don't want to have a cold sore. I think I know the fact about cold sores, which is why I'm not so bothered by the keyboard, but more bothered that it caused me such a stir. I have been to a psychologist for anxiety which helped a lot, but this is something I can't seem to get past and always find myself worrying and googling if x and y scenario could have caused a transmission. Is there anything I can do to help myself? I feel physically tired from worrying about this and it's not something I want to do anymore. Unless my supervisor rubbed her keyboard all over her face and then I rubbed it right into my sore, I assume cold sores aren't transmitted via objects such as this. So why I can't I let this go? I'm not like this with colds, coughs, and other things. Just this. Thank you, and I appreciate the help you've supplied me lately very, very much.

[Sam W]

Hi aj,

You're right that this kind of anxiety can be exhausting, especially when it feels so constant and hard to shake. You mention having seen a psychologist. Is that someone you're still seeing? Too, when you've spoken with the psychologist, what have they recommended to you as ways of addressing those fears?

[aj2234]

I had bigger picture issues to address at the time that were more rooted in anger and anxiety. To be honest, I found some of the things touched on, such as mindfulness/letting the thoughts go helpful, but difficult to practice, and I found the process of psychology too uncomfortable to continue. Unfortunately, this type of worry only comes up in situations such as this, which is why I find it so hard to address. I have good coping tactics with anxiety now, namely thinking things through and trying to see the 'reality' of the situation, which works well my things like my boyfriend, university work and life in general. But it's just this. I know that cold sores are spread from skin to skin or direct contact with fluids, yet I know the next few days I'll worry that every pimple is a cold sore and that, somehow, the virus magically got into a cut that never touched the keyboard. I honestly know my risk of getting a cold sore this way is quite low, but the facts here, which are normally something I use to go back to and as a starting point for more positive, rational thinking, don't work here. They 'what ifs' are almost unbearable when it comes to this. Because it's so specific and situational, I don't necessarily have a management plan in place to cope with this other than time, which always has a stressful, stressful period. I am otherwise quite comfortable with where I am mentally, which is why it's so frustrating to be brought down by something like this. I saw one site that mentioned keyboards and touching and freaked out (lured by the temptation of reassurance, I did unfortunately google it). I trust this is not a path to infection, but even an unreliable website really gets my nerves going. Obviously one step is to cease using unreliable sites, but then I am aware I can't consistently turn to you guys every time a person with a cold sore hands me a pencil or something equally innocuous.

[Redskies]

This is very much sounding like a thing where professional support and guidance would be the way to go. When you're having repeated or ongoing fears that stress, distress or exhaust you, and you don't have coping strategies that reduce those things and make it bearable - yep, that's time to try working with a professional to develop new strategies.

Sometimes anxiety can manifest more around a specific thing, or strategies that work for other things don't seem to work so well for one thing. It happens! I'm sorry you've been having such a tough time around this - it's really no fun at all.

I'm not quite sure what you mean by "the process of psychology". There isn't really one process: different therapies, and different practitioners, work in different ways and use some different methods. It's very much sounding like at least some psychology-things have been very beneficial indeed to you - those strategies that you use to manage the rest of your anxiety (kudos for that, by the way - that's no small thing, and it sounds like you're doing great!). Some approaches are much more appropriate than others for certain conditions, of course, but even after that, some approaches and some practitioners don't fit some people very well. Might you be open to either seeing a different person than before, or going back to that person and asking them to work with and around the things that were sticking points for you before?

I know Heather said this to you in an earlier thread, but I do think it bears a quick repeat: too, with any kind of therapy, it nearly always feels challenging and possibly harder while we're doing the hard work. After all, making changes in our self around things that are scary or distressing or challenging is really hard. A decent therapist should be able to support someone through that and make it bearable. Indications that a different approach or practitioner might be a good idea is if, after some time, it feels like you're not addressing the things that you need or want to address or change, or if you feel disrespected or unheard or misunderstood by the therapist, even after you've tried to resolve those things with them.

[aj2234]

I guess that's something I didn't consider then. With my previous psychologist, I felt like I was wasting her time. I had a lot of Uni work to do and came to an appointment without a lot on my mind but that she she pushed and pushed me to find out exactly how many hours I had left in the week to do the Uni work (which I was a bit worried I wouldn't get done). I didn't really want to talk about it, because it was just a normal stressor, I hated being pushed, and I hated that in that moment, psychology became like home work where I 'had' to have something prepared otherwise a session was useless. The psychologist honestly seemed to be bothered with me and suggested that if we couldn't discuss anxiety and depression further I should go on medication. This was made after, in my opinion, an inadequate amount of sessions. I think I pigeonholed all psychologists as being like this.

