Mental Health Tiny Post: Breath Holding

Did you know that people with chronic anxiety often hold their breath? It’s not intentional, it just sort of happens. I did not realize until my early 40s that I do that routinely. In fact, when I was pregnant with my youngest, I would be sitting on the couch reading (my most favoritist relaxing activity), and would suddenly gasp. I had been holding my breath and my poor fetus needed me to breathe! . Since I realized I do that, I’ve tried to practice mindfulness in deep, even breathing, especially in a stressful situation. Not only does it take my mind off what is happening, but it gives my brain some much needed oxygen. Once again I am reminded that anxiety affects more than one dimension of life.

 

 

 Mental Health Post #11: Book List

Today will be short and sweet.  Here is a list of books I love and have read that deal directly and peripherally with mental health, trauma and accompanying issues, in no particular order.  I'd love to hear any others you recommend.  I prefer the book copy, but I'm sure you can get any of these on Kindle or Audible if you prefer--none are obscure titles.

 1.     The Body Keeps the Score by Bessel van der Kolk, MD: deals with childhood and intergenerational trauma and how they impact physical health

2.     Childhood Disrupted by Donna Nacazawa: also topical on trauma and physical health.  This book is sort of a spiritual successor to The Body Keeps the Score and builds on many of it’s ideas.  This is one of the main reasons the ACE score was popularized by the media.

3.     How to Hug a Porcupine by John L. Lund: talks about having relationships with difficult personalities.

4.     The Highly Sensitive Person by Elaine Aron: this is one of my very most favoritest of all because of instead of pathologizing a sensitive personality, it exalts it.  I highly recommend it to everyone because even if you aren’t sensitive, I guarantee that you will have interactions with someone who is!

5.     Securely Attached by Kristin & Mike Berry: full disclosure, I read this as someone preparing to adopt.  But it has so many great ideas about dealing with childhood trauma and mental health that I got a lot out of it for myself!

6.     The Out of Sync Child by Carol Kranowitz: I think of this one as a nice companion to the Highly Sensitive Person.  It talks about sensory processing disorders, and while I skipped some of the heavy science parts of it, it had some really great info for coping with constant overstimulation for anyone whether diagnosed or no. 

7.     The Boy Who Was Raised As a Dog by Bruce Perry: I should warn you that if you struggle to read about real people who were abused, this may not be a book for you.  I found it an important read as a future adoptive parent, and also very informative on how trauma affects the emotional growth process.

8.     Boys Adrift, Girls On the Edge & The Collapse of Parenting by Leonard Sax: these are really great books that take a look at how parenting and child raising has changed and some ideas on how to ameliorate some of the mental health issue kids have today.  I don’t necessarily agree with everything, but there are definitely some good ideas.

9.     The Anxiety Survival Guide for Teens by Jennifer Shannon, LMFT: this is a favorite hands down.  We paid our kids $10 each to read it years ago.  It is simple and explains how the monkey mind works and how to make better habits to overcome anxiety.  It also lays out some common anxiety issues.  I can’t recommend it highly enough.

This is literally just the tiniest tip of the iceberg.  There are sooooo many great CBT (cognitive behavioral therapy) workbooks, and zillions of books about any mental health issue you can think of.  There are some great videos online (I like Prager U for one) that have science-based information that is really accessible.  When you are looking for stuff online, remember to turn on your BS radar and if something seems off about what is being said, fact-check the crap out of it!  Don’t worry if what you found turns out to be garbage—in an age where there is endless information (and endless trolls) you are bound to run in to stuff that isn’t good.  Or something that isn’t helpful to you.  The beauty is that you know you and can hopefully find the information that will help YOU to grow and be healthier. 

 Photo note: Emperor Sol relaxing in his Royal Corner...

 

Mental Health Post #10: Panic Attacks

Take two—thanks Facebook for deleting my almost finished post…  ☹  Today’s topic is panic attacks.  If you had asked me even a couple years ago if I had ever had a panic attack, I would’ve said yes, I’ve had 2.  But in the short intervening time, I’ve learned that there is so much more depth to the presentation of panic attacks.  The experience is as individual as personal perception.  To this end, here are some of the symptoms I have had when I’ve had a panic attack:

·       intense trembling

·       racing heart

·       sweating

·       nausea

·       hyperventilating-

·       fight/flight/freeze response (Google this if you aren’t already familiar with it)

·       catastrophizing (imaging the worst outcome for many scenarios)

·       zoning out and/or dissociating

The beauty of the panic attack is you can have all of these symptoms or just one.  And rarely has one of my panic attacks looked like what I’ve seen in the theater.  (See meme below just for fun—remember none of this is medical information and should only be taken as anecdotal experience.)  To illustrate, here are three different panic attacks I’ve had in my life time.

