Annabelle Speaks

Ready Or Not

I intended to come here today and write a nice, happy post about my weekend camping at my family reunion and how much fun I had spending time with all of my aunts, uncles and cousins.  And maybe I will write that post, but this morning something else happened that I need to write about first.

This morning I learned that my therapist is moving back east, to New Hampshire, at the end of the summer.  Frankly I fell to pieces when she told me the news.  I cried for pretty much the entire hour of therapy this morning, and I'm still reeling.

For those of you who haven't known me as long/as well, the backstory is this: I've struggled with on-and-off depression and more-on-than-off anxiety my entire life, but it was never treated in any way, I just slogged through.  In January of 2008 I was assaulted on my way home from work late at night, and by March of 2008 my wife and I knew that I was, to put it bluntly, Not Dealing Well with the fallout of the assault.  I sought out therapy, eventually getting a diagnosis of PTSD (along with major depressive disorder and generalized anxiety, just for fun).  I've been seeing Therapist ever since, along with other specialists, and if it weren't for her I wouldn't be here right now.  There were months at a time where the hour (or several hours) of therapy I had each week were the only thing keeping me on my feet.

But I've been doing well lately.  My depression and anxiety are mostly under control, and life is going well.  This is good!  But I certainly wouldn't be considering leaving therapy entirely yet, if not for the fact that my therapist is leaving me.

I am not a fan of change.  I have serious fears of abandonment.  It feels like it is my fault that she is leaving because I neglected to worry enough about that possibility.  If I worried more, clearly the power of my worry would have kept it from happening.  I'm torn between falling back into all my unhealthy coping mechanisims and just saying to hell with it all, and wanting to do everything 100% perfectly for the next ten weeks so Therapist can leave with a positive image of me, and be proud of me.

Straight up - I'm scared.  I know I'm in a completely different place than I was a few years ago, and I am in no way a danger to myself anymore.  But to think about trying to maintain this place without the very therapist that helped me get here scares the shit out of me.  What if I relapse?  What if I falter?  What if I can't find another therapist that I connect with in the right way?  Can I do this on my own?

I guess it's time to find out, whether I want to or not.

Ready or not...

Way Harder To Write Than I Thought, aka OMG HIT PUBLISH AND RUN!

So, it's four in the morning.  What are YOU doing?

Oh, me?  I'm just hanging out here, not sleeping.  I've been WIDE awake since three.  And I didn't fall asleep until almost midnight.  I'm predicting MASS CRANKYNESS in about twelve hours.  I got another cordisone shot in my left heel yesterday afternoon, so I'm hoping this is just short-term insomnia from the pain or from the steroid itself.  I know from experience that I get spectacular insomnia from oral steroids, and though steroid shots aren't supposed to cause the same side effects I do seem to remember a little bit of this from the shots I got in October and November.

Frustratingly, this shot means that I can't exercise for several days.  I have been SO GOOD with getting up and exercising over the past week and a half.  I haven't missed a single day, until today.  I haven't written about it here, but since January first I've been on this revolutionary new diet called Eat Less, Move More.  Awesome, right?  I hear it works really well.  It isn't so much a diet in that I want to lose weight, though that would be nice.  What I'm really trying to do is keep my blood pressure from getting so high it makes my head pop right off my body like a dandelion.  Did you ever do that with dandelions as a kid?  You were supposed to hold them in your fist and say "Momma had a baby and it's head popped off", then flick the head of the dandelion off with your thumb.  Gory and morbid, now that I think about it.  Where in the world did that come from, anyway?  Google just seems to reveal several other people asking the same question, but no one with the answer.  GOOGLE HAS FAILED ME, WHAT DO I DOOOOO?

Uh, what was I talking about?  Right, blood pressure.  Long story short, a combination of two unrelated medications that I'm taking, along with my deep love of salt, have my blood pressure hovering around the pre-hypertension area.  So it is low sodium and more exercise for the next three months before my next checkup.  Exciting, right?

This, in and of itself, is not such a big deal.  I'm not really in the danger zone, I'm not going to die RIGHT THIS MINUTE OMG, and this is all fixable.  What is a big deal, to me, is that I have exactly ZERO confidence that I can pull off any improvement goals that relate to my physical self.  I've never been at all athletic, as anyone who has ever met me will verify.  I mean, I once sprained my ankle playing miniature golf for goodness sake.  The fact that I've even survived into adulthood without being hit by a train is pretty impressive. 