I think the main issue with me returning is I am sad that I've made a lot of progress, but still have this, and it would be doubtful that I could go through with Medicare, seeing as though I don't seem to have GAD to the same extent I used to. If I returned, literally all my income would go towards sessions.

It's probably good if I look into though. Even now I'm sitting here, not feeling physically good about it, just wanting reassurance that transmission doesn't happen this way. If the facts about how indirect this contact was cane calm me it's probably a sign to do something.

[Heather]

Alas, the process of therapy does usually involve homework and some pushing. At the same time, if you feel bullied in any way, or like the way a therapist is pushing, and the things they are asking you for -- especially if you have tried them to see -- are not helping you or are just not a good fit for your needs and your own personality/learning style, then chances are you just don't have a good fit, and would do better by switching to someone else. And a good therapist knows they can't ever be a good fit for everyone, so should this happen again -- or if you want to contact them about a referral now -- you can just be honest about that and ask for them to refer you to someone else, and they should be glad to do that.

Really, anxiety disorders aren't things that are ever just going to go away or be "cured." Instead, they're more like, say, having a chronic physical pain condition that's not going to go away, but that a person CAN learn to manage so that the impact they have decreases, potentially even getting so minor or rare with good management that it's not going to be such a burden.

My best advice with public healthcare systems is always to work them as best you can. If you still need this care, and Medicare is what you have to get your care covered for this -- or at least some of it -- I'd not dismiss how you're feeling or diminish it as "less than." It is still a big problem for you, thus you still need big help and care, so I'd go through Medicare leading with that. By all means, I'm not telling you to lie, but I *am* suggesting you don't diminish the big impacts of this when seeking out care. I'd say this post alone makes clear that this is still very much a big issue for you, and still very much a health concern that warrants treatment.

(Just to get you through in the meantime, should it help, if you just make a regular practice of handwashing -- nothing extreme, just a few times a day, as people do -- you are not going to be picking up HVS from people in ways like this. That's just not how transmission of that virus works. But, as you know, reassurances like this aren't likely to do jack when your fears are coming from an anxiety disorder, because anxiety just doesn't really respond to logic like that.)

[aj2234]

I think I have to see someone different then. And go to a doctor different than my regular doctor if I want to get through via Medicare. Even when I was very sad and physically uncomfortable from anxiety and unhappy with who I was several times a week, he didn't even offer me the tests to see if I qualified through going through with Medicare. I guess this is why I'm putting my currents needs as lower than they need to be regarded. I think the situational nature of this is making me a bit concerned as well,as I am afraid of being pushed again if I don't seem concerned by an issue in bringing up. Once my supervisor's clears up, I doubt I'll think about it. One thing, though, is that I used to be afraid of touching most unfamiliar things. I've gotten much better at assuring myself that anything on a bench or public restroom isn't likely to harm me because germs simply don't work that way. That sort of thinking helps.

You're right though. Although it's helped with other aspects of my anxiety, the facts don't really dissuade anxiety here. I immediately thought 'but what if I brushed my hair out of my face before I got to the sink?' and a few other what ifs. It is good to see it in writing though - makes it easier for me to think, no, those what ifs aren't in the advice you gave me and can't be right. Obviously when I have these worries alone I don't have writing to go back to, though.

In the meantime, while I sort this out, is there any advice you can give me on what, if anything, to people who are less than cautious when having a sore? I by no means want to be rude, but it bothers me that the same people will cover their mouths for a common cold but won't do the same protective things for this.

[Heather]

Unless you're kissing these people, having sex with them or sharing things like their drinks or toothbrushes, there's really nothing TO do or avoid, because those are the ways it's transmitted.

You also -- and this isn't a bad public health practice period, especially during cold and flu seasons -- can always just do a quick wipedown of any shared keyboards or phones with wipes made for that purpose. And just do what you did: wash your hands after using shared things like that. Again, not how HSV is going to be transmitted, but it sure is how some other common viruses can be.

[aj2234]

That's perfectly fair then. I guess it's just my own comfort levels and anxiety that really is the issue here rather than what other people are doing. I will try to have a look for a different psychologist for anxiety.

Just on that note, in your opinion does meditating or anything similar have a marked difference on things such as anxiety? I realise that tackling specific issues would be very important here given how much trouble they've caused me, but in general, would it help at all? That sort of activity is much more within my comfort zone at this point.

[Heather]

There's actually been a lot of study done on the frequent success of meditating and other mindfulness practice when it comes to anxiety! There are a handful of good books out about that currently, but the one I found -- have done a lot of research when it comes to anxiety over the last few years, since so many more young people are struggling with it! -- I think is one of the most accessible, is "The Mindful Way through Anxiety" by Susan M. Orsillo PhD and Lizabeth Roemer PhD.

