Trying to Help Others Understand Anxiety

Whenever I start to explain that part of my mental illness diagnosis includes severe anxiety, I always receive confused looks.  They are usually followed by judgmental comments about how “everyone has problems and stress in their lives”, telling me that I need to “learn to cope and work through it all”.  I get told that I “shouldn’t let every little thing get to me” and that I’d be so much happier if I “stopped stressing over everything and just mellowed out”.

I have others that have gone so far as to make accusations about whether my anxiety is even real or just in my head.  They’ll question how I could claim I’m “too anxious” to go somewhere to fill out paperwork yet am “perfectly comfortable attending things like farmer’s markets or street fairs”.  I’ve tried to explain that it isn’t the same thing.  I don’t have social anxiety.  People and crowds are not my issue.  My anxiety is situational and builds upon itself, making it harder to function in some situations than others.

I’ve tried to explain my anxiety again and again until I was blue in the face, yet I’ve been met with blank stares or judgments more often than not.  I finally sat down and made an overly simplified chart, similar to the pain level chart used in doctor’s offices,  in hope that it might be more  relatable and help others understand.

anxietychart

The average happy and well-balanced person starts an average day with 0 anxiety.  The sun is shining, the birds are singing, their rent and car payments have been paid, their family is healthy and happy.  Life is good.

Little daily stresses might raise things to a 1 or a 2, but it’s nothing they can’t handle.  Every now and then, there’s a 3, 4 or 5.  Life happens.  It isn’t always easy but it’s nothing that can’t be smoothed out and they know it won’t be long until they’re back down to a 1 or two again, or even enjoying one of those blessed days with 0 anxiety.

People struggling with an anxiety diagnosis never see a 1 or a 2, let alone a day with 0 anxiety.  Their good days start around a 3, their average days around a 4 or 5.  It isn’t even that any major crisis may be going on in their lives causing their heightened anxiety.  It is that their body and their mind are reacting and responding as if it was.  And, being already frazzled, every little added thing that goes wrong just adds to their anxiety until inside their heads they are in a complete panic, running around with arms flailing, screaming that the sky is falling, Chicken Little-style.  Or even worse, they just wrap themselves in a blanket and shut down completely.

Now to get back to explaining the situational anxiety I mentioned earlier.  High stress situations already start off at a higher anxiety level than normal for us because our minds are already considering every single thing that could go wrong.  Every time there is a bump in the road and things don’t work out like they should, it adds more anxiety to the pile for next time.  All it takes is a couple times where things go wrong before our bodies and minds start to panic when it comes to anything associated with that person, place or thing.

Managing our anxiety is not as simple as taking a deep breath, learning to think positive or not sweating the small stuff.  We are not intentionally causing our anxiety.  Our anxiety fires off somewhere in our subconscious.  We have no control over it.  Our mind starts sending out warnings and our body responds.  We find ourselves on edge, our chests tightened, our thoughts muddled, our mouths dry, our palms sweaty.  There are times we’re not even sure what we are anxious about, only that the anxiety is there.

Once our anxiety has reached a certain level, we begin to have anxiety attacks.  Our body goes into auto-pilot in a full blown panic.  Anxiety attacks present themselves differently for different people, but in every case it is our body’s way of saying that it cannot take any more.  Beyond the anxiety attack is the shut down, that numbness where you’re mentally, emotionally and physically too exhausted to think or function.  I have not included a level 10 anxiety level because, though I have experienced many anxiety attacks and shut downs, I have never personally experienced anything beyond that.  I do imagine there is something worse, though I am not sure what could possibly be worse than everything I have already been enduring.

That is not to say that conscious breathing exercises, meditation or other such exercises do not help.  They can help pull us back into a state of self-awareness that can stave off a full blown anxiety attack.  But they are not a panacea.  They will not magically cure an anxiety disorder, just facilitate in pulling some people some times back into the here and now.

That is because an anxiety disorder is a mental illness.  It is not something we are doing to ourselves because we are easily panicked or excitable.  It is not something we’ve made up in our heads.  Much like a diabetic can help regulate their highs and lows by eating at regular times and monitoring their sugar intake, someone with an anxiety disorder can use tools such as conscious breathing to help moderate their anxiety.  But getting exercise or not eating that candy bar won’t cure diabetes any more than meditation will cure anxiety.  It is our medical diagnosis.

I know the chart I made is extremely simplified – anyone suffering with anxiety can testify that it is so much worse, but I wanted to give examples that the average person could relate to, as well as providing a build up they might be able to imagine in their own lives.

