In my first post I said that I would come back around to the topic of medication, and well, folks, today is that day.

I’m going to lead off with a blanket statement: if you seriously think that medicating for mental illnesses is “tHe ReAl PrObLeM” or that maybe I should just do more yoga, I’m going to ask you to just keep that to yourself and have a seat over there because this is not a place where I will tolerate med shaming.

Let’s start with some basic concepts.  Mental health challenges are not just “feelings” or something that you can just overcome by sheer force.  (Trust me, if this was the case, I wouldn’t be here writing this post today).  What are they?

Mental illnesses are health conditions involving changes in emotion, thinking or behavior (or a combination of these). Mental illnesses are associated with distress and/or problems functioning in social, work or family activities. (source)

Key point here?  They are health conditions.  Full. stop.

Using this as a baseline, this is why I’m not here for people shaming folks for taking meds for mental health stuff.  You wouldn’t tell a diabetic to not take medication and do yoga in hopes their pancreas decides to produce more insulin.  Or tell someone dealing with cancer to they shouldn’t do a round of chemo.  Or someone with asthma they shouldn’t use an inhaler to breath.  Or someone with arthritis they don’t need meds to handle pain and discomfort.

Now, does this mean you shouldn’t also do other basic self-care things? Nope.  Because as with many illnesses, taking care of your body will help you manage symptoms.  If you are sleeping enough, eating well, and drinking water, your body will have the resources it needs to do what it can, in conjunction with medication, to help manage things.  When I’m not sleeping well, my anxiety will be worse and my ADHD symptoms will be more noticeable.  Same for if I don’t eat or stay hydrated.  “Hanger” is a thing because lack of fuel impacts your body – and for someone with mental illnesses, there are just additional things it messes with.  It’s not an either/or, it’s a both/and.

I’ve been on medication for my anxiety and depression off and on since high school.  I used to be ashamed of this fact, and thought that it was a weakness.  I actually stopped taking medications in college because I thought I didn’t need them any more.  In hindsight, I wish that I not only stayed on them, but also had a more complete care team to help me manage my medications and make sure I was taking the right dose and the right kind.  This is a missing piece for many people since there is a shortage of psychiatrists in this country, and the wait times and other barriers make it not a resource easily available to folks.   There’s also the insurance mess, and barriers with certain meds since they are scheduled drugs by the DEA which brings up other issues.

It is also important to remember that your care team should be that – a team.  I have a therapist, psychiatrist, and primary care doc that work together to provide me with supports and advice to help me manage my symptoms.  I think without this trio, I wouldn’t be where I am today.  They all bring an expertise to the table based on their education and experience that help give me the tools I need to manage symptoms and keep this chronic condition under control as much as possible.

So what do I take?

I take Prozac for my anxiety, Adderall XR for my ADHD, along with Vitamin D and E each day and Ativan as needed for anxiety spikes/panic attacks/PMDD.  I was on Zoloft for a long time, but we found that the Prozac actually did a lot better at managing my anxiety, and I’m glad I made this switch.

However, unlike other types of illnesses, there isn’t a quick and easy blood test to know if the doseage is right.  I have to become aware of my symptoms and how they change from day to day.  I have to note what it feels like when everything is managed well, and hope I notice a difference when things aren’t to know that I need to change something to get back into balance.  This is not easy.  Like I said in an earlier post – when I’m in a bad place with my anxeity, it’s the only thing I know and I can’t think of a time I wasn’t in that place.  So, since this seems like “normal” it sometimes means you miss kinda obvious signs that you need to use your toolbox to get stuff better managed.

This is definitely a place I found myself in recently.  I’m thankful for the people that helped me see this and continue to provide support and guidance when I struggle and give me props when I’m on my A game.  People that let me flail and ramble and be vulnerable because I’m just needing to get thoughts out of my head.  Folks that distract me with memes and other things.  For those that are honest with me, even though they know it may cause me some stress and anxiety short term, but will lead to longer term benefits.  For the people that let me be me, the real me, without having to hide my symptoms for fear of being judged or hated.  Having a sapce where I feel comfortable and safe is not something I take for granted, and I’m thankful for those that help create this for me – whether they realize it or not.

