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

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.

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!

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...

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.

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!

Is Your Christmas Merry?

Are you filled with holiday cheer? Are your jingle bells jingling? Is Santa up on your rooftop? I hope your holidays are looking like a Hallmark movie or a Publix commercial. But if they're not, don't despair. Neither are anyone else's.  The time from Thanksgiving to New Year's is prime time for anxiety and depression. There's usually too much to do, relatives to see that you'd really rather not, disappointment when you can't schedule a time to see people you really want to, and budgets that are stretched thin. Or, on the opposite side of the coin, some of us don't have family, friends, parties, and shopping to take care of. This loneliness can be isolating to anyone, especially if you have anxiety and depression.

I'm not always good about preparing myself for situations that trigger anxiety. I tend to approach them with an attitude of, "Oh, this time I'll feel fine." I ignore the symptoms as they creep up instead of acknowledging them. When I feel good I toss my tools out the window and expect to continue to feel good. It's kind of like never changing your oil and expecting your car to continue to run well. But, this holiday season I decided to make a list of the things that make my holidays bright. I decided not to try to control anything about the holidays except what I can personally control. I decided to practice acceptance and gratitude. So here's my list of holiday anxiety relievers. Remember, these are what I like to do and might not be right for everyone. Create your own list, check it twice, and maybe your days will be a little more merry and bright.

1. Make time to pray, do progressive muscle relaxation, and get enough sleep.

2. Plan time to volunteer.

3. Keep a gratitude journal.

4. Listen to Christmas music. It's my favorite part of the holidays.

5. Keep my tree lights on whenever I'm home.

6. Light an evergreen scented candle.

7. Hang out with friends.

8. Practice acceptance of how the holidays unfold.

9. Understand that others' holiday expectations may not be like mine.

10. Be in the present.

11. Be kind to myself and others.

Merry Christmas and happy holidays, everyone!

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!

Is it Like Walking and Chewing Gum?

Like so many people who want to meditate, I find it hard to think about, well, nothing. The whole concept of clearing my mind is hard to grasp. How on earth do you stop your thoughts? My friend Christine and I were talking about this. She said she can't meditate because she can't turn off her "rat brain." Rat brain is an apt description if I ever heard one. Thoughts continually scurry through my head like rats in a maze. If I'm anxious, they scurry even faster. I told her to try 100 breaths meditation. I can do that because the breaths help me focus by counting. But, I told her, I really want to try this thing I've heard about called walking meditation. Somehow, I think I can clear my mind more easily if I'm up and moving.

So, a few days later, I decided to give it a try.  I had looked up "how to do walking meditation" and, armed with my newfound knowledge, I was ready to go. I walked out the front door and was hit with a blast of Tennessee summer humidity that made me quickly realize that walking at the nearby greenway would not be in my best interest unless I wanted to do a "melt"-itation. Determined that I was going to try walking meditation, I decided to drive to the community center in my neighborhood and use its walking track. Nothing I'd read said walking meditation HAD to be done outside! All you need is a place that's relatively quiet and peaceful. Feeling clever, I drove to the community center and went in, expecting only a few retirees to be there during the early afternoon hours. Wrong. I had conveniently forgotten that community centers, being the center of the community and all, have summer camp programs for school children. Really active, really energetic, really LOUD children. "Ok," I thought, "I'm still gonna do this. These kids aren't allowed on the walking track, so all I need to do is listen to meditation music to drown out the noise." I reached for my earbuds and realized I'd left them at home. I'd planned to walk on the greenway and listen to the sounds of nature. I thought, "I can still do this. Meditation is being mindful and in the present moment. That's all I have to do." Never mind that I have trouble meditating in the silence of early morning in my quiet bedroom with meditation music playing. I wanted to clear my mind now! I was determined to clear my mind now. I remembered that I was supposed to start a walking meditation by standing still and feeling the sensation of my feet firmly planted on the ground. I stood, I felt. Then inhale with one step, exhale with the next. I started. Step, step. Inhale, exhale. Repeat. Those kids were loud. They were filled with the exuberance of kids in the summer, released from sitting still and learning all day. They were alternately so cute to watch, or so irritatingly loud and annoying that I couldn't ignore them. My meditation goal was 15 minutes. "I'll never clear my mind for 15 minutes with all this noise and energy!" Then I remembered I was supposed to let thoughts pass through, bring my mind to the present, focus on the breath. OK, getting a little easier. Then without really even thinking about it, I realized that I was thinking, "walk, walk," with each step I took. My mind was clearing, staying in the moment. And, after two laps, without any thought at all, I ran a lap. My mind said, "step, step" with each running step I took. I would walk two laps, run one, totally mindful of the moment with nothing but the words "walk" and "step" in my mind. When my phone's timer went off I was completely surprised that 15 minutes had passed. I set it for another 15 and continued in my pleasantly cleared state of mind. I no longer heard the kids. I was no longer distracted by their darting, running, jumping, and game playing. I was just walking, running. And, meditating.

