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anxiety and depression: a cursory guide to the land of the irrational
[I wrote this one year ago; repeated by request]
There’s a place. It’s a closet of sorts, the kind of closet that appears in fantastical children’s books, a closet that opens up to a world that can’t possibly exist in those confines. It seems to reach out forever, to have no end. It is made of darkness, mystery, fear and nothingness. You don’t know what you’re going to see when you open the closet doors. And it’s not always a choice to open them. Sometimes they open on their own volition.
The closet looks neat and organized on first glance. Things are arranged concisely, in some kind of order. It’s when you push past that order, when you move the carefully created stacks of things and look behind the aligned rows when you realize there is more than meets the eye. You think there will be a backing, a wall of sorts. The thought of the wall being there is what makes you feel safe. It’s what keeps everything from spilling out of the closet. The appearance of order and the illusion of finiteness is what keeps you grounded.
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I had two panic attacks at work today. I rarely experience panic attacks anymore. Where once they came at the rate of dozens per day, I get them once a month now. If that.
So today was kind of disconcerting.
Even more disconcerting was the way I handled it.
I handled it with shame.
I didn’t want to tell anyone at work what was going on. I didn’t want to say “I’m having a panic attack.” I did not want to have to explain my anxiety disorder, my depression, my bipolar or anything. I did not want get into that discussion with anyone because I did not want to see or hear their reaction.
I didn’t want to hear “It’s all in your head.” I didn’t want to see the disapproving looks. I didn’t want anyone to look down on me because I have mental issues. I didn’t want their view of me to change because they think I’m weak or flawed.
The stigma of mental illness is real. My fears are not imagined. But now I wonder how much of the stigma is self fulfilling. How much of it is mental illness sufferers being caught in a vicious cycle of wanting to open a dialogue about our plight but then worrying about being looked down upon when we finally open up about it?
I made up some excuse and went home at 4:30. I’m mad at myself for letting the panic get the best of me and I’m mad at myself for being angry over something I really couldn’t control. I’m mad at myself for being so weak and mad at myself for thinking I’m weak. I’m everything I perceive the enemies of mental illness to be; I look down on myself, I berate myself, I don’t allow myself breakdowns or panic or low cycles without thinking I should be better than that, I should have learned to rise above all of this by now.
I do these things and feel this way because society has made me believe I am weak and flawed. But I perpetuate it by believing it.
When does the cycle end?
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the daily reminder
As much as I know what my meds do for me, there are some days I don’t want to take them. I don’t want to hear that alarm go off, I don’t want to make the practiced walk over to the cabinet, I don’t want to take out the two bottles, shake a pill out of one, a half pill out of the other. I don’t want to wash them down and wait. Wait to feel normal.
I want to burn the prescriptions and empty the bottles down the drain because I don’t want it to have to be like this. What’s it like to not have to take some kind of medication to keep yourself from crying, sleeping, overreacting, becoming manic, being anxious, acting paranoid, feeling like the world is going to close in on you? What’s it like to not have to swallow pills in order to regulate your moods? What is it like?
I find the whole process exhausting. I hate thinking about it because when I think about it, I get overwhelmed at the concept of having to take these pills every single day for the rest of my life to just feel like a well functioning human being.
I’m grateful for what modern medication offers me. I’m grateful that my brain chemistry can be altered to the extent that I feel like a “normal” human being, that I can function and think clearly and be productive and happy. I am thankful there is this much. Every day I am thankful I have found a way to participate fully in the human race.
But some days it frustrates and saddens me that I can’t do it on my own. I feel flawed. I am flawed. I am reminded of that at 7:00 every morning.
Some days I eagerly swallow those pills, grateful for their company on my journey.
But some days I resent them.
The things that give me relief also give me pause.
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through the past, darkly: bringing my own mental illness to light
I was going through my old blog yesterday, looking for something I once wrote about the Christmas season. I got hung up in my late 2001/early 2002 archives. I read and read and as I read I could trace the history of how my depression, anxiety and myriad mental health issues went from mild to acute. Or maybe just more pronounced.
