Loneliness and Anxiety

I was reading a devotional tonight and discovered a quote from Mother Teresa.


"Today a great disease is that feeling of terrible loneliness, the feeling of being unwanted, having forgotten what human joy is, what the human feeling is of being wanted or loved...there is a tremendous hunger and a tremendous feeling of unwantedness everywhere. And that really is a great poverty."

Mother Teresa's words hit right to the heart of what I think causes most of my anxiety. "Terrible loneliness, the feeling of being unwanted." These two feelings grip me, especially the loneliness. And, they cause me to forget "what human joy is." On days when I struggle to just put one foot in front of the other, the sense of loneliness makes me think I'll never feel joy again. Loneliness, and feeling unwanted, cause me so much anxiety that I can't imagine I'll ever look forward to anything or experience pleasure again. All I can see is a future of just putting one foot in front of the other as I go through life.

Where does that loneliness come from, I've wondered. I remember very little of my childhood, but would have said it was pretty normal if you asked me. But, as I've worked my way through EMDR therapy, I've discovered that I was a lonely child and that loneliness has stayed with me, even though now I'm wanted, loved, and cared for. And, that is "a great poverty."

The poverty of not feeling accepted, of feeling alone, stayed with me long after those things were no longer true. They became part of who I am. So, now I'm faced with the task of learning to accept and love myself. Because, no matter how much others love and accept you, until you love and accept yourself, the "great poverty" will stay with you.

Sometimes Jimmy Buffett is My Therapist

Once again, I've been neglecting my blog. If you're still reading it, thanks for sticking with me. To bring you up to date, I'm still doing EMDR therapy. It's getting easier, and I've worked through more of my unrealized grief, a lot of fear, and some pretty deep sadness. It's so worth the journey, though. And, the journey isn't over yet, but I'm living with less anxiety and more acceptance right now.

During some of the hard days over the past few months, I felt overcome with anxiety and was afraid
I'd never find pleasure in anything again. I'd try to comfort myself by remembering things I used to enjoy, and tell myself that the day would come that I'd enjoy them again. During one of those days I decided to turn on Jimmy Buffett. Jimmy used to cheer me up. And, that morning when I turned on my JB playlist I realized that sometimes he's my therapist.

A line I heard that morning suddenly seemed filled with meaning, even though I'd listened to the song a million times before. "If it takes all the future, we'll live through the past."* Sometimes our pasts are so painful, and fill us with shame, sadness, and fear that's so overwhelming that it stops us in our tracks. The past seems to rob us of our future. Sometimes I've felt like I couldn't put one foot in front of the other. But, as I hummed along that morning, I felt a slight lifting of that overwhelming despair. I started to think about the future a little differently, and with a little more hope. As long as I keep taking steps, even tiny ones, it will keep me from giving up completely. Every step moves me forward. And, maybe it will take all my future to live through what I experienced in the past, but as long as I keep putting one foot in front of the other, I'm OK.

Thanks for the therapy, Jimmy.

*If the Phone Doesn't Ring, It's Me
Jimmy Buffet, Will Jennings, Michael Utley
Last Mango in Paris, 1985
Margaritaville Discography
YouTube "If the Phone Doesn't Ring, It's Me

What's Happened So Far with EMDR

If you follow my blog, you might have stopped because I haven't posted in such a long time. Or, maybe you've wondered what has happened since I started EMDR therapy. Well, I'll catch you up.

EMDR has helped me bring out a lot of things that could potentially be causes for my anxiety. I've been able to discuss some of my deepest fears, my sadness, and found grief I didn't even know existed. As I promised myself from the start, I've been completely honest with my therapist, which I haven't always been in the past. It's been a rough, rocky, tear-filled journey so far. In short, I hate it.

                                                                           

But, my panic attacks have subsided. That's the part that makes it worthwhile. Here's what isn't so pleasant. My generalized anxiety and depression have deepened. I've also gone through spells of intense anger, which my therapist says is normal as you go through EMDR.

In the midst of this, I've started a new job. I'm with the same company, but it's a new job, nonetheless. Probably not the best timing, but life happens and I've always been able to cope with life. It's a job I wanted, so I didn't want to turn it down. So, my general anxiety at work is very high. According to my therapist, it takes three to six months to adjust to a new job. I'm about six weeks in, so I'm looking forward to some of the anxiety dissipating in another six weeks or so. In the meantime, I'm using my bag of techniques from CBT-Meditation, grounding, affirmations, acceptance, yoga.

As I continue to work through, I'll keep you posted on how it's going. In the meantime, if you've had EMDR therapy, please let me know in the comments section. I'd like to hear your results. Thanks for reading and being patient when I take a break!

A New Kind of Therapy

Several times over the last two or three years, my regular therapist recommended that I try EMDR therapy. EMDR stands for Eye Movement Desensitization and Reprocessing and is considered to be an effective treatment for victims of trauma. I ignored my therapist's gentle suggestions and stayed with what I was comfortable with, Cognitive Behavioral Therapy, which is his primary treatment method. In my mind, EMDR wasn't going to help. I don't remember being a victim of a trauma. I mean, sure, I grew up in a dysfunctional family, but so did a zillion other people. And, yes, I have a lot of childhood amnesia, which is a symptom of trauma, but maybe there's just not that much worth remembering. And, then there's that icky, sad, anxious feeling I get whenever I think about what it was like when I was a kid, but surely, if I was a victim of a trauma, I'd remember it, right?