So how does all of this relate to medication? Since I’ve been focused a lot on symptom tracking and management, when I realize that something is off, I can then use the skills I have to try to get back to “normal”.  (I put normal in quotes becuase my normal is not the same as anyone elses. . .and there will always be impacts of my chronic conditions on my day to day).  Recently, I’ve realized that my normal tools weren’t getting me back into balance, so I had to do a hard, yet needed thing, which was talk to my care team about changing or adding medications.  After conversations (thank cheesus for telemedicine – I was able to have many of these conversations via “email” and not have to make phone calls), I established a game plan, with additional steps in case this didn’t work well, to try to get symptoms better managed.

This is harder than you’d think.  Because when my anxiety is out to play and my concentration is shot, the act of remembering to make an appointment and being  in a place where you can be honest and open about your current status is harder than you think.  You want to just pretend that you are on top of everything and that if you just try harder, things will be ok.  (spoiler alert: they won’t be – and some of the stuff you are doing is not helpful)   But earlier today I overcame this and talked to my psychiatrist about changing the dosage of my Prozac both to combat the overall increase in anxiety I’ve been dealing with for the past few months (thanks COVID and the general state of the world!) and also the PMDD anxiety spikes.  We had a good convesation about when I’d start to feel changes and will check in again in a month to see how things are and then go from there.

This is a huge relief in many ways.  Mainly, I hope I can get my symptoms better managed and get back to my “normal” self.  I hope that the increased anxiety can gtfo so I can stop dealing with the physical symptoms that get in the way of so much.  It also showed me that I am strong enough to deal with this, and I can get through this rough patch.  I’ll get through this day and the next and the next.  Every day won’t be perfect, but I can handle things.  Even it it means laying low and catching up on sleep, I can handle this.

I’m sure I’ll come back to this topic again in the future.  And to be honest, it’s kind of scary to have laid this out here like this, but if sharing my reality can help someone, then it’s worth it.  And if you want to hate or judge me for dealing with a chronic condition, that says more about you than it does about me.

One thing that I enjoy doing, especially when I need something that is a distraction but low stakes, is play video games.  I have played video games for years, but never really connected how useful it was until now, but that’s a story for another post.

A few years ago, I found some streamers on Facebook that I got into and enjoyed watching.  As I kept watching, I also ended up becoming a supporter to a few of them because they were providing me with content and entertainment.  

One of those streamers is DWolf.  He has been open in his streams about some of his struggles with mental health stuff and last week launched a podcast where he is going to share things and just talk about his experiences.

I’ve had pretty much no energy as of late, so haven’t had the chance to write some stuff from my perspective (but I have a few posts percolating in my head. . .).  I want to share the first episode he dropped at the end of last week to amplify another person on a similar journey to mine and hoping that sharing our stories can be helpful to others.

More from me soon.

I originally was going to write about something else for my second post in this seires, but I’ve been doing a lot of thinking and reflecting over the last week and that has lead to this post.

I have what is known as generalized anxiety disorder (GAD).  This means that my symptoms have been assessed by a professional and meet the diagnostic criteria for this category of anxiety disorders.  I have a therapist that I’ve seen for a number of years now that has helped me learn a lot of things to help me manage my symptoms when they flare and provide support when those things maybe aren’t working as well.  I also take medication to help with the symptoms because it became clear fairly early on that therapy alone was not going to be sufficient to manage my symptoms.  I won’t got deep into medication here – I’ll save that for another post – but if you’re thinking “you don’t need medication, that just makes the problems worse”, I’m going to need you to just keep that to yourself. No time for that foolishness today.

What is GAD?

