Freedom vs. Slavery – How my anxiety makes me feel enslaved.

thunder

This is part of my assignment for a class I had this semester where we discussed fundamental cultural assumptions on life vs. death, freedom vs. slavery, wisdom vs. folly, and good vs. evil. I decided to discuss how I felt most enslaved by my anxiety. It was my intention to try to explain what I have always felt was so hard to explain – the way that I feel panic, and how it controls me. I hope you find this helpful, interesting, or… I guess anything else!

Hands shaking, heart racing, vision blurring

Unseen to the unseeing, she can’t escape

Behind bars, caught and captured

there’s no way out

Heart racing, chest tightening

“Breathe”

How do you breathe when there’s no air to inhale?

Left to fight these mind demons alone, no hero in this story

The crowd turns away,

blind to the battle inside her, deaf to the cries

Hands shaking, mind racing

Unknown and invisible, a wraith rattling along the cage

Screaming in silence

It comes in waves, threatening to push her over the brink

Sinking, drowning, let it bury her

The crowd stands confused, there is nothing there

She’s gasping for air, but there’s nothing there

When thinking of the question: “When do you feel the most enslaved or free?” the first thought that comes to mind is within my anxiety. I tried to think back to the time that I had a panic attack in the middle of Disneyland, during a busy park day. I’m on vacation in the happiest place on earth, and yet I couldn’t find a way to escape the crowd that kept coming at me in droves. My mind raced to all the life-threatening situations that could possibly happen while stuck in a crowd, even things that weren’t possible like a breakout of a zombie virus. I knew deep down that I had been watching far too much of The Walking Dead, and still I felt as if my life was in danger.

I told myself to breathe, but it didn’t make a difference; there was no air in my lungs. I told myself to calm down, but there was no slowing my heart rate. I lost complete control of my body. And that’s how the panic hits you – it relinquishes your control to function. I was completely helpless and vulnerable to the demons controlling me, the ones that I am forever chained to, enslaved to. This is when I feel the most enslaved because I am constantly fighting this war in my head, even in situations where I should feel safe.

Her hair is curled, her eyelashes too

Her eyes are decorated in soft neutrals and a subtle wing

Her outfit, carefully selected

On the outside, this earthly prison is a painted doll

The her that is seen is happy, successful, outgoing


Stripping this painted doll of all these signifiers of

Happiness, success, desired personality

She is hurting and in pain

No drop of blood will you see fall from her flesh

No physical ailment or disease

Her demons are not worn on her sleeve for the world to see

So they must not really exist.

Her expressions are false advertising, a learned practice,

A permanent smile to appear friendly,

A focused gaze to appear listening,

Inside, her mind is in chaos,

trying to keep up with everything she is supposed to be.

The night before she questioned her sanity,

She wasn’t sure if what she was seeing was real.


The unseen behaviours are subtle, but the only way to cope.

She twists the ring on her finger, counting the turns.

She taps each finger on the pad of her thumb

Trying to feel connected to her own body,

in control of its responses.

Her toes flex and point in her shoes

Hiding under the desk, out of sight.

She focuses hard on the wall behind your face,

Hoping desperately that you won’t notice

she isn’t focused on you.

She knows to repeat the last thing you said

To appear to be actively listening,

though her mind is elsewhere.

She is painfully aware of the shake in her voice,

Her body tenses and she draws in a deep breath,

Trying to calm the demons in her mind.

The demons are not satisfied until every inch of her tingles,

Burns,

Hurts,

With anxiety.

Each cell activated in panic, ready to fight or fly.

The adrenaline of imminent danger builds up,

bubbles to the surface.


There is no danger,

no life or death situation.

There is no problem, no issue, no reason to be scared.

There is only you in front of her,

discussing the answers to a question the professor asked.

It is not threatening, there is no right answer.

There are just opinions.

But for her, there are feelings and she is feeling all of them.


The demons inside are controlling the unseen her,

She knows that she cannot fight them,

So she tries to keep her painted doll face on.

She tries as hard as she can.

It is the only thing she has left to control,

but she’s losing grip.

