Loathing Fear

I suppose what they say is true; youth is wasted on the young. I’m recalling my younger days when I wasn’t fearful, for the most part, of any situation. The foolhardiness of being young, impulsive, even doing stupid things, putting myself in (what I now know were) unsafe situations. Never being completely conscious of the consequences of my actions.

I’m sure we all have those memories of our youth and wonder how we managed to survive to the present day. I can see those years for what they were, but there is a part of me that yearns for that feeling of fearlessness.

Struggling daily with panic and anxiety disorders one becomes intimately acquainted with fear. It is omnipresent, always on alert, and at the forefront of thought. It dictates our actions and limits our ability to function, be present, and experience joy. I loathe fear and how it has impaired my life. As much as I am intellectually aware of fear, its grip doesn’t seem to lessen enough, even with time or therapeutic experience in accepting or mitigating it.

I work hard to manage my panic and anxiety disorders, using many tools and methodologies, yet fear is always with me. This is a testimony to its power. Even though it wins in its influence on me and my behavior daily, I take some credit and gratitude that there are times when I do win the moment, even if it is only one moment in one day.

Yes, I loath you, fear, and harken for a day when you are gone, that is my right, even if I know you may never leave. At least I have memories of a time when you were but a fleeting thought ignored for foolish endeavors.

New State, New City, New Variant!

I moved to a new State in late November 2021 and faced all the challenges, stresses, and frustrations one would expect with a move. I’ve done it before so I felt like I at least had some experience on my side. Even with all the added anxiety, lack of proper sleep, and complications, everything came together well. The pieces of this move fell into place better than the last two moves.

Nothing causes me more anxiety in these situations more than trying to line up new doctors for the continuation of care. Even though I am on a Medicare Advantage Plan, insurance may change and there is little to go on except ratings and reviews. Mental health providers are scarce and even harder to find when you factor in the acceptance of your insurance, whether or not they are taking new patients, and if you feel comfortable and can establish a connection.

I thought finding providers would be somewhat easier in what was to become my new home since it is a university city with an affiliated hospital and in a decently populated area. It is a small city of about 47,00 people in a county of about 100,000. The perfect size for me insofar as not exacerbating my panic and anxiety disorders the way a large metropolitan area does. Large metro areas are simply overwhelming for me.

I was wrong about my assumption of ample providers in the area. I made so many calls and left so many messages I became very disorganized. Not only disorganized but confused too. It was very challenging to keep things in order when your illnesses contribute to memory issues. I kept a list but it wasn’t detailed enough and many times I had no recollection of why someone was on the list or if any conversation had taken place. I was on many waiting lists and cutting it close with the most important of my doctors, a psychologist. I was getting callbacks while driving. I made appointments I didn’t recall making. Luckily, I put them into my phone and could follow up once I arrived in my new hometown.

I had two appointments with therapists in the first couple of weeks and neither was a good fit for me. The third one was the charm and happened to be affiliated with the university health system, which is where I established primary care. We are still in the “getting to know” you stage but I feel confident in their abilities, am comfortable talking, and feel like we will be able to forge a good relationship.

Unfortunately, the Omicron variant has been spreading rapidly and it is limiting my ability to go out and become familiar with my new area. A new area means a whole new set of anxieties and I have to start anew with exposure therapies with stores, doctors’ offices, and of the area in general. I feel behind the curve on this due to the new Covid strain. (I’ve felt behind for the last two years.) I have a lot of anxieties about becoming ill so I am very conservative about going out among people, something I already struggle with. Covid-19 has been extremely challenging for me as I tend to revert to more agoraphobic behaviors. But it is beyond my control, all I can do is the best I can with the situation at hand. I have to keep reminding myself of that and, as my therapist says, count each success no matter how small.

I’ll be talking more about Covid and anxiety in future. Stay safe!

Where Was I?

I spent the pandemic in Florida. I suppose I could end this blog entry there and readers can draw their conclusions since Florida was known to mostly ignore all mitigation efforts. Whatever your political beliefs, there is individual responsibility for others when it comes to public health and safety.  

I arrived in Florida in early March 2020 from New York. I was to be there 6 weeks. 6 weeks turned into 2 years. I won’t take up too much time with this entry since I think many more people have some form of or an increase in the severity of anxiety from the pandemic. Suffice it to say the time during the pandemic was especially exacerbating for me. I don’t feel like I made any progress, and possibly regressed, during this time but when I’m in therapy or reflecting I’ve come to realize that every day was an exposure therapy session. No matter how small the activity, just simply going to the store was a big panic/anxiety exposure therapy. I also had no writing motivation during that time but I survived, mental health issues intact, which is more than many people can say. For that, I am truly grateful.  

