A Letter to My Future Anxious Self

Today, I came down with a painful infection–something that is fairly frequent for me, but that I never get used to. The pain was enough to rock me back on my heels and put a stop to a month free of panic attacks. I got through it, but I wanted to write a letter to my anxious self because I can.

Dear Shelly,

Today I had a panic attack. It was a real rocker. You know the type. I sweated, felt like I would puke, worried I would kill myself, worried I would hurt someone else, worried about work, worried it would never end–all in the span of 20 minutes. It wasn't fun. It sucked. I know it sucks. I know it's hard, but I want you to know you do not understand anything right now. Your thoughts are lies anxiety tells you. Even when there is some truth, it is always a catastrophic version of what might be. Sure, the shit might hit the fan, but you cannot predict the future.

I know you're hurting right now. You might feel like you're not good enough. If you're in pain from another infection, you might think that will never end. You have a lot of fears. I'm sorry you have to go through that. It makes me sad to think of you going through this anxiety, whether it's for a few minutes or a few months. I love you, though. We've done all of this before. I know all the thoughts you have, and I love you! You should know that.

I also want to address some of the things you might be thinking. I know you overthink shit big time. I'm not sure addressing your fears will help, but we try everything else, why not this?

1. The moment you need your meds to get calm, you are going to start thinking you're an addict. It's what you do. Even if you think "I haven't had them in forever. I don't crave them." you will follow it up with "Yeah, but this could be the time." Listen honey, this is the thought you have every time. Remember when you couldn't sleep with your medication near you? You have anxiety about medicine, kid. So what if this is the time? Are you struggling with anxiety right now? Take care of yourself with the tools you have. Let me take care of what's left of you when you're done. I can handle it. I swear. I'm waaay stronger than you think I am.

2. You're going to think the anxiety is going to hit its stride and never go away or stick around long enough to fuck up your work. The first is impossible. The second is rare, but it could happen. So what? The reputation you think you need you're imagining. Even if all of your clients cut you off because you were out of work for a month, you would bounce back up, but I'm not here to reassure you. I'm here to tell it like it is. This shit will happen to you. You are sick. You're also fine.

3. You're going to worry about committing suicide because you have intrusive thoughts about it. I'm not going to bother telling you they are just intrusive thoughts. I know what it feels like. You wouldn't listen to me anyway. I will say this, though. I really want a chance to come back to my life. I would appreciate it if you would take care of us and just endure this until you get back to me, okay? If you have to cling to a book for a month drinking Ensure and playing video games with Adrian, do it please. I need you. No pressure, though, eh?

4. You're going to worry about puking. I'm baffled that we're so scared of being sick, but it happens. So what if you puke? So what if you puke up your meds? Make sure they're whole when they come out so you know which ones you can take again, which brings me to . . .

5. You're going to worry that your meds will stop working. I know why you worry about this. Sometimes, our meds are not as effective as they can be. It's because sometimes we have really prominent symptoms. Here's the thing, a pain pill may not completely knock out UTI pain. An Ativan may not knock a panic attack on its ass (though one just did). They will help make your anxiety manageable enough that you can knock back an Ensure, read a book and walk until you find me again. It might take time, Shell, but you will find me. I promise. It's okay to cry and be sad that I'm gone right now.

6. Do what you would have done anyway. If you sit still and cater to the horrible sensations of your anxiety, it is all you will feel. You might as well feel like shit and do something at the same time. You might enjoy the walk less or zone out during family time, but at least you won't just be sitting there feeling like shit, right? Live your life. When it's going rough, it's going to suck whether you lay around like an invalid or get up and risk puking in the grocery store, which still has yet to happen. I can just imagine us if it ever does. "OMG, I was right!" Ugh. Whatever.

My point is, get through it. Do what you have to do. I promise you that I, your calm self, will be happily waiting for you on the other side. I always am. Even if it's just for a minute that slowly grows over time to be hours, I am always waiting for anxious me to get to the other side of anxiety. This is not reassurance. This is just a fact. I can't wait to see you again. It feels so good to be alive. I can't wait to tell you that.