1.     Over 20 years ago, someone called me out in front of a bunch of family members.  It was humiliating, and I felt unjustly accused.  It was a sore spot in my life (still is difficult today) and haunted me.  About a year later, it came to my thoughts again and I found myself becoming more and more upset.  I sought out my support human (aka Derek) and I talked while he just listened.  During that time, I was shaking uncontrollably to the point where my teeth were chattering and I could barely articulate words.  I was sweating and felt sick to my stomach.  I did not cry, I did not hyperventilate and I did not curl into the fetal position.  After about an hour, I was calmed down enough that I was able to get ready for bed.

2.     About 6 years ago, for absolutely no reason that I could understand, I was sitting in church and suddenly felt the need to flee.  I felt emotionally claustrophobic and could not sit through the service for one minute longer.  I immediately got up and walked home (thank goodness I live close!).  I took a nap (I did not feel the need to take a rescue medication, aka a benzodiazepine) and felt right as rain when I woke up.  I still do not know what triggered this response, so I blame hormones.  So easy to blame because they are so often the problem <<eye roll>>.  I did not cry, I did not have any physical symptom except perhaps a little faster heart rate. 

3.     I have had one stereotypical panic attack.  I contract influenza about 4 years ago (despite getting a flu shot) and found myself struggling to breathe.  Derek took me to the ER (because of course it was the weekend) where there about 300 million other people with influenza in the waiting room.  So we waited and waited and waited and then we waited a little more.  My throat started to close up and I felt like I was suffocating.  I started crying hard, hyperventilating, shaking and my heart was pounding out of my chest.  The nurses came over and took my O2 sats and they were well above 90 (I blame the hyperventilating).  So I was sent back to my chair and told to wait.  I was afraid so I told Derek we needed to leave (here’s the “flight” part).  The staff told me I should not leave but I would not change my mind.  We went instead to my family doctor and they diagnosed me with bronchitis bordering on pneumonia (no Xray to confirm that one of course) and gave me tons of medications.  This one was especially difficult for me because I felt I had been shamed at the ER for my “melodramatic” display—it was especially powerful since the people who had done the shaming were medical professionals.  (Please don’t judge them too harshly—people don’t understand the power dynamics they wield in their various positions and they were full well beyond capacity.)  In this situation, I displayed many of the stereotypical actions of someone having a panic attack.

When a person has a panic attack, they are in an extremely vulnerable position.  The way you act toward them at that moment and afterwards can affect your relationship for a long time.  When someone has been kind to me when I was experiencing severe mental illness, it has changed how I’ve seen them probably forever.  When someone has been short with me and shamed me, it has made me feel unsafe with them.

Here are some things that I do to prevent panic attacks from fully blooming when I feel them coming on.  You will notice that many of them are similar or the same as to what I do to manage my chronic anxiety.  The key for me is to not put off addressing it—taking action immediately is crucial to keep it from becoming consuming.

·       Make sure my physical needs have been met, particularly eating/blood sugar issues.

·       Go for a walk or get some kind of exercise, preferably alone at first.

·       Use the 5,4,3,2,1 rule (I’ll append a link at the end of this)

·       Talk to a trusted loved one about the cause of my stress, if I know what it is.

·       Sometimes I find journaling soothing.

·       Meditation/prayer is of course helpful.

·       The very few times when it was not otherwise controlled, I took my emergency medication, a benzodiazepine.  Thankfully I have only had to do this a handful of times.

 Later, I like to look back over the recent past and see if I can identify what might have been trigger so if possible it can be avoided, mitigated, or at least emotionally prepared for.

Like any other disease, panic disorders take patience and work.  Having a good support system is crucial to my success.  I have had to limit things that are difficult for me like toxic people, reading too much current news, and not overloading on depressing information.  For example I have had to limit how much exposure I have to WW2 media (yes, I am the one white person in America who has still not watched Schindler’s List) because it is so damaging to my mental health—don’t worry, I think I’ve learned the lessons I need to learn from what I have consumed.  I still have times when I get stressed (as laid out in a earlier post) but I don’t feel like I come as close to panicking as I used to.  Again I blame hormones (or maybe I thank them for diminishing?...) and time spent practicing good mental hygiene. 