I’m sure I could come up with many examples from that time of specific events to talk about Panic Disorder, Anxiety, and Depression. I’m equally as certain that virtually everyone has their own stories. I’m re-visiting my blog to pick up in the present so I will leave those stories in the past where they belong. My intent with this entry is just to let you know where I’ve been. If anyone has any specific “coping with mental illnesses during the pandemic” questions, feel free to ask and I’ll try to answer with specific experiences.  

Otherwise, onward we go.  

Warning: Rough Road Ahead

Unfortunately when you live with anxiety, depression and panic disorders there are no road signs warning you of what’s ahead.  One can be traversing a relatively smooth road when suddenly we hit a pothole that dents our wheels and leaves us wobbly.  What damage has been done?  Is it repairable?  What do I do now?  That smooth ride is damaged and we don’t have the confidence to know if things can be corrected.  The abruptness can easily throw you off your game as it recently did to me.

I hit that proverbial pothole and the road after it has been rough and bumpy.  I felt like I was sliding down a hill of progress, contracting to a time when my illness was less manageable, more pronounced and much more acutely active on a daily and even hourly basis.  All my coping mechanisms were forgotten and years of therapeutic knowledge and lessons retreated to the recesses of my mind.

Once the shock of the incident diminished I began to wonder what caused this setback.  I have multiple diagnoses, all of which produce symptoms that can and do trigger a panic attack.  It’s a guessing game of which came first, the panic attack or a physical symptom that triggered one. Having an anxious mind I played out all the possible scenarios in my mind, until my head literally felt like it was going to explode.  Sometimes the over analytical nature of my anxious mind can help me check things, gather information and make sound decisions, this wasn’t one of those times.

I quickly made appointments will my medical providers to get to the bottom of my sudden exacerbation of panic symptoms and with their help began to piece together a puzzle of both the emotional and physical issues at play. I have hypothyroidism and Crohn’s disease in addition to my mental illnesses which are all connected and effect my overall health.   When something is physically off with me it triggers panic and a cycle like the one above begins.  I try my best not to let it spiral but when I’m caught by surprise it happens.

My doctor and I did make some suppositions about what caused me to hit that pothole. My thyroid numbers were off, which could have contributed.  Just knowing the numbers were off most likely contributed and it may have just been anxiety letting me know it’s ever-present.

It was a lesson to me not to become complacent, not to forgo practicing relaxation and coping methods and to continually challenge myself to explore the many facets of the anxiety and panic disorders I live with everyday.  This latest episode also reminded me that the journey of recovery is long, full of hard work, and isn’t linear.  Setbacks, stress, and life happens and even when my demons (as I call them) aren’t right by my side, they are still present just over my shoulder.

 

 

Perils of a Small City

Since I moved from a large metropolitan area in Florida to a small city in NY I’ve had my share of social adjustment issues as well as the previously mentioned problems finding health care providers.

I’ve been here about nine months now and oftentimes I feel like I haven’t made any progress in my recovery journey.  Along with the time I’ve spent finding and struggling with providers comes the typical new patient curve.  As a new patient I have to begin with my history and get to know the therapist or other provider. (most of which don’t bother to read the medical records or summations I bring from my previous providers) It’s doesn’t feel productive and it doesn’t feel like progress when all I’ve done is be a new patient three times in nine months.

I have finally begun to settle in with my newest therapist and she actually did call my previous therapist (who offered to speak to my new one) and get a sense of who I am and what we had been working on.  This alone was not only satisfying but demonstrated her willingness to learn about my history not just from me but from her peer.  It’s still a less intensive therapy than I previously had but I’ve begun to accept that I’ve come far enough that maybe it’s actually what’s required.  I have the tools and I know how to use them.  I should after almost five years of continued therapy.  Of course, in the throws of a crisis, a panic attack or a stressful situation sometimes the toolbox isn’t at the ready.  Metaphorically speaking, sometimes I forget to open it, other times It’s left in the basement and in extreme circumstances I forget I even have one.  That’s all to be expected and with practice and exposure I’m hopeful that using my tools will improve.

The other peril of being in a smaller area is that it makes finding exposures, things to do and places to go, harder to find.  It is more difficult to get out of my safety bubble. I’ve been keeping up on the smaller stuff, visiting stores, parks, and stretching my range as best as I can to keep myself in practice and to avoid the feeling of regression, but lately I really feel the need for a bigger push. Now that spring is finally here (winter saps motivation) it’s my goal, along with my therapist, to come up with some more challenging exposures.

