I Can’t Make Friends – Anxiety

voyagerMr. Clark stopped talking and walked to the ringing rotary phone on the wall.

We were experts, as 7th graders, in anticipating what phone calls would be about. I’m surprised we never got around to making bets. I missed my chance to be a bookie. When the phone rang, it could mean someone was in trouble and had to go to the principle’s office.

Everyone was quiet waiting to see if their name would be called. No. That wasn’t it.

It could mean there was a school announcement. It could mean there was something wrong with our bathroom plumbing! But it had never meant that a space ship had exploded. Seventh grade was not the time to grasp what this meant. If we couldn’t grasp it, if our perceptions were unable to see it, then it could not actually exist. Right?

We kids had other things we were trying to sort out. Boys and girls. Getting your period or facial hair. Zits. What Melissa said about you when you thought she was your friend. These were space occupying in our minds. There was little room for understanding that this phone call announced the end of 8 lives, a billion-plus dollars blew up, nor especially not what it meant politically! Spouses and children, watching and cheering in the bleachers live, front row and center, witnessed as their own individual loved one exploded into tiny particles.

Mr. Clark walked, white-faced and perspiring, to the radio, asked for silence over the hum that had built up, and we heard. The challenger, the 8 people aboard (one of them a teacher), in 1986, was gone.

A spaceship exploding is about what anxiety feels like. That may sound extreme but it is the truth. And those who have experienced it, as if their were going to come apart, will do anything not to experience it again. This urge to avoid anxiety expresses itself in emotions and behaviors. But often, when anxiety doesn’t reach a full explosion, the afflicted individual doesn’t even know that they are sensing the urge to avoid, nor how they are responding to this avoidance. The afflicted person and those who know him get think that these medical symptoms are actually the afflicted’s personality. “It’s just the way I am.” 

You may be someone who feels inner congruence with decisions. By temperament, you like closure! But even so, against your own hard-wiring, you find that you have trouble making decisions. How you talk is driven by indecision. You’re couching what you say, being careful. Your self-esteem erodes.

Manuel had some similarities to this, but also, on top of his medical condition with avoidance symptoms, his personality was one that got energy from being alone. That doesn’t mean Manuel didn’t like people or interpersonal relationships. It just means that he got energy from being alone. And he did stay alone most of the time. When around others, the energy poured out of him like lemonade through an open spigot. However, he wanted others. Being lonely was not his goal. But there he was, more energy when alone combined with a thrumming buzz of nerves when he tried to make friends, when he tried to date, or when he was approached by someone spontaneously in public who asked the time.

Fudge! She only wanted to know the Blinking! Time! he screamed inside.

Manuel had some friends with whom he was deeply bonded to by shared experiences. But he had gone on to college and his friends had not. It was niggling in whispering thoughts that he might still be hanging out with them because they didn’t disrupt him. Because he came apart. Terror, like a spaceship exploding in the atmosphere after take-off, filled his perceptions, if he tried to hang out with anyone else! And Manuel didn’t like thinking about his friendships that way. They lost value when tattered by that persistent wind. Nor did Manuel like thinking about himself as someone who couldn’t get other friends if he wanted to. As someone who would use the faithful. Friendship by default? No. He felt shame just thinking it and he knew it’s falseness. In his most essential self, he knew he loved them for more than proximity. But he really didn’t know if he was weak. It was a possibility. And besides! What girl would want a weak man?

People with anxiety have barriers to any number of connections in life, like coming up to an energy force field we can’t see. There are interpersonal connections we might have had, but never initiated or explored because the anxiety held you in place. This is what anxiety does to us. Anxiety takes away our freedom to choose. And as the consequences and fruition play out, we live out the related losses.

Manuel came to me because, “Mom told me I better come and talk to someone.” Mom was fed-up with his isolation, hours of video games, and she had noticed that he was spending even less time with his childhood friends. 

Talking to Manuel, unearthing these patterns in his life, his insight grew a bit. But once he looked at anxiety, even with a sideways glance, which was anxiety provoking in itself, he came up against the need to decide,

Should I treat?

Deciding to treat is a decision to make between the patient, perhaps including their support system, and their treating clinician. When there isn’t a clear answer though, like a blood test that shows the vitamin D levels are low, we respond with vitamin D replacement therapy, but in these areas of diagnosis, it often feels nebulus to the patients on what to do.

When the decision doesn’t have clear form, like an undefined space, go toward the data. You may trust your clinician to know that data integrate it into all the information that goes toward deciding on treatment. Or you may choose to spend time researching and evaluating the data on your own and then go forward. Either way, if you stay with what you’ve been doing, you will remain ill and the illness will progress over time.