54321 rule:

https://www.urmc.rochester.edu/behavioral-health-partners/bhp-blog/april-2018/5-4-3-2-1-coping-technique-for-anxiety.aspx

 

Mental Health Post #9: Trauma

This next topic has been the one I've ruminated over the most.  It's by far the most sensitive to talk about and difficult for me to know how far to draw the line.  I am a huge privacy nut (because it's all fine and good for me to hang my dirty laundry out, but not other people's).  It's not really super easy on a personal level to address trauma.  There are so many complexities as to why and how people become traumatized.  Some are just so obvious: natural disasters, death, divorce, abuse of any kind including rape, and chronic illness are all things that we would expect to traumatize a person.  Other things that are clear when you think about them a little more may be having a more sensitive nature (the orchid gene is a fun rabbit hole to fall down on the internet if you are between books...), moving a lot as a child, inter-generational abuse/trauma, experiencing systemic discrimination of any kind, etc, etc.  One thing is certain: it's not generally up to a casual outsider to determine if a person has experienced trauma and be dismissive of it.  My opinion is that you and perhaps a trained mental health worker are the ones who can truly determine if you have suffered from trauma.  And not all mental health care providers are created equal unfortunately, so in the end, you are probably your best bet in knowing if you have experienced trauma and/or traumatic events.  And then with the help of a compassionate and qualified mental health care provider, you can work on creating habits and behavior modification to help you to have a better, more functional quality of life.

The reason I want to bring this up is that I believe people can make progress on their mental health in almost all cases.  I also believe that if it is ignored or not treated in any legitimate way, then it will get worse and progress as does most untreated disease.  When I say treated, I want you to know that I am absolutely not saying everyone should be taking pills or seeing a therapist 5 times a week.  There are a wide range of things that can be done to help treat mental illness, much of which is dependent upon how severe the disease is and how many other factors may be involved.  I won't go into a lot of detail in this post on medications or therapies, but I will mention that I personally have been on an antidepressant for over 18 years and have no intention of ever stopping.  There is a clear demarcation for me in how functional I feel and how happy I am.  Therapy has not been continuous for me, however, I leave open the door to receiving more should the day come that I need it.  (Derek calls me a boy scout because my motto is "Be Prepared" and that is definitely true in this case!)  I've talked in prior posts about things that a person can do, and that a person who has a loved one suffering from mental illness can do so, I won't repeat myself.  Know that long-term change does not happen over the short term.  Know that it takes continued work (while giving yourself much grace a long the way because it is such hard work) that will last a lifetime.  Know that you deserve it.

But back to trauma: as a child, I struggled from several forms of trauma, most of which happened over a period of years.  I moved several times (which I don't regret, but was nevertheless traumatic for me), I experienced emotional and physical abuse, I was bullied at school, I have a deeply sensitive personality, and I rarely had the gift of "felt safety" until my marriage.  ("Felt safety" is the subjective experience of feeling safe whether or not a person actually is.)  And while I come from a white upper-middle class background, like all women on this earth, I have experience systemic discrimination.  (It's certainly no comparison to what a gay woman of color would experience for example, but it is traumatic to me and I believe that because of that, it should be validated.)  This is one of the reasons I think that I suffer from anxiety (but certainly not the only one).  Because of this trauma, I have been challenged in making and maintaining long-term relationships, particularly with those with whom I closest.

How does this relational dysfunction present itself in me?  For one, I am deeply suspicious of other people's motivations.  I'm WAY better than I used to be, believe me, but even now, I worry that people who give me things will do so because they expect something in return.  (To a certain extent, I am right because many people that I have interacted with behave in a transactional way.  If you do something for them, then it's expected that they will do something back for you.  Clearly we need to change some of that about ourselves, without allowing toxic relationships to flourish.)  I also worry that when someone says something to me in text (social media, texting, email, etc), they might be casting aspersions on me in some way.  I'm continuing to learn that text is an imperfect way to communicate, and to not worry too much about how and why other's are saying things to me a certain way.  When you grow up with emotional trauma, you learn to question every single phrase or facial expression because you are desperately looking for patterns of behavior that will help you keep safe and know what you can do to avoid punishment.

Another negative effect on my ability to attach with those around me is my need for control.  This is, as many of you probably already know, also a manifestation of anxiety.  While I still struggle with this some, it's not anywhere what it was say 20+ years ago when I was first learning to parent.  I was deeply inflexible and could not handle changes in routine.  I had expectations about how an event would go or how I would perform some social role, and when that was shattered, so was I.  Thankfully Derek & God would help me put the pieces back together each time, and each time contributed to a little more resilience here and a little more grit there.  Now when something doesn't work out, I can usually comfort myself that better days will come.  Look, it's not perfect.  There is no fixing things like a beloved relative dying or someone being given a cancer diagnosis, or chronic mental illness for that matter.  But somehow, when you loosen those tightly clenched hands a little, you learn that it's okay to not be clutching so hard all the time.

