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Last summer, in the midst of a terrible bout of panic attacks, a friend (and fellow sufferer) loaned me a self-help book on dealing with anxiety. I read it, took some parts to heart and dismissed others. One thing that stood out to me was this: that confidence has something to do with anxiety. The connection didn’t become clear to me until recently.

Something interesting happened in the midst of panic, and in a public place. I was standing in a check-out line, fumbling to get money out of my bag, when I came across an old school photo ID. The ID was from a community college where I adjunct as an English teacher. It’s a nice photo: while not glamorous in any way, it looks like me on a day when I felt good about myself. And not just how I looked, but my life in general. It was a moment of shock, revelation, but mostly of recognition. It was me, myself, looking confident.

I know this girl: I know who she is and what she is made of. This photo did for me what no amount of positive self-talk has done lately: it gave me a moment of confidence. It grounded me. I had no idea something so simple would have such a powerful effect.

This moment wasn’t about looks or vanity but simply one of self identity. Anxiety has a way of making you feel as if you don’t know who you are, or where you are. At the worst point in a panic attack, you may not even recognize your surroundings. It can feel as if you are separated from yourself and your life. It can be terrifying. In these moments, you need something to hold on to, something to ground you. It might just be your self that you turn to.

The crisis of confidence, of self, is clear to me now. You doubt yourself, you are afraid you will ‘lose it’ in public, or have a panic attack in front of others. You fear the unknown; you fear fear.

My moment of self identity passed quickly. But there is hope in this, too: anxiety can be dealt with, and I will start with that.

There was a moment when I was reading last night when I felt inextricably linked to the author.  These are moments I live for: that moment during reading when you know for sure it is the author coming through, and not a fictional voice.

I was reading an essay titled “The View from Mrs. Thompson’s” in David Foster Wallace’s collection of essays Consider the Lobster.  Though he skirts around it at first, the essay is about 9/11 and the reaction of his particular town at the time, Bloomington Indiana.  The event is referred to as the Horror, maybe in an attempt to give it an alternate or different meaning.

As DFW has no TV to watch the Horror, as soon as he hears what’s going on via radio, he jumps straight from the shower and heads to a fellow churchgoer’s home to watch. (I never thought of him as a church-going person, another revelation from this essay.)  But before this, before Tuesday, we learn what happened on Wednesday, the dreadful day after.

Wednesday was the day of the flags; American flags everywhere, planted in lawns “as if they’d somehow all just sprouted overnight.”   Showing your flag was somehow supportive not having a flag was, well,  bad.  DFW doesn’t have a flag and goes off in search of one, ending up in a convenience market, having a small breakdown.

DFW’s struggle with depression is well known at this point, though I’m not sure how well known it was at this time.  But there’s this moment in the essay, this one striking moment, when he is completely vulnerable, in a public place, in front of others:

“All those dead people, and I’m sent to the edge by a plastic flag.” 

His panic worsens as others ask if he is alright, and he ends up in the store’s storage area trying to calm himself.

This is so dead-on what it’s like to have depression, to feel panic, to be overwhelmed by something so small and so damn inconsequential.  It’s completely maddening.  And to be in public during an episode is the worst.

This single moment was a gut-punch to me.  I felt simultaneously tender towards the author, and as if I were looking in a mirror.  It feels so stupid to get worked up over something that seems so small, and yet… This is what emotional problems look like.  This is what they are.  Thousands of these kinds of moments make up what we know as depression.

My very own little GNA strands have finally proven what I’ve known all along: SSRI’s will not work for me.

About a month ago, I saw my psychiatrist, who asked me if I’d yet taken my pill.  No, I said, not surprisingly.  I want to, but no.  She then suggested a new test:  a DNA saliva test that would tell me what liver enzymes I had, and what genetic markers I might have, which would in turn tell the doctor what medications would work for me, and which would not.  Something about metabolism and how fast my body would metabolize certain drugs.  I did the test there in the office and was told I’d need to come back to discuss the results with the doctor.

Today, I finally got my results.

Let me refresh your memory on how I feel about prescription drugs and the pharmaceutical industry in general:  I hate them.  I loathe them.  I think pills in general (SSRI’s in specific) are evil and I am reluctant, to put it mildly, to take them.  When I took the GNA test, I hoped that it would show some reason for my aversion.  And I was not disappointed.

In regards to serotonin transmitters, I have a gene that causes ultra-rapid metabolism.  In plain terms, this means that any SSRI’s I take will go straight through my system, not staying long enough to produce positive effects, but long enough to cause nasty side effects.  Basically, all these years, doctors have been throwing SSRI’s at me (the new and improved treatment for depression/anxiety!) promising me that they would work, they would help.  Wrong.

