panic

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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!

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Forgive to Get Friendly With Yourself

 

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Self-Care Tip #80 – Forgive.  Be a friend to yourself.

A reader wrote yesterday

Always intrigued by the possible connection between empathy and forgiveness….

Great progression of thought.  From both an anecdotal perspective and some biological considerations, David Mullen PhD and Everett L. Worthington Jr. PhD, are two of my favorites.  Other than Jesus, they have and do say it better than just about anyone.  I heard Dr. Worthington speak when still a resident-physician in psychiatry.  The story he told of his mother’s murder and how he came to forgive her murderers seared into my memory and has ever since been a reference for me in my personal life and medical practice.

The call came on New Years Day, 1996. His brother’s voice was shaky. “I have some bad news,” he said. “Mama has been murdered.”  …Their mother had been beaten to death. Rage bubbled up in him like lava. He heard himself saying, “I’d like to have that murderer alone in a room with just a baseball bat. I’d beat his brains out.”

Here’s where the empathy came in

…He tried to picture the crime scene. He imagined how a pair of youths might feel as they stood in the dark street preparing to rob the house. Perhaps they had been caught at robbery previously. They would have been keyed up. The house was dark; no car was in the driveway. No one’s home, they must have thought. Perhaps one said, “They’re at a New Year’s Eve party.“ They did not know that Worthington’s mother did not drive.  …Worthington imagined their shock when her voice came from behind. “What are you doing in here?”

“Oh, no!” one must have thought, “I’ll go to jail. She is ruining my life.” He lashed out with his crowbar, slamming his mother three times. Panicked, the youths went crazy, trashing the house, both for having their plans ruined and for the shame of having murdered.

This is part of the process that led Dr. Worthington to forgive the murder.  You can read more in his book, The Power of Forgiving.

There is an interplay, between choice and biology/non-choice.  It’s uncomfortable to think and talk about.  I can feel the hackles on the necks of my readers start to stand up just writing it and I humbly acknowledge my limitations in sharing this concept.  It is what I have tried to describe through many of my earlier blog posts.  This unlikely union between such polar concepts.

Being a Christian, I have awareness of the culture that frowns on taking bad behavior out of the church and into the laboratory.  When I think of empathy and forgiveness, I see party-hoppers moving in and out of those very places irreverently perhaps in some people’s minds.

Some other time we will broach further the idea of self-care being Christian v. scientific.

Self-Care Tip #80 – Forgive.  Be a friend to yourself.

Question:  Does any of this resonate with you?  Please tell me your story.

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Be Empathic to Others to Get Friendly With Yourself

 

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Self-Care tip #79 – Be empathic to others.  Be a friend to yourself.

Yesterday I wrote about considering intent and context when comparing self-care with selfishness.  That carries over to the people sharing life with those of us who have mental illness.  Do they see us as selfish?  For example, how is the spouse of the Panic Disorder going to make sense of the 40 phone-calls he gets while at work?

Mary’s husband told me that she’s been calling him “all day,” terrified she was going to die.  Checking to see when he was coming home.  She couldn’t go to the market because people would laugh at her.  Afraid.  Afraid.  Just plain afraid.  Really, everything had become about her.  She was like a scared kid.  Frankly it was annoying.  He was in a stressful work situation with the economy slumping.  People he knew were being laid off.  The other day he had to leave in the middle of an important job to go home and reassure her.  She was sobbing in the living room.  Sure she was going crazy.  He realized that he might have to tell his boss what was going on but what was going on?!  Who had his wife turned into.

In yesterday’s blog, we spoke about the ability to abstract v. concrete thinking.  Being able to abstract helps with empathy – connecting emotional content between people.  To put yourself in someone else’s shoes, as if you were them.  This is a critical part of relating, i.e. being in a relationship.  Many different mind illnesses affect our ability to abstract, including panic disorder.

In Mary’s case, she was not empathic when she was anxious.  She was thinking about herself.  Understandably, if you read the part about her believing she was going to die or go crazy.  But when you’re married to her, empathizing with her gets old.  It’s not so easy when it seeps into your work life, you haven’t had sex for months, and you have to do everything that has anything to do with going outside of the home.  Some part of you knows it’s not true, but another part of you screams, “Get over it you selfish child!”

Is Mary selfish?  Some might be able to answer even after all the phone-calls and unrecognizable behaviors, no.  Mary is not selfish.  They can do this specifically because they can abstract.  They can empathize.  They can consider the context of Mary’s disease and the intent of her behaviors.

Not everyone does this.  Not everyone is able to let “It” be about someone else.  Not everyone doesn’t have to have “It” be about them.

The best thing for those in relationships with someone emotionally ill, is to view the way they are behaving as biological.  When treated medically, than Mary or whoever it is in your life can do their own self-care.  But until then, staying in their lives requires maintaining an empathic view that considers intent and context.  It also means furthermore, doing your own self-care individually.

There are over-lapping flaps to our lives.  Scales on the back of an armadillo.  Me as encased by my body.  Me, that includes the space between me and you.  Me, that includes you, because you will always be a part of me.  Self-care really involves all that by degrees.  A chain-link.

So the question is, can empathy be chosen?  With money in the bank and wisdom, yes.

Self-Care tip #79 – Be empathic to others.  Be a friend to yourself.

Question:  Does any of this ring true for you?  Please tell me your story.

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My Essence – A Matter of Love

Betrayal?

Connecting that behaviors are linked to brain health is often confusing. The distance traveled to reach that point may have been long. It may have involved experiences painful to themselves and their loved ones.

For example, they may have lost a job because they couldn’t get out of bed in the morning. A divorce might have come after changing into someone irritable and angry. A trucker might no longer be able to drive on the freeway because of panic. But once they connect that this change in personality relates to a change in their brain health, how do they feel about that?

Some people feel relief. That they didn’t personally fail. That they aren’t a bad Christian. That it wasn’t because they didn’t try hard enough to “feel good,” to stop itching, to get up and do something with their life, to quit gambling, etc… Maybe they feel for a moment that judgment can be suspended for them.

However there is a group of people, maybe overlapping these, who feel betrayed. Betrayed by their very essence. The question of, if they can’t trust themselves, what is real in life at all? They struggle with the shame of betraying their own person. “Who am I if I’m not…?” and the questions roll on. It must be a question for all of us with changing bodies, Who are you if your mind gets sick?

There is the temporal line of thought, that if your brain changes, your memories, your personality, than you change. Your human form is different. Like getting your arm cut off, you have to grieve and grow a new picture of how you see yourself. A changing person through the span of life. This is in fact healthy adaptation.

There is also a thread in this weave of believing that our essence isn’t wholly related to our changing bodies. That somehow when the various curtains of life fall and open and the final curtain comes around, that this bit remains. I don’t think you can believe this unless you believe in a Love which is stronger than death.

Love is stronger than the death of my neurons, my dendritic connections, stronger than the death of my mind.

The adaptability needed for this life is a no-brainer. We can’t survive if we don’t. It takes courage to adapt when your person is changing. It takes courage when you are loosing yourself. Such courage, like someone in war or flight or determined movement that others could only imagine.

But how you define your essence also matters. I see it as a related step, but also apart from these excellent coping skills. I see it as a matter of Love. It’s win-win when Love weaves through you.

Self Care Tip #16 – Choose Love. Be a friend to yourself.