Experiencing derealization for the first time.

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This week, I learned that my anxiety and derealization are new friends, and they’re a scary combo. I remembered afterwards that we covered derealization in one of my psychology classes, and I never truly understood how the mind could just forget that the world around it is real. Of course the world is real, this isn’t the Matrix and I’m not really into conspiracy theories.

Derealization and depersonalization are slightly different, in that derealization deals with  “a feeling of unreality or detachment from, or unfamiliarity with, the world, be it individuals, inanimate objects, or all surroundings” (Bressert, 2014). Depersonalization is within the individual and “the individual may feel detached from his or her entire being (e.g., “I am no one,” “I have no self”)” (Bressert, 2014). If you want more info from a quick 1 minute read you can check out the rest of Dr. Steve Bressert’s article here: Depersonalization/Derealization Disorder Symptoms

After I was able to pull myself out of the downward spiral of “I’m going crazy”, I made my way to r/Anxiety to get support from the community again. I asked the community to help me confirm that the world is a real place that I live in and there are others who also experience this disconnect. I had an overwhelming response from the community that confirmed I wasn’t crazy, things are real, and they’ve experienced what I just went through before.

So what did I experience? Trigger warning – if this is something that sets you off, please skip past this paragraph.

After being unable to determine the cause of a spill in my kitchen, I had an overwhelming and consuming feeling that it didn’t exist. I felt like both my brain and my eyes were deceiving me and I felt paranoid that I was going crazy and hallucinating. I went into full panic attack mode, spiraling and snowballing down to dark places while my heart rate increased and it felt like my throat was closing up. I had to shut my eyes tight because I was terrified that I was going to start seeing other things (insert fear of horror movies, paranormal, ghosts, etc. here). I reached for my dog Loki as usual, since he helps me out of more panic attacks than I can count. Loki has an expected response when you scratch his cheek and he will lift his lip in a snarl. It’s not aggressive, just ticklish and usually something we giggle about. He did that while I was petting him and scratching his cheek and I found myself in a moment where I was terrified of his face. It didn’t distort, it just scared the absolute shit out of me – even though it is an expected response. I was glad that Jeff was home at the time, because he helped me back to reality, where it was safe and real. At the end of it all – what was the spill? We determined my other dog, Arya, drank – gulped – water too quickly and it went right through her, making it look like water and not smell like urine. But it definitely was there and I was definitely not crazy.

The feeling of being in my house, but it didn’t feel like my house was a pretty terrifying experience. I never experimented with drugs in high school, but looking back I can imagine things might feel similar.

It happened again the next night when I returned to my house after Easter dinner with my family, though nothing triggered the feeling except being in my kitchen. Even now as I sit at my laptop at the kitchen table, I don’t feel the overwhelming sensation of being in a world that isn’t mine, but after we got home on Sunday I definitely had that feeling.

What helps?

1. Grounding techniques –  something that pulls you out of your head and back into the present.
One that I learned in counselling is called 5-4-3-2-1. You choose 5 things you can see, 5 you can physically feel, 5 that you can hear. Next you choose 4, trying to keep them unique, but don’t get too worked up if you are running out of things. Once you get to 1, the idea is that you have put yourself back in the present and you will feel better. Often when I try this, I don’t need to go all the way to 1, which is a good feeling.

2. Getting a good night’s sleep.
This is a tricky one for me especially, since my anxiety loves to roll around at nighttime. I know that my panic is more active during the days where I am not well-rested, so usually if I have a really bad day, I try to do what I can to go to bed early that night.

3. Other people and/or animals.
Though Loki’s reaction did scare me, after it happened a second time, Jeff put both the dogs on the couch with me and we cuddled and I was able to just pet them. Animals are incredible for people who struggle with mental illness (I’ll probably do another blog post later on all the benefits… just waiting for my social work application to come back positive before I jinx it!!). Jeff also was a major factor in helping me back to the present as he reassured me that what I was worrying about was not real.

4. Distract yourself by keeping busy.
That night, even though I was scared to go to sleep right away, I went right to Netflix and focused on what was going on in the show I was currently binge watching, and it helped. Not everyone will do well with distractions like this and it isn’t good to avoid life and responsibilities for too long, but you just went through a scary thing and it’s totally okay to take a break. Your brain and body is telling you that you need one. Colouring is also a really good way to keep yourself busy!

I hope that this may help someone who has experienced what I did this week before, or isn’t sure how to help a loved one. I know that everyone experiences depersonalization and derealization differently, but knowing that you’re not alone really helps. Remember that it’s temporary, and probably a good sign that you’ve been under a great amount of stress. Practice some positive self-care and remember to take a break if you need it.