I lived in a land of make believe. I was delusional. A compulsive liar to myself and to everyone around me. I lied about how my life was going. I lied about being happy and content with the path I chose. I lied about my relationship. I lied about stupid things like what I got for Christmas because I had to make it look like he was buying gifts for me when I was buying them for myself and presenting them as if he did. I had to keep up the illusion that I made the right choice, that I wasn’t crazy and making decisions only a crazy person would make.
It was exhausting. And it took a toll on me. It’s so weird looking back on everything I wrote and watching myself fall apart. I recognized then I was falling apart but I was struggling so hard to maintain the facade of normalcy and happiness that I started to believe all my own lies because it was the only way my brain could deal with the duality.
It’s like reading the blog of a stranger. I don’t know who that person was. I barely remember living that life. I block out more and more of it as time goes on and then I end up going back and reading all of those posts and I remember, but I don’t remember. It’s like living through someone else’s memories.
I wish I got the right kind of help sooner. I wish I didn’t go to a doctor who just threw pills at me without really ever hearing me out. I wish I didn’t feel too embarrassed to tell people close to me that I needed help. I wish I would have somewhere to turn to without feeling like I was being judged.
I swallowed the pills that doctor gave me and they made things worse. I listened to people tell me “there’s something wrong with you” and “you need help” with disdain in their voices. I felt weak. I felt useless. I felt helpless.
I stopped taking the pills. I spent three weeks in hell going through withdrawals. I stopped seeing that doctor. I started drinking heavily. I continued to live a life of delusion and sadness, I continued to pretend everything was ok, I continued to be mentally exhausted and burned out and I continued to feel like maybe the world - and my kids - would be better off without me.
Just when everything was coming to a head, when the depression got worse, when the agoraphobia hit, when I almost lost my job, when I was drunk at work, when violence entered an already emotionally abusive relationship, I was thrown a lifeline.
Not everyone gets that lifeline. I was fortunate. I am fortunate. It still took years from the point where I was thrown that lifeline to finally feeling whole and healthy, but I got there.
There are people who don’t get there. There are people who won’t have someone come into their lives who offers them a hand, a heart, a second chance. There are people who will remain alone in their struggles. It is a difficult, awful thing to feel broken. It’s even harder to feel broken when you are alone, when you have nowhere or no one to turn to.
I don’t know what would have happened to me had I remained in that world I no longer know.
Would I have snapped?
Would I have killed myself?
Would I have done something drastic and terrible?The crescendo of my madness was filled with anger, bitterness and rage.
If help had not come when it did, my world right now would not be as it is. And how many other lives would I have changed had I continued on that path?
I am fortunate. I am so very fortunate.
Not everyone is.
It needs to be easier to get help. To ask for help. To find help.
It needs to get better or there are people who will never get better.
Reading all those old posts make me ever so grateful for the life I have now. I’m grateful to the people in my life who listen and reach out and understand. I’m grateful for an empathetic doctor and good medication. I’m grateful that the life of mine I read about, the life that seems to belong to someone else, is gone, over, never to be relived.
Yet it’s still there, in black and white, in pixels, forever a reminder.
Do I need that reminder?
Sometimes. Sometimes I need to not take what I have now for granted.
And sometimes it pushes me to ask why. Why is it so hard? Why don’t we want to talk about mental illness? How is it that the term “mental illness” makes people look at you in fear instead of with empathy?
We are among you. We are here. We need your hands and your hearts.
[written at 4am, pardon the rambling nature]
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Homeward bound, finally.
Let me tell you something about this week.
This week has, more than any other thing, made me realize that I am living as close to normal a life as I can, thank to the right meds.