Here's another fun one: I am so social awkward.  Ya, I know it doesn't seem too bad now, but for those of you that were my high school friends, know that that person you knew then is still lingering inside of me.  I'm bad at reading cues like it's time for me to stop blabbing and get out of someone's hair.  Or that I should take some hint that someone is carefully veiling with their words.  I guess the good part that comes out of this is that passive-aggression doesn't really work on me.  On the other hand, I also don't get subtext, like, at all.  <<awkward smile>>  I know some people would call this perhaps a bit of autism, and I'm not going to fully discount that since autism is such a wide and spectrum-y diagnosis anyway, but...  I think of it more like a dog that hasn't been properly socialized.  (What?  So I always have dogs on the brain...)  Because I had troubled relationships, and lived a pretty closed life until my mid- to late-teen years, I think I may have missed a few things.  Plus you add the the constant cortisol that was pumping through my veins and you don't tend to pick up as many things as perhaps the average secure child.

What has motivated me to work on changing?  For me, it has been an intense drive to do the best I can for my husband and children.  I refuse to allow my own trauma to destroy their lives.  I know that it does still affect them, not just the biology but also because they've had to live with me as I've grown into better habits.  I hope that with the bad also comes a sense that we can change, and no matter our age, we can progress in our emotional resilience.  As it said in some literature I've recently read, like you, I hope I'm a "good enough" parent.  While I know I'm defined by the trauma I've experienced, I hope that is in both a negative and a positive way.  I believe we can start changing at any age when we have the support and the desire to do so.  

Photo note: I saw this resilient little darling growing out a crack between the asphalt and the pavement.  Credit goes to the AWESOME portrait setting on my new phone.  I cannot stop taking pix with that setting!

 

Mental health post #8: Resources for Helping

More business: If you tried to look at these on my blog (giveusprozac.blogspot.com) and it said you could not, I think I've fixed that. Please let me know if you are still having problems accessing it.

Another common question I've been asked is what can be done when someone you love is suffering from mental illness. I've thought of a few things, but I'm sure there is just so much more to this topic so PLEASE comment with things that have helped you or that you've done to help yourself or others.

1. Educate yourself: we take time to look up whether Roger Federer is married (he is) and how many kids he has (two sets of identical twin girls--girl dad for the win!), so why wouldn't we take the time to look up major symptoms of a mental health disorder? Contrary to what many pundits have claimed, there is an absolute wealth of excellent, scientifically-proven information at your literal fingertips. The key is how to search so you get relevant results, and how to know if the information you are getting is valid. How to search I leave up to you to look up (try search string: "how do a good search for medical information online"). How to know if results are valid is often the result of time spent online researching, i.e. the more time you spend searching, the better you will get at recognizing reputable names online. One big hint is whether it's showing up in the first page of results on Google (almost always your best results will be on the first Google page if you're search string isn't too wonky--Google has essentially perfected it's algorithms).

Another hint that you are on the right track is that you are seeing the same or very similar information on several sites. Here are just a few English-language sites that are some of the most well-known and respected in the US: WebMD, the MayoClinic, Healthline, NHS.uk (UK National Health Service), and the WHO (and these are just general health sites). Mental health specific sites include: NAMI.org (National Alliance on Mental Illness), NIMH.NIH.org (National Institute of Mental Health at the NIH), Psychiatry.org, PsychologyToday.com (this is a for-profit magazine, but I really like a lot of what is written in there). When you are ready to level up, you can check out Google Scholar for peer-reviewed academic articles on a huge range of sub-topics on mental health. There is SO much out there. Just remember though, that if you start reading that you can cure mental illness through jello shots or that paying $35,000 to a Nigerian prince will alleviate any psychiatric pain, you are probably in a non-legitimate corner of the internet. I should also note that you should definitely take one-person accounts (like this one) with a grain of salt. They are great jumping-off spots for beginning to learn about mental health, but they are never the end. People are individual in their experience with mental health. Quick shout-out to many fabulous books I've borrowed from the local library and tons and tons of great podcasts that talk about all aspects of mental health from the biggest celebrities to your average Jo/sephine....

2. Show compassion: even if you cannot empathize with someone, you can always show compassion for the suffering they are experiencing. Dismissing and ignoring suffering does no one any favors and can make a mentally ill person feel worse. (Not that anyone should ever take blame for another person's depression willy-nilly. I know this is hard because as a parent, I am constantly worrying that I didn't do something right that led my child to have a hard time, but it's not always your fault. In fact, it is sort of the height of narcissism for me to think that I am responsible for everything good, or bad, that my child experiences.) So saying validating things like, "I can see that you are suffering and I am sorry that it is so painful right now" or suggesting actual things that you can do ("please call me anytime about anything", or "I'm coming to weed the yard you were just saying is stressing you out"). And please, for the love of all that is holy say I love you more often. Tell your friends, your family, your coworkers, the cute dog you see on the street. We all wish we heard it more often and it's not like it isn't true. Last thing: don't wait. Say it immediately & often, say it out loud, say it with your actions.

