Death doesn’t take a holiday

Just when I thought I was out….anxiety pulled me back in.

It’s been over a year since my last post here. I had exited therapy some time ago and was making decent progress in dealing with panic and irrational fear. Highly functioning for the first time in years, things were looking up.

In therapy, my doctor had worked extensively to drive home two main points. First, rather than trying to anticipate and control every possible scenario in a futile attempt to impose safety, my energy should be better spent developing tools to deal with events when they occurred. Second, understand that even though I had a rocky history involving trauma and loss, the worst doesn’t always happen, so don’t anticipate that it will.

Skeptical? You better believe it. But her advice was sound, and it made a real difference for a long time.

August 2010, on our second day of vacation in North Carolina, my wife drowned in the ocean. It was starting to get dark so we prepared to leave, and she said that she was going to catch one more wave. Two minutes became five, then ten. Frantic searching was unsuccessful. 911 was called and rescue teams screamed to the beach, already notified of an apparent cardiac arrest.

Two people, a father and son, had been walking far down the beach and had found my wife floating, lifeless. Paramedics told me she was already cold by the time they got to her. They were very sorry for my loss.

My oldest son was with me, but my daughter had taken my ten year old son back to the beach house when things got frantic. I stumbled back to the rental property and told them Lisa was gone.

It was agonizing. I couldn’t sleep or eat. I had to wait for her body to be released by the medical examiner, then travel to a local funeral home to arrange for the return of her body. I had to make many phone calls to friends and family, including Lisa’s parents.

The worst doesn’t always happen. For me, that’s not true, as has been proven countless times.

The last ten months have been spent holding the family together, and administering my wife’s estate. It’s excruciating. After years of being told that it’s not my responsibility to always look after others, I’m right back in the role I despise.

My young son struggles, as we all do, but he’s already challenged with moderate-to-severe ADHD, and this provides additional burden for him. He’s demonstrating significant anxiety responses of his own, and we’re both seeing the same psychiatrist. She’s been great. But another generation of my family has suffered great trauma. I had hoped the chain would break with me.

Lisa wasn’t there for the first day of school, or Halloween, Thanksgiving, or Christmas. We did the best that we could, but it was miserable. January would have been our 13th wedding anniversary, April her 46th birthday. Mother’s Day was difficult, teary, and hollow.

We’re coming up on the 1st anniversary of her death, and I’m not sure what that will be like. Sad and lonely certainly. But what else?

We were going to grow old together, be wonderful grandparents, travel to new places, make a difference in areas we cared about. And now she’s gone and that won’t happen. What do I do with that?

I feel like a psychological Sisyphus, rolling an anxiety bolder up the hill, sweating and grunting, doing the hard work to take me to the pinnacle, only to have the stone return to the bottom yet again. And now my young son has a boulder of his own.

So I’m back. I’d like to say it’s good to see you all again, but that’s not true.

Damn it all the hell.

Am I Cold, or Sad?

Henry Wordsworth Longfellow was once quoted as saying, “Every man has his secret sorrows which the world knows not; and often times we call a man cold when he is only sad.”

I’ve been thinking about that quote lately, as the world has grown topsy-turvy and I find myself in an unsafe place. One of my defense mechanisms is to withdraw, like one of those potato bugs that curls into a ball at the first sign of danger, its hard outer shell offering a modicum of protection from the harsh reality of nature.

But the potato bug is small, and the world is very big. A threat of any consequence would easily overcome the tiny armored exterior. If nothing else, the insect could be completely crushed, smashed flat by an attacker.

That reality doesn’t stop the potato bug from curling up when danger lurks. Maybe it’s just one way for the bug to make it from day to day, confident that the instinctive reaction repels the enemy every time, until of course it doesn’t, but then the potato bug would be dead, you see, and the whole point would become moot, at least to the potato bug.

Getting back to me for a moment – when I’m feeling unsafe, or unsure, and I retreat, do people think I’m cold? Unapproachable? Distant? Aloof?

Maybe. Probably not those who know me well, and that’s admittedly a rather small group. Potato bugs don’t show their vulnerable underbelly unless they have to. But do I care about everyone else? And if the answer is “no”, does that make me less human? I don’t think it does. But if I had all the answers, I wouldn’t be sitting here in the shadows, typing black letters on a white screen.

Maybe it’s the difference between being detached and dejected, or separated and sorrowful. I’ve never been a “misery loves company” kind of guy, so it stands to reason that dysphoria could often be mistaken for distance. I take a pill for that. Maybe it’s time for a new pill?

I don’t know. I should probably ask about that the next time I see my doctor.

I’m not cold.