He’s been gone a week. I had not instance of anxiety. Not one moment of worry. Not a single what if. When you have an acute anxiety disorder, your life is generally full of irrational fear that takes over all rational thought in your brain. That’s how I’ve lived since time remembered. I have lived with the anxiety, worry and what ifs. I have lived in constant fear that the worst possible thing was happening at every single moment. So whenever Todd was away, those thoughts would consume me. If I didn’t hear from him in a certain amount of time, I would start freaking out that something bad happened to him. Accidents. Earthquakes. Kidnappings. Murder. Alien abduction. My head would swim with the possibilities of what could have gone wrong. I’d spend hours trying to talk myself down from a ledge all the while the irrational part of my brain was talking me closer to that same edge. I battled with myself constantly about whether to panic or stay calm. Calm never won.
I think about how this week went. How I never worried. How I knew when I didn’t hear from him it was because of the time difference and the heavy load of meetings he had over there. I went about my day, my night. I made plans, I wrote, I worked, I lived, I slept. Not a single, solitary moment of panic or fear or what ifs. I did not sleep with my phone clutched in my hand just in case he called. In fact, I went to the store one day and left my phone home. Instead of turning around in a panic to go home and get the phone because what if I miss an email or phone call from him, I just went to the store thinking, if I miss his call, he’ll call back later. You have no idea what a foreign concept that has been to me up until now.
I think about how I lived before this. I don’t know how I did that without having a mental breakdown, all that chatter in my head, all the irrationality, all the worst case scenarios, the anxiety, the abject fear that everything I know and love is going to disappear any second.
Then I also think about earlier today, standing in a room crowded with people, giving direction, being social, talking to strangers. Doing all that for hours was an impossibility for me before now. And while it’s something that exhausts me, it’s now something I can do.
This right now is as close as I’ve ever been to being a rational person. To being sane. To having a clear, rational thinking process.
That I have been able to manage the Sacks for Sandy business, go to work, do my writing work, keep up with day to living and be stress free this week without ever once wanting to get under the covers and stay there says a lot about how this medication is working out for me.
I know it’s still there. I know this does not make my anxiety disorder go away. It does not make the bipolar disorder go away. They are there, they will always be there. But they are manageable now. They don’t own me. I own them. I still have fear. I still have anxiety. I still get manic. I still get depressed. But I can manage those things and wrestle them away now.
I’m looking at the flight tracker not because I’m afraid his plane is tumbling into the sea somewhere or being hijacked or making an emergency landing. I glance at it every once in while just because I’m glad he’s coming home.
No worries.
I’m as close to “normal” as I’ll ever be. It’s a good place.
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supertrains, agoraphobia and other stuff
I was listening to the Supertrain episode of Roderick on the Line (again).
I find myself doing this when I start thinking about agoraphobia and my fear my agoraphobia will come back. Is there a word for a fear of a fear? Metafear?
I guess it’s always there, it just lays dormant, a sharp clawed owl waiting to swoop down on a mouse.
There’s this one part in Supertrain where John talks about riding in the presidential car of a train, how it was like an apartment on tracks - three bedrooms, a living room, a kitchenette. It’s like bringing home with you when you travel. Imagine traveling like that all the time, feeling at home no matter where you are. Rumbling through the country, heading far away from home yet feeling like you are still there.
I wish I could live like that. I’d be more inclined to do things, to seek adventure.
Whenever I’m away from home - and this can mean in another country or just at work - I always need to feel like I’ve brought my home with me. It’s why I overpack for trips, taking things that bring me comfort. It’s why I take fifteen minutes to make sure I have everything I need when I leave for work in the morning because my tote bag is packed in such a way that I can sit at my desk during lunch and feel the comforts of home. It could be something as small as bringing real utensils instead of plastic to eat with. It could be something larger like taking my Macbook with me on vacation even though I don’t have to have it with me. It’s that routine in the morning of sitting in bed with the news on, checking email, writing a little something on tumblr, that makes me feel less far from home and the routines there.
