Tag Archives: Anxiety

On Death and Dying

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I’m going to warn you up front that this post is morbid and depressing. I’m reluctant to write it, but this is what’s been on my mind, and I’m committed to writing what’s true. So here goes.

My friend’s father died last week, and I have been obsessing about death and illness since then. I am terrified of getting older and of dying. And I’m terrified of watching someone I love die.

If I could have, I would have asked my friend if his father was in pain. If he gave any indication that he was ready to let go. His doctor thought he would only live 9 more months, and it occurred to me the night before he died that perhaps he didn’t want to live that long. I imagined being in his father’s place, lying in bed, in pain, not being able to do anything. Not feeling like myself. Perhaps 9 months felt like too much.

When my dad was depressed, he looked like the walking dead. A shell of his former, manic self. It was painful to see him in that state for four years. But he got better, and every day I say a prayer of thanks for this. He is in full form now, reckless in his pursuit of happiness.

It’s disconcerting, all the crazy stuff he’s doing. But if he has to go, I guess he wants to do it on his terms, being fully alive when it happens. And to be honest, that’s how I want him to go, too. I don’t want to have to go through that again–watching him become less and less like himself until he is gone.

I also had the morbid realization that if I were diagnosed with a terminal illness, I would not have anyone to take care of me. No one to take me to my appointments, to make sure I got my meds, to bear witness to my suffering. I guess that’s why people get married. In sickness and in health, ’til death do us part.

Perhaps it doesn’t matter, because I don’t have any one who I need to live for, anyway. No children or spouse who relies on me. And I wouldn’t want to ask anyone in my family to put their life on hold to take care of me. I can barely ask for help as it is.

Maybe I wouldn’t even tell anyone. Maybe I’d just keep going to work and playing tennis and blogging until I couldn’t do it anymore. I don’t want to be known as the person who is dying during what little time I would have left to live.

That might be a problem with my commitment to honesty and vulnerability in my blog, though.

This is the most depressing line of thinking I’ve had about being single.

When clients are obsessing about things to come, I tell them that they don’t know what the will future bring. That when they get there, they can worry about it then. So I guess for now, I’ll take my own advice.

Learning to Listen to My Inner Bodyguard

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Did you know that the word intuition means to guard or protect? I just learned that in The Gift of Fear, by Gavin De Becker. If you haven’t read it, I strongly recommend that you do. Thanks to De Becker, I can no longer be in denial about my disregard for personal safety.

De Becker says that intuition is always in response to something. That doesn’t mean that we will always make the correct prediction, but we owe it to ourselves to explore what that something is rather than trying to explain away or dismiss our fear.

I’m trying to pay closer attention whenever I get anxious. I’m trying to honor my fear. But I’m having trouble figuring out what my anxiety means because I am never sure what is intuition-based fear and what is pathologically-based fear, since I have an anxiety disorder.

In my relationships, not hearing from the guy felt like life or death. I always thought it meant I was just really insecure. And sometimes that’s what it was. But sometimes it was because that’s how the guy felt about me. And because of the whole hyperempath thing, I couldn’t tell the difference between his fear of separation and my own.

Or sometimes it meant they were up to no good. But there’s always that doubt. Maybe I’m just being paranoid. And it’s not the kind of thing that is easy to confirm. It’s not like they’re going to admit that they’re doing something that would piss me off when they’re not around. But in retrospect, they usually were.

I also have a hard time saying no to any request. De Becker says that you should be wary of the stranger who ignores the word no. A guy who isn’t trying to hurt you would totally understand why you would not let a complete stranger into your house to use your phone.

And yet, back when I was in grad school and the UPS guy asked me if he could use my phone, I said yes. I wanted to say no, but it seemed rude. Maybe he would be offended. Luckily, nothing bad happened. But it’s still hard to forgive myself for putting myself at risk like that. And it’s hard to imagine how I will be able to overcome this deeply ingrained impulse to give people what they want.

It’s hard to trust my instincts because I want to believe that other people are trustworthy. I don’t want to live in a world where I have to be worrying all the time that people may be trying to hurt me. Although De Becker provides some pretty convincing stats for why I should be worried.