As for a complete adjustment to this area, I don’t think it will ever happen. It’s just not where I want to be.  I’m doing the best I can but I look forward to leaving when my partner finishes grad school.

I Will Visit When I Can

Recently I joined a couple of online groups for people with Anxiety disorders and depression.  I thought it might help me to read the stories of how others deal with their own personal demons.

My heart is opened from my own suffering and my emotions are always at the surface, raw and at times uncontrollable.  I found that tears fall easily reading other peoples stories.  Each story is different,  yet each has a twinge of familiarity, both with myself and with the other posted stores.

I too have survived and I too endure, frustratingly taking one moment at a time.  I am someone with a deeply empathic nature, both a blessing and a curse,  and my heart feels deeply the pain others.

I want to read these stories, feel the experiences of others with similar dilemmas.  They are after all the stories of us all, touching, suffering, surviving, but most of all inspiring; yet I find I must severely limit my reading and participation. It truly is too much for me on most days.  It may seem selfish but my energies need to be focused on myself and working through my own pain, dealing with my own symptoms, living with my own illnesses, and walking with my own demons.

To all those whose stories I would like to read and to all those suffering, many greater than myself, all I can say is I will visit when I can.  At the moment it’s all I can do.  I trust that journeymen and women on similar paths will understand.

 

Unwelcome to NY… Transitioning (pt2)

We arrived in NY in the middle of the July heatwave.  It was hotter here than it was in the Sunshine State we left behind.  Our new NY mini city wasn’t the same area we lived in before.  This area is comprised of a small city surrounded by some small towns surrounded by rural mountainous terrain.  It literally made me dizzy.

Our new apartment is great, movers arrived and it looked like home.  It just didn’t feel like home.  I arrived with my mental health toolbox and did my best to keep in practice all I had learned from the therapist I left behind.

My first appointment here was with a gastroenterologist (for Crohn’s disease).  He’s a nice guy who seemed very knowledgeable.  I signed the obligatory records release, presented him a summary I had prepared ahead of time to give him some history and we had a good first visit.  I hoped all the visits to my new providers would go as smoothly.

That hope was dashed the following week at my new mental health facility.  There too I presented some information on my diagnosis, history, and treatment regime.  It was an intake appointment and was completely focused on new patient procedures.  A first appointment was made for two weeks later with someone who was to become my therapist.  I didn’t like the basement office.  It felt cold, clinical and unwelcoming.

After seeing my previous therapist weekly I both missed her and was acutely feeling the need for therapy.  Five weeks without therapy had passed by the time I arrived to their basement lair anxious to meet my new therapist.  My partner was available to accompany me and I brought Gracie, my ESA, along as I always do.  We waited impatiently in the waiting area.  It was crowded and noisy, two things that trigger a heightened level of anxiety for me.  Facing the glass wall that separates staff from patients I noticed a lot of activity.  People dashing in and out and talking at a low volume.  It seemed tense and busy but I attributed that to it being more of a clinic setting.  It was now almost 20 minutes past my appointment time.  I was beginning to feel agitated in addition to anxious.

Through the glass wall I noticed talk with a look in my direction.  I was called up to the window.  Two staff members, the receptionist and an unknown person standing above and beside her were waiting for me. I was curtly informed by the unidentified person that Gracie was not allowed in their facility.  Their rule was only service dogs were allowed.  (this after the receptionists and other therapists fetching their patients from the waiting room all commented on how lovely and well behaved she was without ever questioning me)

I explained the important role Gracie plays in my treatment but was greeted with unsympathetic stares and a regurgitation of “the rules”.  I argued that of all places, a mental health facility, they should understand the roll of emotional support animals.  My pleas fell on deaf ears.  Now completely agitated I lost it and become argumentative.  I wanted to know who could override “the rules” and allow my treatment to begin.  I had been sitting there for 20 minutes and in my intake appointment mentioned I had an ESA.  I was told only the director could make an exception and they of course were not available.  If I wouldn’t give Gracie to my partner to remove her then I would need to reschedule. I discovered then that the person who had been going back and forth behind the glass and who was arguing with me was my new therapist.  That only fueled my fire.  If I were to reschedule it wasn’t going to be with her I shouted!

I was so livid by now I flatly refused. I blamed them for delaying my treatment further and exacerbating my conditions.  My partner tried to calm me from aside to no avail.  I continued my verbal assault insisting to speak to someone higher. A person came but was simply another voice in what was now a chorus of unsympathetic health care staff.  My partner tugged at me to leave. When I turned to leave was when I finally noticed the security detail that had been called and placed on standby.  Not wanting to escalate more and cause their intervention and my possible forced confinement, I threw in one more dig about how the stairs to their basement were closed which was a fire hazard and left.