So either way, going with the data, either via your clinicians recommendations directly, or indirectly. Accept treatment. In fact, run toward it! You will have a much higher quality of life. And… those around you will too.

Self-care tip – Go toward the data!

Questions: What had influenced your choices in treatment or not to treat? Please tell us your story. We need your voice!

Sweaty and Worried – Generalized Anxiety Disorder

Hank had to sing an Italian song for his tests.

His music instructor did not believe that he had been practicing two hours a day. When Hank asked his voice teacher to sign off on those hours, his voice teacher still did not believe him.  He had nothing to feel shame about.  “Then why did I?” Hank wondered.  Card in his hand, signed off, Hank resentfully kicked at the rocks covering the path back to administration.

Looking out over mostly empty hard wooden seating in the music hall, Hank slaughtered the song. Even so, it was still the best performance he had ever done.  His father was there in his stained tie and largeness.  His mother in her too many colors, smiled loudly.  She was tone deaf.  Frank’s shame followed him.  He had practiced.

Hank’s older brother dressed in silk shirts, a big gold medallion, a tuft of hair coming out of his barely suppressed neckline.  When they prayed, Hank heard these smacking noises, and thought, “Pray for my nausea,” hoping they would stop kissing.  His brother always had a girlfriend.  The girlfriend was at his recital.  There were noises.

Everyone was scared Hank’s brother would marry too early and maybe marry for the wrong reasons.  His dad was always like, “Wait, wait!” But with Angie, Dad was like, “Get married now!”  Angie was the best in a long line of noisy kissers.

They asked Hank to sing at their wedding.  They insisted.  His brother, his brother’s girlfriend, his parents – they spoke in harmonics all at once.  “Hank!  You sing like Sinatra! Don’t worry so much! You should sing!”

In a rented tuxedo, Hank sang.  The mike didn’t work.  Aunt Augusta told him to sing louder.  Aunt Augusta didn’t hear well, even if there was a mike.  Hank forgot his words and had to start over.  Sweat filled his shirt and he thought about the dry cleaning.

Hank has never had a girlfriend and he is almost twenty-five.  Standing in front of all those people without the song lyrics, the only words that came to him were, “I am like a sweaty doorknob.”  His brother, facing a battle of his own between his ruffled shirt and his manliness, did not help.  Hank thought, “He is probably waiting for prayer so he can start kissing.”

The second year of college, Hank got caught with pornography.  “Hank!” His mother pulled his ear, towing him while she shook the fisted magazine through the house.  He didn’t listen to her words.  He only listened to his memories asking his music instructor for his signature. Was it as bad as the wedding?  Talking to Sarah or walking across the campus greens were bad. He fingered his worries like a beaded necklace.  He worried a lot.  Worry and shame.  He wished he could have a girlfriend but thought that was a hopeless cause.  Hank was already planning on buying a new magazine before Mom had thrown that one in the garbage.

It is so easy to explain away why Hank is the way he is.  We have heard enough to say, his parents, his brother, his isolation, his treatment from teachers.  We can use these to say, “Who wouldn’t be anxious, worried, down, and isolated, when going through these experiences?”  If we did though, we might miss the generalized anxiety disorder, the medical.  Conceptualizing the medical in this way can be so difficult.  We could call it, “the un-reasons why” we feel and do what we do.  So then we don’t have to deny it.  The un-reasons why don’t have to make sense.  They are un-reasons, after all. We don’t have to deny them by our inherent need to point at the cause and effect, or explain into uselessness the reason we are this way.  We don’t have avoid eye contact just because they can’t be seen.

Hank, like so many of us, is included in the statistics that generalized anxiety disorder, or GAD, is one of the top reasons why we don’t get intimate with others.  The anxiety is distracting.  It isolates us.  It preoccupies our thoughts.  It fills us with self-doubt and develops over time, almost inevitably if not treated, into depression.

Getting by with something as subtle as GAD, or other brain illnesses such as degrees of depression, have potentially devastating effects on what occupies our life-line.  The moments that construct the overall devastation may be explained away by one injustice or another, by what are thought to be personality quirks, or simply by neglect of self. But they could be different. The moments, the otherwise same moments, could be different.  The same rude, distrustful teacher, the rejection from Sarah, the quiet mike – those moments could have been different with the same guy, different only in his brain health.  Brain health makes the sameness different.

As Nancy A. Payne, of New York University (NYU) Silver School of Social Work, wrote about treating brain illness,

“There is tremendous satisfaction gained from facilitating the transition from profound illness to equally profound recovery.”

