Understanding

understandingDear Loved One,
It’s me, your (wife, daughter, sister, friend, girlfriend). I know it’s been really hard lately, watching my meltdowns. I don’t think I could be in your position, witnessing panic attack after panic attack, and an overall highly anxious state. It must be utter hell.

Now imagine what it’s like to live through it. It’s worse than hell. It’s like being promised heaven, having it dangled in front of you like a carrot, and then snatched away at the last minute. You know how when your foot falls asleep and it feels like pins and needles when it wakes up? Having anxiety feels like your whole body is on pins and needles all the time.

I love you so much, but it doesn’t help me when you say “It’s going to be okay,” or “It’s fine.” Those are like empty words and they make things worse instead of better. When I’m in a dark place, I want you to climb in there with me, put your arms around me and say, “Here I am. I’m in the darkness with you..”

When you don’t know what to do, don’t improvise or make something up. Tell me, “I don’t know what to do. What can I do?” That helps more than you know.

Just be here. Just love me. Just sit next to me and be my reality. You know and I know it’s not always this bad. We’ll weather this storm.

The Anxious Oneheartunderstanding

Therapy

T (1)Therapy can be a very helpful tool to get one from “here” to where they want to be. So much depends on the therapist, and the relationship between client and therapist. There are as many different kinds of therapies as there are grains of sand on the beach, literally. I was going to introduce them all here, but I went on Wikipedia, and they were actually alphabetized, there were too many for me to count.

When choosing a psychotherapist, there are some important things to keep in mind. Like the fact that a therapist can be a social worker, a psychiatrist, a psychologist, or someone with religious training. It’s good to ask a person’s credentials (or at least ask for a card) before you get too involved with them.

There are other good questions I always wish I would ask before I got too deeply sucked into a therapeutic relationship. lol Maybe next time. They are:

What theories do you use? Why?
(You’re asking because you want to know why they think it’s effective, not what they personally like)

There are many new techniques and ideas, how do you stay on top of all of it?  (look for “attend training, conferences, reading”)
I’ve read that [X THERAPY YOU ARE NOT PLANNING TO USE] is sometimes used with [PROBLEM I HAVE], what are you thoughts about this?

What role do you think medication plays in mental health?
(You’re looking for an answer like “it depends”. Some psychiatrists think “non-compliance” to medication regimens is like total rebellion)

I know everyone is different, but what is the time-range for this therapy to show some progress?

Have you treated anyone with issues like mine? What was the outcome? What was the likely cause of that success/failure?

How will we measure progress?

When do you start thinking about termination (ending the relationship), and what will that look like?
(e.g. will it be a shared decision, is there a set number of visits and then review etc).

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As for anxiety, CBT therapy is purported to be the most helpful. CBT is cognitive-behavioral therapy.

  • Cognitive therapy examines how negative thoughts, or cognitions, contribute to anxiety.
  • Behavior therapy examines how you behave and react in situations that trigger anxiety.

Personally, as someone who has gone through and is going through CBT, I detest it. I hate, hate, hate it. I find it tedious and time-consuming. But *sigh* that’s just me.

Have a wonderful evening, my friends.

Ciao, Bella.therapy

Relaxation and Social Anxiety Disorder

front-porch-utah The first time I ever learned a relaxation technique I was in a psychiatric hospital. This must have  been, ooooh at least twenty years ago now.

Doug, who was the Activity Therapist, had us all go into a quiet, dark, room (he had turned off the lights), grab a floor mat, and find a space on the carpeted floor. It’s weird, remembering it now. Some of us lay on our tummies, some on our backs, our sides with our knees pulled up. All the while, Doug just said to get comfortable.

Then he told us to close our eyes and quiet our breathing as much as we could. He put on a tape. I still remember it to this day. It was about walking down a staircase, and the further down you went, the more relaxed you felt. Until, at the very end of the stairs we came out into this gorgeous meadow of flowers.

When it was over, I didn’t want to move. I didn’t want to open my eyes, and I certainly didn’t want to come back to the “real world.” Happily, Doug gave us each copies of that tape.

Relaxation is so very important for anxiety, and especially helpful to panic attacks.

whyhateWell, I don’t think it’s any secret that I have social anxiety disorder. I’ve shared my problems with just going out to get the mail during daylight hours, and that’s purely about being judged and found wanting. It’s a deep-seated fear; I don’t know exactly when it began or how it got so big. I only know I wish it would go away.