I know that it can be hard for those who have never experienced a mental illness such as anxiety to truly understand what we are going through.  Please try to keep in mind, though, that it is not something we are intentionally doing to make our lives, or yours, harder.  Our brains are always reacting and responding to the world around us at a heightened state.  We have no control over it and are trying our best to manage our anxiety to the best of our ability.  But it is a medical diagnosis that needs treatment.  It is not something we can magically cure on our own.

mightylogoRepublished on The Mighty on 3/27/18.

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Living on the Corner of Functionality and Falling Apart

For years, I was a barely functioning depressive.  I struggled to at least appear like I had myself together, living panic attack to panic attack behind the scenes.  When my facade of togetherness would begin to crack and show wear, I would pull away and isolate as I slapped on layers of concrete to hide all my breaking points.  I lived in a land of make believe, pretending I was okay while I fought against my own mind to keep functioning.

Over time, however, as is usually the case with anyone residing on that precarious perch of functional depression, the cracks continued to grow and expand.  What I once was able to find ways to get through with a manageable amount of struggle began to feel more like insurmountable obstacles.  Bit by bit, it became harder and harder to continue to function.

It is not that I wasn’t trying as hard anymore.  If anything, I was trying harder and harder to hold things together.  The weight of each added stress, each added emotional pain just kept building up over time.  You often hear people describe the proverbial straw that broke the camel’s back.  I never had a camel.  I carried my mental illness on my own shoulders and eventually found myself broken under the weight of my own problems.

One of the hardest things I ever had to do was admit that I needed help, that I could no longer manage to do many things on my own.  Even harder still was trying to explain to others why I was no longer capable of working through things like I had somehow managed to do for years.  Many people seem to believe that once you have done something, you’ve set a precedent and you should then always be able to complete that task again.

It is easy for people to accept that, over time, a person’s body cannot physically do as much as it once did.  On average, a physically fit person in their forties cannot lift as much as they could in peak fit condition in their twenties.  They cannot run as fast or as long and they tire much faster.  It just makes sense.  Bodies get older and wear down over time.  Aging takes a toll.

The same is widely accepted with other physical attributes.  A person’s metabolism slows over time so it becomes harder to maintain a healthy weight when eating the same diet.  Eyesight and hearing are both dulled over age and often need extra aids in order to perform as well as they did in our youth.  Added stresses on our bodies build up over time, compounded with age-related issues such as arthritis.  These are all accepted facts.  Bodies physically wear down over the years.

Yet very few people seem to grasp that mental and emotional health might decline over time, as well.  Many people assume that a mental illness is a temporary thing that will fade away over time as people just “learn to cope better” and “try a little harder to get over it and be happy”.  If I had a nickel for every time someone looked at me, befuddled and bewildered by the fact that I can no longer function even as well as I did five or ten years ago and that my mental health has instead deteriorated in many aspects, I’d be able to take a very nice extended vacation somewhere sunny and warm.

I have days where my depression leaves me in a thick mental fog, struggling to remember basic facts and information that I know is in my head somewhere.  I have days where my anxiety has reached such heights that I cannot reasonably verbalize simple or complex thoughts or information, stumbling over my words like a child learning to speak a foreign language.  I have days where my PTSD has flared up, all my senses become heightened and everything around me feels unsafe and dangerous.  There are days I cannot stop crying and days I feel like more of a mess than anyone deserves to be saddled with.  There are days when life itself weighs down so heavily on me that I pull away from the world and isolate, all the while assuring everyone that I’m fine, that they don’t have to worry, because I just don’t have the words, or the energy to adequately explain everything I am feeling.  My mind and my emotions are often all over the place.

The worst part of those feelings and many others I experience due to my mental illness, though, is that I cannot plan for any of them.  I could wake up one day numb, feeling nothing at all, or wake up completely frazzled as one or more conflicting emotions battle themselves out inside my head.  There’s no knowing, either, whether any state of mind will last an hour or a day or a week, whether it will exist on its own or build upon other emotions already wreaking havoc.  Every single one of those feelings has increased both in potency and frequency as I have gotten older. Every day feels like a game of Russian Roulette in my brain where the game is fixed and, no matter what the outcome is, I know I am going to lose.

Over the past year or so, I have begrudgingly accepted that I’m struggling more than I used to and that I need extra help, that I sometimes need others to intervene on my behalf and to work with me to get the care I need.  I’ve begun building a safety network, a support system of people who can advocate with me, for me and speak on my behalf if I find myself struggling too badly to adequately do it on my own.

