Saturday, February 11, 2017

Panic & Peace.

It's been a roller coaster of a week. At first, I wasn't doing great on the Wellbutrin, then after a couple days on it, I was starting to see glimpses of light and I could read more than a page of a textbook and I was starting to think better about myself and the world...But the wheels of anxiety were starting to turn anew in my mind, creaking back to life and then whirring faster and faster. My brain was feeling more and more like a whirlwind of "What ifs" and "WhatdoIdowhatdoIdowhatdoIdowhatdoIdo", etc.

Tuesday, I woke um in the wee hours of the morning and felt like I couldn't breathe. Then it happened again in class later that morning. I had never had a panic attack that felt quite like that before. The mind-whirring anxiety continued. I couldn't shut my brain off. I couldn't stop obsessing over the question of what I should do with my future.

Today, I had been awake about an hour and was sitting in bed, trying to do some reading for a paper, when suddenly an indescribable pain clutched my abdominal region, spread up to the left side of my chest, and simultaneously struck in the left side of my head. I was terrified. What the hell was happening to me? It really felt like a heart attack or something. I faintly cried for help and my sister gave me a heating pad to put on my stomach. I clutched it to me, even though it wasn't that sort of pain. I lay down and stared at the ceiling, panicking. What was happening? What the hell was happening?

Thankfully, the pain subsided in maybe ten minutes, thought the ache in the left side of my head remained. I kept half-joking to my sister that I had had an aneurysm. I picked my book back up, determined to actually work hard today.

The slight headache remained and worsened and I started to feel worse and worse. I remembered that I might have forgotten to take part of my Klonopin dose last night, so I wondered if I was going through withdrawal I took a small amount to alleviate the symptoms and rested.

After dinner, I forged on in my reading. But it just got harder and harder. The house seemed to get louder, the sound of water running in the kitchen became more grating. My ears were ringing just hearing it. Then my head started to feel like it was turned to a static channel on the radio. I abandoned my reading as my head became too "noisy" and "busy".

I felt my torso fill with a similar panic-y feeling; everything was topsy turvy, like my insides were a bunch of bingo balls in a cage, being spun round and round. My heart felt like it was both fluttering and pounding. My stomach was full of butterflies that were escaping to frolic around the rest of my midsection. I kept getting waves of panic feelings, hitting me anew. It was frustrating. I just wanted to do my stupid homework. But I was in such an agitated state, I couldn't focus on anything.

I think both of these occurences today were probably panic attacks. The weird thing is that they were different iterations from the ones I'm used to experiencing - different symptoms, different feeling. But a little research into Wellbutrin's side effects revealed that panic attacks and extreme increases in anxiety are semi-common side effects.

And my shrink insisted that Wellbutrin had next to no side effects.


I'm tired of the b.s. and I'm tired of people messing around with my head and my life and taking my money, pocketing it, and sending my to the secretary to schedule a med check a month out, barely giving me a method to contact them should something go wrong. Like, if I was ever suicidal, I wouldn't know how to get in touch with my psychiatrist in a timely manner. That is ridiculous.

I guess I'm just frustrated at how out of touch these people seem with things. You're effing around with my well-being, my chance to do well in school and make a career, my chance to live...literally. There were times my bad medication reaction took me to such a bad place, that I was suicidal. But the doctor will get back to you within twenty-four hours.

Medication saved my life - I don't know what I would have done if I hadn't been able to get on Klonopin so I could start sleeping again the one semester panic attacks kept me up almost all night, every night. But it also ruined it; I had to give up everything because of the depression that my meds caused. It was devastating, heartbreaking. It gets frustrating when people who didn't see that, live that, feel that, don't listen to you or take the time to really evaluate what is best for you as an individual, not just what they learned in class in their manual. It's frustrating to try and communicate over a decade of struggle into a thirty-minute interview.

I know these people are trying, but on another level, I sometime feel a certain level of robotic detachment, even apathy. And that frustrates me because every day I feel turmoil. And all they give me is detached, distant once-a-week therapy or once-a-month med checks. Where do I turn when I'm spiraling? Where do I turn when I question if it's all worth it?

I'm going to call my doctor once the business week starts and tell her I'm going off of the frickin' Wellbutrin. If the anxiety is this bad now, it will likely only get worse. And I don't want to turn back into the girl lying in the fetal position in her bed barely able to murmur, "I can't" when her sister asked why she hadn't gone to class yet. I don't want to be the girl who leaves her group work partners hanging and gets those shameful "W's" on her transcript because she's too anxious to leave the house any more. I'd really like to graduate, thanks very much, and I'd like to do so with flying colors, not dragging myself with bloody fingernails to the finish line.