In another blog post, I talked about how I am trying to say yes to what I want and no to what I don’t want. Maybe I need to do the same thing with trust. If I have to choose between trusting my instincts and trusting another person, I need to choose me.

I need to let my intuition do its job.

In This Moment

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I’ve always been reluctant to tell people what kind of music I like, because it’s pretty mainstream. In fact, I’ll make that #11 on my list–my preference for Top 40. Some of my friends have criticized me for what they consider my poor taste in music: it’s so unoriginal. So superficial.

And it’s true that the lyrics usually aren’t profound, but sometimes they still touch upon universal feelings. That’s why even the sappiest of love songs can be appealing when you have a broken heart.

Yesterday on my drive home the song “Daylight,” by Maroon 5, came on the radio. Every time I hear this song I think of one of the long distance relationships I was in during high school. My boyfriend went to college 5 hours away, so we didn’t see each other often. And when we did see each other, I was so anxious by Saturday about him leaving on Sunday that I couldn’t enjoy our time together. No amount of reasoning could stop me from obsessing.

That’s what happens when you have an anxiety disorder. The things that other people find difficult, like saying good-bye, are intolerable. Adam Levine can still hold her close for one night, even if he’ll have to go in the daylight. I, on the other hand, would obsess about how sad I was going to be when that moment came and would end up ruining the whole evening.

Despite the intensity of my negative feelings, I have often chosen relationships that have been characterized by a high level of drama. Which doesn’t make any sense, I know. You would think that I wanted to be miserable. But love is like a drug–especially in the early stages–what with all the obsession and longing and all. Even though the cons outweigh the pros, you get addicted, anyway, because it’s not a rational process.

My relationships were like an addiction in that I craved connection, but no amount of contact was ever enough. And I would experience withdrawal during even the smallest periods of separation, yet I still preferred long-distance relationships.

That’s why I’m proud of myself for not being in a relationship. I’m learning how to tolerate my fear of being alone. And I’m learning how to live without the addiction of drama. And my behavior doesn’t seem as crazy and contradictory–in relationships, at least.

Other things have helped with my anxiety, too. I resisted meds for a long time, even though people begged me to take them for their sake, if not for mine. But I have to admit, even though I don’t like taking them, they make my anxiety bearable.

I also have a therapist who I can call when I’m freaking out. I meditate, which has helped me tolerate my feelings. And I practice mindfulness as often as possible.

One of my favorite mindfulness mantras is any sentence that begins with “in this moment.” In this moment, I am anxious. It’s hard to breathe. I am in pain. But in the next moment, I will feel differently.

And I always do.

Faking Good

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Did you know that some personality tests are sophisticated enough to detect when a person might be faking bad or faking good? When I took one in grad school, the computer report said that I could either be faking bad, or that I’m just really hard on myself. Talk about sophistication! My Inner Critic was detected right away.

In general, I think people are more likely to fake good than fake bad. I am no exception. Most people can’t tell when I’m upset. Even when I tell people I’m upset, they don’t believe me because I’ll be smiling–like when I bought my mattress. So even when I’m trying to be honest, my face is still faking good.

Facebook is the perfect example of millions of people faking good every hour of every day. Even though I know from experience that things are often not what they seem, I still feel like my life pales in comparison to my friends with their happy spouses who declare their undying love for each other on their anniversary. Or their children who are winning sports competitions and getting good grades and saying funny things. Or their vacations to exotic places while I’m stuck at home because of the snow.

But then again, sometimes I’ll scroll through my pictures and wonder if people feel the same way about me. All of the happy pictures with my family. Pictures at sporting events, tennis tournaments, and karaoke parties with my friends. Pictures of my latest knitting project or the jewelry I just made.

Even if we want to be more honest on social media, it’s hard to do because it’s so visually oriented. Like, it never occurred to me to take a picture when I was getting my divorce papers notarized. Or to take a selfie of me lying on the couch, too depressed to do anything. I guess I could have taken a picture of that time I shattered my microwave door and had to sweep up hundreds of shards of glass, but I was too busy being pissed off.