“Generalized anxiety disorder includes persistent and excessive anxiety and worry about activities or events — even ordinary, routine issues. The worry is out of proportion to the actual circumstance, is difficult to control and affects how you feel physically. It often occurs along with other anxiety disorders or depression.” (source)

Ok, that gives some basic information.  

Now, many people *think* they know what anxiety is.  They may use this term to describe the feeling before giving a big speech, taking a test, a job interview, or other things are short-term rises in an emotional response to a specific thing.  Yes, you may have sweaty palms, or your stomach may feel uncomfortable, but these reactions go away after the thing happens. I’m going to be clear here – this is not anxiety.  This doesn’t mean your feelings and reactions aren’t real or appropriate, it just doesn’t rise to the level of an anxiety disorder.  I say this because many people want to empathise with someone suffering from anxiety because they were nervous before a big test and offer some trite suggestions for getting over it, but that doesn’t work for someone with anxiety.

This doesn’t mean that you shouldn’t try to offer support to a someone with anxiety, but you just need to understand that you likely don’t know the true extent of what someone is going through, and how it overwhelms your mind and your life when it is at its worst.  Listen to the person you are trying to support and ask them what they need.  Don’t just tell them to do some yoga or get over it.  Trust me, if it was that easy, we’d do that.

But, back to the core question, what is anxiety specifically?

Common anxiety signs and symptoms include:

• Feeling nervous, restless or tense
• Having a sense of impending danger, panic or doom
• Having an increased heart rate
• Breathing rapidly (hyperventilation)
• Sweating
• Trembling
• Feeling weak or tired
• Trouble concentrating or thinking about anything other than the present worry
• Having trouble sleeping
• Experiencing gastrointestinal (GI) problems
• Having difficulty controlling worry
• Having the urge to avoid things that trigger anxiety

(source)

For me, it’s often all of the above, either alone or mix, from sun up to sun down each day.  When I’m on top of my symptoms, I can help keep these symptoms from getting in the way of the day-to-day activities.  When I’m not?  I basically just want to sleep and be in a space that feels safe.  I’ll have problems keeping up with laundry (pretty sure I’ve set the record for re-washing the same load because I keep forgetting to put it in the dryer) and really wish the cats could just feed themselves becuase I don’t have the energy to deal with them.  I won’t want to take Scout on walkies.  I’ll often also try to “fix” things that aren’t actually the source of my anxiety, but I think are.  At these times I’ll often wonder – why can’t I just be a “normal” person?  Well, that’s because my brain isn’t normal.  It’s got a few differences that make some things more difficult that it is for others without anxiety.  Doesn’t make me a bad person, just means I do things differently.

High anxiety will also make me anxiety at people.  I’ll do things that I think will help ease the anxiety, or at least it does when my symptoms are under control.  It’s like a child that sucks their thumb to soothe themselves. . .doing this every once in awhile can be ok, but doing it too much can really mess up their teeth.  When anxiety is high, these actions sometimes end up being more harmful because I’m unable to actually internalize the feedback I recieve.  It also means I am often in my head and unable to read people and situations as well as I normally can.  This too can lead to issues, because something that I could normally understand seems like the worst thing ever when anxiety is high.

My anxiety makes it seem like everything is much more big and scary than it actually is. It takes things – things that wise mind me knows to be true – and skews them and makes me believe the opposite of what the evidence shows.  It is exhausting, frustrating, and something I wouldn’t wish on my worst enemy.  Simply stated – anxiety is a dirty liar. 

You know how when you have a cold and can’t breathe out of one side of your nose and you can’t remember what is was like to breathe normally and you feel like you’ll never breathe normally again?  That’s how I feel when my anxiety is at its peak.  I can’t remember things not being clouded by anxiety, and I truly believe that I never again will experience things without being impacted by anxiety.