One last thought before I sign off: This evening as all this anxiety was going on, I also had another emotion: inferiority. I felt ashamed of being so "crazy" and "unstable" and of not being able to function and keep it together. That silly lie of, "Maybe I need to try harder and this is all my own fault" crossed my mind.

I felt inferior to the people who relish travel instead of feeling terrified of being stuck in a plane or vehicle, hurtling away from the safe, known to the insecure, unknown. I felt inferior to the people who set off with a few dollars in their pocket to pursue their dreams 1,000 miles from home. I felt inferior to carefree, well-adjusted, sociable, amiable, gregarious people who have perfect white teeth and can do no wrong. The truth is, I felt inferior to one person in particular, who shall remain unnamed.

But I have a struggle. I don't know why. I was born with it. Most of the people who cross through my life will never know about it. Most of my life I will probably be affected by it. But I'm trying. I'm fighting. And I'm trying to make a difference and encourage others and change at least the little circle where I have a bit of influence. A lot of the beautiful people out there can't necessarily say the same.

People might not get your struggle, but it's real. It's hard. It's amazing that you are still fighting. My hat goes off to you, friend. I hope you keep up the good fight. I hope you don't let others make you feel inferior for feeling. For fighting. For being who you are.

People may think you're weak because you struggle so much, but you're strong for getting through days tougher than some could ever even imagine.

Here's to you, friend.

Tuesday, February 7, 2017

Meds and shrinks, oh my!

I'm not entirely sure what people mean by the term "crossroads" (as a figurative term that is...I know what it is literally...duh), but I always think it sounds cool, like something you name a hipster church or a young adults group. This past week has seen a lot of change for me, so I felt like it warranted another post. I guess I feel like I'm at a lot of crossroads or turning points or something. I just feel like some shifts have happened.

For starters, I went to a new psychiatrist, which is always nerve-racking. The shrink I had been seeing was $200 for 15 minute med checks, a pain to get to, and it took over a week to track her down to get her to refill my prescription. Not cool. Dangerous, in fact. My mom found someone on our insurance plan (miracle of miracles) so we figured it was worth a try.

I started seeing my previous psychiatrist with the express intention that I not go on any new medications. I was shaken and scared by the experience I had had the previous year, being debilitated by the meds I had been put on that I had a bad reaction to but the doctor didn't have the sense to take me off. I wanted someone who would refill my Klonopin prescription and my L-Methyfolate and maybe offer some sage advice about sleep patterns. (Actually, that's a lie. I want to sleep how I want and I hate how that doctor's sleep advice haunts me, telling me I'll give myself the effect of jet lag if I sleep in on Saturday mornings.)

This time, I didn't have clear expectations of what I wanted; the appointment snuck up on me because I was busy starting school. So when I went in, naturally the psychiatrist did what they're trained to do: put me on a new prescription.

I was a bit shocked and pretty apprehensive, but Wellbutrin did show on my genetic testing to be a drug I shouldn't have an interaction with and it was true that while I had been on Wellbutrin, it had always been while I was on an SSRI, and the SSRIs were what I was clearly "allergic" to. Plus, the shrink said it can help with concentration, and I've been increasingly concerned about how much difficulty I have focusing to complete schoolwork. I figured that now that I'm well-informed about meds and the potential of having a bad reaction, it was worth trying the thing out and I could go off of it if I found myself getting worse.

That's not to say, of course, that my mom and I haven't been hypervigilante and constantly on-edge the past few days since I started it, combing through my life for any possible signs of a bad reaction.

But weirdly enough, the thing that's almost as scary as getting worse because of the medication is the thought of getting better. It sounds bizarre, but every time I feel my mood and outlook lifting or my ability to cope and have a healthy perspective increasing while on this med, I have a hint of fear. I mean, part of it might be my own pride; I kind of wanted the psychiatrist to see she was wrong and I was right to be apprehensive. As my mom put it to a friend, "This woman wasn't there when my daughter was curled up in the fetal position, too agoraphobic to leave the room because of these meds." But I think another part of it is a fear of a new normal; happiness is an unknown. Being well-adjusted and even-keeled is a strange concept. A tiny part of me almost doesn't want to be better. I guess it feels like losing part of myself. More than that, it feels like conforming. Becoming normal. Becoming one of those happy people who it pains hurting people to see. I guess I will continue to have empathy for hurting people because I can never remove the scars of this past torture from my heart and mind -- nor do I want to. But a part of me kind of resents those normal people who don't hurt or struggle constantly and I don't know if I want to be one of them. Maybe that makes sense, maybe it doesn't. Take it or leave it. But the feeling is there.