"Every path, every street in the world is your walking meditation path." Thich Nhat Hanh

                                                                     

Let the Sun Shine

I forget that it's OK not to worry. Somewhere along the way in life, I got the idea that if I worried about all the bad things that could happen I could somehow prevent them from happening. I also got the idea that if I wasn't worried about something, it was a guarantee that something bad would happen. So I worried as a preventive measure. I also refused to enjoy anything too much. Enjoying something was a sure fire way to make something bad happen. Stare blissfully at the waves of the ocean while on vacation? Ooops. Better not get too relaxed. You just have to go back to work next week. Gaze with amazement while one of my babies slept? Stop it. She could get a terrible disease and die and you won't get to see her grow up. Breathe in that wonderful new car smell as you drive off the lot? Don't do it. You could lose your job next week and not be able to make the car payments. It was like always having a black cloud over my head. It was the "if I worry enough about something I can prevent it from happening" cloud. Or, maybe it was the "if I don't enjoy this very much it won't hurt so much when I lose it" cloud. I had a huge expectation that things would go wrong. I was the epitome of that expression "I feel like there's a black cloud over my head."

The funny part of it is that, of course, none of this was true. Worrying about whether something bad will happen doesn't prevent it. And, enjoying something can't make something bad happen. Being on high alert for the bad in things just makes you anxious, depressed, and not able to function at the capacity of which you're able. It means you can't be fully present for your job, your family, your relationships, or, most importantly, yourself.

Now I've learned that letting the sun shine around my black cloud is not only OK, it can actually make the dark clouds disappear. Sure, bad things are going to happen. There will be times when there are dark clouds in your life, but when they're not there, enjoy it. Don't worry about when the next storm will come. When I feel those clouds appearing without good reason, I literally start to visualize how it looks when the sun begins to peak out after a storm. I imagine the warmth and beauty of a pretty day and I let the sun shine into my jittery life.

Ending the Sabotage

Helen Keller said, “Self-pity is our worst enemy and if we yield to it, we can never do anything wise in this world.” Wise words from an amazing woman. I'll add to this and say that negative self-talk and self-abandonment are also our enemies. And, these three things can sabotage our ability to be confident and comfortable with ourselves. 

Self-pity makes us feel victimized, powerless, and out of control. It takes away from our capability to live a good life. It's good to feel sorry for yourself when something bad happens and acknowledge and accept your feelings. But, continuing in self-pity holds us back. As I've journeyed through life, I've had times when I felt sorry for myself because I have depression and anxiety, and it's created responses in my brain that made me feel helpless and trapped. And, even those who don't experience anxiety or depression know that feeling helpless leads to a lack of energy that holds us back from doing the things of which we're capable. 

I'm the queen of negative self-talk. It can be a product of self-pity, from hearing words that made us feel unworthy or useless, or, as in my experience, from being in situations where it was implied that we didn't measure up. You start to get what I think of as "ruts in your brain." A tiny rut is created when you hear words or experience situations that make you feel like you're not good enough. If you hear or experience it often, the rut grows deeper. Sometimes it comes from feeling sorry for yourself and feeling like a victim. Sometimes it's from the implication that we don't measure up. It can be from back-handed compliments like, "You're so pretty and polite that you don't need to be good at ..." My favorite scenario, which comes from my childhood (and was well-intentioned,) is this. You don't understand something, you ask a question, and there's a laugh. Then you hear, "It's complicated. You won't get it. But, I love you anyway."  And, you know that you'd be loved a whole lot more if you'd gotten it. At some point, you start believing all this stuff. The ruts in your brain get a little deeper every time you hear it. Eventually, when you start on something, the "ruts in your brain" give you a nagging feeling that you're not good enough to complete the task, much less succeed at the task. 