For me, I also don’t often realize my anxiety is as bad as it actually is.  I have so much experience before I got my diagnosed, with using a bunch of poor coping strategies to “hide” (I’m likely not really hiding anything to those who know the signs) how bad things were.  This is a place I recently found myself in.  I thought that I was on top of everything and bringing my best self to the various parts of my life.  However, after some reflection, tears, conversations, and just stepping back a bit, I realized that my anxiety is a bit out of whack right now, and I need to be a bit more deliberate in using the tools I have to get it back under control.  All someone in this place is asking for is the space and judgement-free support to sort this out.  

I’m also a little angry.  I’m angry that I didn’t see this happening.  That I let it get in the way of being the kind of person, the kind of friend that I strive to be.  I’m angry I let it get to this point.  I’m angry that this is a chronic illness that I have to deal with. But anger isn’t a solution.  Anger doesn’t get the symptoms under control.  Anger doesn’t allow me to bring my best self to all that I’m doing.  So I’m working to let that anger go, and instead focus on the fact that this is my reality and I not just let it happen to me and suffer BUT step up and do the things I know I am capable of to manage this.

I’m also thankful for a great support system when I deal with anxiety spikes.  I have people who let me ramble for hours to help walk myself through something and work through an anxiety spike.  People who send me the reminders that I’m not the worst person ever and that they don’t hate me.  I’m also thankful for the people in my life that do things that I may not realize at the time are for my own good, but do it anyways.  As I’ve said a few times recently, it may take me a little bit, but I eventually connect the dots and piece together things.  Just have a little patience and know that while sometimes I can’t see things unclouded by anxiety, eventually I will find myself in that place and I will keep on doing what I need to do to be the best me I can.

So what does the work to get my symptoms under control look like?  It means I need to cut myself some slack.  I need to communicate and not assume people can read my mind.  I need to make sure I’m eating, drinking water, and sleeping.  It means remembering boundaries. It means realizing that short term changes don’t mean forever changes.  It’s being open and honest.  It means not holding myself to unattainable expectations.  It’s taking the time to reflect and try to challenge the whack conclusions that anxiety tries to make me think are going to happen.  It’s being patient.  It’s trusting – trusting in myself, in others, in my skills.

And I guess now, it means writing things like this.

“Depression is a choice”

This is a tweet I saw come across my feed yesterday, thankfully with comments from people about what utter trash of a take this is. Why would anyone choose to be depressed or any other mental health issue like that?

I just wish that we were able to really get beyond the stigma and have people understand that mental health issues are no different than any other issues. It would be nice to be able to one day drop “mental” or “physical” as a qualifier before the word health and focus on the fact that health is health. Healthcare isn’t just for things like allergies, asthma, or the flu – it includes help for things like depression, anxiety, addiction, grief, PTSD, etc.

I know for myself, I would never wish having anxiety on my worst enemy. And I sure as hell would never choose this for myself. My anxiety, especially when it is at its worst, is exhausting. It robs me of my ability to do things to the best of my ability and makes the most mundane tasks seem impossible.

I guess that is why I have decided to start writing more openly about my current struggles – to provide a glimpse into what happens when I have a flare up of what is a chronic condition for me. Doing this could make people think I’m weak or broken, but I honestly hope it maybe allows people to gain an understanding for what these struggles are like. To maybe have compassion and understanding for people. And to learn how to help support friends and family that may be dealing with a flare up.

As for myself, I’m getting through this rough patch. I’m using the skills I have developed through work with my therapist (she’s the best). I’m trusting my support network (for the most part. . . .but that’s where I have to remember that anxiety is a jerkface) and I’m not pushing myself and giving myself breaks when I need them.

If you’re curious, you can read more about my anxiety disorder at the link below.

 https://www.helpguide.org/articles/anxiety/generalized-anxiety-disorder-gad.htm

I’d be remiss if I didn’t also thank the people in my life that are providing me with support and reminders that this too shall pass and that I’ll be better prepared for the next flare up. Y’all know who you are.