3. Model healthy living: you know how you teach your kids to do things like brush their teeth multiple times a day, only drink in moderation, and limit sweets? And then you don't actually do those things yourself? Wanna guess which lesson they are actually going to implement in their adult lives?... Let's just dispel one big stigma right now: counseling is for everyone. It's not just for people with "problems." There is no person on this planet that couldn't benefit from counseling. And frankly, if you have a close loved one who is suffering from severe poor mental health, then then you are one of those people with a "problem." (Pardon my sarcastic quotes--I really hate the stigmas surrounding mental health and sometimes get a little heated discussing it. <<awkward smile>>) The same goes for all the other things I talked about in post #5: exercise regularly, get enough sleep, meditate, self-reflect, perform service, take your vitamins and any prescription medications as directed, and take time to laugh. Not only will you be healthier for it, but you will also be better equipped to deal with the stresses of loving and possibly caring for someone with poor mental health.

4. Practice patience: we cannot force other people to change. I love the phrase, "You can lead a horse to water, but you can't make it drink." At the end of the day, we do everything we can to help the person(s) we love who are struggling but we cannot force them to choose different habits or to seek medical help. It can be excruciating to witness and at times, make it difficult to maintain relationships with these people. This is where we get to practice patience, and if you are religious, pray continuously that your loved one will make choices that brings them relief from their psychological pain. I have been very proactive about trying to better my mental health, and baby, I have a long, long road ahead of me still. I'll spend my whole life working to change my behaviors and knee-jerk instincts brought on by mental illnesses. In this way, we are again showing compassion for those around us, and the same grace we hope others will show us.

*Thanks again for everyone's comments. It's overwhelming to think of how much could be written about this. This perspective is solely mine and everyone has different experiences and perceptions of mental illness, so I really appreciate how y'all have chimed in. I also want to reiterate that I am in a good place right now--I've had some comments that make me worried that some may see this as a cry for help. Believe me, posting such vulnerable things on Facebook is the LAST thing I would do if I was not feel well. So don't send casseroles (but you are welcome to drop by sugar cookies at all times for no reason... ;) ) and know that things are good right now.*

 

 

Mental health post #7: Anxiety Traits

First some business: y'all know I'm not a trained health professional, right? I am simply talking about my experiences with mental health issues. Just want to make sure you understand so there's no suing me down the road... ;)

There are so many things I've been thinking about writing that I find it hard to be concise and cohesive. I hope you will excuse my poor skills at articulation--please always feel free to ask for clarification on anything. If it's something I don't feel comfortable sharing, I'll say so. You don't need to feel like you are prying. One of the things I recently pondered was some of the specific behavioral traits I see in myself when I am particularly anxious. (I talked a little more generally I think in post #4 when I described a day in the life of...anxiety (name that Beatles tune!) Here they are in the ever unglamorous list form:

1. Repetition: when I am anxious I find myself being repetitious. I mean that in both the literal and figurative way. Literally, I repeat myself over and over. I re-ask questions, I repeat instructions and requests, and I bring up the same topics over and over again. Anxiety got me one-track minding it all the time. This is, I'm sure, completely annoying to my loved ones, but also to me. One way I've heard neural pathways in the brain described is as well-worn roads. Our brain likes the path of least resistance too and will continue to re-travel down the same route because it's easier. I find when I am falling into this trap, it can be difficult to look outward too, and be concerned about the people around me. It takes effort and practice to get out of those ruts and put my brain into another gear. Since I want to make new roads that are less anxious and less-inwardly focused, I take the effort to do this even though my brain becomes alarmed when I am not hyperfocusing on the thing worrying me.

2. Irritation: yeah this is one of those things that is not by itself an indication of anxiety because we get irritated when difficult things happen in our lives, or we have PMS, or we didn't sleep well. But if I am suffering from an overload of anxiety, there is a good chance that I am going to be wrestling internally with irritation. I'm not always perfect at keeping a lid on it and sometimes I find I need to take a walk or have some alone time while listening to podcasts (or eat or sleep or whatever the case may be). The consequences of unchecked irritated behavior may seem small, but they stack up quickly. I appreciate in the love languages book (by Gary Chapman) how he talks about relationships being like a bank account: if you are constantly overdrawn with your loved ones, they find it hard to have a healthy relationship with you. So irritation, for me, is something I like to address as soon as I recognize it as a problem. Even if it means just stuffing a cupcake in my mouth so I can have the social capital to deal with whatever is needed at the moment. ;)

3. Poor concentration: so when a person is anxious, their sympathetic nervous system hits the gas and sends out stress hormones like adrenaline & cortisol throughout the body. And when a person is chronically anxious, they can chronically have this gas pedal gunning the engine. When I am anxious, I find that I have poor concentration. The amount of anxiety affects how little or much concentration I can tap into. Conversely, if I have zero anxiety at all, I actually feel like I don't have much in the way of concentration skills either. I've heard some people call this brain fog also.There must be a sweet spot of low-level anxiety that is helpful in situations that it's called for: tests, performances, etc.