I usually avoid situations that I find too incredibly difficult. I learned this as a young child, when I would hide in my bedroom during large family gatherings, like Thanksgiving, or Christmas. It didn’t always work, but sometimes it did.

Today I do little experiments. I started the crochet meetup. It failed miserably. Groups like that don’t work if no one shows up ha ha ha. But I did take a chance, and I put myself out there. I do other things, like once I went to Panera and sat in one of their comfortable chairs and just crocheted for a while. Of course, all the while, my mind was going 90 to nothin’. “Is that man looking at me? Why is he looking at me that way? People do needlework in Panera all the time. This is not that unusual. Do I have something on my shirt? If I move now, and look down at my shirt, surely I will look like a total idiot. Stay calm. Maybe he’s not looking at me. Maybe he’s looking in my general direction and it just feels like he’s looking at me.”

You can see how it can get pretty exhausting. And that was just one person.

Hope you have a great rest of the day.

Ciao, Bella.

Quivers And Quavers

Q (1)Often, medications have side effects which include shakiness. But mostly, if we have anxiety, shakiness at one time or another, sort of comes with the territory. Either our hands can shake, our voices, or both, or our whole bodies can tremble if we’re very afraid.

It’s actually extremely common, and the only way to stop it is to deal with the anxiety beforehand. If you’re already anxious and trying to prevent shaking hands, it’s too late; kinda like closing the barn door after the cows get out.

There are different types of shaking. There may be more, but these are the ones I know:

  • Short term anxiety  Everyone–even people who don’t have anxiety—sometimes shake when they’re in a situation that makes them feel nervous. A first date, called to see the boss, bad thunderstorms, tests. It’s really very normal.
  • Generalized anxiety disorder  Those of us with GAD are in, like, super-charged “worry” mode all day, every day. Our fight or flight system is firing all day long at low levels.  This may cause shaking to happen for what might seem to be no reason at all.
  • Panic attacks  Before, during, or after panic attacks, shaking can be very normal. This type of shaking is absolutely caused by the intense fear that panic attacks cause.
  • Unexplained shaking incident (USI)  Those of us with day to day anxiety may simply feel shaky or develop a tremor in our hands. Long term stress can have unusual effects on our bodies, and so it should be no surprise that we experience tremor during unusual situations.

In the times that I’ve been anxious and felt my hands begin to tremble, nothing has calmed them sooner than cuddling with my Lucy dog or holding a baby. What is it about that?

Well, I did not mean to get so long-winded! Shush me much more quickly next time! 😛

I will see you tomorrow. Be good to yourselves. 🙂

Ciao, Bella.

Panic Disorder

P (1)Well, I did manage to bring in the mail during the day yesterday and, as always happens, by the time I got back in the house my heart was pounding, I was sweating, I could barely catch my breath, and I had to sit on the stairs before I could take the mail either up or down (we live in a bi-level).

So, before I could celebrate that I had achieved something which was a 9 (on a scale of 1-10) on my Fear Ladder, I needed to calm myself down. I did something my therapist had taught me. I placed my right hand on my chest, my left on my stomach, and began to do my best to take deep breaths in through my nose, and out through my mouth, then eventually out through my nose as well. I kept my eyes open the whole time, so that every time I caught my chest rising when I breathed in instead of my stomach, I had to change that. I thought about how babies breathe. They’re such belly breathers! Not a care in the world as they lie on their backs wherever they are, breathing in and pushing that belly out. When we sleep at night, we’re belly breathers. We’ve just forgotten this in our hell fire hurry to get things done.

Let’s belly breathe more often. I’ll sure remember it, next time I get in a tight spot.

This is the entirety of my Fear Ladder. As you can see, it’s written for, and leading up to, a very specific reason:

3 Imagining walking the dog
3.5 Draw self walking dog
4 Look at pictures of lots of people outside
4.5 Watch video of someone walking outside
4.5 Ask for help in a store
4.5 Buy jeans
5 Putting gas in car
5 Walk with someone in a private area
5 Answering the phone
5 Driving in the car
5 Ask for directions
6 Walking into unfamiliar store or business
7 Walk with someone in public
7 Sit outside reading a book and smoking
8 Watch video of someone else with social anxiety disorder
8 Stand outside, look around
8 Taking garbage out
8 Walk with Lucy to the mailbox
9 Walk alone to the mailbox
9 Walk dog around the block
9 Walk down Meadowbrook with Lucy

Hmm. It occurs to me that I’m opening myself up for lots of ridicule by being so vulnerable and, well, open about myself. But I couldn’t think of a better example about panic disorder that didn’t sound straight out of a textbook.