Klutziness aside, physical activity has never been "my thing".  I never had a particular inclination for it, being more the bookish introverted sort who preferred to stay in my room reading or playing on the computer than doing anything that involved actually leaving the house.  But if I'm really honest, I just had a fear of trying anything I wasn't positive I would be good at.  Okay, I have a fear of trying anything I'm not positive I'll be good at.  At least if anyone else is looking.  I'd rather not try than try and fail.  Is that the right/healthy way to approach life?  Not at all.  I know that.  But it's hard to fight against something I've been doing for 29 years, you know?

So now, with this, I'm trying.  Even though I might (likely) fail.  Talking about it isn't easy, because then you all will know when I fail, and obviously that means you won't like me anymore, and I will die alone and friendless before I turn 30.  Obviously.

I don't mind talking about my klutziness or any of my "safer" faults - at least they are funny.  With those, people are laughing with me, not at me.  But cripplingly low self esteem?  Not so funny.  No one wants to read about that, or so I tell myself and four in the morning when I'm typing away at my laptop, trying not to wake T.  I'm too lazy, I'm not strong enough, I don't have the willpower, I'll give up because it is easier, I can't do it, I'm too weak, I'm not good enough, I'm not smart enough, and gosh-darn-it, people don't actually like me.  I've lived with that internal monologue every day for as long as I can remember.  Almost two years into therapy and I still haven't managed to turn it off.  (Does that mean I fail at therapy, too?  Goddamnit.)  But I'm trying.  And now I'm telling you all about it.  I suppose that counts for something.

This Too Shall Pass

For me the cruelest thing about depression is how I feel like I can't trust myself.  I learned early on in treatment that the thing I most want to do at any given point in time generally the last thing in the world I should be doing.  I'm constantly distrusting my own motives in everything I do.  When I want to take a day to relax at home or go to bed early, I worry I'm being avoident.  When I want to stay up late or go out, I worry I'm too "up".  When I want to eat, I question if I'm hungry or if I'm just trying to fill a void.  When I don't feel like eating I force myself to eat on a schedule so I make sure to get food in my system.  It's like being trapped in a body being run by the spirit of a particularly strong-willed child who always does the opposite of what needs doing.  It's frustrating as hell.

This weekend alone I had to force myself to get out of the house and go to a party when all I wanted to do was stay home and play on the computer.  I had to force myself to make a cake and work on an art project and clean instead of letting myself sit in front of the television.  I had to force myself to eat, and then force myself to stop eating when I was beyond over-full.  I had to use my sleep medication for the first time in almost two months to make myself get some sleep, then two days later I had to fight to not sleep all day.  Yesterday I made the unwise choice of taking the same medication during the day when I could feel myself flying up, up, and away and friends were commenting that I was talking too fast and seemed really wired.  That caused such a fabulous crash that I spent the rest of the day at the hospital instead of going into work.

Right now I don't feel like I recognize myself at all.  I feel like I'm watching my life and the world around me on a movie screen, and I'm not really a part of it.  My stand-in is filling in for me while I just hang out in the background, sort of not caring if I get my part back or not.

I know it will pass.  Likely it will pass very soon, as it often does.  But the same way I know it will pass, I also know it will come back.  And that?  Really fucking sucks.

I know this sounds hopeless and morose right now.  If I were to write about this same subject tomorrow morning or next week or next month it could have an entirely different feel.  Maybe I'd be making sarcastic jokes about the checklists I keep in my phone to motivate myself to do basic life things like flossing and doing chores.  Maybe I'd be laughing at how I whine at myself inside my head, throwing spectacular temper tantrums over the littlest things.  But today it appears morose is the only thing on the menu.

But at least I still remember that this too, shall pass.

Adventures in Hospital Billing

Yesterday I had an internal temper-tantrum over the fact that the hospital AGAIN billed my insurance for my appointments that are supposed to be self-pay.  It saves me thousands of dollars a month to use their self-pay discount vs run the charges through my insurance, thanks to my insurance sucking very much, thank you. 

So, anyway, I left two messages for the hospital billing person.  The first was regarding the fact that for the month of March they sent me a bill for cash-pay (which I paid) and for my co-insurance amount after they ran the same charges through my insurance.  I left the second message after I learned from my insurance company that they had also been sent charges for the month of April, even though I had been assured by the hospital that this was taken care of last month and that mistake would not happen again, at which point my head exploded.  Despite said exploded-head, my voice mail messages to them were quite reasonable and calm-but-firm in a friendly tone.  I imitate my mom whenever I have to deal with people over the phone, because my mom is possibly the world's most friendly and like-able person, and it tends to get me what I need without having to be crabby at people.  (Side-note: As an example, my mom is so friendly and love-able that she once got our family invited to the wedding of someone she met in the line for the bathroom at a comedy club.  Honestly.  I can't make that stuff up.)