Love, Shelly

My Anxiety's Relationship WIth Sleep

This has nothing to do with
my anxiety, but I thought it was funny.

 

When you have an anxiety disorder, you more than likely have sleep problems to go along with it. The two don't always go hand in hand, but most people who suffer from anxiety seem to have trouble sleeping at some point or another. This trouble can take various forms and has had many faces in my life–not all negative, believe it or not. Here are a few troubles I've had with sleep and that you may have if you suffer from anxiety:

• Difficulty falling asleep
• Difficulty staying asleep
• Difficulty falling back to sleep
• Difficulty waking up
• Difficulty staying awake
• Difficulty trusting the efficacy of your sleep medication

Okay, that last one isn't really anxiety related as much as it is related to my dismay that medication is not magic. 

Anxiety is the antithesis of sleep. Check out this study abstract if you don't believe me. If you are worrying or having physical anxiety symptoms when you lay down at night, you are not likely to fall asleep fast or have restful sleep. I have spent hours laying in bed worry about life, worrying about worry, having panic attacks or stressing about sleep while trying to fall asleep. I know I'm not alone in this, though I never saw anyone else pacing the halls or asking the nurse for anxiety meds at 3 a.m. when I was in the hospital. I suspect they were giving everyone else better meds.

Trouble staying asleep and falling back to sleep is something I experienced mildly in the past. However, it came about full force at the end of last year. I was waking up multiple times a night with panic attacks and having trouble getting back to sleep. This was different from waking up a bit early and laying there hoping for more sleep. It was a desperate clawing need for sleep coupled with panic symptoms that prevented it from happening. The meds that helped me fall asleep did nothing to help me stay asleep. It's been about three weeks since this has happened after a period of it happening every night, so you could say I'm pretty excited.

It is much more common for me to have issues with sleep than it is for me to sleep too much or feel sleepy enough for a nap, but it happens. It typically happens when I'm a bit depressed, but don't have the underlying anxiety that usually triggers it. It also happens when I'm on psych meds for my conditions, and they are working. I think I've decided it's better to sleep too much than too little, so I'm going to be super med compliant this time . . . I promise.

I mentioned at the beginning of this post that not all affects of my sleep problems are negative. It's true. I'm typically a night owl, so much so that I may stay up until 5 a.m. and sleep until noon. When I go through a bout of strong anxiety, I tend to get up earlier–a reset that usually lasts a few months after the relapse has resolved. I also tend to get fewer bouts of profound sleepiness in the middle of the day, which is nice. My relationship with sleep may be strained at these times, but I am really productive when I start to come out of the anxiety with a "normal" sleep pattern. It's never long before I'm cleaning the house late at night and reading until the sun comes up again, though.

If you suffer from anxiety and have a hard time sleeping, open up to your docs about it. They say sleep is one of the most important things you can do for your mental health, so seek ways to have a healthier relationship with sleep. Good luck!

5 Things I Know Now That I'm Mentally Ill

Unlike many other people with mental illness, I lived most of my life thus far free from mental illness. Therefore, I went through a long period where I didn't fully understand it. Sure, I have a family with so many sufferers they could trigger another re-write of the DSM, and I had my fair share of angsty teenage moments, but I didn't know mental illness intimately until I was in my twenties. Since then, I have learned an extraordinary amount of things. In the process, I've regretted some decisions I made before, saw a few things in a new light, and realized things I never thought about before my first OCD spike happened.

1. A lot of psych meds can make you hopelessly sleepy–and it's worth it.

I don't want to give away too many details about things that aren't just about me, so suffice to say I used to be in a relationship with someone who had an anxiety disorder. This was both before and after mine reared its ugly head. His disorder was severe enough that he was heavily medicated. This medicine made him sleep more than anyone I've ever known, and it made me aggravated.