So there you have it!

Ciao, Bella.'That's right! No huffing a puffing for 30 minutes on a treadmill. We've developed a new stress test that is faster and more accurate.'

 

Obsessive-Compulsive Disorder

O (1)Most people, when they think of OCD, imagine the comedic detective, Monk. While he shows some of the fears, obsessions and compulsions that may indeed be typical, I think it’s mainly a caricature. It was still a wonderful way for people to be exposed to this particular illness.

The obsessive part of OCD symptoms usually includes: fear of contamination, having things in order or symmetrical, strong or horrible thoughts about harming yourself or someone else, and unwanted thoughts, especially sexual.

The compulsive part of OCD symptoms usually includes: washing or cleaning, counting, checking, asking for reassurances, following a strict routine, and being very orderly.

The two main treatments for OCD are psychotherapy and medications. Obviously, the best treatment would be a combination of the two.

I have never heard it called this, but ERP (Exposure and Response Prevention) therapy is supposed to be the most effective treatment. It involves gradually exposing the person to the feared object (dirt, etc.) and talking about whatever comes up as you go; being in the anxiety and not running away.

Deep Brain Stimulation (DBS) has also been suggested for individuals who don’t respond well to either psychotherapy or medications. People should be warned it hasn’t been thoroughly tested.

Coping with OCD can be difficult. There are things we can do to help us get through, such as: join a support group, find a healthy outlet (like a hobby), or learn relaxation and stress management.

Hope this was helpful. Have a wonderful Friday!!

Ciao, Bella.
bother you

Neutralizers

N (1)Welcome to the letter “N.” It might be easy to smile or, even, laugh at the picture I’ve included with today’s post of Will Smith from MIB holding a neutralizer. But–picture this. There you are, stuck in a panic-anxiety cycle, with no clear end in sight. Along comes handsome, sexy, Will. He flashes his neutralizer at you and suddenly you’re perfectly fine. In fact, you can’t even remember what it was you were so anxious about! Because that’s what the neutralizer does, right? It zaps your memory. I think that would be incredibly clever.

In a way, outside of the fantasy/movie world, neutralizers aren’t really very different at all. Three examples of anxiety neutralizers are:

1. Understanding. This includes both understanding oneself and being understood by others. How is this a neutralizer? The more we understand ourselves, the more we get to know our personalities, our core values, our bodies, our dreams, our likes and dislikes—the more compassion we will have for ourselves, and the more absolute ability we will have to come against fear. Or so I’m told. 😉 And, I don’t think I need to explain how much it matters when others understand us. We all know what it means when they don’t, right? So just imagine the opposite of that.

2. Fun. The extreme importance of fun is not lost on me. I surely don’t have enough of it. Lord, my mother is always telling me I’d be prettier if I’d only smile more often. I think we’re all so serious because–well anxiety is a serious business, and we spend half our lives looking over our shoulders to see where the next shock is going to come from. But you know what? Let’s not. Let’s not do that. Let’s pretend we all live in a Disney movie. One of the old ones from when Walt was still alive; an animated one, like Cinderella. You know, she comes from a bad situation but she gets out of it and she marries a prince. Right? Not too shabby! I wouldn’t mind that. Try to have some fun. Don’t be afraid to look a little stupid. Hell, I look stupid all the time. 😛

3. Mindfulness. One of the biggest problems with anxious worriers is they spend half their time obsessing about something that happened yesterday, which they can’t change, or panicking about tomorrow, which hasn’t come yet. Mindfulness teaches us to focus on right here, right now, this moment. There is no other.

This was a little longer than I wanted it to be, but I tried to say it as succinctly as possible. I hope you found it helpful. Again, sorry for the tardiness. We were out of internet all day and, while I could have gone to Panera or something, I needed to stay for the Brighthouse guy because my mom wasn’t sure what to tell them.

Ciao, Bella. You all brighten my days so much. 🙂

P.S. I got the mail during the day twice this week and if I do it again tomorrow that’ll make three times!
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