4. Compulsive habits: yes, I'm talking about nail biting, hair pulling, and picking to name a few. I believe the DSM-V included this, called excoriation disorder. As a life-long cuticle picker (not proud of this!), I can attest to the fact that there is something calming about these habits. I don't fully understand it, but I can tell you that you can generally tell how bad my anxiety is by how bad my nails are (though I believe that it has become so habitual to me that I often do it while reading which is my most favoritest recreation outside of sleeping). This is related to OCD I believe. OCD, like most other mental health disorders, functions on a spectrum. I know there are other compulsions people feel: I occasionally went on a check-on-my-kids-to-make-sure-they-are-still-breathing obsession, or checked the locks somewhat excessively. But this wasn't as much of an issue for me as I know it can be for others.

5. Inability to commit: waffling, indecision, these are the common issues I face when anxious. I struggle to see myself capable of doing anything else because, as mentioned before, my body is already running with all pistons firing at all times. In my healthy state, I can make good choices about how much I can say yes to. When I am anxious, I may say no to everything because I cannot reasonably decide if I can handle it or not. Or I may say yes to too many things and then have to say no to all of them out of desperation.

6. Poor memory: ever walk into a room with no idea why? Multiply that times infinity and you get life with extreme anxiety (depression too for me). Unless we are talking about the top thing on my mind that is triggering my anxiety reflex, I am forgetting things right and left. I should clarify that this isn't necessarily something that can be measured between people. For instance, Derek misplaces things every.single.day. ;) I know it's not anxiety most of the time for him. The trick is to measure your performance against that of times in the past, and throw out the other variables that may be affecting your memory. Are you sleep-deprived, have low blood sugar or under the influence of a prescription medication? (Have to bring that last one up because we all have elective surgeries at sometime in our lives.) And, do you have other signs of anxiety?

7. Startle reflex: when we lived in family housing at the University of Michigan, Derek used to startle me almost every day, even though he made noise as he was coming toward me. That still happens today, but not to nearly the effect it once did. For a long time I wondered why I was just so prone to being startled when other people weren't. I posited that it was from anxiety. A decade later, I read a peer-reviewed article that confirmed that people with chronic anxiety can suffer from an over-active startle reflex. I don't even need to explain how this makes sense because we all get that our bodies can act differently when on constant high-alert.

Okay, sorry for another epic read. At some point here, I am going to address how mental illness has affected my close relationships. It's a little hairy to discuss so it may take some time, but I promise all will be divulged and nothing held back. Just kidding, I need to time to make sure I don't put my foot in it... ;)I'm also hoping when the semester settles a little, Derek will have some time to talk about things from his perspective as someone married to someone who has mental illness. (He's a perfect foil because he has NO mental illness at all. Not sure how he got so lucky but he definitely does not have the orchid gene!)

Picture note: Jocelyn, pretty sure I don't look as good in this as you. Also the kids told me that I'm not allowed to wear this in public. I'm considering wearing it while I run down Timpview Drive when the high school gets out...

 

Mental health post #6: Emotional Responses When Depressed

One of the things that is so ubiquitous and so devastating about anxiety and depression are how they dampen the more sensitive feelings. By this I mean those delicate feelings of pleasure, joy, love, etc etc. For me, as with all things relating to mental health, it is a spectrum. Mild sadness seems to blunt my emotional responses mildly. Severe depression or unremitting anxiety affect me severely. When I am at my lowest I find I am literally unable to to even enjoy eating, nothing is funny, and I cannot feel my own internal guidance system. For those of us that are religious I would call that the promptings of the Holy Spirit. Others might call it an internal compass or moral code. But no matter what you call it, it’s pretty hard to sense. During my very worst depressive episode, I could not feel anything when I prayed. This happens to me too when I experience severe anxiety, mostly because my thoughts are obsessively going over my concerns and my plans to address my concerns, leaving no room for spiritual conversation between myself and diety. During those times I have to rely on faith and believe that my relationship with god hasn’t changed, and that those negative feelings won’t last forever. Because that’s the big lie about poor mental health—your brain tells you that you’ve always felt this way and you will always feel this way. And it really can feel like forever because the perception of time is slowed to the point of seemingly stopping. It takes so much strength of will to get through each day, hoping for a better tomorrow.