What was I talking about?  Right, hospital billing.  So this morning I get into work and find that I have a voice mail from the hospital.  Our voice mail system is set up so that voice mails are automatically emailed, as well as available through the phone lines.  When I opened my email I noticed that the file size for the voice mail was strangely large, but didn't think much of it and hit play as I was getting other stuff set up for my day.  The message, it turns out, was so full of apologies and promises and lists of ways that this will be fixed and more apologies that the message went on for a full three and a half minutes.  A three and a half minute apology is almost enough to make me forget the billing mistake entirely.  This is what calm, well-reasoned, voice mail gets you.  It gets things done! 

Or maybe it has something to do with the fact that my diagnosis of "major depressive affective disorder, recurrent episode, severe degree, specified as with psychotic behavior" is probably written in bold at the top of my chart.  Either one.

This is What a Panic Attack Looks Like

It starts with a sort of buzzing, vibrating feeling in my skin.  I'm not actually shaking.  I repeatedly hold my hand out to prove this fact to myself, as if as long as I am not really physically shaking, then everything is just fine.  Somehow feeling it without being able to see it is more comfortable.  Safer.  I'm not really losing it; it's all in my head.  Ha.  As if that phrase holds any comfort to me anymore.  It is things "only in my head" that have caused me the most trouble and pain.

 

Emotionally I feel fine.  The sun is shining, it is warm outside, and my week is full of scheduling wonders like dinner with friends on Wednesday and a massage on Tuesday.  And yet, something is off, and it is starting to make me nervous.  I check again to see if I can hold my hand out steady.  I wonder why every nerve ending in my arms and hands is tingling and firing at once, and how this is not showing on my outside.  I'm positive this is what it would feel like to have a thousand ants marching on the inside of my skin.

 

I wish I could crawl into bed and wrap myself tightly in a blanket and take a short nap.  I know that would help, but I can't because I'm at work.  I take some papers to the scanner to try and get some easy mindless work done while I pull myself together.  Standing at the scanner I alternately feel like fainting or running laps around the floor.  I feel like the world is twisting my top half one way and my bottom half the other way, like a cosmic "snake bite".  I want to scream, or run, or cry, or hit something, or just do something, anything, to get rid of this energy.  I see it in my mind as an electric charge building up in my body, making me glow-in-the-dark bright.  If someone told me the energy buildup could be seen from space I would only be surprised that it took them this long to notice.

 

I close my office door, turn on my calming play list on my iPhone, and take a series of deep breaths as I press the heals of my hands over my eyes.  I will my heart to please, please, please slow down.  I bounce my legs up and down, trying unsuccessfully to lower the volume of the buzzing in my body.  Tears leak out around my hands, still covering my eyes.  I notice that I'm nearly hyperventilating and again concentrate on slowing my breathing.  I know I should take my panic meds, but I'm just so sick of needing pills to stop this.  I just got myself off having to take the panic medication every day, and currently view every "as needed" dose as a slip towards returning to that level of reliance, that level of numbness.  I don't want that.

 

But I don't want this either.

I wrote this when I should have been eating lunch

Psychologists call it "free-floating" anxiety. What contradictory words. Anxiety doesn't free-float. It stalks. It attacks. It lands on you with a thud. - Martha Manning, in Undercurrents: A Life Beneath the Surface, an amazing book about her struggle through depression that I find myself in every time I re-read it.

 

One of the places my anxiety is constantly getting the best of me, much to my chagrin, is in food.  I am hardly the first woman to write on the Internet about her issues with food.  Food issues, disordered eating, and eating disorders are disturbingly common, particularly among women and girls (though men and boys are not at all exempt).  And while I certainly have all the "usual" issues around food and weight (I shouldn't eat X because I'll get heavier, I should exercise more to lose a pants size, if I lose more weight/keep this weight off X will love me more, etc), I've also got this whole generalized anxiety and panic disorder that latches onto the existing insecurities and supports them with fear and panic in highly disruptive ways.

 

Weekday lunches are my biggest problem.  I don't normally have trouble eating at home or when I go out with T or with people I know well (and it is usually easy enough to avoid eating out with T's friends/coworkers that I don't know well), but for some reason eating at work in the middle of the day horrifies me.  I frequently go from a banana for breakfast at 6:30am (eaten on the way to the train) until dinner at home at 7pm without consuming anything more than water.  The days I don't pack lunches are the worst; it is almost certain I won't eat anything for lunch.  I work in a large office building in the middle of downtown Chicago; I'm certainly not lacking in food options.  But I start to worry around ten or eleven about where I'm going to go to get food.  I worry about lines, and crowds, and having to be around noise and people.  I have mini panic attacks when I think about going to a new place because I don't know the menu, I don't know the flow of the line, I don't know exactly where to stand, and I have to decide what I want while people look at me and I just can't do that; it's too much.  No way.