The most honest posts I’ve seen are the ones where people say how they still miss a loved one on their birthday. I have not yet lost someone close to me, and the thought of doing so fills me with fear. And now I know that the sadness stays with you for the rest of your life. It exists right alongside of those happy family posts. But at least it makes the picture of their life seem more realistic, and therefore more relatable.

If you scroll through my wall, amidst the posts of family and friends, sports and crafts, you’ll see my blog posts. Verbal snapshots of my obsessiveness in action. Guilt and shame over failed relationships. Evidence of how difficult it is for me to be kind to myself. To believe that I deserve to be loved. That I’m worthwhile. This is my attempt to be honest through social media. My tribute to the complexities of real life.

But not everyone has a blog. So if you have ideas for how to stop faking good on social media, I’d love to hear them. It could be the beginning of a campaign. Like the one to stop bullying. We can work on the catchy phrase later.

Why I Blog About Mental Illness

Yesterday someone asked me to write a 1,000 word essay on my personal experience with mental illness. After I wrote it, I realized that I have never told my story to anyone. I have now added it to the menu on my blog, but I thought I’d include it in a post, too. Here it is:

I come from a family with a history of depression and anxiety. My dad and two of my brothers have bipolar disorder. My mom has an undiagnosed anxiety disorder. And I struggle with both mood and anxiety disorders. Because of this familiarity with mental illness, I played the helping role in my family for many years before I chose my profession. So becoming a clinical psychologist almost felt like a calling rather than a choice.

I first became depressed in high school. It’s hard to separate the angst of adolescence from clinical depression, but I had thoughts of suicide by the age of 15, so I’ll say that it started then. At that time, my diagnosis would have been dysthymic disorder—a more chronic, lower grade version of depression.

When I left for college at 18, I crossed over to major depression. However, I didn’t do anything about it for a year. At 19, I had my first therapy session with a psychiatrist who confirmed my diagnosis of depression. At the time, that was enough to make me feel better—to have someone tell me that what I was going through was real.

So I didn’t follow up with therapy until after I graduated from college, when I was 22. I can’t say I thought that therapist was particularly helpful. He never told me his opinion on anything, never gave me homework, never offered me another way to look at things.

The 3rd time I went to therapy was with my boyfriend right before we got engaged. I was 25 at the time. It was clear that she thought that our relationship problems were because of my depression and suggested that I go on meds, which really pissed me off. We didn’t see her for very long.

Still, she planted the seed of meds in my mind, and I started a trial of antidepressants about 6 years after she suggested it. And it did help. But after a year and half, I stopped taking them because I didn’t want to have to rely on meds to feel “normal.” Then I started them again a few years later when my husband and I started talking about separation.

I also went back to therapy. And she is the therapist who I have seen on and off for 13 years now. Her unconditional acceptance and belief in me, over time, has allowed me to accept and believe in myself. Still, I would see her for as little as I could get away with until I became functional, because I didn’t think I deserved to take up more of her time.

My 2nd major depressive episode happened almost 6 years ago when I was 40. I had stopped taking my meds again, and about 3 months later, I got depressed again. And it was even worse than the first time. It probably took me about 9 months to recover completely.

This time I was not able to just restart my meds and return to normal, so I saw a psychiatrist for the second time. Surprisingly, he was more concerned about things like light therapy, sleep hygiene, and supplements (Omega-3, NAC, Folic Acid) than he was about antidepressants. But I had to take those, too. He also added Ativan, because my anxiety had worsened, and lamotrigine for bipolar depression, because of my family history and my hypomanic episodes.

It was difficult to accept that for the rest of my life I would be on a regimen that requires an AM and PM pill box. But I had suffered so much through this last depressive episode that I got over it and was thankful to pharmaceutical companies for coming up with drugs that could make me feel like myself again.

Since that last depressive episode, I have gotten much better at taking care of myself. Mental health professionals have a tendency to put other people’s needs first, usually to their own detriment. I guess it’s sort of like how physicians make terrible patients. However, my determination to avoid a 3rd major depressive episode has motivated me to make my well-being a priority.

I have never shared this detailed of an account of my mental health history with anyone because I was ashamed of my depression. I felt like a failure. I was supposed to have everything under control, but sometimes I was struggling more than my clients were. But then a few years ago I decided to write a book about self-acceptance where I make use of both my personal and professional experience.