What can be especially difficult also is that I often don’t sense my declining mental health immediately. It seems to come over me slowly, sort of like the frog in the kettle never realizing how hot the water actually is until it’s too late and he’s dinner. This is why I am constantly keeping a background program running in my mind that is monitoring my mental health. I’m certainly not perfect and things can creep up on me still. Like I know that the amount of daily sun is waning in the late summer, and of course I will feel a little less energized and occasionally have slow days. But I forget when caught up in driving kids around and frantically keeping up with all my responsibilities.

One of the beautiful things I feel like I have gained from dealing with mental health challenges is perspective. Although I still sometimes have high anxiety days, or social anxiety, I know for a solid fact that those pressures don’t last forever. I am learning to control my lizard brain instead of letting it control me. And yes there will be new issues to tackle, but I have people around me that support me and I have overcome some gnarly things in my life that have led me to believe that I can do it again.

Picture note: super fake smile when my oldest was being blessed. I felt absolutely nothing but pressure and endless tears when this picture was taken.

 

 

Mental health post #5: Things That Help Me

Over the years I’ve found several things that help me to have good mental health. I like to think of them in two different categories: long-term and emergency methods. Long-term means things I need to be doing daily/weekly to do well. Emergency means things that I have to do in the short term, usually to deal with unexpected or particularly difficult life challenges. I’m just gonna go ahead and put them in numbered list form because I’m fancy like that:

*Long-term*

1. Exercise: I’m sure many of you are just sooo sick of my preaching about exercise but I will not stop until I have converted the world! I’ve been a runner off and on for about 15 years now. I chose running initially because I don’t have to drive somewhere else to participate and other than shoe purchases, it’s basically free. It takes no training and can be done almost anywhere. I grew to need running because it really calmed my anxiety down in a way that no other exercise does. Would it surprise you to know how much I hate running? How hard it was for me to get in the habit of it, especially as I went through multiple pregnancies and would be forced to quit and then remake my habits? Sadly, I am not one of those that actually likes running—I’m as lazy as a pig in a wallow. But I know how desperately I need the exercise and how important it is to me to be mentally healthy for those who depend on me. The hardest part about this method is it takes true willpower to force yourself out the door day after day. Thankfully the habit does get easier, especially after the first couple of weeks. I’ve not been able to run regularly for almost a year now, so I have replaced it with extra walking with my fuzzy sausage. It’s not as effective for me as heavy aerobic exercise, but it’s def waaaay better than no exercise.

2. Meditation: Rob touched on this in an excellent comment in a previous post. For me, meditation consists mostly of the prayers I offer throughout the day, and especially before bed. I do not believe that the benefits of meditation are restricted to the religious. I’ve heard of many who use cultural meditation practices, or even some excellent YouTube sessions. I’ve also done meditation with a therapist and it’s the darndest thing—I didn’t go to sleep, but when I came out of the deep state of being I was in, I felt so refreshed like I had taken the best mini-nap ever! When I was running consistently (6 days a week), I found that I often fell into an trance-like state in the middle of my runs. Like exercise, I believe that meditation is most effective when practiced regularly.

3. Self-reflection: this one is really a part of my form of meditation but I know many people like to separate the two. I was not born with the gift of self-reflection, but thanks to therapy (aka mostly from Derek in the early years of our marriage ) I find that it is a part of an average day for me. Why is this so important to me? Because mental health statuses change allllll the time, sometimes within a short amount of time! And if you don’t practice constant vigilance, mood can trend downward at a slow pace until you are in such a hole that it becomes difficult to extricate yourself. I’ve heard of friends who do daily or weekly check-ins with themselves. I find after some many years now that I tend to pick up pretty quickly when something is awry. Another component of this for me as a female is being aware of my menstrual cycle. You better believe that has an impact on mental health! Other cycles I keep track of include seasonal ones (since I suffer from seasonal affective disorder, aka SAD) and the normal ups and downs of societal changes like school starting or stopping, holidays approaching or ending, etc. Being introspective of these trends and cycles helps me better understand if I am experiencing something expected and transitory, or if it’s something I need to pay attention to it in case it morphs into something more serious.

4. Service: one of the great collateral damages of poor mental health, in my opinion, is the tendency to only look inward. When you are struggling, it’s impossible to look outward because all of your precious energy is being used just to stay afloat. And then when you are doing better, not only do you have the habit of looking in all the time, but you do need to be practicing regular introspection. I’ve found service to be absolutely essential to helping abate the unhealthy part of only looking in, as well as expressing a part of who my true self is. So when I find myself slipping, one of the first things I like to do is force myself to do some sort of service opportunity. No grand gestures here—it’s generally a very simple thing and it’s incredibly hard to do. It might be smiling and saying hi to someone as I walk by or running someone’s garbage out on garbage day. Sometimes it’s a note I’ve been meaning to write and putting off. Either way, it sort of jumpstarts my engine of looking outside myself.