 

Days I pack lunch or days I'm planning on eating from my always fully stocked food drawer aren't much better.  I probably eat lunch about 50% of the time I've packed food to bring with me.  If there is too much food then it is overwhelming.  An entire sandwich can seem like an impossible amount of food to eat.  Every bite is torture and takes me forever to get up the nerve to take another bite, chew, and swallow, and not throw up.  Last fall I bought a bento box type of lunch box so I could deal with one small portion of lunch at a time, hoping that would be less overwhelming.  It is, sometimes, but most often it takes just as long to eat that way as it does when I confront the whole of my lunch at once. 

 

The longer the panic and fear pushes back my lunch, the weaker I feel, the more I shake from lack of calories and energy, the more tired I feel, and the worse the panic gets.  It's a circle I don't know how to stop.  Coworkers tease me that it often takes me hours to finish my lunch.  They point out how healthy it is to eat small amounts all day instead of the "regular" three meals.  They compliment me on how I eat or my recent weight loss and I want to hide in a corner and cry.  "I'm not doing it on purpose!  I can't help it!  I don't know why I'm afraid of food!  I wish I could make it stop, but it just isn't that easy!"  It doesn't matter what food I pack, when I try to eat it, or if I'm alone or around people.  It's frustrating and no matter how often my therapist and I go over it, we haven't managed to change a damn thing.  It doesn't seem connected to my self-esteem or body image.  It's just there, and it won't go away.  I hate that I feel like I can't control this, stop it, make it better.  It seems so simple.  But it isn't, and I don't know why.

Sometimes the hardest thing to do is NOT try and help

It’s pretty common in my field to feel a strange combination of elation and depression after the end of the busy season.  There is elation at the idea of free time, sunshine, a return to family and friends, and a sense of balance.  Yet there is still some depression over the end of a race; a race run as hard as you could possibly run it with coworkers who are your friends.  It isn’t so much that I want to jump back into busy season – far from it.  It is just hard to find a direction when I’m no longer running from one fire-drill to the next; hard to adjust physically and emotionally to a different pace of life.

The first few days after the end of busy season are something like a sugar crash or a hangover on steroids.  It feels like every cell in my body has been storing up the pain and injury I’ve caused it over the last three months, and they are only now bringing these ills to my attention.  After months of poor diet, little exercise, and even less sleep, I am now reminded that a diet of orange juice and swiss cake rolls is maybe not the best idea.  Every year I get sick right after busy season, and every year it surprises me.

First I have to work through the physical effects of the crash.  I need to catch up on sleep, and vegetables, and quiet time.  Next I’ll have to deal with the emotional crash and depression that tend to follow.  Right now I’m somewhere in the middle of those two phases.  I’m still catching up on sleep and rest and quiet time, but I’m also starting to notice the emotional fallout, and I don’t know quite what to do with it.

It is 12:36am, and I don’t know who to call.  I have wonderful, supportive people in my life who would absolutely wake up to talk me through this, but I don’t really want them to.  This morning at the hospital I told one of the staff that I was still not okay, and she offered suggestions of work I could do to help myself fix this.  She laid out the foundations of a plan – a checklist of things to do, but I don’t feel ready for that quite yet.  I approached her not knowing what I needed, but felt myself shutting down and withdrawing when she went down the path of trying to fix things.  I can’t go there yet.

Yesterday at the hospital several of the nurses noticed I was not doing well, and one in particular approached me to ask if I was okay, if there was anything I needed.  The concern and worry were clear on her face, and I very nearly hugged her.  I didn’t realize it at the time, but that is what I needed; probably what I still need.  Support and care without a list of things to do and solutions attached.  Just a listening ear, a held hand, and time.  But I’m so good at standing on my own two feet and pushing through things that I don’t have such supports readily available around me.  I’m not good at accepting that kind of support until I no longer really need it much, and as a result I don’t know where to find it when I do need it.  When I’m strong enough to be pushed a little, when I’m ready for ideas and solutions, I’ll have plenty of people to call on.  But right now?  I’m noticing something I’m missing in my world.

For now, I think I’ll just go to sleep and see if tomorrow brings a better day.  One step at a time, I’ll get through this.  I always do.