I decided to start with a mental health blog where I would be open and honest about all of the things that I ordinarily try to hide as a way to demonstrate how to practice self-acceptance. Because it’s that hard to do. Even when you know what you’re supposed to do.

Surprisingly, readers are more interested in my personal experience than my expertise. Although I think it helps them to know that I am a psychologist, because it’s further proof that everyone struggles. Being an expert doesn’t make you exempt from suffering. From avoiding help. From resisting treatment. It is all a process that slowly improves with time. And as I blog and get feedback from readers, I become increasingly more comfortable with being me.

So even though I started this blog to help other people, it has turned out to be the best gift I have ever given to myself.

Smile: It Gets You Free Stuff. And Followers.

Appearances can be deceiving, even when you’re trying to be honest.

Today was a terrible day. I don’t want to waste an entire post on the details, so I’ll just hit the highlights:

1.  I spent 2 and 1/2 hours hanging out with the cable guy. This was after having a different cable guy show up at 8 a.m. yesterday and after multiple conversations and chats with customer service reps whose only troubleshooting advice is to tell you to unplug your cable box and turn it back on again.

2.  The office where I get my allergy shots randomly closes fairly often. So often that, to avoid getting into trouble, they’ve asked me to call ahead to make sure they are there. Which is ridiculous, because their job is to be there when the clinic is open. So today I didn’t do it. And guess what? They were closed!

3. I had to spend a bazillion dollars on a mattress today. OK, maybe not that much, but you know how I am about spending money. I have been sleeping on the same cheap mattress for 17 years. I only gave in because my back and hips hurt. And since I’m doing this whole self-care thing, I figured I should invest in a good mattress. Plus I had to get the reclining thing because of my stupid GERD, which was also expensive.

OK, that was a little more ranty than I meant it to be, but I had to give you some context about what my mindset was when I walked into the mattress store. When Mr. Salesman asked me how I was doing, I told him about the cable guy, the doctor’s office, and how he was robbing me of my savings. He told me that I didn’t seem like I was in a bad mood because I was smiling. Which is true. I’m always smiling, no matter how upset I feel. I told him not to be fooled.

After our transaction was complete, Mr. Salesman asked me what I do for a living. I told him I was a psychologist, and he was surprised by this. He said that all of the psychologists and psychiatrists he knew were super uptight, and I was super laid back.

What the hell? I don’t think I could have possibly had a worse attitude when I came into the store. And I’m pretty sure I’m just as uptight, if not more so, than most mental health professionals, given my various mood and anxiety disorders. Can my pathological smiling response really make me seem laid back and happy when I am actually pissed off? I don’t get it.

But I guess it’s a good thing. Because I made him give me every possible free thing he could throw in. Plus I told him that he needed to start following my blog. I also told him tonight’s post would be dedicated to him. So here you go, Mr. Salesman!

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Turning Pain into Posts

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Yesterday was not a good day.

Yesterday, for the first time in his 16 year career, Federer withdrew from a major tournament, and I had planned my entire day around watching the match. That may not sound like a big deal to most of you, but to a Federer fanatic like me, it’s downright traumatic.

Then I played tennis and lost to the same team for the 3rd time in a row. Plus my opponent accused me of making a bad call. Which would ordinarily make me worry about going to hell, but instead it just pissed me off.

Then my doubles partner thought it would be funny to insult Federer because he knows how much I love him. Which was the last straw. So I punched him in the arm. Hard. Twice. No, three times. Twice in his right arm, and then when he turned away from me in self-defense, I punched him in the left arm. Then I paid for his dinner because I felt guilty about my violent outburst. Although I still think he deserved it.

During dinner he gave me the same old advice that everyone gives whenever someone is upset. Something along the lines of how it’s all about your attitude and he doesn’t even let the big things bother him. Which pissed me off even more. But instead of hitting him again, I just told him he was lucky.

Sometimes I can tell myself to think about all those people whose lives suck more than mine does and it helps me put things in perspective. Like when I had to pay $1000 to replace my water heater and reminded myself that at least I don’t have Ebola.