I had a home visit recently to go over some paperwork.  Instead of being proud of myself for holding myself somewhat together that day, though, I found myself stressing that I might have seemed too together.  You see – that day was a good day for the most part.  I was able to think of important and relevant questions to ask, I was able to constructively contribute to the meeting and didn’t collapse into tears over all the stress hanging over my head.  I really should have been proud of myself.  Yet, after they left, all I could do was worry that I might have appeared more together than I actually am on a regular basis, leaving them to determine I no longer need the assistance I have had to fight so hard to receive.

I panic and I worry about having even a somewhat functional and manageable day because society automatically puts people with mental illness on the defensive.  It isn’t enough to say that you simply cannot manage to function on a reliable schedule anymore or function on some days in particular at all.  You’re always put on the spot.  Why can’t you do it?  Why some days but not others? Are you even trying?  What do you even have to be depressed about? That’s especially true if you used to be able to function better in the past or if your level of functionality varies day by day.  Physically, the body can deteriorate and nobody questions it but mentally, it apparently is a different story.  And heaven forbid you have a good day where you’re able to contribute more than expected.  If you’re semi-functional today, people will demand to know why you might not be able to function as well, or even at all, tomorrow.  Your diagnosis is often irrelevant, not even taken into consideration.  If you’re able to do something today, you must always be able to do it.

I live on the corner of being able to somewhat function and falling completely apart.  Sometimes I go slightly down one direction before boomeranging back to my corner again.  I have good days and bad days.  I have days that I might genuinely smile and laugh when, even though my depression is present, I still feel like I am running the show.  I have moderate days where I’m still able to pretend I’m okay and do enough for myself that others don’t readily worry.  And I have days where I desperately need help if I have any hope of getting anything constructive done, otherwise I would just sit there in an agonizing numbness, staring blankly into the abyss.  But to be fair, I’ve seen people who struggle with painful afflictions such as arthritis that have good days where they are able to get out, go for a walk and run errands, powering through the pain, and other days where it is difficult to even pull themselves out of bed.  The difference is that mental illness presents itself in the mind instead of the body and is not as easily seen.

Over time as I get older, my completely functional days are becoming less frequent.  I find myself struggling more and more as my mental illness compounds upon itself.  I honestly need to give myself a break on my functional days and learn to count them as blessings instead of worrying what others might think or how they might judge me.  Being able to function again, albeit for a short unexpected period here and there, should always be celebrated as a good thing.  After all, I’m right on that corner and could go either way.

mightylogoRepublished on The Mighty on 2/7/18.

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Republished on Yahoo on 2/7/18.

A Realistic Way To Look At Mental Illness

Mental illness carries a lot of stigma.  People often hide their diagnosis or minimize their symptoms because they are afraid of the judgment that will follow.  It seems easier for many to suffer in silence than to have everyone else look at them as broken or crazy, as something to be feared or pitied.  Many people would rather struggle every day to function than to become a pariah or a joke.

Realistically, there is no shame in having a mental illness.  A mental illness is, in the simplest terms, an illness of the brain.  Our brain is just one of many organs in our body.  When another organ isn’t working properly, we see a doctor and get treatment.  No one is shamed for it because we understand that the body is a machine and that all machines have issues now and then.  The more pieces to a machine and the more functions it performs, the more likely that the machine might have an issue or break down from time to time.

Take the pancreas for example.  It is the organ that maintains the glucose levels in the body.  When the pancreas isn’t working properly, a person can become hypoglycemic, hypoglycemic, or diabetic.  All those conditions can be treated.  Nobody is shamed for having these conditions because we understand that sometimes organs do not work properly.  People go to a doctor and are given medications and treatments that will help improve their quality of life.

Take the heart. There are many conditions that affect the heart.  Heart disease is an umbrella term that includes all the disorders of the heart much like mental illness describes all the illnesses that affect the brain.  Yet there is no shame in talking about heart disease.  Food packaging proudly advertises that food is “heart healthy” and people are reminded regularly to take care of their heart so they can live a longer, healthier life.

The approximate overall cost of heart disease in the United States is 207 billion dollars every year.  That total includes the direct cost of treatment & medications, as well as the indirect cost of lost productivity.

(Based on: https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_heart_disease.htm )

In comparison, the combined direct and indirect cost of only SERIOUS mental illness every year is over 300 billion. That total does not even take into account moderate or mild mental illness, JUST the serious cases.