Second, there is an indication that I have impaired folic acid metabolism.  Folic acid is turned into methylfolate in the body; methylfolate is a precursor to neurotransmitter synthesis (serotonin, dopamine, norepinephrine).  I was given a prescription for a ‘prescription food’ pill (more like a supplement).  I was given some pamphlets to peruse.

So what does all of this mean?  That for years– nay, decades– doctors have been winging it.  They’ve thrown pills at every problem and hoped for the best.  They’ve gambled to see what pill would work for each person, not having the slightest indication if that particular version or brand would work, what side effects might be, what other complications would arise.  It’s been a complete and total guessing game.  Trial and error performed on humans.  But with this new testing, the age of ‘personalized medicine’ has been born.

Another important implication from all of this is that what was recommended for me isn’t an actual drug.  It’s more like a supplement, which isn’t a far cry from an actual supplement… or from food.  The next step for me may well just be upping my nutritional game and investing in good organic foods that can be used medicinally.

Personalized medicine will be huge, I think.  But with results such as mine, will doctors start leaning more towards natural and nutritional based remedies over chemical ones?  Let’s hope so.

I’m not a religious person, and so when asked why I wasn’t in the ‘Christmas spirit’ this year, I was surprised.  Yes, I do normally participate in all of the pagan rituals of Christmas, without the church-going.  But this being a tough year for me, and with my aversion to leaving my safe apartment and actually going out into the world and being around people, I really don’t want to shoulder any of the shame or feel the retributions of others who feel I should be ‘in the spirit.’

I’m not; and regardless of the many reasons, why should I feel bad about that?  Why am I required to feel a certain something just because it’s December?  This may be a national holiday and it may be a long-standing tradition, but that in no way impels me to participate.  I’m not bitter. I’m not opposed to anyone celebrating any damn thing they please.  I’ll give to charity and I’ll gift my family members.  But my spirit will be what it always is, one that is always giving, one that is a non-believer.

I’m the Charlie Brown of Christmas: I know I should feel something, but I only feel let down.  This is the same feeling I had when I actually realized that I was in fact, an atheist. I used to feel like I should feel something, but it just wasn’t there.  It was a lie that I told myself.

And I’m allowed to feel what I feel, right?  This is another frequent argument I have with others.  Don’t tell me how I should feel; I have a right to feel whatever emotions that come, regardless of what others want me to feel.  I think this is where empathy is very important; allow others to go through their emotions and stop dictating what you think those emotions should be.  Stop saying “Oh you shouldn’t feel that way!” and start allowing emotion to run it’s natural course.

Allowing me not to get the ‘spirit’ is only fair, to be honest.  I don’t go around proselytizing to you about becoming a non-believer, so stop pressuring me to participate in your religious rituals.  I feel this is a good compromise.

And, considering all the times I wrote ‘feel’ in this post, I feel I should end it here.

I’ve had a life-long aversion to pills; I’ve written about it, I’ve talked about it, I’ve cried about it.  I’ve never, ever trusted man-made chemicals, and this is mostly based on my sensitivity to any of them.  I’ve long sought out herbal or natural remedies over pills, and most of the time, this has worked.

A visit to the psychiatrist this week (who has been pushing SSRI’s on me for the last eighteen months, none of which I’ve taken) surprised me this week with a new test.  DNA testing can now determine what liver enzymes you have, which will tell you what drugs you can/can’t metabolize, and how fast you will metabolize a drug. It can predict whether or not you will have side effects.  INSANE.

There are many implications for this kind of science.  The consumer, for one, might be much better served and find a more tailored treatment for their specific problems.  Instead of throwing random pills at a problem, doctors might actually be able to find the right drug sooner.  I also wonder how this will affect Big Pharma.

I gave the nurse a saliva sample and should get results back in ten days. Will I ever conquer the pill?  We shall see.  The likely answer is that I will continue seeking out herbal or natural remedies.  But knowing how my body will respond to certain medications– efficacy, side effects, etc– is kind of exciting.  Science is just crazy pants some days, but in a good way.

It’s my constant battle with myself:  to stay and face the danger, or flee from it. 

Except, there is no real danger.  My brain is playing games with me.  

Except, it doesn’t feel like a game.  It feels real.  It feels like actual danger.