When I’m depressed, it just makes me feel ashamed that I can’t think positive thoughts, count my blessings, and call to mind the less fortunate. What right do I have to be depressed, given that I have a good life?

When I’m anxious, these strategies just freak me out, because I start thinking about how someday someone that I love will be in poor health. Someone that I love will die. Someday I will be less fortunate than I am now. So then I start panicking about the passage of time and I have to take an Ativan.

And sometimes it just makes me mad. Because I’m a psychologist so it’s not like I’ve never thought of these strategies. In fact, I practice them all the time. They obviously haven’t been reading my blog! But then I feel guilty because they’re just trying to help. I’m just being too sensitive. And I can’t just go around punching people when they piss me off.

Last night I tried to tell myself that in the grand scheme of things, nothing that happened that day was a big deal. I counted my blessings. I thought of Ebola. Nothing worked. So finally, I gave up fighting it and told myself that it’s ok that I’m upset about Federer’s injury. About jokes that I find mean-spirited. About losing. Being called a cheater. Having to listen to unhelpful advice. About being in a bad mood in general. I reminded myself that at some point, I would not be upset anymore. Perhaps I would even feel differently in the morning.

I did feel better when I woke up. Not happy, but better. Then I remembered that pain makes for good blog posts. So I started writing, which finally gave me something to be happy about.

So when all else fails, there’s always blogging.

Do Something that Scares You

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Sometimes anxiety is a good thing.

The other night I gave a presentation on anxiety to Active Minds, the student organization whose mission is to raise awareness and reduce stigma about mental illness. I began the presentation by reminding everyone that anxiety is not always something we want to get rid of. It motivates us to act. It socializes us. And it warns us when we are about to do something scary.

But sometimes it’s good to do something scary.

When I started my blog, it never occurred to me to use an avatar, because the point was to get people to know me so that they would buy my book someday. Plus, anonymously blogging about vulnerability seemed hypocritical. But I have to admit, sometimes I wonder what the hell I’m doing, telling people all my deep, dark secrets, and I wish there were a way I could take it all back.

Some posts are scarier than others. The post that I wrote a few weeks ago, Undeserving, was one of the scarier ones, because what therapist admits to having the exact same fears that her clients have? Publishing it felt a bit like standing in front of people naked and saying, go ahead; judge my body.

Which nobody did, thank goodness. Not to my face, at least. Although the most vulnerable posts are always the most popular, knowing this won’t make it less scary to bare my soul the next time. Because anxiety has no memory. It does not distinguish between past, present, and future. It does not know the difference between reality and fantasy. In the moment, there is only fear.

Actually, I am growing accustomed to baring my soul before friends, family, and strangers. But the thought of standing naked before students and clients still terrifies me. Therapists are supposed to be blank screens. At minimum, they use self-disclosure with caution. They certainly don’t let clients know that they struggle with anxiety and depression and that they don’t think they deserve to be loved.

Last night a student from the school newspaper emailed me some questions about Seasonal Affective Disorder because she’s writing an article about depression. I realized this was an opportunity to publicize my blog, since my last post was on this very topic. But the thought of doing so gave me an anxiety attack, so I decided to sleep on it.

Plus it was midnight, and I promised myself I wouldn’t start working on stuff after midnight so that I don’t screw up my sleep cycle. Even though I ended up staying up until 1:30 a.m., anyway, doing pointless stuff like playing Sudoku and Minesweeper. What is wrong with me?!

But I digress.

This morning I answered the student’s questions and told her about my blog. Part of me hopes that it will lead to a thousand new followers, and a part of me hopes that she ignores the reference to my blog altogether. In any case, I did it; I pushed myself to do the thing I fear the most, as far as blogging is concerned.

And I have to say, it feels pretty good.

Angels and Demons

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I thought of something I can say to the part of me that tells me I’m undeserving. In fact, I say it all the time. It’s “Shut up demons! You don’t know me!”

People usually think of that little devil on our shoulder as the part of us that tells us to do something bad, like “Go kill that person!” Plus some less extreme things, like “Call that ball out! You’ll win the game!” From a mental health perspective, the devil tells clients to do things like “Get black out drunk instead of staying in to study. And then miss your therapy session so you don’t have to talk about it.”