Finally, this year, with my anxiety at peak levels, I knew I had to try something new. My experience last summer with the CLARITY intensive outpatient program helped, but I was still having pretty severe anxiety, weird physical symptoms that my doctors couldn't explain, and it was starting to cause me to miss school and work. Until then, I'd never missed work because of anxiety. I'd always been able to tough it out. I was desperate to find something to help me before anxiety took control of my life. So, I asked my therapist why he thought EMDR would help, since I don't remember being a victim of a trauma. He told me that it has shown good results for people with anxiety and panic attacks and suggested that I just talk to an EMDR therapist on the phone and learn more. (My therapist doesn't do EMDR.) So, I agreed, he gave me a referral, I called the therapist, and got a lot of information. The EMDR therapist said he didn't want to waste my time or money if he didn't think EMDR would help, so he also got a lot of information from me. He got my permission to talk with my regular therapist, and a release from me so he could talk with the therapists at CLARITY. After several phone conversations and emails, he and I agreed to meet.

I was anxious (no surprise there, right?) when I went to my first session. We had a get-to-know-each-other conversation, paperwork, and some history to go over. After meeting him, I decided I wanted to continue with the therapy, and left with a lot of homework and an appointment in two weeks. My promise to myself was that I was going to be completely honest with myself and my new therapist during this process, something I don't think I've always done in past therapy. Some of my phobias, fears, physical sensations, and thoughts are so embarrassing that I don't want to admit them. And, sometimes, I feel like I'm making a big deal out of nothing, so I just don't bring things up. No more. So what if your therapist thinks you're crazy? Isn't that why you're going there?

I've had five sessions so far. Yes, they've been hard, and I've been disturbed by some of the things that have come up in our conversations. Some of them made my cry and I hate to cry. Today I had my first experience with the actual tactile stimulation that's used in EMDR. (Some therapists use eye movement, some use sounds, some use tapping, and some use vibration. Mine uses vibration.) And, yes, some images came across, and I had some uncomfortable physical sensations, but I knew I could stop at any time. I made it through, and feel like I'm making progress. I very much want to be better, to be less anxious, and I know it can take continuous work and practice. I'm willing to do it.

I found this website in case you want to learn more about EMDR. EMDR.com

Go Away

Anxiety, you're a sneaky fellow. You come slipping in when I'm feeling just fine. You, with your sense of dread and doom. You, telling me to be afraid of things that aren't there. You, telling me that something is wrong when it's not. You make my body feel all sorts of things that may or may not be real. You take all the pleasure out of things I'd normally enjoy. You make my mind focus on things that might go wrong. You take away my appetite, you cause my heart to race, and my throat and chest to hurt. Maybe you're just being overprotective, like a mama who's too worried about her child. But, I don't think so. I think you're mean. I think you're trying to make my life difficult. I think you just want to see if you can win with your scary tactics and fake frights. But, you won't win. I'm tougher than you. God made me stronger than you. I hate you. Go away.

Learning to Breathe

Most of the time, we don't think about breathing, right? We just go about our business and we're breathing. Oh, we might think about it when we hurry up a flight of stairs, or go out for a run (not that I'd know anything about that)! Maybe when we do yoga or meditate we'll focus on breathing. Or, if we have panic attacks, we might check our breathing. But, in general, it's safe to say we don't spend a ton of time thinking about breathing. We just do it.

Last week I was having an anxious week. I wasn't having any full-blown panic attacks, but my generalized anxiety was pretty strong. I felt tense, my appetite was poor, I had a sense of unease that I couldn't seem to escape. To top it off, my acid reflux was really terrible. I decided to see if I could find some yoga poses on YouTube that would help with acid reflux and digestion. Well, sure enough I found a great one. (If you happen to have acid reflux, also known as GERD, check out this link. Yoga for Heartburn with Adriene) And, like most yoga practices, this one began with taking deep breaths. As I began deep breathing, I noticed that I was so anxious I wasn't taking normal breaths. I was taking small, shallow breaths, and my body was a mass of tense muscles. I was holding my stomach, hips, and shoulders so tightly that they hurt. Of course, as I did the yoga poses, I began to breathe, relax, and lose the tension in my body, as well as helping the acid reflux.

The next day, I woke up with morning anxiety. As I did a few yoga poses to relieve the anxiety, I wondered why I never think to check on my breathing unless I'm having a panic attack. During yoga, when I breathe fully and relax my tight muscles, my anxiety lessens. Why not try to put this into practice throughout the day? Now, granted, I can't stop and do a yoga pose in every situation, unless I want to get some weird looks. But I can take full breaths and relax my muscles.

As the day went by, every time I started feeling the twinge that means anxiety is building, I reminded myself to breathe all the way down into my belly. I checked in with my body and deliberately relaxed my stomach, hips, and shoulders. I made myself relax into the anxiety instead of fighting it. The results were good. Instead of building up, the anxiety would start melting.

I've continued to practice this with good results. I've also starting checking with myself even when I'm not feeling anxious to see how I'm breathing. And, what I've learned is this- Most of the time, I take short, shallow breaths and my stomach, hips, and shoulders are sucked in tight. They actually hurt. But, stopping frequently to breathe fully and relax my tense muscles is helping reduce my anxiety. My appetite has improved, my sense of unease is less. I've even felt more energetic.

I think I'll continue to breathe. Breathe deeply and fully. I'll drop my shoulders, relax my stomach and hips. And, just breathe.