(Based on: https://www.nimh.nih.gov/health/statistics/cost/index.shtml )

Yet when it comes to mental illness, the room becomes so quiet that you could hear a pin drop.  You don’t see cereal boxes displaying that they contain nutrients for a healthy brain though so many of them do.  You don’t see advertisements recommending meditation to strengthen your brain like you do ones recommending walking and jogging to strengthen your heart.  The fact is – WE SHOULD.  The only advertisements we see regarding mental illness are the occasional commercial for a prescription illustrating that if a person feels broken, their medication might fix them.

The brain is just another organ in our body.  Like the heart, it is needed to survive.  The brain is the most complex organ in our body.  It controls so many things, from basic tasks to thoughts and emotions.  As the most complex organ in the body, it also has the highest chance to develop an issue.  According to the latest statistics from the National Alliance on Mental Health, “1 in 5 adults in the U.S. —43.8 million, or 18.5%— experiences mental illness in a given year”.  Those numbers are staggering.  When you consider how many others are suffering in silence and haven’t spoken out or received treatment, you can only imagine how much higher those numbers might go.

(You can find NAMI’s mental health statistics at: http://www.nami.org/Learn-More/Mental-Health-By-the-Numbers )

With that many people affected, and so much money being spent on mental health treatment, it is clear that mental illness has become a crisis of epic proportions.  When the number of people affected by heart disease skyrocketed, it became clear that something had to be said and done.  Change was needed.  It is no different with mental illness.

Mental illness is the umbrella term to describe conditions that occur in the brain.  No more, no less.  There should be no shame when someone has a mental illness because it is no different than if they had diabetes or heart disease – only the organ affected is different.  No more, no less.

Mental illness needs to stop being that dirty little secret we are afraid to talk about.  The stigma needs to end.  We need to rally behind those with mental illness like we do other health conditions, encouraging them to speak up, speak out and receive help.  We need to stop letting stigma label those who are suffering.  We need to educate and to encourage wellness.

Like many other conditions that affect a person’s body and organs, mental illness can be treated.  It is ridiculous that so many people are untreated or undertreated because stigma has turned mental illness into a dirty word.

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Republished on SelfGrowth.com on 10/17/17.

The Meltdown

I grew up with a mother who emphasized repeatedly that appearances mattered above all else.  As a child, behind all my decisions, my mother’s voice was ever-present, asking, “What would the neighbors think?”  The household was a dysfunctional battle-zone, but only behind closed doors.  From an early age, my mother implanted in my head the belief that neighbors gossip and the worst sin of all was giving them any fuel to add to their fire.

So I learned to carry myself a particular way, to walk tall, shoulders back, and smile like everything in the world was just peachy.  I built walls to hold in my pain and bolted on a mask to hide my tears.  I put on the performance of a lifetime for years, doing multiple shows a day.

On extremely stressful days or periods when my depression is weighing heavily on my soul, I try to push myself to go out in public because that is my last line of defense.  Though I might break down and crawl into bed for the day in the privacy of my own home, when I am surrounded by people, my mother’s voice is ever-present with me.  Somehow, though I want to curl up in a ball and cry, that little voice continuously harps to “hold it in, hold it together, don’t fall apart“.  After all, what would those strangers think if I had a meltdown and became a crying, sniveling mess?

Every now and then, however, the cracks in my veneer begin to show.  As much as I try to hold everything together, my walls crumble around me and I become a quivering, sobbing mess as all the depression and anxiety that has built up inside me comes pouring out.

Usually it is in response to something someone has said or done to me, especially if they are unnecessarily hostile or aggressive towards me.  It pierces through my artificial calm and triggers my flight response.  Alarms sound within my mind to flee, to find somewhere safe before the fragile walls I’m hiding behind begin to shatter.

I honestly hate that I am so fragile, especially when it comes to conflict.  For me, hardwired somewhere in my brain is a connection between conflict and abuse.  When I was a child and my mother became upset, some sort of harsh and irrational punishment was guaranteed, whether or not it was warranted.  When my older brother saw red, I quickly learned to get away before fists began to fly.  Though that little kernel of logic in my brain might reassure me that not everyone who acts aggressively means to inflict physical harm, my mind and my body react impulsively as if imminent danger lies ahead.

When I can neither flee nor quiet that alarm sounding in my mind, panic sets in and a meltdown occurs.  The artificial calm demeanor I have created begins to collapse and it feels like the floor has dropped from beneath me.  I feel as if I’m tumbling down a never-ending hole with nothing to grab onto, no way to prevent myself from falling apart.