Whether the Wellbutrin will work, I don't know yet. I have to grudgingly admit that it does seem to be helping. But I have one last rant before I hit the Publish button....

I woke up at 4am this morning, hours before my alarm. This isn't uncommon for me. since I have to take one of my supplements on an empty stomach, so I usually stumble out of bed like a zombie and take it in the wee hours so I can eat breakfast right away when I wake up for real. But once I had lain down again, I couldn't get comfortable. I tried different positions, but nothing was right. I felt like I couldn't breathe. I couldn't get enough air. I tried to tilt my head different ways in case I was blocking up by air passage. I started to worry I was allergic to peanut butter suddenly and my throat was swelling up (I had also eaten a peanut butter cracker b/c I was so hungry I was miserable). I opened the window. Nothing helped. I sat up in bed and felt a little better. I sang Hank Williams songs to myself softly ("I Saw the Light" is a must-see if it doesn't contain triggers for you). Finally I realized I was having panic attacks. Eventually I was able to drift off again.

Later, in class, I was overwhelmed by how crowded the room was. The classrooms don't have windows that open or a ton of ventilation and there were thirty bodies packed into one smaller-sized room, consuming oxygen. I was again overcome with the sensation of something like a low-level suffocation. I felt physical discomfort that's difficult to explain, but wasn't unbearable. I couldn't wait to just get out of that classroom.

I realized once again that this was a panic attack of some sort, though it lasted for a while. (As a side note: I've noticed I tend to have panic attacks in crowded places. I think it's something to do with the lack of oxygen.) I told my mom about both occurrences that evening and she immediately told me that she had researched and found out that one of the big side-effects of Wellbutrin that people complain about is having panic attacks. "I should have told you sooner," she said, "well, heck, your psychiatrist should have told you."

I actually asked my psychiatrist what side effects there were and she did not mention this at all. She emphasized that Wellbutrin has relatively few side effects -- maybe a headache. Ummm...panic attacks are a pretty significant side effect and one that you need to be informed about. I hate to get all salty, but I'm getting frustrated with what I think isn't a stretch to call irresponsibility on the part of some psychiatrists when it comes to informing patients about potential side effects and what to do should they occur or should symptoms get worse. None of the three psychiatrists I have seen gave me much of any information on the subject.

What if I had never had a panic attack or wasn't familiar with them and experienced them? How freaked out would I have been? Panic attacks can be difficult to identify because your mind tends to get confused and frightened and you think you're dying or having some other medical emergency or you just can't think straight period. I've also had them manifest themselves in many different forms, so sometimes it's hard to tell when they're happening. It would've been nice to prepare myself.

I guess playing into this is my frustrated that psychiatrists (at least the ones I and my family members have seen) don't closely monitor -- or even encourage the patient to closely monitor -- their emotions and physical symptoms when they start meds or give them much guidance in general. Bad reactions to medications can be life-threatening in that they can involve suicidal thoughts, not to mention be downright frightening.

I guess I just got really irritated last year when I saw an article saying that Paxil, the medication I was on for a year, had been advised not to be given to teens or young adults after a study that had been done years ago, but that the study had gone largely ignored. Then another study had confirmed the original's findings. I got mad because my life was ruined by these people's irresponsibility.

I don't want to say that psychiatrists don't take their jobs seriously or have no emotions (well, sometimes I wonder...), but I want to add my voice to the conversation. I understand why shrinks don't want to overwhelm new patients with the black box of super freaky potential side effects and make them run away from treatment, so they downplay the info. Or maybe what happened to me really was a strange fluke (though judging by the research I've seen and stories I've heard, I don't think that's true) and most people who walk through these people's offices are totally fine on whatever. But, again, I want to add my perspective.

In particular, I want to emphasize that shrinks should encourage people to track their mood and physical symptoms closely, give the client an easy way to contact them and game plan should their symptoms take a turn for the worse, and give patients information about the side effects and adjustment process. I also would venture to say that we should reevaluate giving meds, especially SSRIs to teens and youth. I'm not saying we should rule it out entirely, just do more research and exercise more caution, which I know is beginning to be done.

Well, I meant to talk about some other things, but that rant has been longing to come out for a while. Thanks for bearing with me, readers. I will talk about my other crossroads some other day, I guess. On the plus side, I do have a new, much, much more affordable psychiatrist who, in spite of what this post might indicate, seems pretty competent. (And I bought myself a new scented candle as a reward for surviving the stress of going to a new psychiatrist. It smells like jam and makes my soul smile.)

One last time.

I hate first weeks of school.