I don’t like being away from home. I venture out a lot more than I used to. There are times I feel like I’ve finally gotten past my agoraphobia enough to say I don’t have it anymore. But then something comes up - my daughter gets free tickets to a Taking Back Sunday show I really wanted to attend - and I beg off because it means more hours away from home than I can deal with right now. And I know. I’ll never get rid of it. I’ll never be over it. It will always be there, lurking inside me, waiting for the right moment when I’m vulnerable enough to suddenly have a night out of the house seem daunting and overwhelming.
I hate this. I hate that my fears will always be with me. I hate that I can feel recovered for so long and then be completely thrown off when a fear pops up again, a skeleton jumping out of a closet rattling its bones at me.
I want that train. I want a place that feels like home even when it’s not. I know, I know, home is where the heart is. Home is always inside you. Wherever you are, that’s home. And all those platitudes are great for people who aren’t carrying around a suitcase full of fears. But they are not for me. They do not work for me. A week away from home - in another country, no less - triggers that need to cocoon myself in my own house. The thought of going back to work tomorrow brings back uncomfortable memories of the days when my fear was so bad I almost lost my job because of poor attendance. The difference between then and now is now I can make myself do it. I can get up and go to work and deal with it because I have medication that helps me deal with it and because I’ve progressed in my mission to abolish my fears.
But not enough. Not enough progress. Not enough success. Because it’s still there, still an active disease and it will never go away. I can’t go to the show Wednesday night because I don’t have the emotional strength to both go back to work with a smile and go out for several hours without the familiar panic working its way from my brain to my stomach to my throat.
There are places I go where I can bring home with me. But I can’t do that all the time and for now, when that fear of being out of my element is triggered, I have to stay home rather than make that effort to feel at home somewhere else.
It’s not always like this, but is now and it pisses me off that I miss out on things when this happens. I wish I could always be home. Or, no. I wish I could always feel like home is with me.
Now a Supertrain? A supertrain will always feel like home.
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it’s not a tumor
Revelation.
I don’t think this has anything to do with my sinuses or allergies.
I think I’m withdrawing from Xanax.
I went from two .5 doses a day to one .5 dose to one .25 dose within two weeks time. The dizziness started right around the time I halved my dose and it got worse when I halved that half.
So now I’m experiencing dizziness, lightheadedness, shortness of breath, heart palpitations and light sensitivity. I know they are not side effects of the Abilify because this started before I started taking that. In fact, the Abilify is the reason I’ve been able to go off the Xanax without experiencing any anxiety. And if you look up those side effects with Xanax withdrawal, they are all listed.
It just makes sense.
Good news: I’m not dying. I don’t have a brain tumor.
Better news: Withdrawing from Xanax sucks but is not nearly as harrowing as withdrawing from Paxil or nicotine for that matter.
Bad news: I don’t know how long this lasts or when I can safely stop taking that last dose I’m down to.
Yes, I’m going to call my doctor. But I think this is something he should have picked up on when I told him I was weaning off the Xanax. He also dropped the ball on getting me the MRI referral yesterday and the only reason I’m going to be able to make that appointment today (if I go ahead with it) is because I said something on twitter last night like “Waiting for MRI referral from Aetna” and an Aetna rep tweeted at me about it and they are taking care of it for me. Twitter to the rescue again.
Anyway. Mystery solved. This chapter of Encyclopedia Brown and the Case of the Mystery Symptoms is closed.
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clearance
I hate for this to become a medication journal, but I’m sure it’s just temporary. I’m hoping what I’m experiencing becomes my “normal” and I’ll stop being amazed by what I’m feeling. Or not feeling.
I’ve been through other medications. It was obvious they were not working or, in some cases, making things worse. That’s why I was just happy to pop a Xanax and not take anything else. Because I could handle this, right? This is who I am and I can deal with it.
No. No I could not deal with being bipolar. I could not deal with the manic phases. I could not deal with the low phases. I could not deal with hating myself for the way I was and the way I was making people around me feel. So I had to put aside my fear of bipolar/depression meds and tell myself that while past meds made me crazier, I had to give something else a chance or run the risk of getting worse, mentally.