I begin to feel unsafe, unheard.  I am transported back to a time when I was a little child with a little voice that went unheard.  Instead of reacting rationally, the floodgates open and a river of emotions cascade out.

My hands begin to shake.  My mouth struggles to find anything coherent to say.  I want to cry out and run away, yet I feel frozen in place, my feet cemented to the floor.  I find myself sobbing, melting down, babbling this endless stream of verbal diarrhea trying to simultaneously explain and defend myself.  My thoughts and statements ricochet all over the place, from one topic to the next, following no pattern, rhyme or reason.

Inside, that young child is screaming that it is all too much, that I can’t take any of this, that it needs to stop!  She is in a complete panic, scrambling for the right words to say to make it all go away, to make herself feel safe again.  An endless stream of “No more! No mas!” echoes within every word she manages to squeak out between sobs.

Meanwhile, the older, wiser, more rational part of myself seems to be standing to the side, witnessing it all in disbelief.  That logical fragment passes judgment, demanding to know what on earth I am doing, insisting I stop making a spectacle of myself.

Back and forth they battle in the background as the meltdown continues.  The small, injured childlike facet of myself falling to pieces while the other more logical facet scoffs and demands I pull myself together.  Little by little, my body and mind exhausts itself and the river of sobs transitions into a slow trickle of tears. I find myself mortified that I allowed it to happen again because I know I should be stronger than this.  I’ve had a lifetime of building walls and bolting on masks.  They should be strong enough to withstand anything by this point.

I wipe away my tears, take a deep breath and take my walk of shame out the door because I know this won’t be the last time I fall apart or meltdown.  It is all part of the burden of the functional depressive.  Though we may put on a brave face and act like our world is full of sunshine and peaches, our walls are made of dirt bricks that cannot withstand the waves of aggression from others or our own flood of tears that follows.

mightylogoRepublished on The Mighty on 4/26/17.

Responding to Voices from My Past

In the last month or so, I have received a handful of messages and emails from people from my childhood: old friends, neighbors and classmates I haven’t spoken to since I was a teenager almost twenty five years ago.  They had seen my t.v. interview, read my book and my blog and all felt the desire to reach out to me.

I haven’t been able to bring myself to reply to any of them yet.  It isn’t that I doubted their sincerity or that I didn’t appreciate their compassion or empathy.  Truthfully, each letter brought me to tears and meant more than any of them could imagine.  It’s that honestly I do not yet possess the words to respond.

For almost twenty five years now, I’ve been running from my past.  When I was a child, I was trapped in a hell I never thought I would never escape.  When my mother shot my father and my world turned upside down, I saw it as an opening, my one chance to get away and free myself from my past.  I began to run, pushing everything behind me, hoping if I ran long enough, fast enough, far enough, I might one day finally be free.

I still carry with me an odd mixture of unresolved feelings from those years.  Beyond the hurt and the anger that others might feel is only logical, there resides other emotions that are not as easily explained and even harder to process and move beyond.

I carry with me shame for some of the things that happened, because I allowed them to happen, though I know deep down that I was just a child who had her will crushed and had lost her ability to say no.

I carry with me guilt for not being stronger, not being able to fight harder, to be braver, to make it through more intact instead of the crumbling mess I often feel I become when I allow myself to return to that time and place.

I carry with me regret that I distanced myself over the years from so many people, due to no fault of their own, simply because their place in my life existed in close proximity to traumas I was trying to escape.

I carry with me an irrational fear of reopening doors from my past because my past is where all the most terrifying monsters I’ve known reside and part of me worries that reopening one door might open the floodgates, allowing everything to rush back at once.

Beneath it all resides a jumble of other feelings I have yet to even unearth or decipher.  Just when the waters surrounding me appear to calm, they wash over me unexpectedly like waves in a storm, threatening to throw me overboard again.  For years now, I’ve been fighting to stay afloat while I work my way through each wave as it appears.

I’m slowly letting down walls, reaching out and trying to let people back in but it is not easy.  It is a painfully slow process, untangling those threads of my past from the jumble of razor wires that had cut me so deeply all those years ago.  I am truly grateful beyond the words I currently possess for every kind and gentle word they have extended my way and do not intend to leave their letters unanswered.  I just need to first find the strength to delve back into my past, the courage to face my fears and find the words to help rebuild bridges I burned long ago in my haste to flee from the nightmares I feared I would never escape.