I guess the good news is that last week was my last first week of school, at least for a while. It hasn't really sunk in yet, though, that this is the beginning of the end. And I really want to go through this semester with some sort of consciousness of that. I want to appreciate these moments before they're gone. I want to revel in the feeling of transition.

But back to first weeks...They're awful when you're an anxious person. My therapist says I shouldn't call myself an "anxious person" because that means I let my anxiety define me, but eff that...All I've ever known is life with anxiety and it does define me; it influences my every moment. It shapes my personality and my actions. People get to define themselves as white or black or Latinex or gay...why can't I define myself as mentally ill? I don't mean it in a bad way; it's just part of my identity, perspective, and experience.

Rants aside, I wanted to take a few moments to reflect on life right now because I've wanted to write about first-week anxiety last semester but never got around to it because, well, schoolwork caught up with me.

First off, I wanted to give a shout-out to all the anxious people starting school again. I learned to dread going to school when I was young, and I think I mentioned before on this blog that I would always cry and cry the week before school started. I didn't have a particularly horrific school experience or anything, but I just hate the stress, the regulation, the loneliness, the detachment, the oppression. Even though I'm a good student and always get things in on time and do a thorough job, I always feel like I'm drowning once school begins. All the deadlines feel so impersonal and even though I know everyone else is stressed, you're the only one who can do your own work, so there's an element of loneliness. I guess it doesn't help that I've never had a ton of friends. It also doesn't help when you have friends who invalidate your fears and anxiety about school when you confide in them.

First weeks are awful because you get syllabus after syllabus of deadlines, due dates, projects, readings, expectations, grading policies, office hours, participation grades...It's like a giant vortex of anxiety. If the mantra to combat anxiety is, "Take everything one day at a time; don't worry about tomorrow", syllabuses undermine all of that. And we've all had those teachers who love to talk up their class to be as intimidating as possible to weed out people. I recall getting so anxious about being in honors math class when I was in sixth grade after listening to the teacher tell us all that we would be covering that semester (I've never been particularly confident in math), that I dropped down to the grade-level math class. It was not an appropriate fit for me and my teacher kept telling me to move up to Honors, but I was terrified. But that was the only year I got an award for my performance in a math class, and trust me, that's never going to happen again...

You think that after, what, eighteen years of first weeks (I guess more if you count semesters...) I would be able to not get freaked out and tell myself, "Hey, you've done this seventeen times and everything turned out alright, even when you were, like, almost dying, so I'm pretty sure you can do this." But no, I still got pretty overwhelmed. Not as overwhelmed as before, but freaked out. And it didn't help that my professors gave the syllabuses in a casual, "Oh, btw, nbd but there's a ten-page paper and two three-pagers but they'll be a breeze." And when I expressed my overwhelm to fellow students they seemed non-surplussed by the workload.

This week, I'm feeling less overwhelmed. I guess I'm just taking the "one step at a time" approach. But my heart goes out to all the people who feel completely out of their element and overwhelmed. It's not a fun feeling to have. That's an understatement. You feel like you're in a pressure cooker. Like someone just placed your head in a crock pot. Maybe you get headaches or neckaches or realize you're constantly tense. Maybe you start having panic attacks again or waking up in the middle of the night. Maybe you feel emotionally like you're drowning and can't possibly get this all done. You need a break just when you can't take one. You feel overwhelmed with inadequacy and uncertainty. Your calendar is your enemy but it is also your master; you can't ignore it but it terrifies you and it's marked up with commitments and deadlines in red ink.

It's okay to feel overwhelmed. It's completely understandable and valid; don't let other people who are excited and blase let you feel like you're crazy. (Personally, I feel like they're the crazy ones...) Give yourself room to breathe though. Take a moment every now and then to pause and say, "I am alive. This moment is mine. I am here. It is a miracle. I am breathing. I am working. I am achieving. I am enough. There is a future, but my job is to do my best today."

Look around you when you walk. Look up at the trees and admire how their branches stretch as if trying to touch the sky. Notice the little things: a house's shutters you like, a plant you've never seen before, a bird flying by, no matter how small. Dwell on the small miracles that all this life is happening. It's not all about this stress bubble that has encapsulated you (I'm not blaming your for the stress bubble, by the way...I hate how life puts us into these bubbles.)

I know the pressure is unrelenting when the semester starts, but I also know that people who are anxious and/or struggle with other mental illness are strong. They are survivors. They are overcomers. Every day is a battle for them, and they beat it. Just getting through a day is achieving sometimes.

When the world is putting pressure on you, be the one to give yourself a break.

You are a miracle.

We will be okay. One day, one hour, one minute, one second, one breath at a time. One sentence, one word, one formula, one math problem...It's going to be okay.

(I do wish there were a couple extra hours in a day though...)