To be fair, my ex wasn't exactly domestic or helpful in many areas pertaining to our relationship, so part of my aggravation had to do with what wasn't being done when he was finally awake. However, I stop short of letting myself off the hook. Since then, I've been put on meds that make me ridiculously tired. I fight it and stay up until bed time, but I would nap all day sometimes if I could. The contrast between that and the lack of sleep when I am not medicated is stark. I'll take feeling nappy all day over that anytime, so now I know why he did. I feel bad for mornings when I woke him up, pissed that he would just roll over and ignore me . . . for hours. I feel bad for thinking he was just lazy. I'm not saying he wasn't, but I definitely know now that these pills can knock you out big time.

2. You can totally joke about mental illness. 

Before OCD popped up in my life, I was either reverent or dismissive of mental illness–in equal measure. Sometimes, I would make more light of it than perhaps I should have. Other times, I was very somber about it. As society tried to become more politically correct about mental illness topics, I tried to follow suit, at least in public. I did have sincere empathy for people with mental illness and didn't want to be an *ss, so I wouldn't joke about it in polite society.

After being diagnosed with OCD, generalized anxiety disorder, depression, agoraphobia and even PTSD (I find that last one up for debate.), I am less inclined to take mental illness seriously in terms of humor. I have had a lot of laughs at the expense of myself and with other sufferers since I started talking openly about my experiences. In my opinion, some of them are hilarious. I've never known life to be this colorful, and I led a wacky life even before I got sick. Don't get me wrong. Mental illness is mostly dark side. Light barely gets through when we're in the thick of it. Nonetheless, the light that does get through has a lot of humor in it. I don't think people should ignore that. Seeing the humor in mental illness may help shed some of the stigma. Today, I don't care how polite the company is. I crack jokes about whatever I want.

3. Anxiety attacks run the gamut of physical symptoms.

Roughly eight years ago, I was working the line in a restaurant kitchen when a bunch of waitresses started huddling around the back door to the dock. This was unusual, as only one or two would go out to smoke at a time. I admit, cooks don't really like being distracted by big groups hanging around the kitchen, so I went to have a look. One of my favorite front of house gals was sitting in a chair hyperventilating. While another waitress offered her an inhaler, the wheels in my head clicked into place. I'd seen and heard of it dozens of times in my life at that point. This was the picture of a panic attack. She couldn't breathe. She was crying. She was scared. I waved off the girl with the inhaler in the dismissive way I had back when I was a young and cocky cook and informed the scared girl that she was having a panic attack. This is what I thought they all looked like until I had one myself.

When it came time for me to have anxiety attacks, it took me forever to know what was happening. They look nothing like what I thought a panic attack was supposed to look like. I've never hyperventilated. I hope to hell that stays true. I hate the idea of it. I think it looks like it sucks something awful. By now, I've probably had hundreds of panic attacks and recognize them for what they are. For me, and many others, panic attacks come with any of these symptoms: sweating, shaking, nausea, vomiting, heart palpitations, digestive upset, crying, heaviness in the limbs and numbness. I'm sure I missed some. I read once that panic attacks affect more of your body's systems at once than any other condition. I believe it.

4. Mental hospitals are not spas or asylums.

If you've been fed mainstream media your entire life like the rest of us, you've seen a few versions of what acute mental health treatment looks like. On the one hand, you have retreat-like, therapy-laden getaways that middle and upper class folk like to joke are vacation destinations for the over-stressed first-world adult. On the other hand, you have horrifying asylums that are so traumatic for patients that they are invariably haunted when they are inevitably abandoned after a scandal.

Neither picture painted by fiction is remotely true. I'm not sure I can even say it's somewhere in the middle. Most modern mental health hospitals are not at all what the uninitiated imagine. There's barely any viable therapy because most of them are not long-term. There's no forced cold water baths. Really, it's just a place where people who are more like security guards make sure you don't kill yourself or someone else. There's some vague, one-size-fits-all group therapy, meetings with overworked social workers and brief meetings with prescribers. There is a mix of people detoxing and the not addicted mentally ill with the former tipping the scales in many areas. Sure, there are some glimpses of fiction in the fact, such as mouth checks at med time, a bed with straps for unruly folk and a strict no touching rule that is repeated several times a day, but other than that, it's just a bland place filled with really interesting patients.