Sometimes that little devil will disguise itself as the angel and will try to make us believe that we are doing something good when we are actually hurting ourselves. Things like “There are people starving in the world, and here you are eating all of this food that someone else needs more than you. You really shouldn’t be eating at all.” Those are the most insidious messages of all.

When I was depressed I went around yelling at my demons all the time. They were constantly telling me that I should kill myself for stupid reasons. But I didn’t want to die. I knew it wasn’t coming from me. So I would literally go around the house telling the demons to shut up. Which I found hilarious.

My psychiatrist, on the other hand, did not appreciate my sense of humor. When I told him I had started yelling at my demons, he did that stereotypical psychiatrist thing where he just looked down and wrote something on his legal pad. Probably something like “She’s f@%ing crazy!” But whatever. It worked. All that warrior training paid off.

I was really tired on Sunday and Monday. I had been obsessing about my Halloween party for weeks because I have an anxiety disorder. I am in the midst of the busiest part of the semester and rarely have an hour to myself, unless someone doesn’t show up. I’m playing on two tennis teams and am captaining one of them. And the weekend before I drove 4 hours to watch my beloved UVA team blow another lead to lose the game, which was both tiring and depressing.

So for once, when I needed to sleep all day on Sunday and a good part of the day on Monday, I did so without beating myself up about it. Without trying to will myself to be productive. Without telling myself how pathetic I am for being so tired, when the average human being wouldn’t be. Instead, I tried to take care of myself. I would ask myself things like, “What do you need right now? Are you hungry? Do you need to go back to sleep? Would it help to take Advil? How can I make you feel better?”

Sometimes the little angel on our shoulder tells us not to do bad things. But more often, in my case at least, it encourages me to be more loving to myself. So I’m going to counteract messages about being undeserving with love. And by yelling at my demons.

Sixth Sense

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I read recently that elephants can detect rain storms from 150 miles away. This is a helpful ability to have in Nambia, where it rains very little. Researchers aren’t exactly sure what the elephants are sensing but suspect that it might be related to their ability to hear very low frequency sounds, since this is also how elephants communicate with one another in herds.

I have been really anxious lately. Sometimes for no reason, which is really annoying. I know this sounds crazy, but sometimes I’m anxious about something that hasn’t happened yet. And it’s not because I’m worrying about something in the future. And it’s not that I’m psychic. I have no idea why I’m feeling anxious. But then something happens, and my anxiety makes sense. Except that the cause and effect is reversed.

I think I might be like an elephant. I think there’s something that I sense that goes beyond the usual 5 senses. I can sense distress from far away. Anxiety, like sound, is also a way that herds communicate. If you are in a pack of gazelles and one of the gazelles in the back sees a lion, it’s not like the gazelle can say, hey everybody! Run for your lives! We are about to be attacked! And whatever means of communication they use has to be instantaneous–like when we break suddenly to avoid hitting a deer. Even though you’re not supposed to do that.

People can feel it when someone is anxious, too. I think that’s why people try to stop other people from feeling. Because they don’t want to feel anxious. And usually the anxiety isn’t adaptive. These days we usually aren’t feeling anxious because we are about to be attacked by wild animals. We’re anxious about something that isn’t life threatening at all–like an interview. Or because we slept through our alarm clock and are running late. Or because we are imagining how we would get to work if we broke our leg without having to call our ex. (I was really worrying about that a few days ago for some reason.)

The problem is, my instinct to move towards the source of distress isn’t like an elephant moving towards water. Moving towards water is adaptive. Moving towards danger is not. If anything, I should be running for my life, like the gazelles.

But then again, there are people who run towards danger. Like the firefighters and police officers in 9/11. In fact, when you talk to someone who has done something heroic, like jump into a river to save a stranger’s life, and you ask them what they were thinking, they say they weren’t thinking anything. They were just responding. So we do need people whose instinct is to run towards danger.

I have always considered myself risk averse, but maybe I’m not when it comes to psychological things. Maybe I’m like a psychological fire fighter. That doesn’t sound so crazy after all.