You'll have to see about how available it is in AU, but that title alone should lead you to some of the other good ones.

(Caveat: I'm Zen Buddhist, so I'm kind of always going to be a cheerleader for meditation practices, just to put my own possible bias on the table.)

[aj2234]

Haha, I don't mind the bias at all here. Well I'm really happy to hear it might help. It's been something I've been thinking about but because it's so popular I was a little worried it might be a fad. I'll try and have a look for that book around and I might attend a few classes to kick things off

[Karyn]

Just poking my head in to say that the book Heather suggested is available at Dymocks: https://www.dymocks.com.au/book/the-min ... sTuEpN97fY.

Also, if - now or in future - you figure you would like to check in with a psychologist, Headspace is a mental health organization for young people ages 12-25, and they're free. They have centres all over the country, and offer an online chat service as well as in-person counselling: https://www.eheadspace.org.au/

[aj2234]

Oh wow is it! That actually surprises me quite a bit that they have it, but that's really good, thanks Karyn!

I didn't know they did the online chat service. That's definitely a good feature.

[Redskies]

With your concern about finding it hard to talk about something when it's not a major problem for you right there and then, I wonder if a little re-framing might help? If you were having severe intermittent pain, it'd still be important to see a doctor and get that investigated and treated, even if you weren't having pain right before and while you were in the room with them. They'd also struggle to help you if you were unable to tell them anything about the pain. For sure, no-one wants to remember and think about severe pain while we're having some respite from it, but it's necessary in order to get the pain dealt with and have less pain in future.

One really useful thing for situations like this is to keep records and notes of the problem while you're actually having it. You can then take those records in to the doctor/therapist, and they have a decent amount to work with from the beginning.

[aj2234]

That's a good analogy that I'll take with me. I did used to take notes when it seemed to be happening every second day (worry in general) so I guess it'd be useful to continue that with this.

[Karyn]

With any health issue - mental or physical - the more information, the better, pretty much, especially if it's something ongoing. Noting patterns in when it happens, what seems to set it off, that kind of thing, just makes it easier for a healthcare provider to figure out the best way to help you.

[aj2234]

Hmm so ideally I should show it to a mental healthcare provider? I only ask because I did record it last time and my psychologist was more interested in the practice of me doing it, and then me giving the 'worst' of what had happened. Is showing the full picture (even good things where I'm not set off) presumably going to assist a bit more you think?

[Heather]

I would think so, just in terms of showing someone the whole picture here.

That doesn't mean your last therapist was wrong in only wanting it to be an exercise for you, mind, because as someone already working with you, you were presumably sharing a lot of what you were writing down in therapy verbally. That would be the usual assumption, anyway.

[Redskies]

(oops, cross-posted with Heather )

Yep, it's a good idea to give this information to a mental healthcare provider. The more they know about your difficulties, the better they'll be able to target treatment and strategies. Do be aware, though, that they may very well not work through it point-by-point: they'll use it to inform how best to treat you. With any kind of condition, mental or physical, a point-by-point approach may not be appropriate, and that's especially likely with anxiety conditions. It's also okay if it's not all relevant to them: it's part of their job to use their expertise and focus on the things that are.

The information you've already put in this thread would likely be very helpful, for example. You'll want to record things like:
- what triggers it in the first place
- how you feel
- how long you feel that for, or does it ebb and flow
- what thought patterns you have
- what strategies you try, and what happens when you try them
- what other things you do (whether that's healthy and helpful or not)
- information about your general anxiety, what triggers that, what strategies you use for that, what treatment/help you've had

[aj2234]

Okay then I'll start journaling things like that. That might make it easier to discuss it for me too because it's hard to relate to my own emotions when I'm not in the midst of anxiety. Is there anything I can do or say to a therapist at a session when I don't feel as though I have much to say? With my last therapist, going with nothing on my mind (I had a lot of Uni work and just mainly felt neutral, blank, and blah) made me feel guilty about going, and the fact that she pushed me made me feel worse about not feeling the need to bring anything up (although I'm aware that was far from her intention of doing so). Should I just work through the stuff I'm journaling at that point or just tell them I'm not feeling anything in particular that day?

[Mo]

Having notes from the rest of the week can be helpful as something to draw from if you're stuck for things to talk about. Even if you aren't feeling much at the moment, you could say "not much happening today, but a few days ago X happened and we could talk about that." It might be helpful to just say up front that you have a hard time coming up with things to talk about when your session comes around. Knowing that might make a therapist put a little more thought into coming up with ways to draw you out a bit or asking followup questions relating to things you discussed in earlier sessions. Therapy doesn't have to be just about what you're dealing with or thinking about the very moment you're in the session, so having notes from your journal sounds like a great idea for when you're not sure what else to discuss.