I'm also good at self-abandonment. I didn't figure out what I was doing to myself until recently, when I read Sally Brampton's book, Shoot the Damn Dog. A Memoir of Depression. (Just so you know, no dogs were harmed in the writing of the book. The dark dog refers to depression.) I tend to be more anxious than depressed (although I've experienced both) and Sally's journey has been through deep and severe depression. But, I recommend the book to anyone, and one page, that I've dogeared and read till it's a little grimy, is about self-abandonment. I'll take one quote that summed it up for me. "If somebody hurts you, and you pretend that you are fine, you abandon yourself." The passage, which includes a list of ways people abandon themselves, concludes, "You suffer from a failure of care." Some people don't care for themselves because early in life they weren't emotionally cared for and eventually began to feel unworthy of being cared for. Some people have relationships in their lives where there's an expectation of emotional care that doesn't happen. So, you stop caring for yourself. 

You sabotage your capability to feel well, to enjoy life as best you can, and to have career success, when you engage in self-pity, negative self-talk, or self-abandonment. And, whether you actually feel depressed and/or anxious, or just have a tough time achieving what you want to achieve, recognizing these behaviors is important. Even more important is taking steps to end these behaviors. Take those "ruts in your brain" and re-fill them with self confidence, positive and realistic self-talk, and self-care. Fill your social agenda with like-minded people who want the best for you. And, most importantly, fill your mind and soul with thoughts of your capacity to be "wise in this world." 

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.

I'm Leaving on a Jet Plane...

In my imagination I'm a world traveler. I confidently jump on planes, trains, boats, and automobiles wearing a variety of cute travel outfits, appropriate for my exotic destinations. I stroll through the airport pulling my classic Hartmann tweed suitcase looking seasoned, confident, and a little excited about my next adventure. 

OK, here's the real world scenario. I enter the airport in a bundle of anxiety, heart racing, sweaty palms, obsessively checking my purse to be sure I have Xanax. I shakily make my way through checking my bag (OK, it's a Samsonite, not a Hartmann) and on through security I go, not like a world traveller headed on her next adventure, but like a woman walking to her cell on death row. The only thing similar to my imagination is the cute travel outfit appropriate to my destination. I have my rituals and they have to be done and somehow in my jittery mind I feel a tiny measure of comfort and protection. First water fountain inside security is where I take my Xanax. Don't want to take it too late. I want it to be working when I get on that plane. Don't want to take it too early. It might start wearing out before the flight is over. I get a decaf coffee. I wait till they are almost ready to call my flight and go to the bathroom. My rituals are done. I pray and walk down the jetway like a condemned woman. I fervently hope that my favorite seat by the window, just behind the wing, is available. My heart is pounding. I'm not sure if I'm more worried about the plane crashing or having a heart attack while in the air with no fully qualified medical personnel to save me. My terror begins to subside as I use all the tools I have to manage panic, but by the time we push back I'm sweaty palmed again, my heart is racing and negative talk is racing in my head. We roll down the runway and we're off, with my heart in my throat. When, miraculously, I don't have a heart attack and the plane doesn't crash on take off, I settle down. Oddly, I'm not very anxious once we're flying unless I see or hear something I think is weird. When they say we can turn on mobile devices and the flight attendants begin beverage service, my anxiety thinks everything is normal. 

Most of the time I fly with my husband. He's awesome. Before our trip he books the reservations, checks us in online, gets the boarding passes. He knows all the preparation increases my anxiety. He pats my hand on the way to the airport, understands my weird rituals, and supports me if I freak out. He never asks me to sit in the center seat even though he prefers the aisle. He knows I like the window and sits in the dreaded center seat so I can be in my safe spot.

We were on our way to Tampa to get on a cruise ship when I wrote this. I don't really love cruise ships, either, which added to my anxiety. I feel a little confined and think cruises are a bit cheesy. But, this was a family cruise with 15 of my in-laws, and we knew it would make my mother-in-law super happy if we went, so I decided to go. But, managing the anxiety wasn't easy. The night before our trip, I lay in bed for two hours with my heart pounding. Two rounds of Progressive Muscle Relaxation plus a guided sleep meditation and my pulse was still 92. I forced myself to stop obsessively checking my pulse. Finally, I drifted off to strange dreams of flying to Alaska in a tiny plane. 

After a rocky morning of getting ready to board the plane, and a short, uneventful flight with my sweet husband, we landed. I had used all my coping techniques, I arrived unscathed, and as we headed to baggage claim, I felt like that confident world traveller who's living within me.

P.S. I few weeks after writing this, I found Tim Benjamin's website Fearofflyingschool.com with tips to reduce anxiety when flying. I thought my readers would like the tips!

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.