Chill the F*** Out

Coping with anxiety can often be a staid, tiring endeavor, and it helps to occasionally take a lighter approach. To that end, I give you this entry from one of my favorite blogs, Dear Coke Talk.

A woman writes in lamenting about her new boyfriend and some of the feelings that she’s experiencing.

My boyfriend and I are in what I suppose would be considered a “serious relationship.” I don’t date a lot, only had one other “real” relationship and it was a joke compared to what I have now. I have never felt better about myself, what I’m doing in my life, or where my life is headed. Even though I’m a college senior and about to jump into a life of uncertainty when I’m a person who hates change, I’m excited about what will happen to me and to us.

And:

Is it egotistical of me to think that after three months of a relationship he’s seriously considering our future together? After all, we talk about how we would raise kids and even looked at engagement rings (in what I thought was just a goofy moment).

Pretty typical stuff, right? And those of us with anxiety issues should immediately recognize a key phrase used by the reader. Did you spot it?

Dear Coke Talk did:

Okay, I need to read between the lines for a second. When you say “I’m a person who hates change,” what you really mean is “I’m a magnificent control freak.”

Also, when you say “I’m excited about what will happen to me,” what you really mean is “I’m terrified of the gigantic spinning fireball known as adulthood hurtling toward me at incredible speed.”

I point this out because it’s key to what’s going on here. You’re anxious about the future, and all of this silly flirtation with notions of marriage is merely is a coping mechanism for dealing with your crippling fear of uncertainty.

Bingo!

The rest of her response is equally precious. This passage stands out:

I know I’m stepping outside the boundary of the question here, but this next bit of advice doesn’t just apply to your relationship: don’t be in such a rush to play it so damned safe.

I know you can’t wait to be a music teacher and a stay-at-home mom, but why not start a fucking band first? You’ve got your whole life to drive minivans and vote for Sarah Palin. Go do something wild before settling down.

Go conquer your fear of uncertainty. Go spend some time experimenting with the human condition. Go have your own personal rumspringa and only come back when you know you’re ready.

Come on, you’ve got the soul of an artist. I don’t want you to regret not having any crazy stories to tell your grandkids.

Good advice for us all.

Childhood Anxiety Can Start Early

As an adult with anxiety challenges, I’ve often wondered at what point in my life I climbed aboard the anxiety train.

A new study published in the Journal of Child Psychology and Psychiatry posits that up to 15% of preschool children may have “atypically high depression and anxiety levels”, a number that I find statistically significant and somewhat surprising.

What wasn’t surprising was the genetic aspect of childhood anxiety documented. Children with high levels of anxiety and depression are more likely to have mothers who suffer from depression.

The study revealed that children as young as a year old demonstrate indications of higher risk. Given how quickly kids develop in that first year, it makes sense to think that the genetic similarities might come into play, but for me, it raises questions around environmental factors too.

The concept of preventative intervention in very young children with significant risk factors might be a good way to address core issues before they have a chance to lead to atypical behaviors and suffering. It will be interesting to see where the research eventually leads.

Anxiety Insights link

Can Yoga Help Workplace Stress & Anxiety?

With the often relentless pace at work, it’s sometimes difficult to carve out even a half-hour for lunch. Stepping away for 20-30 minutes to have a bite to eat, stretch my legs, and just get away from the workplace energy for a little while can be helpful in reducing those feelings of stress and anxiety that slowly surround me like a misty fog.

So when I read about this study that included guided workplace yoga and meditation to help with stress relief, my first thought was, “Where do I sign up?”, although I’m unsure that anyone wants to see me in full downward facing dog while wearing my Dockers.

I’ve written before about the benefits of mindfulness-based stress reduction therapy, most notably here and here. Conceptually, being able to recognize and be aware of your stressful, anxious state is the first step toward doing something about it. Over time, I learned breathing and relaxation techniques that can be put into use in just about any situation, at any time, the result being a more relaxed, unstressed version of me.

The study, conducted at the Ohio State University here in Columbus, was specifically designed for office worker types wearing business apparel, and involved an hour meeting once a week during lunch, plus 20 minutes per day of yoga and meditation performed at the subject’s desks. The results were impressive:

Mindful attention awareness increased significantly and perceived stress decreased significantly among the intervention group when compared to the control group’s responses. Overall sleep quality increased in both groups, but three of seven components of sleep were more affected in the intervention group.

On average, mindfulness increased by about 9.7 percent and perceived stress decreased by about 11 percent among the group that experienced the intervention. These participants also reported that it took them less time to fall asleep, they had fewer sleep disturbances and they experienced less daytime dysfunction than did members of the non-intervention group.

Two things jump out at me from this study – one, that simply being exposed to the concept of mindfulness, becoming aware of what you are feeling and why, is enormously beneficial. Secondly, there is an amazing sense of empowerment that comes from having effective tools, like yoga and meditation, to help address the stress and anxiety, and feeling better even a little bit can help spur you on, which can lead to even more effective results.