I had never been treated this way by any healthcare provider before.  I definitely contributed to the escalation of the situation but as trained staff they did not, in my opinion, handle the situation and their patient professionally.  There was no empathy, no understanding, no attempt at compromise, just cold uncaring workers behind a glass wall.  As hard as it was to find this provider to begin with, months ahead of time to ensure continuation of care, I vowed to find another.

After many calls and conversations I finally found another mental health clinic that was able to “accept” new patients.  Unfortunately I’d have to wait another couple weeks for an appointment.  They assured me Gracie was welcome.  I started again with an intake appointment and was subsequently assigned to a social worker.  By the time I starting seeing my new therapist social worker I’d been here two months.  Two months without therapy.  My new primary care physician was writing my prescriptions until I fulfilled my three visits with the therapist before being offered an appointment with the psychiatrist.

 

Transitioning Medical Care (1)

I lived for three years in a large city in Florida.  Prior to moving there from NY in 2015 I had set up appointments well ahead of time to avoid any waiting times.  It worked out well and I  was lucky to have found some amazing providers.

My most important services were mental health related.  Continuation of therapy and medications were naturally paramount.  My physicians were all connected to a medical research university.  I was extremely fortunate to find both a psychiatrist and a psychologist with who I immediately felt at ease; comfortable with them and their abilities.

At this time I was literally at my lowest point.  I hardly left the house and panic attacks occurred often and intensely. I had traumatic flashbacks and nightmares often.  I tried to work but found out the hard way that I couldn’t maintain it.

I did a lot of work with these doctors.  I could not have come as far as I did without their support, guidance, caring and knowledge.  Some of my experiences are in my previous blog posts.

Having debilitating mental illnesses and not being able to work took a huge toll on me and both providers were extremely supportive of me and to my SSDI case.  My partner had to put off graduate school to support us while I worked on my health.  I couldn’t let him put it off forever so in early 2018 we began planning on him pursuing his degree without waiting for my SSDI determination.  This ultimately led to us having to move for the fall as he chose a school that had a good program and provided some financial help in the form of an assistantship.

Planning an out of state move presents many challenges and is quite stressful as I’m sure anyone who has ever moved will attest. Stress triggers anxiety/panic disorder and mine was definitely higher during this period.  One of the biggest stressors for me was having to leave my doctors.  I was both saddened and fearful I wouldn’t find the quality of care I became accustomed to.

I followed the same script from my prior move and began calling around to try and set up appointments with providers to coincide with my arrival at my new location.  At the time my SSDI case wasn’t yet adjudicated so I wasn’t sure if I’d have Medicare or Medicaid, which made finding providers harder.  Every independent practitioner I called was either not taking new patients or wouldn’t take Medicare/Medicaid, one of which I was ultimately going to have.  Days turned into weeks of phone calls to practically every mental health professionals office and I still couldn’t find providers.

This is a much smaller city without a medical university.  I quickly discovered there was a mental health provider shortage in the area.  I could find therapists (mainly social workers) affiliated with the two local hospitals and a mental health clinic but each had their own rules and procedures.  Differing a little it was basically you must see their therapist for so many sessions before getting a referral to their psychiatrist, which could take months.

This clinic structure wasn’t something I was used to and I felt like I had no choice but to simply pick one and go with it, which is exactly what I did.  I chose a mental health clinic affiliated with the largest hospital/doctor group in the area.  I used this group to blindly pick a primary doctor as well as two specialists for Crohn’s disease and hypothyroidism which mirrored the providers I had.  I scheduled appointments with all of them within the first month and a half of my arrival.  Everyone of them had excessively long wait times for a new patient appointment so it was good that I was doing this so far ahead of time.

With my continuation of care set up I finally felt some stress lift.  I made final appointments with all current my doctors to see them one last time and to let them know I’d be moving.

Of course my therapist was helpful in listening to my frustrations throughout this process. It was her I was most saddened to leave.  We had such a bond and her help bordered on life saving.  She assured me I was stronger than I thought and would be alright.  She also offered to personally speak to my new therapist to help ease my transition.  I cried during our last session.  I was going to miss her.  She was the most important person aside from my partner in my journey of recovery.

Letting go of things has always been a struggle for me but I did my best to believe that one part of my journey was ending but another was beginning. The next chapter in my life was just 21 hours north.  I had with me a toolbox full of tools, methods, strategies, and knowledge that we had worked on for three years.

Away we went… me, my partner and Gracie, our Yorkie and my support dog.

