Anxiety: Are you stuck in this cycle?

Continued dry eye pain and discomfort, coupled with uncertainties, unanswered questions and worry about the future, often produce a level of anxiety that can lead to poor decisions and inconsistencies in how you manage the condition.

In my experience it's really helpful to be aware of your anxiety and how it's affecting you, and to be aware of the features of your dry eye experience that cause your anxiety to spike. It's easier to plan and head things off. Anxiety is so crippling when you have a condition with pain or a chronic condition - anxiety can make pain itself worse, and it definitely interferes with good decision making. It can also seriously interfere with your ability to benefit from good medical advice.

I'm going to talk a bit about one of the most common traps I see people falling into that I think can result from anxiety and can cause more anxiety.

The trap I'm referring to is where absolutely everything is driven by immediate comfort. In that world, all new treatments get judged by whether they make you feel better, worse or no change. Obviously, you need to feel better and that is the point! But dry eye disease develops slowly over long periods, and reversing it takes time too. It's entirely possible that you could be on the right track - for example, inflammation may be decreasing or your meibomian gland function may be improving - but that progress may only show up in a clinical exam, not in how you feel today. You won't know unless you try to be methodical. When trying news treatments, "bookend" them with exams before and after a period on the new treatment, so you can find out what the treatment is actually doing to your tear film or your eyelids.

Here are some examples of common patterns that happen to people who have a lot of corneal pain, and ideas for how to avoid them:

Trying every drop known to man, and when none solves your problem, deciding you've "tried everything and nothing works".

Here's some alternatives: Explore the wide world of non drop treatments. But first, you're going to want to read my article Dry Eye 101 and learn why drops aren't the be-all and end-all anyway. And consider asking yourself what it means if a drop or a treatment "works". What does "it works" mean to you?

Giving up on a treatment in between doctor visits because it was uncomfortable or didn't seem to be helping.

Here's some alternatives: Ask more questions in your appointments, like "Will the drops sting? Is there any way to prevent that?" "How quickly do you expect this to start to help? If it doesn't should I continue to use it anyway or call you?" Find out other patients' experiences on social media, how long things take to start helping and the practical strategies they found to make treatment more comfortable.

The kitchen sink mentality: Churning through one treatment after another without really sticking it out long enough for your doctor to ever properly evaluate whether something is going right.

Here's some alternatives: Find better comfort measures (dry eye glasses? cold compresses? less computer time?) that do not interfere with medical treatments, and max them out while you're trying a new treatment, so that you are able to give it more time. Make sure you get evaluated when you have been on a new treatment continuously for awhile.

Using too much stuff at once. It makes it impossible to know what's helping.

Possible alternatives: Like I said before - focus on finding the most effective comfort measures, then try to keep treatment changes to a minimum.

Doctor-hopping in search of relief. If your doctor is not sufficiently qualified in dry eye, you may need to move on. But switching around too much has its drawbacks too. You may get what seems to be contradictory information from each doctor, and while they will each have their unique insights, it becomes very stressful trying to put it all together and make sense of it. The anxiety factor increases and it becomes harder to decide what to do or who to continue to see.

Here's an alternative you might want to consider for eye doctor appointments: Be intentional about your appointments. Take a brief list of specific questions, but make sure you talk about your goals, specific, practical goals, and how your eye doctor can help you achieve those goals.

That's all for the moment. Please remember, if you're in that hard place with your eyes, it gets better. It may take hard work, but it does get better. Please always feel free to reach out to us here at the Dry Eye Zone for information and to get connected to others for support.