If you would like to know more about the study, you can read the full details at Anxiety Insights. Go forth and unwind those tight muscles and loosen that tense mind!

NY Times: Taking Anxiety to a New Level

The New York Times has a posting in their Fashion and Style section on anxiety. Who knew that my psychological disorder was either stylish, fashionable, or both?

The author experiences some knee-knocking while looking over a cliff at Big Sur and notices that as she gets older, she’s much less inclined to engage in activities that involve elevation. She claims to never have been afraid of heights before, but now, at 47, altitude causes her anxiousness.

From a clinical perspective, as one gets older, we lose some of our mobility, and our confidence in being able to handle some of the physical demands as well as we did in our youth can wane. But is that anxiety?

From the article:

There is a difference between a fear and a phobia, of course. The people at the Anxiety Disorders Association of America will tell you that we all have things that scare us, after all. It’s when fears start limiting our behavior that they become the kind of full-fledged anxiety-producing phobias that afflict more than 19 million people nationwide. That’s more than 8 percent of the adult population, and the only reason I agreed to hike on the headlands trail in the first place was to keep myself from joining them.

So she takes to nature so she doesn’t have to join our ever-growing group of anxiety sufferers? Really?

I think there’s a big difference between fear and anxiety. Standing on the edge of a craggy cliff that juts out over the ocean is the kind of thing humans learned to stay away from, because experience reminded us of the time when Urg the caveman did that and plunged to his death. Our self-survival mechanisms kicked in, and over time it became ingrained in us to avoid doing silly things like that. It reminds me of a cat that sits on a hot stove. He never sits on a hot stove again – but he never sits on a cold one, either.

I’m guessing that the writer was trying to be cute and draw comparisons between loafing at Big Sur and having a panic attack for no discernible reason, but I’m not buying it. We don’t have the choice to avoid our everyday lives like she can avoid Big Sur, or an expensive dinner at a rotating restaurant at the top of some tall building.

Please don’t use anxiety for alliteration purposes, especially if you don’t understand what it is. A couple of quotes tossed in from authoritative anxiety sources doesn’t help explain how crippling anxiety disorders can be, and equating them to being afraid of falling into the ocean do nothing to educate the general public about a very real, very serious illness.

Image via Wikimedia Commons – Dysepsion

It Is What It Is

This may sound completely idiotic coming from an anxiety sufferer, but Murphy’s Law is generally correct. More often than not, things don’t go exactly as planned.

For the anxious control freaks among us, that’s like crack. What better way to get revved up and knee-deep in the drama surrounding something unanticipated than to slap a label on it? If things didn’t turn out like we thought they should, that’s bad. Right?

Or is it?

One of the big challenges I’ve faced over the years has been the struggle to accept things as they are, without assigning a value or judgment to them. Admittedly, that’s a difficult habit to break after 40 years. My natural response to something like stripping a bolt thread or dropping the eggs on the floor has been, “well, that sucks, dammit.” which obviously removes the need for a mind-reader to ascertain what I’m thinking at that moment.

Similarly, whining about how I wished this hadn’t happened, or feeling put upon (this always happens to me at the worst possible time) did nothing to change my situation or act to prevent something from going wrong in the future. The universe doesn’t work that way!

The world is an imperfect place. Screws fall out all the time. Why are we so surprised by this?

If anything, when something goes awry, I should take comfort in the realization that the universe is working exactly as designed. Things are supposed to break down, not work, or turn out poorly now and then. It’s my unrealistic expectation of perfection that’s the problem, not the egg yolks staining my socks.

When I moved into a new job about 18 months ago, it came with a different level of interaction with senior management, one that didn’t always make it easy to be heard or advocate for my programs. After a couple of frustrating weeks of trying to prepare and anticipate where the obstacles would pop up next, I decided to post a handy reminder on the cork board by my Cisco IP phone.

It is what it is.

Sounding like a phrase oft-uttered at the Bada-Bing club by Tony Soprano, it was the perfect cue to draw my focus away from getting caught up in making judgment calls about what was happening, or more importantly, who was causing it to happen. Rather, I began to deal with just the facts of the situation, without worrying if they were good or bad, happy or sad, positive or negative. It all depended on perspective after all – what seemed good to me was bad for someone else, and when we got caught up in trying to convince someone to change their position or outlook, we were missing the main point. It just was – so what do we do next?

Success has been mixed, but it’s important for me to stay engaged and focused, and when events occur, to not lament or wish things are different. They aren’t different. Everything is as it should be.