Friends Can Help

Honestly, last week was rough. I had a panic attack at home that was so bad it made me miss work, which is really rare for me because I'll usually tough it out. I had some of my hardest tests so far at school. I was on antibiotics because I was sick, and I have a phobia about taking medicines, particularly antibiotics. (More on that in a future post.) I was getting ready to leave on a trip, and travel can make me anxious, even though I love it. And, my husband was out of town all week, and he's my biggest cheerleader, confidant, and supporter. Shew.

On Friday I took my last test before spring break and felt really confident about how I did. We got out of school early and my husband was going to be home by evening! I felt pretty good as I left school on a beautiful, sunny, early spring afternoon. I was ready for lunch followed by an afternoon of getting my fingers and toes done by my favorite nail tech, who's also a good friend!

I'd really been struggling to eat the whole week. When I'm anxious, my normally good, (OK, way too good) appetite disappears and it's hard for me to eat anything. And, while I need to drop some pounds, not wanting to eat anything is not the way I want to do it. So, I was pretty excited that I felt hungry at lunchtime Friday. I stopped at my favorite organic grocery store for one of their yummy sandwiches and ate almost all of it when I got home. I gave my house a quick cleaning and noticed I had heartburn. I hate heartburn. It makes me have panic attacks because I'm sure it's a heart attack. I ignored it, and left for my mani/pedi appointment.

I was having a good time chatting with my nail tech friend and getting my pedicure, when I suddenly felt dizzy. It only lasted a second, but on top of my heartburn, that was all it took to start a panic attack. But, I wanted to manage it without taking my medicine. I didn't want to have to tell my friend I needed to take a pill. I was embarrassed. And, I was sure, as usual, that I was having a heart attack.

I used the many anxiety-management tools in my toolbox and the panic was subsiding as I moved from the pedicure chair to the manicure chair. I picked my nail color and felt like I was going to avoid a full blown panic attack. After all, the manicure is actually my favorite part. I nearly fall asleep when my hands are being pampered. But, I started feeling anxious again. I just knew I was having a heart attack. I tried grounding, I tried re-thinking. Finally, I had to tell my friend I was having a panic attack. I was so embarrassed. Even though she knows I have anxiety disorder, I felt humiliated having a panic attack right in front of her. But, telling her was the best thing I could have done.

She was kind. She was understanding and compassionate. She cancelled her next client, in spite of my protestation that I could go home. She has a private room where she does nails, so she suggested I try a couple of yoga poses, and spread a towel out so I could do them. She talked about when she herself had a couple of panic attacks. She even offered to drive me home, or to a hospital if I felt I needed it. Her calmness, her willingness to help, were what I needed. I took my medicine, I did the yoga poses, I talked with her about how hard it is to struggle with this disorder. After a while she finished my nails, gave me a hug, and I was able to go home feeling better.

I learned a lesson that day. It's one thing to talk to people about having anxiety disorder when I'm not having a panic attack, because people can't see what's happening. It's easy to write a blog about it because no one can see me have a panic attack through my blog. But, when you're having a panic attack in front of someone, it's humiliating. You want to run. But, the lesson I learned is that people can be kind. They can help.

Many thanks to my friend for helping me. I'm so lucky to have her for a friend.

Winter Blues

This has been the longest, coldest, grayest winter I can remember. I live in the South. I'm not used to this kind of weather. But, I don't mind the cold so much. In fact, I kind of like it. What I don't like are the gray days. When late fall arrives and the days shorten, my anxiety increases. And, it's always a little more trouble to manage till the longer, lighter days of spring begin to arrive. In this year's seemingly never-ending winter, I've felt my anxiety symptoms increase, and I've also been tired and irritable. I've had to be more conscientious than usual about managing my anxiety.

The first step in making it a little easier to manage is recognizing and accepting that my anxiety is worse during the winter. It's a little less frightening when I remember that this happens every winter and that it's common, even in people who don't normally have depression or anxiety.

The second step is to not get lazy about using daily techniques to reduce anxiety and depression, like grounding, progressive muscle relaxation, gratitude, prayer, and exercise.

The third step is to keep moving. No matter how appealing it is stay curled up on the sofa with a blanket when I don't have to be somewhere, it's important to do things like household chores, errand running, or just getting out and going to a coffee shop to read or write. Being around other people helps alleviate the sense of isolation that anxiety brings.

The fourth step is to keep my body comfortable. Anxiety makes us tense, can cause stomach issues, body pains, and other physical symptoms. I take warm baths, go for short walks, see the chiropractor for adjustments, and get massages.

The fifth step is to get outside when the sun happens to shine. I've noticed that being in the sun, even for a short time, lifts my mood. If you can't get outside, try sitting near a window where you can see the light. Or, it's a little weird, but if it's too cold to want to be outside for long, I'll sit in my car in the sunshine for a bit and listen to the radio!

Other small things are helpful, too. For instance, staying at a comfortable temperature reduces my anxiety. I've noticed my anxiety symptoms increase if I have to be in an uncomfortably cold environment. Conversely, some places are kept too warm in the winter and can make me feel hot and anxious. If I dress in layers where I can stay reasonably comfortable wherever I go I'm less likely to get anxious.