The life-line takes courage to look at.  It takes courage to believe that the effect of our negative thoughts and distorted perceptions could indeed have that pervasively profound effect.  It takes courage to consider that medical treatment can likewise, profoundly change our quality of life.

Hank tried to take his life with a rope before we met.  I’m so glad he didn’t break his neck or die.  He is now well treated and his disease is in remission.  His life-line has changed.Bo-J0zyIEAA_Y3h

Questions:  What are you brave with?  What do you spend your courage on?  Tell us about it.  We gain so much from community and connection.  Keep on.

Self-Care Tip:  Look also at the un-reasons, at the reasons less apparent, at what isn’t seen – look  into those reasons of why we feel and do.

To Use Tension, Or Run From it…

English: Waterfall near Lepena, Slovenia Slove...

English: Waterfall near Lepena, Slovenia Slovenščina: Slap, Lepena, Slovenija (Photo credit: Wikipedia)

A few days ago, we talked about tension being a tool for balance.  Col, in her comments, asked to expand on this.  Aside from feeling incredibly tense about it, I thought, “Ah!  All right.”

You’ve heard the term, “One’s man’s junk is another man’s treasure.”  Tension is like that.  It’s all kieshy now and pop! to meditate into oblivion, (I exaggerate,) and “medical” marijuana couldn’t be easier to get, but where do we get the opposition that provides so much of the pleasure in the calm?  Tension.

If you’ve never been quite calm yourself, imagine standing under a waterfall trying to dry off  when people say, “relax.”  (Got to love it when people say, “Calm down,” or, “Relax!”  …Ahem.)  Using tension as a tool for balance is learning to do something else in the downpour other than drying up, like take a shower or make a rainbow.

This is easier to say than do, for sure.  But just simply knowing that tension isn’t the enemy is a great boon.

Question:  When have you noticed that tension is a tool for balance in your life?  Do you use tension or run from it?  Please tell us your story.

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Be a Celebrating Hero

An Asian black bear, shot after charging the &...

An Asian black bear, shot after charging the “Old Shekarry”, as illustrated in Wild sports of the world: a boy’s book of natural history and adventure (Photo credit: Wikipedia)

Potty-stench made going to the bathroom awful. Phong would wait for days rather than use a public bathroom. Just going near one left him showering for hours under scalding water and layers and layers of soap. He would work through three bars of soap at a time before he could even think about stopping. Stopping before was too horrific. If he did, before he stopped feeling dirty, than something horrible would happen, or so his thoughts shouted at him. The devil would eat his little girl.

Phong knew that was not going to happen but the thoughts were tormenting and nothing made them better. Sometimes he would rather die than see the bloody gruesome scene in his thoughts another day.

Obsessive Convulsive Disease is a bear. Getting treatment is seriously scary. The treatment not working is petrifying. And just about anything in between is fear invoking. You get the picture. Who will go up against a bear like that?

I remember in the Disney*Pixar movie, Brave, when the dad, Fergus, yells:

Mor’du! Elinor, hide!
[Elinor and Merida run off, one of Fergus’ men passes a spear to him, Fergus charges towards Mor’du (in bear form) but he snaps off Fergus’ spear, then we see Elinor and Merida escape on horseback, then Fergus holds up his sword at Mor’du and shouts]

Fergus, like the beast he fights, growls a bellow:

Come on, you!
[suddenly Mor’du lunges forward and the screen goes blank]

Eventually we learn that Fergus won but suffered the casualty of his leg. The amount of adrenaline in that time and sympathetic hyperawareness Fergus experienced is just close to the amount that Phong has daily or multiple times daily sometimes in his Exposure and response prevention (ERP) therapy and medications. In ERP, he has to choose to expose himself to this nearly incomprehensibly horrible fear, respond to it and then wait until the fear lessons. This is a bad case of, “it must get worse before it gets better.” But Phong does it. Mostly. He just does not want this to go on and like a prisoner of war, he is eating the grass under the fence line to survive. The man has courage. Can you imagine going through that kind of cortisol crisis every day?

And as mentioned, on top of that, he takes his medications. Anyone who takes medications, knows that we don’t need courage once to do it, but every day, hand to pills to mouth, we need sinew. Phong is one of my heroes.

Question: Do you know you are a hero? Any ideas, why? How do you celebrate that? Or would you if you would celebrate this? Please tell us your story.

Self-care tip: Growl a bellow at what you fight! Be a celebrated/celebrating hero.