The past twelve months have been book-ended by two truly unhappy events.  Last August, I was at Nashville airport ready to board a plane to San Diego, what would have been my first trip to California.  It’s a long story, but in the end, I didn’t make it to San Diego.  I sat in the airport and cried, and popped Xanax.  I even got another flight for the next day but never made it.  I haven’t written about it because it was too painful.  Too embarrassing.  

It was like something you’d see in a movie, or see happen to someone else.  It’s something you never imagine would happen to you:  this is what would happen to someone else. This would never happen to you because you are in control, you can control your anxiety, you are strong.  This is the narrative in your head.  This is what you tell yourself in crowds, in movie theaters, on planes.  You are strong.  You’ve been through worse.  You have anxiety but it’s under control.  You would never let it get out of control.

This narrative has worked for you for years.  You don’t need medication because it’s under control.  

And then, you find yourself screaming in the last seat of a plane, a plane that is taxiing away from the airport, a plane already heading towards the runway.  You scream until they turn the plane back, go back to the gate.  You have to get off of the plane.  The entire cabin full of people knows it’s you because the captain has announced that there is an ‘anxious passenger’ that has to get off.  You are in the last seat and so you must walk past each and every passenger on the way to the door. You are embarrassed, humiliated.  

Two nights ago, Tori Amos played at the historic Ryman Auditorium.  I had a ticket and was looking forward to seeing her again at the Ryman.  I live less than five miles from the Ryman.  I took a xanax and got ready for the show.  

Well, you can guess how this turned out:  I never made it to the show.  Just being in the car caused me to panic.  Agoraphobia?  Probably.  But it’s been a year– a year in which I had ups and downs, went back and forth to work, traveled.  It’s tiresome, dealing with anxiety.  It wears me out.  It tears me down. 

In our culture, people don’t take anxiety (or depression) seriously.  Everyone has felt anxious about something in their lives: speaking in public, or flying overseas.  There are a thousand reasons to feel anxious, to feel nervous.  But having an anxiety disorder is so much different than nervous butterflies.  It’s so much more threatening.  Constant anxiety isn’t healthy and it’s not productive.  I myself have not taken it as seriously as I should have.  It’s already caused tremendous changes in my life: I’m unable to work, I’m unable to function like normal. I can’t bear to be away from my apartment.  I feel stuck, unable to make necessary changes.  

My body and mind are in constant fight or flight mode.  The question I’m asking myself is this:  will I run away or stay and fight?  

I’ve written about this so many times that it feels like a broken record.

Pills: tiny, mostly white, totally innocuous in appearance. Normal, even. Pills are the answer to everything, if you believe Big Pharma. But for me, pills are still one formidable foe, one I haven’t been able to defeat entirely in eighteen years.

Why eighteen years? In 1996, I was an undergrad at UT Knoxville, living alone, isolating, yelling at my cat. I was miserable and had no idea why. It was one of the hottest falls I can recall, and walking to school each day, I felt the heat. I had headaches for hours on end, for months, yet each time I made the trip down to the local drugstore (many, many trips), I stood in the pain reliever aisle and stared. And moved bottles around. And obsessed. And walked away. I could not even purchase a pain reliever, much less get one down. So I suffered until the headaches went away.

This was just me in the very early stages of what would become a very serious journey into OCD. Not only could I not make a decision on taking a much-needed pain reliever, I couldn’t make decisions about anything.

Indecision seems like such a small thing. For me, it’s a sign that things are not quite right. It means that I may not be able to do the things I should do, the adult things, the things most people find easy. It might mean that I am wearing out already thin grooves in my brain. Those obsessive thoughts are easy to resurrect, happy to torment me once more.

It’s time to take stock: it’s been 18 years since I was diagnosed with OCD, and how far have I come? What have I accomplished since then? That’s not fair to myself, really, seeing as there’s no cure for OCD and I have done remarkably well for extended periods. I’ve worked, finished grad school. Finished a book, even. And yet, pills.
Pills still haunt me. Pills still have the ability to ruin an entire day.

OCD makes my life much more challenging. If I’m having a bad day, whether due to obsessions and anxiety or whatever else, meaningless, habitual tasks become mountains.

So what did I accomplish today? I got out of bed.

Years ago, there was a hugely popular theme park in Nashville called Opryland. It was torn down and replaced with a mall, stupidly, and I think whoever made the decision to tear down a perfectly wonderful and popular theme park to put in a horrid discount shopping mall must be regretting it. At least I hope this is the case.

Anyway, my dad, who is a carpenter by trade, did some work on Opryland, and was able to test ride the famous Wabash Cannonball. I used to love telling this story to friends, adding that my dad rode it before they ‘slowed it down.’ I’m not a huge fan of coasters, but I did ride them when I was younger. Until, one day, when, of course, I had a massive freak-out. In the middle of a ride.