Eating well is also good for anxiety. In the winter, we tend to eat more and eat heavier foods. Eating warm, comforting food is great for decreasing anxiety and depression, but overeating, eating foods that are high in sodium and sugar, and not getting enough fruits and vegetables can make my anxiety worse. We just bought a NutriBullet at our house and it's helped me be sure I'm getting enough green, leafy veggies during this cold, long winter.

As I wait for spring, I look forward to more daylight, warmer temperatures, and seeing the daffodils show their pretty faces. In the meantime, you'll find me staying warm, looking out the window in search of sunshine, and remembering I'm not the only one whose anxiety is worse in the winter.

My Tried and True Tool for Panic Attacks

There's one tool I always turn to when I'm anxious. It helps prevent panic attacks and shortens an attack if I'm having one. If I do it every day, or even a few days a week, it lowers my generalized anxiety. It's my go-to, tried and true, helps-every-time technique called Progressive Muscle Relaxation.

I heard about it years ago when my therapist recommended "The Anxiety and Phobia Workbook" by Edmund Bourne, which became my favorite book on anxiety. Although my therapist recommended reading the whole book, he specifically wanted me to learn how to use this technique. And, I've been using it ever since. Without fail, Progressive Muscle Relaxation provides me with some relief from both generalized anxiety and from panic attacks. It works best if I practice it a minimum of three times a week, more if my anxiety is acute. And, if a panic attack is starting, I've found that it reduces the symptoms and shortens the attack. In other words, I can keep it from turning into a full-blown panic attack, which I ALWAYS want to avoid.

Progressive Muscle Relaxation isn't new. It was developed in the 1930's by a physician, Dr. Edmund Jacobson, and originally had over 200 exercises to reduce stress. Thankfully, it doesn't take all 200 exercises to reduce anxiety; about 15-20 are commonly used. And, don't freak out over the word exercise. No work-out is involved. If you read my blog often, you know I'm not using something that involves a work-out...

So, how do you go about doing this amazing technique? It's pretty simple. It involves systematically tensing and releasing your muscles while breathing. You can do it lying down or sitting in a chair. If you're doing the whole series of movements it takes about 20 minutes, and a dim, quiet place is ideal. However, I've found doing even a few movements under the table at a business meeting or sitting on a plane can be helpful. I first learned to do it following the written instructions in the book, but now I use a guide that I downloaded. Actually, once you have it memorized you don't really need a guide. I just like the voice and the music.

To learn the technique you can click on this script I found online that was adapted from Edmund Bourne's book. Or, you can download a guide. The one I like is by Ken Goodman and I found it on the iTunes store. You can also get it from his website.

Let me know what happens when you try it. I hope it helps you as much as it's helped me!

Love and Anxiety

I thought I'd write about love since Valentine's Day is this week. Specifically, I want to write about how being loved has helped me with my anxiety. A bit of a love letter to my husband, actually.

It can't be easy to live with someone who has anxiety disorder. The panic attacks, the sense of doom, the phobias. It must all be hard to understand for someone without anxiety disorder. They even seem irrational to me, so I can't imagine how irrational they must seem to my husband. But, in spite of that, he's always ready to offer support. He's always available to listen or just pat my back. He never tries to tell me that it's all in my head, or that I need to get over it. He talks to me, asks me if I'm using my tools for managing panic, and even gets out a list I once gave him of things that help me when I have a panic attack. He's never once complained about the cost of therapy or trips to the ER when I was sure I was going to die. He's been to doctors and ER's with me and comforted me. He knows the situations that trigger my anxiety and helps me through them. He supports my decisions about my treatment. And, most importantly, when I have a tough time, he reminds me that I'll get through it and that he'll be there with me. He reminds me that we're in this together.

Love is a powerful tool for helping with anxiety. I'm thankful that I have my husband's love.

How to Exercise When Exercise Makes you Anxious

It seems like everything you read says exercise is key to reducing anxiety and depression. "Get those endorphins pumping and you'll feel better!"  "Exercise helps the brain cope with stress more effectively!" And, so on...

Now, I know that all this is based on scientific evidence and is true. But, exercise doesn't do any of that for me. It makes me hot, tired, and irritable at best. At worst, it makes my anxiety increase. Here's what happens when I exercise.

1. I start to work out.
2. I feel myself getting hot.
3. Sweat starts to form on my face and hair. I hate to be sweaty.
4. I notice my heart is beating faster. Oh my gosh. My heart is speeding up. I tell myself to calm down; that my heart is supposed to speed up when I exercise.
5. All I can think about is my heartbeat. Is it too fast? Should it speed up this quickly? Was that a pain in my chest? Am I finally having that heart attack I worry about all the time?
6. I start feeling anxiety symptoms because I can feel my heart.
7. I force myself to keep exercising. I'm not going to let this get the best of me.
8. I go through the cool down portion.
9. I can still feel my heart beating fast.
10. I'm now hot, tired and sweaty with a big dose of anxiety thrown in. Sometimes I even have a panic attack.

Sounds fun, right?

I don't get it when people say things like, "If I weren't a runner, I'd need a therapist." "Exercise is my therapy." "I feel so energetic on the days I work out." Why doesn't it work like that for me?

Well, the truth of the matter is that I know I have to get some exercise for both my mental and physical health. And, I also know that if I exercise on a regular basis, it's like exposure therapy. I do it, I don't die, and each time the anxiety symptoms get a little better. And, when I get regular exercise, my general anxiety is less.