Gratitude

How do you find gratitude in a world of never-ending suffering?  How do you find gratitude in your own life if you live with the chaos of anxiety, depression and panic disorders?

Finding gratitude is a journey as individual to each of us just as our lives are uniquely different.  For me,  when I could easily be consumed by my limitations or simply by the news cycle, I like to check in and make a dedicated effort to see things with a grateful heart.

Some days it’s easy to feel grateful.  I may have accomplished a goal, had a pleasant conversation with someone I love, or enjoyed a moment of calm and clarity.  On bad days, when everything seems to feel off, whether depressed or hyper anxious, it’s harder to feel grateful. Oftentimes, on hard and challenging days, I need a gentle push back into the here and now to remind me to just be grateful for being exactly as I am. I think it’s those days when I consciously seek to find a moment of bliss and beauty that the feeling of gratitude feels more poignant.

Quietly, I acknowledgement that others are also suffering and that everyone is on their own journey, following their path, enduring their own pain,  and walking with their own demons.  It’s while in this repose that I can connect with the universe, nature, and all of humanity, sharing my thoughts and healing energies.  What I ask of the universe for myself, I ask for all those who suffer.  I find comfort in this continuing circle of energy and in the warmth of it’s flowing gratitude.

Just as you share in suffering, you can share in the joy of all that surrounds you.  Take at least a few moments each day to pause and feel what is around you.  What makes you smile?  What stirs your heart? What do you find beautiful and special? What are you grateful for today?

Today,  I am grateful for this blog and my ability to let words flow as both an aid to my healing and as an outlet for creativity.  I am grateful that my feelings go forth into the universe as energy to be shared.

Love, light & peace…..always

EMDR Take Two

I said I would be writing about my experiences with EMDR therapy and It’s been awhile since my first post about it.  I’ve had some difficulty writing about it because although the sessions and the treatment seem simple and straight forward, I find its effects anything but.  Also, the nature of the treatment makes it hard for me to convey my experiences accurately with words.

A typical session begins by selecting a starting point for visualization. It can pretty much be in any location or situation I want but we’ve focused it around my trauma event.  From the starting point I simply visualize and sort of watch a movie in my mind.  As my therapist taps my knees gently, my mind takes me where it chooses, much in the same way your mind might wander from point to point while daydreaming.  Initially as my movie plays across the screen of my mind I am taken many different places.  It can be unrelated to the starting point of thought and/or the present circumstances, it could even be about last nights dinner.

I just realized I don’t actually know how long each tapping session lasts but after a time my therapist stops and we talk about where I am in my “movie” and what I am feeling both internally and externally.  After that she begins again.  As the session continues my mind, even if its jumping, is playing memories, feelings, perceptions and emotions across different points in my life.  Most often it is within the timeframe of the chosen starting point from the beginning of the session.  Again, she stops and we discuss where and when I am in my movie and the associated feelings.

We do this usually 3 to 4 times in a session. Sometimes more, sometimes less, depending on how much time is devoted to talking in between.  Often times talking in-between is an analyzing of a situation, my perception of it both before and now, and any feelings and emotions associated with it.  At the conclusion we might talk about each stopping point in this manner or a summation of the entire session.

There is no right or wrong in any part of this therapy.  I am told that after the sessions your, or in this case my, brain keeps working behind the scenes.  Although it’s unclear to me the exact mechanisms at work, the brain continually processes the experiences of the sessions;  doing the work of reprocessing and re-association of events, feelings, and emotions into new and less traumatic and stressful associations.  The consequence of which is to lessen or ultimately remove the traumatic triggers.   For me these triggers are both in relation to PTSD and panic and anxiety disorders.

In the days after the sessions I notice a marked spike in my general anxiety levels.  I’ve been known to have additional or more pronounced panic attacks and more episodes of agoraphobia.  This heightened state usually lessons as the days pass.

Oftentimes it feels as though I am regressing by being more symptomatic but as the weeks have passed I have a greater understanding of myself and a clearer and better understanding of what’s happening to me both mentally and physically.  By stepping back and looking at things as a whole I can tell I have, and continue to, benefit from this therapy.

I am not the typical EMDR patient addressing one specific PTSD traumatic event, but rather a series of events linked by trauma and debilitating panic and anxiety disorders. Consequently, the therapy is very much tweaked and adapted to my situation.  I do not have sessions every week because my therapist has found I respond better having the extra processing time.  The extra time allows me to return to a better baseline of functioning.  From there we begin again.

Like many things, this therapy requires work, patience, and faith.  I have hope that I will attain the best possible results from EMDR and will again share my experiences with it as things unfold.