5. Take your prescribed medication every day. Put timers on your phone and cover your home with sticky notes if you need to. Just please, for the love of all that’s holy, be consistent. Most psychiatric medication work because they are in your system for a period of time and cause beneficial changes over that time. Trust me as one who used to forget all of the time—consistency is vital here. And don’t fall into that trap if I’m feeling better, I’m cured and don’t need my medication any more. I know I struggled for a long time with significant stigma about even taking an antidepressant and rushed to get off of it ASAP the first time I took one. I’ve also struggled to find the right drug(s) for me and that takes time and patience. Don’t give up! The hard work pays off.

6. Lots of other things I can put here that are important for all humans. Don’t get too hungry or eat too much junk food—that can mess up the most stable person. Please get enough sleep! (Don’t believe me? Watch Naked & Afraid or Alone! ). Laugh a lot at yourself and the ironies of life. Laughter truly is the best medicine. Take time for self-care like reading or watching a movie or playing ultimate frisbee (you’re welcome, Derek!). Don’t spend too much time alone—I know as one with social anxiety that it can be so seductive but you know when you need to push yourself to get out there more! Feel free to post more things that help you in the comments.

*Emergency*

1. Dropping things off the to-do list: do you ever get so overwhelmed but you have all these responsibilities and you know they will sink you? Sometimes I feel trapped by this situation. And I make unreasonable demands of myself that I would never ask of someone else in my place. When those times come, I sometimes must regretfully set aside some things I wanted or planned to do. I learned it usually doesn’t have to be much—just taking one thing at a time off of my plate can make it so I can keep going a little longer before things ease. (Sometimes I can come back to that thing too.). Again with the constant vigilance. One of the trickiest parts about this is making sure that I say no when I’m asked to do something that I definitely cannot do. I’ve gotten better for sure, but it’s taken practice. I remember a time when I had 5 kids 10 and under and I was just drowning. I was asked if I wanted to help with a certain project. I really wanted to, and knew I would also make a little money. Against my better judgement I said yes. After some self-reflection I realized there was absolutely no way I could do this project and it was my duty to tell the others in charge so they could find someone else right away. It was hard to say no but my priorities are my family members and I knew I could not be the mom my kids needed without caring for myself. (I’ll refrain from using the breathing mask on airplanes metaphor. You’re welcome. )

2. Using my emergency medication: I hope I can articulate this well because I absolutely do not want to be pushing a drug that is extremely addictive and tolerance-inducing. But I cannot be frank without mentioning how important having a benzodiazepine on hand is for my mental health. I have used Ativan, Xanax, and Klonopin over the years which are all in the same drug family (benzodiazepines). I use these rarely and at very small doses. I have set limits on myself as recommended by my psychiatrists over the years. Please note that important fact: I use this drug only as it has been prescribed for me. Not only do I not want to end up addicted to a drug, but I also really don’t want to lose this tool just because I’ve built up a tolerance to it. It is important for me because my biggest single enemy is ruminating when I go to bed, and taking this infrequently helps reset my sleep patterns so I do not stay up all night or sleep fitfully with nightmares. Again I really want to stress how important it is to set limits on how you use this drug and only ever do so under the guidance of a physician. That being said: hallelujah for benzos!!

3. Ask for help: is this the hardest one on the list OR WHAT?!? Probably just my own independent nature but I still struggle with this one. I promise I’m working on it. Here’s what I think of when I dig my heels in and resist asking for help: what happened the last time you expressed true need and asked your trusted support group for help? Did they laugh at you? Turn you down? Block your texts? No, they stepped up and said things like: let’s get you home immediately before you do something drastic on your internship, or come live with me while we get you over the hump of terrible post-partum depression, or I can work at home today so you can get some errands done, etc, etc. Like I said, still working on this one, but I have learned who to trust and they have come through for me every time. Sometimes it has been hard for me to express how much I need them, but once they understand, they are there. I wouldn’t be here otherwise. And that’s what I want to address soon: my own experiences with suicidal ideation.

If you made it to the end of this, you deserve the prize of the Wait, Wait Don’t Tell Me voice of your choice on your answering machine. Too bad I’m not in a position to give you this most coveted of all gifts… . Thanks for all of the kind comments. I’ve been surprised at how difficult some of this has been to share—it has meant so much that y’all have been welcoming and reassuring. Now get back to your regularly scheduled programming!

Edit: oops forgot a pic but you’re welcome I added one of end of season basil residents.