It still amazes me when I look at this tiny pill I take every day that something so small can contain the ingredients needed to give someone like me a clear head and a strong mind. I don’t understand chemistry. Not chemistry of the brain, not chemistry of modern medicine. Then again if I could, back in the 70s, grasp the concept that a tiny microdot of mescaline could change my brain chemistry I should be able to undertand this. And yes, I have wondered if the drugs did something permanent to my brain. But then I remember most of my childhood was spent in a state of mild depression. I think my drug use was a reaction to my depression and anxiety rather than a cause of it.
So here I am today, trying to explain to you what my little dose of Abilify does for me.
Think of a tv that has no connection to cable, no antenna. You turn it on. It’s just static. Just all those shades of black and white and gray, little specks of information colliding with each other, making nothing more than visual noise. There’s something back there waiting to come into focus. It just needs something. A connection. A wire. All that static, all that fuzz and noise are thoughts and ideas, dreams and memories, fears and hopes, equations and shopping lists and song lyrics and important reminders and words waiting to be written. But the get in each other’s way and each one shouts to be heard above the other and you stop trying to make sense of any of it. There are days the static show takes over your brain and everything is a jumbled mess of noise and there are days you just can’t deal with the noise and turn the tv off so there’s just nothingness.
That has been my brain.
And suddenly, a picture forms. A wire gets uncrossed. A plug gets a connection. The static clears up and you can see the separate pieces of information pulling away from the mass, becoming their own, whole thoughts. There is color. There is defined movement. There is life.
My brain keeps smiling and saying, “We have clearance, Clarence.”
It’s my little inside joke with myself.
Now I’m able to compartmentalize. I’m able to prioritize. I can, for the most part, control my emotions because my emotions are no longer coming in manic waves. I can have a sustained thought process without it meandering off into seven thousand other thoughts, branching out to something unrecognizable from the original thing I was thinking about. I can concentrate on what’s important. I can do. I can be.
And there are other things. The desire to do. The desire to be. Where before they were half hearted and all my attempts to make something of my world and do something with my life were attempts I felt were destined to fail, thus keeping me from really putting my all into them, now I see everything as a possible triumph. It makes me want to do more. Be more.
Yes, there have been side effects. But I’m working my way through the insomnia (thank you, melatonin). And yes, I am still taking Xanax for now (I’ve worked my way down from 2 .5 doses a day to one .25, which I hope to be off of by the end of the month). But unlike the side effects of my previous medications, these are bearable. They are worth getting through considering the benefits I am getting out of the good effects.
I still marvel at how one little pill can change my life like this. How a bunch of chemicals put together by human beings can replicate the chemicals my brain has been missing. Science, right? Amazing stuff.
I feel like I’m on the verge of something big here. The Abilify has allowed me to take this giant leap I’ve been holding back on for so many years out of fear of where that leap would land me.
And that’s the big thing.
The fear is gone.
The fear of the future, the fear of the past, the fear of the unknown, the fear of everything from getting up in the morning to driving to work to going into a crowded subway to doing anything alone, those fears are gone, replaced by a strength that I have to believe was inside me all along, just waiting to be let loose from the noise and fuzz of the static that was keeping it from being seen.
This is a new life for me. A new way of being. And suddenly, instead of pretending I’m looking forward and excited about things, instead of going through the motions while waiting for the fear, anxiety, terror and depression to kick in, I’m really excited about what I can accomplish now.
Oh, yes. It’s all still there. I know there will still be days when it hits me. I know the anxiety is so acute it will always be lurking, waiting for the right moment to leap out out me. That’s why I’ll keep the Xanax prescription. That’s when the people I love will be there for me. That’s when I’ll feel the difference between letting it overtake me and taking charge of it. Because I feel like I can do that now.
There’s a specific kind of personal heartbreak that comes with the knowledge that you need a pill (or two or four) to help you become a better person, a mentally healthier person. It’s jarring. It makes you feel weak for a moment or two. And there are people who will try to make you feel even worse about it, whether they mean to or not, who will use words like “crutch” or “get over it” or “just stop being sad.”