Reference:

Bressert, S. (2014). Depersonalization / Derealization Disorder Symptoms. Psych Central. Retrieved on March 29, 2016, from http://psychcentral.com/disorders/depersonalization-derealization-disorder-symptoms/

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Deciding to use medication and deciding to quit.

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My journey with medication and anxiety began shortly after the panic attacks started to explode. I decided to give medication a go because the experience I had with counselling was not working quickly enough for me to be successful in school and I didn’t want to waste too much of my semester. I am not a medical professional, so my next advice is purely anecdotal, but it helps to have some firsthand knowledge when you decide to try medication. Medication isn’t for everyone, but I learned that it was helpful to try.

I have tried citalopram (Celexa), escitalopram (Cipralex), paroxetine (Paxil), fluoxetine (Prozac), and now desvenlafaxine (Pristiq). All but Pristiq are considered SSRIs and are also used for things other than depression, such as anxiety. Pristiq is classified as an SNRI, which acts on both serotonin and norepinephrine, instead of just serotonin like the SSRIs, essentially to achieve the same outcome.

The experience one has with each drug will be largely different in most cases. For Celexa, I had crazy bad headaches and was not on it very long. For Cipralex, I didn’t have any bad side effects, but it didn’t really do too much and I was on it for a few months. Paxil was the best fighter against anxiety for me, but it did its job a little too well and the term zombie was an understatement. I didn’t have emotions on Paxil and I slept a lot, but I don’t really remember having a panic attack. Paxil was also the hardest to taper off of and felt like the worst hangover I’ve ever been on. I was prescribed Prozac to help me taper off of Paxil and it was very similar to Cipralex – good, but nothing really changed. I’ve been on Pristiq for the longest time now (since May of last year) and I’ve had a love-hate relationship with it. As an SNRI, it seems to take my anxiety and make the baseline higher, but the intensities much, much less. My panic attacks don’t feel to be as world-ending, but I feel more anxious all the time than I have on other medications.

With that quick little update on my background with medication over the last two+ years… here are some things I’ve learned about medications and how they affected me:

1. It takes a few weeks to kick in and to get off of it.

The choice to start medication isn’t a sudden fix. It takes a while to find the right one and on top of that, it takes a few weeks for your brain to be able to let the medication do its thing. I really had to convince myself to be a good sport about giving the medication the chance to work for real, but it wasn’t always fun. For the first two weeks, I often felt icky. It was slightly nauseous, slightly headachey, slightly hit-by-a-truck-when-is-my-cold-starting kind of feeling. However, that did go away as my body got used to it. When I would switch a medication, especially with Paxil, it was also really important to taper under my psychiatrist’s direction. I learned the hard way one week that quitting cold turkey because “f this shit” is a really, absolutely, truly horrible idea. Red light, don’t do it, listen to your medical professional.

2. There are definitely side effects.

The side effects I experienced weren’t scary or bad, but annoying. After a few weeks on Celexa, with horrible, horrible headaches, I was swapped off it pretty quickly. That was really the only one that hurt. I would say, for me, Paxil and Pristiq have the most recognizable side effects, but I definitely gained weight a lot easier on all of the ones that I have tried. Paxil made me sleep all the time and I really lost my bucket of f*cks to give. Most of them had sexual side effects that came with them, but Pristiq really made me lose that bucket for good. Across the board, I’d often feel dizzy on bad days, which I self-medicated with caffeine, in the form of unhealthy energy drinks (NOT a good idea – caused pretty much a guaranteed panic attack). I did notice an increase for intrusive thoughts about self-harm, but I’m not completely sure if that came with the medication or the frustration with nothing working like I expected it to.

3. It changed my anxiety and how I experience it.

Overall, there have been a few noticeable changes in the way I experienced anxiety. Sometimes that meant that I coma’d my way through life, which was cool because no more anxiety, but really not because I didn’t accomplish anything. Other times, as in the case with Pristiq – I feel anxious all the time, but my panic attacks changed and I am able to pull myself out of them much more quickly and they don’t last as long. It really is a balancing act with medication and I think that’s why working with Cognitive Behavioural Therapy and positive self-care really helps through the whole process of feeling better.