I was 19, and my family, along with an aunt, uncle, cousin, and my best friend, all drove down to Disney in Orlando. After spending a few days in the parks, we drove over to Daytona Beach, just an hour or so from Orlando. Daytona Beach has a boardwalk right on the beach, filled with shops, Ski-ball, the usual attractions. But this boardwalk also had an indoor amusement park, which, to this day, I don’t understand. Why indoors? Especially on a beach?

So I took my young cousin in and we decided to ride the Scrambler. That may or may not have been what it was called, but there was a ride just like this in Panama City Beach (at what used to be the Miracle Mile Amusement Park, also now a shopping mall) and it was called the Scrambler. Two people to a pod, with the pods spinning on their own while going in a circle, and also the arms moved up and down. Quite thrilling, if you like that sort of thing.

This indoor park was really quite shabby, and as we whirled round and round, I heard noises and creaks and things that didn’t sound exactly safe. Not to mention I’m pretty sure that the ride was going way faster than is allowed. Which says a lot– at 19, I was what was termed a ‘speed demon’ and had just earned in the neighborhood of 8 speeding tickets in one year.

The faster we spun, the more unsafe I felt, until finally I couldn’t stop myself from screaming. I screamed until they stopped the ride and let me off. As I write this, it’s hard to decide whether to laugh or cry. There is enough distance in time from this event that it’s funny, but with recent events being what they are (a subject for another day), and my anxiety levels being at an all-time high, it’s hard to hold back the tears.

Surely I’m not the first person to do this, but I’ve never witnessed anyone else having a meltdown on a ride. Thank fuck there were no cell phones back then to record my meltdown. I guess that is one huge positive note in an otherwise sad tale.

Looking through my family tree this week, I’ve discovered some unpleasant surprises.

While its true that I’ve always known that my biological father and maternal grandmother died of different cancers, what I failed to pay attention to was their ages. Both were relatively young, and I was very young at the time they both died (19 and 25, respectively). But now, 20 years later, I’m not so young. And I’m very close to the age my father died, which was 47.

At twenty, 47 didn’t really seem that young to me. Now I realize it was incredibly young, especially considering modern medicine. And now it terrifies me. Terrifies.

I hate that lately I’ve had these horrifyingly clear epiphanies about life in general, and my own life specifically. I have obsessed over these realizations, wondered why it took me so long to get to them. How had I not known that I’ve had serious anxiety all my life? Why wasn’t I treated for it? Is it because I minimized it in an effort to seem strong, or did everyone around me minimize it for whatever reason? Why have I suffered through trauma and not be treated for that either? Why are my parents so bad at taking care of their health problems and why have I followed that stupid and dangerous pattern?

It seems my genes have doomed me in a way, have made the possibility of fatal diseases of the mind and body damn near inescapable for me. I’ve often felt, in the last month, in the midst of the multitude of health issues I’m facing, that I was also going through the proverbial mid-life crisis. Which may or may not be the case. With a father dead at 47 and a grandma at 65, it doesn’t seem very likely. My sister did remind me, thankfully, that our great-grandparents lived to their 80’s and 90’s.

All of which has brought me to here and now. And the future. And what I want it to be. And some very big questions.

The first time I visited the psychiatrists office a few weeks ago, I was a quaking wreck of a girl. I could not sit long enough in the waiting room to fill out the paperwork, instead pacing nervously around the room and hallway. I felt ridiculous and not just a little bit like a circus act. The kids in the room stared.

I went back to that same waiting room today and talked to a therapist. We talked about a lot of stuff, but two things stood out to me as being very important and immediate: I have symptoms of PTSD, and those symptoms have never been treated.

I told her my sordid and long history of ‘mental illness’ (including my mother’s history as well) and she asked had I ever done any therapy for the trauma. I hadn’t and wondered why not? I had done behavior therapy, cognitive therapy, why not this too?

I’ve felt, very deeply, that what I went through was traumatic, even if no one else ever said it. I
am glad to finally have some validation of this. The event was 20 goddam years ago, and here I am, still dealing with the effects.

How can one not know that an event that changes your diet, your daily routine, your entire perspective on things and your life, in general, would be considered traumatic? Of course it is.

I do feel somewhat relieved in the fact that there are non-chemical therapies, and that my therapist had some book recommendations for me on other, newer therapies. I’m intrigued by the EMDR but trepidatious as well. Or terrified, as is my normal response.

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