I’ll just smile at them. They don’t know. They can’t know. And they don’t know how lucky they are to not know.
All I do know is that I’m better. I’m not cured. I’ve not banished the demons of mental illness. It’s all still there. But I’m able to now focus on being a functioning human being instead of focusing on being unwell.
That’s a victory.
We have clearance, Clarence.
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I can honestly say I’ve never been stalked by an angry bathrobe, nor can I say that I have thought of my depression and anxiety as an angry, stalking bathrobe.
But the ad for Abilify says my angry bathrobe will no longer stalk me. Or at the very least I’ll be able to say “fuck off” to it and have it turn and leave.
So, my doctor’s visit.
In a turn of events that will surprise no one and only serve to validate the two previous doctors whose diagnosis I summarily ignored, I am bipolar. Or, I have Bipolar 1 Disorder, however you would like to phrase it.
I knew this. It’s been painfully obvious for years. But the fact that this time I let me doctor talk and I listened to him and he listened to me and we talked out my fears and worries and needs and desires (medically related only, of course, I don’t think he wanted to hear about my weekend at the Hollywood Hotel) made a difference.
Hearing it, repeating it back to him, hearing it again.
I’m bipolar.
Ok, now what?
Now we start with Abilify and see how that works. We start with a small dose and I take it in addition to the Xanax for the first couple of weeks until we see how I’m dealing with it and I’ll go back the end of October and we’ll talk about if it is the right medication for me and if I need a different dose and maybe start using the Xanax only on panicky occasions.
I feel good about this. Instead of treating the anxiety only, I’m treating the whole picture.
I hope this works because I’m really into the idea of feeling like I’m on even ground.
I am not Googling side effects for Abilify. Not at all.
I don’t know why I had such a hard time with my previous diagnosis of the same thing. Maybe because all those years ago - when bipolar was called manic depression - there was more of a stigma. Maybe because saying “I have an anxiety disorder” is not nearly as harrowing as saying “I’m bipolar.”
But you know what? It’s not harrowing. It’s not horrible. It’s not anything but who I am. The whole time I’ve been telling other people “This is who I am and how my brain works so deal with it,” and now it’s my turn to deal with it. And I’m dealing with it not by saying “I can do this on my own!” but with the miracle of science and better living through chemistry.
I’m not expecting miracles. Very few people find the right med the first time around. But what I am expecting is to not be stalked by an angry bathrobe.
I can ask for that much, right?
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fixing a hole where the rain gets in
I have a doctor appointment today.
It’s both a general “have to see him this month or he won’t renew my Xanax” visit and a very specific “HELP ME OBI WAN” visit.
I don’t want to be on Xanax long term. I don’t want it to be my daily medication.
I have gone too long quieting the anxiety without treating the depression.
For years - since I stopped the Paxil/Wellbutrin combination I was on from 2002-2005 - I said I could handle this on my own. I just needed to recognize my low cycles and my manic cycles and handle them accordingly. You know, just tell myself “It’s all in your head” and everything will be fine.
That doesn’t work.
I’m 50 years old. For the first time in my life I am financially stable, in a very healthy relationship and have no major worries. I’m traveling, I’m doing awesome things, I’m making amazing future plans and having the time of my life.
Or I should be.
I’m tired of not enjoying what I have. I’m tired of constantly feeling like I am fighting a battle with myself. I’m tired of making the people around me feel like they have to walk on eggshells in accordance with which mental phase I’m going through. I’m tired of my headspace.
So today I will see if I can finally and less grudgingly address my depression and, yea, medicate it. Keep the Xanax for an “as needed” basis which is really in my mind what it’s for, not something to be taken every day, twice a day. Get something that will allow me to be happy. Or less unhappy. Something that will allow me to enjoy the people in my life and let them enjoy being with me more.
Brains. How do they work?