The things that I really feel affect your relationship with anxiety, medication, and feeling better are also included in what is going on in your life currently. At the end of September this year, I lost my best friend from junior high and I haven’t really felt okay since. I noticed that shortly after that emotional blow, my relationship with Pristiq drastically changed. I am caught in an abnormal sleep schedule that I can’t fix no matter what I do, and that lovely change with my panic attacks seems to have lost its touch a good amount. In a situation like this, all I can hope to do is make another appointment with my awesome psychiatrist and see what he thinks. He is an excellent resource and always includes me in decisions about my mental health and the direction I want to go next. At the end of the day, I think that is the most important point: I have the choice to continue or to try a clean slate. At the end of the day, you do as well. I can only hope that my experience with medication relieves a bit of hesitation or anxiety you may be feeling towards it. When I was first making the decision to try medication, I utilized personal accounts on r/Anxiety to help me understand what was going on as well as questions to my pharmacist and health link line. Good luck, friend, you’re not alone.

Healthy anxiety?

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I remember sitting in my abnormal psychology class and my professor comes out with this phrase of ‘healthy anxiety’. I was instantly confused – how is an increase of heart rate, shallow breathing and higher blood pressure healthy for you? What he meant by this was a moderate amount of anxiety that pushes you to perform well at things. Would you have scored that goal if you weren’t a little nervous that your giant opponent coming after you was going to take that chance away from you? Would you have aced your last exam if you weren’t just anxious enough to make sure you studied as hard as you could?

Healthy anxiety pushes you to perform well. Where we go wrong is when it stops you from doing well. My anxiety changed from worrying about my grades on a test to being unable to even study. I felt cross-eyed and I couldn’t focus on any of the words I was reading in my textbook, even if the concepts were simple. I had to read the same sentences over and over again to even comprehend what the topic was about.

Since my experience is within an academic setting, I can only suggest methods of alleviating some anxiety that relate to resources available for students. Also input disclaimer that I am not a medical professional, so my advice is simply based on my experiences. But here’s what worked for me:

1. Ask for help.

What I first did was gathering the courage to speak to my family doctor. Here in Canada, I was able to make an appointment with her and get the referrals I needed to focus on mental health. I signed up with my school’s student accessibility services, had my family doctor fill out the required forms, and the SAS was able to make accommodations for me. They are there to help you, and are usually extremely creative to find out what works for you the best. My accommodations were things like having a program that reads my textbook for me, so I could focus on listening to the words instead of reading them. I also write my exams in a distraction-free environment, where I am able to take breaks if I get overwhelmed and they won’t count against my time. Things like these accommodations really took a load off.

2. Let music pull you forward, but not distract you.

The things that I did outside of school to help my anxiety really helped as well. I created a music playlist of songs that had no lyrics, were calming and had a steady, slow beat. Studies since the 1950s have looked into the detrimental effect that high tempo music has on studying and reading comprehension. Music has the ability to influence your emotions, and when you’re dealing with anxiety – you really don’t need anything else that is adding an obstacle. These studies have shown that soft, relaxing music has no obvious change to performance in studying and reading comprehension, but can help with mood. (If you want to look into this more and do not have access to a scholarly journal database, you can check out this article).

3. Take control of your environment.

Another thing about those who struggle with anxiety is that we are often stressed out by our environments. When I can’t control my environment, my desk is out of control or I am completely disorganized, I can’t focus and I get both irritated and even more anxious. The best thing that I can do in that situation is clear off my desk, sort out my books, articles, writing tools, etc. in a way that they are all easily accessible and light a candle or pull out my essential oil diffuser. Aromatherapy has done wonders for my anxiety. I began looking into it after wandering in to a store in a mall one day and haven’t looked back since. I do not ingest the oils, but I simply have pleasing blends diffused throughout my home so that when I get particularly anxious, I can take a deep breath and focus on the smell.

4. Build a support system.

Because I had kept my diagnosis quiet at the beginning out of fear of being stigmatized, I felt like I had no where to go except to my boyfriend. A friend directed me to Reddit to get involved in the r/Anxiety community. I read threads of other anxietybrain-type people and started to feel like I wasn’t alone. Soon enough, I made posts of my own and managed to get a lot of advice through their community. This support group helped me get through a lot of obstacles that I was going through in a way that offered outside/third-party advice. Sometimes I convinced myself that Jeff was telling me what I wanted to hear instead of what I needed to hear, and I would often bring the concern up in r/Anxiety and 9 times out of 10 got the same response. It was a way to deal with what I was going through with people who also were going through the same thing. Though I lean on Jeff a lot, r/Anxiety was always there when he was at work, when it was late at night, or when I just needed the opinion or advice of someone who is going through the same thing.

The biggest thing to remember is that you’re not alone. There are resources out there that you don’t even have to leave your bed to use. That knowledge in itself will help a great deal.