So, how do I make myself get started and keep going? Here are a few common sense tips:
1. Start slow. Do just a little at a time. Even five minutes is better than nothing.
2. Do something that doesn't feel like exercise, like gardening, dancing or even vacuuming, so that your mind doesn't automatically focus on your heartbeat.
3. Watch TV as a distraction while you work out.
4. Do a lengthy cool down so your heart rate is back to normal by the time you finish.

Now, all I need to do is get up from my computer and do some exercise...

The Doctor is In

One of the worst triggers for my anxiety is a visit to the doctor. To make it worse, I worry obsessively about my health. Back in the day they called it being a hypochondriac. These days, the fancy term is "medical anxiety." Well, let me tell you, I've got medical anxiety in every sense of the term. I'm anxious  that there's something physically wrong with me, and I'm anxious if I have to go to the doctor to be checked out.

One of the worst parts of having anxiety and panic attacks is that most of the symptoms are also symptoms for scary stuff, like heart attacks and strokes. Chest pain, tingling hands, numbness, feeling like you can't breathe, dizziness, nausea. The list goes on. Google those symptoms and you're going to find things you don't want to have. And, when anxiety starts to spiral, your mind starts saying things like, "This feels different than it ever has before." Or, "This time there really is something wrong."

Also, for those of us with medical anxiety, every twinge, every slight pain, every twitch or muscle jump takes on significance. We constantly scan our bodies for changes, are hyper-vigilant about our breathing and heartbeat. We have unrealistic expectations about how good we should feel, so that if we catch two colds in a row we think it's because of some scary, underlying disease.

The question is, what do you do? If you run to the doctor with every symptom, you'll be broke, because the doctor will be professionally obligated to run tests because the symptoms are similar to the ones for serious physical illnesses. And, believe me, I've done this. Or, if the thought of going to the doctor creates so much anxiety that you can't bring yourself to go, you don't get the medical care you need. I've done that, too.

The best answer I've come up with is to find medical professionals that understand anxiety disorders and are willing to work with you. This has meant being very honest with my medical doctors and their staffs, being able to tell them about my anxiety without being worried they'll think I'm a lunatic, and then very honestly describing any symptoms. I've been happily surprised that most of the medical professionals I've used have been understanding about anxiety and have answered my questions patiently. They've explained why I should or shouldn't have tests or medications, and have understood that to treat me properly they also have to take my anxiety into consideration. It's also meant finding doctors who have great phone nurses who're able to talk with me and (with the doctor's input) determine if I need to come in. In fact, some of my doctors take the time to call me personally. This eliminates a lot of unnecessary office visits and alleviates a lot of my health fears.

Does this mean I'm cool, calm, and collected at the doctor's office? NO! I'm a mass of jittery nerves. But, when they call my name and I head back, I remind both the staff and the doctor that I have anxiety about being there. And, it's almost always a part of the discussion I have with the doctor. After all, they always notice that my pulse is fast and my blood pressure's up! And, almost without fail, everyone is calm, reassuring, and understanding. No one has acted like I'm a lunatic, that they're annoyed with me, or that it's "all in my head." And, if they did, I'd change doctors...

Flexing Your Mental Muscles

The other day I read an article from Forbes called "Mentally Strong People: The 13 Things They Avoid." The article was hugely popular and was shared like crazy on social media. I read it when Healthy Place (one of my favorite mental health websites) posted it on their Facebook page. You can read the article and form your own opinion about mental strength. The main reason I mentioned it here is because it made me start thinking about the concept of being "mentally strong."

What exactly does "mentally strong" mean? Does it mean you're smart? Does it mean you're in control of your emotions? Does it mean you'll be more successful, more happy, more capable if you're "mentally strong"? And, exactly who decides what it means to be "mentally strong"?

I decided to come up with my own definition. And, here's what I think.

Mentally strong people get out of bed every morning and put one foot in front of the other, even when they're so anxious they feel like their hearts will come out of their chests. They continue through the day even when their thoughts won't stop racing around in their brains. They go to their therapists and talk about things that scare them, that depress them. They use the tools their therapists teach them, even when it seems like they don't work. They take the medicines their doctors prescribe, even when they don't like the side effects. They keep trying, keep getting up, keep going no matter how hard it is. When they feel better, they celebrate. When anxiety or depression sets in again, they still get out of bed in the morning. When it's so bad they can't get out of bed, they remind themselves that it won't be so bad tomorrow and they'll be able to get up again. They do whatever it takes to keep themselves safe from the frightening, depressing, anxious thoughts that run through their heads. They hang on to the memory of the days when they felt a little less anxious, a little less depressed. And, then, they get out of bed again and put one foot in front of the other. And, eventually, they feel better.

To me, mental strength has less to do with the characteristics of people who achieve what our society calls success and more to do with living your life the best way you're able. It has to do with trying new things when the old ones aren't working. It has to do with going forward no matter how much you want to stop. It means you never, ever, give up.

Grounding

Have you ever used a technique called "grounding" when you felt anxious? I learned about it when I was in the Clarity program that I mentioned in a previous blog. Grounding is a set of easy strategies that allow you to detach from emotional pain by focusing outward on the external world instead of inward towards yourself.  For me, it helps stop a panic attack from accelerating. It also stops me from ruminating or "catastrophising" when my thoughts start heading down their familiar, depressing paths.

Grounding gives you ways to detach yourself so that you can gain control over your thoughts and feelings. It anchors you to the present, to reality, and puts you at a healthy distance from the thoughts that create anxiety or depression. The best thing is that it's easy to do any time, any place, and no one can tell what you're doing. It also gives me immediate gratification by reducing anxiety or depression.