The first few weeks of class I tried to attend as often as I could, and still my mind went back to the fall semester when the class was so full and students crowded the door. I thought to that first class in September when people kept coming in, taking their place by the only escape route in the room. Even though the door remained clear in the beginning of this semester, I knew that it was only a matter of time for more people to join. The class was half over and still the door was clear, but all I could do is stare and anticipate my next panic attack. It was so exhausting that I gave up. I stopped attending classes and tried to focus my attention on going through the material on my own.

This prison also manifests in agoraphobia. I am so aware of everything that moves and breathes when I go outside. In the corner of my eye, I could see my neighbour, and I knew that I had to be more aware of my actions… rushing them to get out of view as quickly as possible. If I was too slow, I might be victim of judgment, I might be confronted about how I live or behave, I might be pulled into a conversation that I have no input in. This mind reading is constant; it never rests. In class, I am sure that I am not writing down enough notes – or maybe I’m writing down too many. If I am on either end of the spectrum, I clearly have no idea what the professor is saying. I must be dumb. I don’t belong here. This snowball of anxiety is always how the panic starts. When the body responses join and my heart rate increases or my breathing becomes more shallow, that’s when I know that this one is going to be the last – I’m surely finished. It’s a heart attack this time, not just the panic.

My mental health controls my life. It decides the days that are good, the days that are bad. It determines whether or not I go get groceries that day or I show up for the test that I have scheduled. It chooses the nights that I sleep and the nights that I am awake until morning, when I can hear others’ alarms going off to let them know it’s time for a new day, but mine hasn’t finished yet. I tried to control it with medication. I tried to control it with therapy. It is a resistant beast. Yet still, I refuse to fall. My focus is set to freedom from this prison, where I am in control again.

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Experiencing derealization for the first time.

distance

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/

Deciding to use medication and deciding to quit.

besoniceif

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.

Finally having a ‘normal’ sleep.

4amknowsall

My anxiety visits me without fail every night. I enter the battle of snowballing about things I have to do, things I didn’t do, things I should have said or things I should not have said. I am often unable to fall asleep before 3am, and even more often it’s 6 or 7am before I am finally able to fall asleep. Unfortunately, I also crash pretty hard when I finally sleep, so I end up missing the majority of my day. This often results in missed classes, appointments and other social things. I usually wake up in the late afternoon, guilting myself for missing everything I should have accomplished that day and feeling frustrated that I slept through 5 or 6 alarms.

Last night I was able to sleep before 11pm. I wasn’t sure what came over me, but I was actually tired at night. I got ready for bed before my boyfriend had even gone to bed, which is a feat in itself because he usually tries to go to bed early as he works early. I managed to fall asleep fairly quickly and even though I woke up a few times during the night, I was able to fall back asleep instead of waking up and staying awake for hours. I woke up at 9am today and I don’t remember the last time I saw 9am from this side of the day.

If you’re reading this and you cannot relate with my troubles sleeping, I don’t think I can put into words how amazing it was to fall asleep at a ‘normal’ time and wake up at a reasonable hour. I opened my eyes to see the light shining through my window as usual, but when I looked at my phone to see the time – it was still in single digits. I felt a rush of relief wash over me because I had the whole day ahead of me to do whatever – even if I just took the day to read and cuddle with my dogs, I had the whole day.

After I reveled in the time of day with the hallelujah chorus playing in my mind, I frantically tried to remember everything I did last night to make myself fall asleep quickly so I can try to replicate tonight. That’s my experience with sleep. It’s often such a battle to quiet my mind so that I can fall asleep, so when I do have a good sleep, I need to remember everything that I possible can about what I did so that I can try my best to do it again. I’ve always had troubles sleeping and I’ve always envied those who can hit the pillow and fall asleep. Especially if they can wake up with only one or two snoozes of the alarm in the morning and still attend things before 11am.

In taking the advice of my recent post – I’m going to celebrate the crap out of this day. No matter what happens today that may stand in my way, at least I was awake to experience it. It may seem like a small feat, but I can’t begin to express how proud of myself I am right now. I don’t have to make an excuse for why I can’t meet up before 3pm if I have days like this.