5. It's a layer cake of hurt.

I make a lot of light of my anxiety and resultant depression. However, it can hurt in an existential way that I never imagined. I've been sad before, but depressed is so different I can't even describe it. It's the cancer of emotions. I've been scared, but feeling anxiety everyday for no reason month after month until it finally lets up is another experience I can't describe. It's like you feel the typical pain of being sick, having difficulty functioning and worrying about what people will think layered on top of the deeper pain of your mental illness symptoms. On top of all of that, the people around you sometimes hurt because you are hurt. If this miasma of shame, guilt, fear, hopelessness and sadness were real layer cake, we sufferers could feed the world à la Marie Antoinette.

Still, mental illness has it's upside. I don't say any of the above to make people feel bad for those with mental illness, though maybe they should. I say it because it's true. Sometimes, life is almost all black. Other times, it's only a little black with lots of neon colors mixed in. One of my favorite things about getting sick is that I think all the black has made me appreciate the neons more. I actually think I feel happy and calm in a bigger way now that I know what it's like to lose my ability to feel happy or calm.

*Disclaimer: I know Marie Antoinette never said "Let them eat cake." I still think it's funny.

Managing Anxiety is Different Everyday

A little time on the mat will often 
help me manage my symptoms.

I have anxiety of some level virtually every day of my life. It can be low-level anxiety, such as slight nervousness when I can't get out of the house immediately to get something I don't want to do over and done with. It can be severe anxiety that is hard to kick, such as panic attacks. I get anxiety on every part of the spectrum of severity. On days like today, it's moderate from the time I wake up, which leaves me with a few options for how to deal with it.

When I have low-level anxiety, I am always good without a fast acting anxiety medication. I take a deep breath, put on my big girl undies and get on with my life. When I have severe anxiety that threatens to make me puke or pass out, I go with medication that takes the edge off just enough that I can control the symptoms with mindfulness, positive thinking, distractions or whatever else is working that day. It's the days that I have middling anxiety that tend to be difficult. Sometimes, I can get through them without help and be as proud as a peacock and sometimes, I have to give in and resort to meds, which makes me feel like a failure. (You shouldn't feel that way if you resort to meds. I have clearly faulty thoughts and feelings.)

I woke up with moderate anxiety this morning and decided that getting up and kicking some ass around the house would be helpful. I cleaned our bedroom, took a shower and even ate breakfast, which is rough when I'm panicky. Once I had my chores squared away, I sat down with my husband while he played on the Xbox and I made a huge mistake. I thought this day of moderate anxiety would be a good time to look at the hospital bills from just one of my three most recent stays.

Even though we have a somewhat affordable deductible, are intelligent enough to negotiate prices and have a decent income, I panicked. While my husband calmly told me it's not even the step in the process where we start paying people, I was imagining us huddled together in a homeless shelter, as if we would both suddenly lose our ability to work. I imagined being hospitalized frequently and racking up insane bills, even though I know we have a maximum of out-of-pocket expenses per year. I was caught up in some seriously unrealistic and often vague thought processes. I'd given myself a panic attack. Crap.

I went upstairs and managed to keep the anxiety at bay for a little longer while I organized our home office and upstairs hallway. I tried to do a bit of yoga when I finally decided these methods weren't working for me today. I didn't want to rely on my medication, but it was going to be a no good, very bad day if I didn't. So, I took my medication (sadly, most days have been like this for the past month) and now, the lady who was going to be homeless, helpless and destitute a few hours ago is sitting on her couch working.

It sucks to have to rely on medication some days to feel well enough to eat and work. I know that feeling. I live that feeling, but if you are out there beating yourself up about it, I hope you stop. As people with anxiety, we are extremely hard on ourselves, not to mention the stigma that adds to that weight. We don't need to bully ourselves over using the help that is available to us when we need it. These are the things that help us lead fulfilling lives. Yes, use your relaxation techniques and whatever else helps you when it is effective, but know your limits and respect them.