Image by KaroliK via flickr

Germany Building a Better Anxiety Drug

Via Reuters, German scientists believe they have found a new drug for panic disorders that works effectively without many of the effects of current compounds such as Valium (drowsiness, forgetfulness) and that work much more quickly than SSRIs that can can weeks to build up effective blood levels.

The new drug, termed XBD173, appears to work by targeting a much different “panic button” in the brain than other medicines. It also appears to be both safe and fast-acting. Studies showed XBD173 began to work as quickly as one hour after being administered, which would be ideal for people having acute panic attacks.

Also promising is the discovery that there are no withdrawal symptoms once patients discontinue use of the drug. Valium and other similar compounds are well-known to present dependency challenges and unpleasant withdrawal.

Let’s hope research continues on XBD173 and we see it on the market sometime in the near future.

German research points way to better anxiety drug , via Reuters

Repressing Trauma Not Harmful?

Anxiety Insights has the details of a Geisinger Health Center study that suggests certain people exposed to traumatic events may not suffer harm when they repress memories of those events.

“Going back to the days of Sigmund Freud, psychiatrists and mental health experts have suggested that repression of traumatic memories could lead to health problems,” Dr Boscarino said. “Yet we have found little evidence that repression had an adverse health impact on combat veterans exposed to psychological trauma many years later.”

One thing that leaps out in the article is the view that the use of exposure therapy – where people are asked to relive painful or traumatic events – may actually serve to trigger PTSD symptoms and psychological distress in those who had otherwise been doing just fine, thank you very much.

“While the dominant therapy model for PTSD should not be abandoned at this point, emerging research suggests that it might need to be seriously re-evaluated, at least for some PTSD patients,” Dr Boscarino said. “More research is clearly needed.”

Repressing traumatic memories may not be harmful to some , via Anxiety Insights

Living a Happy, Anxious Life

Paul, over at AnxietyGuru, asks the question, “Can You Live A Happy Anxious Life?”

It’s an interesting question, and I had to sit down for awhile and think about what my answer would be.

Paul posits:

Relative happiness is the kind you get when you buy something, say shoes or a motorcycle or whatever. It is temporary and subject to the whims of external change. Whereas inner happiness is yours no matter what, like all those fabulous bits of information you learned in school that you can’t use anywhere else, but yours they are.

I’m talking about inner peace and happiness. Now, admittedly you can be a Buddhist monk and never get there, but you can if you try. The fact that you can try should be, I hope, a signal that you can do more to be happy than you’re doing right now.

Dictionary.com has the following entry under happy:

1.         delighted, pleased, or glad, as over a particular thing: to be happy to see a person.

2.         characterized by or indicative of pleasure, contentment, or joy: a happy mood; a happy frame of mind.

3.         favored by fortune; fortunate or lucky: a happy, fruitful land.

4.         apt or felicitous, as actions, utterances, or ideas.

5.         obsessed by or quick to use the item indicated (usually used in combination): a trigger-happy gangster. Everybody is gadget-happy these days.

Anxiety, by the very nature of its presence, makes it difficult to achieve #3, since we anxious folk are generally skeptical of fortune or luck. But if we use #2 as our guiding light, which is what I think Paul was doing, then the answer is a resounding yes.

One of the very best things I learned in my treatment was to acknowledge and embrace the reality that things happen that are out of my control, and all of those years of pre-planning and proactive worrying didn’t change that a bit. It certainly gave me the illusion that nothing would go wrong, or if it did, I would be able to rapidly respond to the crisis. But it burned up energy and time for no good reason.

The downside of that – well, there were scores of downsides, but this is one of them – was that I was never in the moment during those times, because my mind and my emotions were perpetually skewed toward scanning the horizon for the next bad thing.

Once I began to let myself be present in the moment and feel the emotion that was appropriate for that snapshot in time, it became much easier to feel happy in an enjoyable way, not in the “if I let myself feel joy or peace, it will be crushing when it ends, because it always does” manner of my high anxiety years.

So when I stop to think about the things that make me happy, it’s much easier now to have clarity around what that means. I find great joy in time spent with my family, and I now allow this sense of calm, contentment, and happiness to wash over me like a waterfall, soaking me for as long as possible. Will this moment end, and will I eventually dry off again? Of course. But for that moment, that hour, that day, I’m drenched and soggy, which feels so much better than before.

I would call out these instances, these events, as reminders of my happiness, not happiness itself. I’m not engaged in some zero-sum game anymore, where I need to track and measure my level of joy, peace, and tranquility. I’m just me, a pretty happy guy, who often gets reminded of my happiness by people, places, and things. Other times, things don’t go as well, and rather than dwell on that, I seek out those very same people, places, and things that I know will keep me going until the dark cloud of anxiety passes over me.