There are three ways of grounding: Mental, physical, and soothing. Mental works best for me, but I've described all three ways here so you can discover which is best for you. And, if you get bored easily, it's good to have options.

Mental grounding means focusing on your mind. Some ways to use mental grounding are:
~Describe your environment in great detail silently (or out loud if you're in a place where it's appropriate.) For example, "The walls are tan, there is a blue sofa with three red cushions, and a window with a green tree outside."
~Read something, saying each word deliberately. Or, say the letters of the words rather than reading the words.
~Count forward or backwards slowly, or say the alphabet.

Physical grounding is focusing on your senses. Some ideas for physical grounding are:
~Run warm or cold water over your hands. Focus on how the water feels on your skin.
~Grab tightly on to your chair as hard as you can. Concentrate on how the chair feels.
~Walk slowly, noticing each footstep and saying "left" or "right" with each step.

Soothing grounding is talking to yourself in a very kind way. To ground yourself with soothing you can:
~Say kind statements, either silently or out loud, almost as if you're talking to a child. For instance, "You're coping with this situation well," or, "You'll get through this because you're using all your tools correctly."
~Think of your list of favorites, like your favorite color, food, animal, season, book, or movie.
~ Remember the words to a comforting or inspiring song, poem, or quote.

Like anything else that's new, grounding takes a little practice. You can even practice when you're not feeling anxious or depressed, just to get in the habit. At first, try all the types of grounding to see if one is more effective than another. Since it's hard for me to remember things when anxiety or depression start to spiral, I also wrote down some grounding techniques on a card and keep it in my purse. And, just in case I don't have my purse, I put the same techniques on the notes app on my phone, since I never go anywhere without that! That way, if anxiety strikes, I'm prepared.

I hope this gives you a new tool to use if you start to feel anxiety or depression creeping up. Always remind yourself that anxiety and depression are feelings. They don't define who you are. And, if you keep using your tools, you will feel better.

How Do You Feel About the New Year?

New year. Fresh start. Resolutions. Hmmm. It seems this is the time of year when people are setting goals, planning, and looking forward. For me, it can be a time of sadness. I tend to look at the year that has passed. It makes me feel I'm running out of time to accomplish what I want to do, so I'm overwhelmed by all I didn't get done. Then, focusing on new goals becomes exhausting. And, there I go again, with the ruts in my brain looking at the gloomy side of things. So, what can I do to cope with the anxiety this thinking creates?

After looking through my mental box of tips and tools, I came up with a plan to cope with my new year's anxiety. I decided to live in the present. Anxiety (depression, too) can be caused by living in the past or worrying about the future. So, when I have thoughts about the things I didn't accomplish, I can put each thought on a leaf and let it float down the river and out of my head, figuratively speaking. When I start to worry about how I'll get new things done, I can remind myself of this quote from Thomas Jefferson. "How much pain they have cost us, the evils which have never happened." I can get up from my wall of worry and over-thinking and get busy with a simple task. Almost every time I focus on a task, I notice my anxiety is less, or even goes away, because it's very hard to think about two things at once. (Side note-that's why multi-tasking is actually almost impossible.)

I'm already feeling better, because now I have a plan. A very simple plan that is SMART. Strategic, measurable, actionable, relevant, and timed, as all good plans should be!

I'd love to know how you're coping with the coming New Year. Do you have a plan? How do you feel? I hope to see some comments, and if you have any tools that work for you, please include those, too!

Rather than saying 'Happy New Year," I think I'll say to my readers, "Here's to a new year that's right for you, with less anxiety and more peace."

Happy Holidays???

These days the pages of social media are filled with posts and pictures of holiday beauty, merriment, family, and faith. Instagram, Facebook, Twitter, Google +...The list goes on. If you're looking at them, or even just reading good old-fashioned holiday cards or the ubiquitous family newsletter that's often sent this time of year, it may look like everyone's leading a lovely life. And, if you're a person with mental illness, you may wonder why you don't have all the joy that others seem to have. Or, you may feel jealous of all that happiness and wish you could feel it, too.

I am very fortunate, and I actually have a pretty lovely life. But, anxiety and depression sometime make it hard to feel the happiness that should accompany my life. The symptoms can blunt feelings of happiness. And, my medication causes a reduction of feelings at both ends of the spectrum. In other words, anxiety and depression are less, but also feelings of joy, excitement, and expectation are reduced. I really, really miss those super-excited, over-the-top, giddy moments.

But, when I start missing those moments, I take a breath, acknowledge that I miss them, and then replace those thoughts with gratitude that I'm not filled with anxiety. That I'm not deeply depressed. I remind myself that the more thoughts I have of gratitude, of happiness, of goodness, the greater chance I have of experiencing those feelings. And, every once in a while, I actually have a moment of super-excited, over-the-top, giddiness. When that happens, I savor it for all it's worth!

How Gratitude Relieves Anxiety

It's Thanksgiving today so I thought I'd write about, well, giving thanks. Or, in other words, gratitude.  Gratitude is defined as "the quality or feeling of being grateful or thankful." That quality and feeling hasn't always been present with me. When I'm feeling anxious or depressed my mind always jumps on the well-travelled path of worry. The path of what-ifs. Of catastrophes and worst-case scenarios. I've travelled this path so often I've created "ruts in my brain." Ruts of anxiety. Of sadness. In my jittery life, I was sure if I thought about everything that could possibly happen, I could somehow be in control. I could stop the worst-case scenario. Then, my mind would think up a scenario I couldn't control. Panic! But, when I began to recognize that going down that path doesn't prevent bad things from happening, that I can't control everything, I needed to make a new path to travel. I needed to start creating new ruts in my brain. And the path I've chosen is gratitude.