Feeling Afraid

Celine was made to fidget by something moving inside her.  It tooled with her body while working her over.

I’m afraid.

Rich.  We are all afraid.  Knowing it and naming it is more than many of us have the spit to do.  But not being named doesn’t make us more courageous.

I am afraid.

Celine wanted help and as her perception grew of what she was looking for, she knew.  It was fast.  Awareness appeared in progressive pictures into her own flip book.

Remember those flip books when we were kids like, Mickey Mouse tapping his foot as the pages sped by, leaning over to kiss Minnie?  Celine’s flip book showed her that she felt unappreciated at work.  She resented her authorities, lack of control and felt ashamed that she wasn’t acknowledged.  Scenes in her life gave her the illusion of movement toward more than just danger though.

Being in fear is not in itself wrong or amoral.  Sure as yams are sweet, it’s going to happen.  We all have fear.  Feeling afraid doesn’t mean that we are bad.  It doesn’t confirm the accusation or shame.  It doesn’t close on us.  It just is.  Fear.  Celine’s illusion was that she was moving toward being the wrongness, being amoral, and being especially bad.

Ironically, Celine found some comfort in this and decompressed.

The medical reasons behind fear are of all varieties and certainly important, but this post isn’t about those.  It’s about our flip books.  Lick thumb and finger and let’s see what pictures we’ve sequenced into our own illusions. We all have a book.  We all have fear.

Question:  What does looking at your flip book do for your sense of value?  Please speak.

Self-Care Tip:  Remember what makes “Me” special by being present with fear.

From a Fellow Commentor – Her Friend Suicided

Anxiety Always

Anxiety Always (Photo credit: Wikipedia)

i woke up this morning to find out that my friend shot herself last night. she texted me, said she hoped i had a good night and said goodbye. she then walked outside and shot herself in the head.  
there are so many emotions i can’t even sort them out.  i don’t know what to feel, i can’t even cry.  why haven’t I cried?  I didn’t hear her stupid text, I didn’t know… I knew she had her demons we all do, but they convinced her to end it.  it’s so finial, so F-ing stupid!!!!!
is this how it ends for us that are so f**ked up in the head?  she wasn’t on meds, would that have even helped?  I don’t know what to think sana. last month i got a phone call from my friend who lives in Fallbrook and she had been dealing with anxiety couldn’t take it anymore, said she didn’t want to feel the anxiety anymore and tried to kill herself.  she was admitted and stayed for 4 weeks.  she’s on so many meds that she’s speaks in a monotone voice.  it’s has really scared me.  
is this how it’s going to be for all of us that deal with fear, anxiety and panic? I need to go for a walk, i feel numb. i feel so pissed off and feel bad that I’m mad. 
i’m scared
didn’t know who else to share this with that would understand
Questions:  Do you?  What do you understand?  Is this how it’s going to be for all of us?  Please tell us your story.  We need to hear.

Medications and Being Chosen by Fear

English: In 1870 he lost an arm, in 1917 he lo...

Many have been hurt by medications.  There are those life ending treatments.  There are accidents.  It doesn’t matter what remote or near number in the chance-line the side effect has to the victim or the survivors.  They happened and they happen.

If you are a survivor of something like this, if your child died or your mother almost did, if you lost your favorite thing in life – lost what you identified yourself by or if you were changed without being asked, you know what I am talking about.

How do you come back after that?  How do you endure opening your pill dispenser on Wednesday, on Thursday, every week, every day, how do you take medications when they are prescribed?

On my end as a physician, each prescription is a choice.  Each prescription carries the bit I am allowed to participate in.  Signing my name, I am saying with the informed patient, that the benefits outweigh the risks.

When you take your medications, know that you are not alone.  Know that you are doing this with numbers of other courageous people taking their medications.  Know that your physician, with the research behind this, with the high numbers of other persons generous enough to enroll themselves in those medication trials before the Federal Drug Administration (FDA) approved it.  Know that the FDA is with you and know that the benefits out weigh the risks for you.  That you decided the benefits are greater than the risks means you know what they are and you are choosing to take care of yourself.

Medication isn’t for everyone.  Medication hurts a lot of us.  Taking medication with this knowledge is still something many of us choose.

If we are not taking our medication because the fear precludes it, we can do better than that for ourselves.  We can choose not to take it without being chosen by fear.  On the flip side, we can choose to take medication without being chose by fear.  Being chosen by fear hurts us too.

Self-Care Tip:  Go into the space of where your fears are and let it lose power over you.

Questions:  How do you claim your freedom to choose when it comes to something as complicated and scary as medication?  Please tell us your story.