I started thinking more about gratitude when I was in Clarity, the intensive therapy program I wrote about in my last post. One of the tools for recovery thinking that we learned was gratitude. Particularly, we learned about keeping a gratitude journal. Once a week we wrote down five things we were thankful for. When we started, it surprised me how little I was thinking about what I was grateful for. I was so focused on the worrying, the what-ifs, (see complete list above...) that my jittery brain had no time or energy for thankfulness. For my first journal entry I had to think really hard to come up with five things to be thankful for. I finally decided to start with the basics and I wrote down five things that, honestly, I have always taken for granted. Shelter. Food. Water. Car. Clothing. I wrote them down and was startled that the very act of writing them down warmed my heart. It also gave me a written reference so that when anxiety strikes I can pull out my journal and fill the ruts in my jumbled brain with thoughts of gratitude. And, amazingly, I saw how filling my mind with gratefulness left less room for thoughts that create feelings of anxiety and depression.

Each week it's easier to find five things I'm thankful for. Sometimes I can't limit it to five! And, now I make it a practice every day to remind myself that I need to look around and name the things that are good in my life. And, slowly, surely, the ruts in my brain are less full of worry and more full of gratitude.

Happy Thanksgiving!

Hello Again!

Well, it's been a while since I last posted, but I was inspired today by a friend who also has anxiety and depression. I was telling her about a three week intensive outpatient therapy program I did back in the summer called Clarity. Connecting Lives; Activating Resources; Integrating the Total You. It was a life changer. I don't actually like the phrase "life changer." It's overly dramatic and overused. But, Clarity really did give me some tools that changed the way I manage my anxiety and it has decreased to a much more comfortable level. (As if there's anything comfortable about anxiety disorder...) So, it was a life changer for me.

My therapist recommended the program because I was making a transition from employment to going back to school and, as much as I wanted to make this change, it was creating depression and anxiety. And, being me, I was in denial that the transition would cause me stress. I tend to think I should sail through everything without a bump. "I can handle anything!" "This is no big deal!" "I'm looking forward to this, why should I be anxious?" Wrong!! Like everyone, transitions (good or bad) create some anxiety. And, for me, that's usually not a little anxiety. I like to do it up right, with BIG anxiety, toss in some depression for good measure, and all the while tell myself I should be ashamed for not being able to handle it.

Many of the things I learned while in the Clarity program I already knew, but wasn't putting into practice. But, there was something about going to therapy three hours a day, four days a week, that made me focus and realize I could be so much better if I used all my tools. And, I picked up some new skills, too. The program is in three segments, one per week-Safety, Recovery Thinking, and Communication. Each day reminded me of the tools I already had and gave me some new ones to add. Here are some of the things I learned in Clarity:

Trust myself and other people who deserve my trust. It's pretty hard not to feel anxious if you don't think there's anyone you can trust.

Take good care of my body. Eating, sleeping, exercising, relaxing, in the proper amounts, all play a
big role in managing anxiety.

Deliberately change my emotional climate. I can choose to change how I react to the way I feel about things and I can change my thoughts.

Use grounding to detach from emotional pain and anxiety. There are three major ways of grounding-mental, physical, and soothing. I'll cover those is a future blog post. This was huge for me!

Thoughts and feelings are liars.

Constantly feed my soul. For me, this is deepening my relationship with God. This program isn't religion-based, but spirituality, however you view that, is part of it.

Feel gratitude daily. My life seems pretty awesome when I list out the specific things I have,
materially and otherwise.

Now that I'm back to blogging, I'll share more about some of these tools in future posts. I'm looking forward to your comments, and I'm glad to be back!

Forgetting to Take Care of Myself

Anxiety builds up and I don't notice it. I don't pay attention to the subtle signs. I forget that taking care of myself when I'm not anxious will reduce episodes of acute anxiety. I start thinking that I'm done with anxiety, and phobias, and hypochondria. I'm invincible. I can handle stress. Just pile it on. I'll sail right through it.

Then I start noticing that my heart's beating fast. Or, I get that funny feeling in the pit of my stomach. But, it's just for a few seconds and I think, "Oh, it will be fine. You can handle this. You've been doing great." And, I go about life as usual, never slowing down, not stopping to take care of myself. Because when I'm feeling "normal" I lull myself into believing that I won't be anxious anymore. It's easy to do, because when I'm not anxious I forget that recovery is a path. I forget that recovery requires care and that I'm responsible for taking care of myself. I forget that I have to be intentional. Then, when I least expect it, I have a panic attack. I start thinking negative thoughts. The dark cloud of worry takes its place over my head. I'm obsessively thinking about every breath, every heartbeat, to see if it seems normal.

You'd think after all these years of managing my illness, I'd remember to take care of myself. I think it goes back to wishing that I didn't have this and hoping it will just GO AWAY. But, even if I didn't have to manage my anxiety, I need to take care of my self. Many of us, even those without anxiety or depression, just don't do enough to treat ourselves well.

Here are some things that give me peace, energy, and a sense of life being good.
Progressive Muscle Relaxation. If you've never done it you don't know what you're missing. For a guided version that's a little bit shorter, but super effective, check out Ken Goodman's "Stress Free" in the iTunes store.

100 Breaths Meditation. Easy as pie and if you do it in the morning, your work day will go smoother. All that's involved is sitting quietly and breathing 100 deep breaths. Be sure to breath into your abdomen and exhale longer than you inhale. I like sitting crossed legged with my hands palm up to receive the gift of relaxation, but you can sit anywhere in any comfortable position. Add some relaxing music and it's even better.

Stop and enjoy life. I try to take a minute (or more) every day to intentionally enjoy something. It can be as simple and quick as watching a bird or a butterfly and think about how pretty it is or taking time to have lunch with a friend and really paying attention to the food and conversation.

Gardening. I love to pull a few weeds, or plant some seeds, or water the plants.

Writing. Recording my thoughts and feelings is cathartic.

Telling someone I trust how I'm feeling. Whether I'm happy, peaceful, frustrated, scared, or sad, saying it out loud helps, especially if I can tell someone else. I try to remember to talk to my husband or a close friend about how I'm feeling. This one is hard for me. I don't come from a family where acknowledging your feelings was acceptable and my husband doesn't talk about his feelings often. But, he knows how good it is for me to be able to say my feelings out loud and he's always ready to listen. And, I have friends I can talk to. If no one is available to listen, I just say it out loud to myself.

Music. I have a library of music for stress reduction. A couple of favorites are Mozart for Meditation and David Benoit's Letter to Evan.

Exercise. In my dreams I'm a runner and wake up every day wanting to go for a run. But, in reality, I hate exercise. So, I try to get a 30 minute walk in every day. Or, I substitute gardening, or taking the stairs instead of the elevator. Or, walking to the store. Or, even, cleaning my house. It's a proven fact that regular exercise reduces anxiety.

Go outside. This is probably my favorite stress reliever. I love to be outside. Sit on the porch, or the steps, or under a shady tree in the yard, or on a bench in the park. Sit on a bus bench if that's all that's available. Even if it's cold or rainy, just go outside for a few minutes. There's something about being outside that helps with anxiety.

Sometimes, in spite of everything, I still feel anxious. But, consciously taking care of myself, making self-care a priority, reminding myself that I am worthwhile and deserve to take care of myself, are tools that make my jittery life a little less jittery.

And So It Began

Panic attack: "A panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. Panic attacks can be very frightening. When panic attacks occur, you might think you're losing control, having a heart attack or even dying."  Mayo Clinic

I still remember my first panic attack. I was on a date in a restaurant. There were several of us. I don't remember who my date was, or who the other people were. But, I remember the panic attack. I thought I was dying. I didn't want anyone else to know. I went to the bathroom. I was sick to my stomach. I forced myself to leave the bathroom when I didn't die and I acted like nothing was wrong. I was 21 years old. It was the beginning of my jittery life.

Depression and anxiety have been part of my life for 33 years. Sometimes it's barely been there. One time it was so bad I was in a psychiatric hospital for  two and a half weeks. It always centers around thinking I'm going to die. I'm going to die before I get everything done.

Even after 33 years, and countless hours of therapy, and drugs that work well, my logical mind and my anxious mind don't work together sometimes. I'll use every tool I've learned, I'll know I'm having a panic attack, but my anxious, obsessive thoughts take over and I'm convinced I'm dying. It's the most frustrating aspect of my mental illness. Knowing something is true, but not believing it.

It's taken  my whole adult life to learn to manage this illness. I thought for so long that if I could just figure out what happened in my past to make me so anxious, that I would be cured. No more panic attacks! I'd be like "everyone else." I was convinced if I just got to the bottom of what happened in my childhood that makes me depressed and anxious, that it would go away. In spite of several excellent therapists who helped me learn behaviors to manage the anxiety, I continued to believe that if I could pinpoint what happened that caused me to feel anxious and depressed, it would miraculously stop. I didn't want to manage my anxiety. I wanted to be well!

Then, there's medication. I've been on anti-depressants for most of my adult life. There have been some great ones, there was one that had weird withdrawal symptoms if I took it even a couple of hours late, there have been some that helped the depression but weren't so great with anxiety. There have been times when I thought I didn't need medication anymore. And, finally, five years ago, after going off medication and having one of the worst periods of depression and anxiety I've ever had, I accepted it. I will never be able to be off medication. So, then I wanted the medication to take care of my problem. I wanted to take my medicine and be well. I thought, hoped, wished, that I could be like "normal people" if I just faithfully took my medicine.

A few months ago I was going through a transition in my life. My medicine wasn't doing all I wanted it to do, which was to allow me to breeze through this change. Then, I had another bump in the road, then another, smaller bump, but a bump nonetheless. Anxiety, depression, panic attacks! Extra visits to the therapist. And, in the midst of a therapy session, something I'd heard a million times before suddenly made sense. I need to take care of myself all the time, not just during the times when I'm overwhelmed, anxious, and depressed by life.  Life is full of transitions and bumps in the road. But if I take care of myself every day, when the bumps come along, they won't be quite as scary.

I have mental illness. I won't be "cured." I can have a fantastic life. I can be a happy, productive, successful person who happens to have an illness. And, that requires me to take care of myself. To believe that I'm worthwhile enough to make self-care a priority. And, to finally admit, out loud to other people, that I have a jittery life.