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Anxiety

The way I discovered what an anxiety attack was is a little embarrassing.  I know, a person who writes a blog informing the world that she has trouble with anxiety probably doesn’t get embarrassed by much, but this one causes me to blush a little…  Toward the end of my engagement to the man who decided it would be better to date indefinitely (after we had a house, a ring, a dress, and a wedding date), I did what I always do:  I bought a book to research the problem called Men Who Can’t Love: How to Recognize a Commitment Phobic Man before He Breaks Your Heart by Steven Carter.  Embarrassed to even pick the book up, I was just desperate enough to understand what was happening in my carefully crafted world that I tried it. 

I only read a few pages of this book before I found something that stopped me cold.  It described the way commitment-phobic men feel when expected to commit.  It was a graphic description of an anxiety attack.   If I still owned that book, I’d directly quote it here, but it’s one of the few books I didn’t exactly want lining my bookshelf.  Two days before I read this description, I’d experienced those exact symptoms myself and had considered the possibility that I had a terrible disease or food allergy.  I didn’t feel anxious during that episode; I felt sick.  I felt very, very, horribly sick. 

I had worked for several hours to prepare for a business trip the next day.  It was after 5:00 and I had a pre-marriage counseling session scheduled for 7:00 that night.  I still had a lot of work to do and was in a hurry to finish.  Suddenly I felt an urgent need to go to the bathroom.  Before I made it there (50 feet away), I started to sweat and felt light-headed.  I had diarrhea, profuse sweating, shaking, a rushing sound in my ears (high blood pressure), and a feeling of not being present in my body (derealization).  I was hyperventilating and my stomach cramps were so severe that I thought labor pains probably couldn’t be any worse.  I had endured episodes similar to this countless times before, but this time it got worse.  In a thankfully narrow bathroom stall at work, I passed out.  When I came to, I was still seated, but leaning against the side of the stall.  I didn’t know where I was for several moments.  My vision distorted and the walls of the stall appeared 30 feet high.  I had a terrible metallic taste in my mouth and I was freezing.  I felt weak and so cold that I couldn’t stop shaking. 

What happened to me was not only frightening, it was embarrassing.  These are not symptoms people typically broadcast.  Forgive me for over-sharing.  I only share the details because I would’ve never picked up a book on anxiety disorders, never known that’s what I was dealing with, and I’m willing to embarrass myself if it helps someone else figure out what’s happening to them.

I called these episodes “upset stomach.”  I had looked for a common cause to connect them since I was thirteen years old and never found one.  My mother was the only person I really discussed them with and she didn’t know what they were either.  They weren’t life-threatening and they didn’t happen every day, every week, or even every month, so we didn’t think to ask the doctor.  Not that we had a doctor.  We went to a chiropractor who attended our church.  (He probably could’ve diagnosed me accurately without horrible tests if I had told him.) 

The book also told me that irrational fears accompanied these attacks.  That is where I got confused.  The only concerns I really had during an attack surrounded thoughts like – How bad is this one going to be?  How long is this going to take and will it make me late for my next appointment?  Is something terribly wrong with me?  How will I survive this horrible pain?  Is anyone around to help me if I need medical attention? 

At my counseling appointment the next day, I told my counselor about it.  She expressed shock that it had gone on so long and I had never mentioned it.  But why would I mention a medical problem to the person I was going to for counseling?  I still wasn’t convinced it wasn’t a physical illness only.  She told me to call my doctor and tell him that she suggested I try Xanax, an anti-anxiety medication.  She warned me that it was highly addictive and I should use it sparingly.  She said if my problem was anxiety, when I started to feel the symptoms come on I should take ½ a pill and feel better within 15 minutes.  They make a pill for this problem?!?!  Amazed, I called my doctor, was given 10 pills, and found that it worked. 

I was still struggling to understand how what I experienced was anxiety.  The idea of being labeled with an anxiety disorder was unacceptable.  I didn’t know anyone else who had the same problem and I never planned to tell anyone (especially since it wasn’t something I even believed was really wrong with me.)  I felt mortified.

Since then I have discovered the reason I didn’t think I felt anxiety or fear during the attacks.  During my long history with them, I taught myself some coping mechanisms to help me through.  I noticed when I focused on the fear, my condition worsened and lasted longer.  I learned to empty my mind of disturbing thoughts/fears, focus on breathing normally, and relax during the attacks.  It became an automatic response when an attack started; I immediately cleared my mind of fears.  So when I thought about the attack later, I didn’t remember having any fear.  I had to go back and remember what I was thinking about before the attack started to identify the fear that caused it. 

In the years since then, I’ve learned some valuable things.  I went through two or three prescriptions for Xanax (10 pills of the lowest dose) in as many years, but then I lost my health insurance and couldn’t afford the medication.  I researched natural remedies and found some things that work for me. 

The first and oddest thing I found that works really, really well came from an infomercial for a treatment plan.  It explained that a big reason anxiety attacks get the best of us is because they are so horrible that on top of whatever is causing the anxiety, after the first attack we fear the attack itself, which adds fear to fear and makes it worse.  The truth is the anxiety attack is NOT going to kill me.  I’ve lived through them plenty of times before and I will live through this one.  The guy said I should talk to my anxiety like it was a person and tell it I wasn’t afraid of it.  Say something like, “Bring it on!  I can handle you!  I won’t die from this pain and in an hour I’ll be back to whatever I need to do next.  You might slow me down, but you won’t stop me.”  I felt a little dumb, but I tried it and it worked. 

The second thing I found that works is to avoid stimulants of any kind – caffeine, diet pills, too much sugar, herbal energy supplements, etc.  If I am anxious, my adrenaline is already pumping and I don’t need anything to kick it up a notch.  Caffeinated sodas are the absolute worst with the combination of caffeine and high sugar.  When I was looking for a connection before, I noticed that sometimes an attack came quickly on the heels of drinking a Coke, but I could sometimes drink a Coke and not have an attack, and at other times I had attacks without drinking Coke.  Stimulants exacerbate anxiety:  no anxiety, no problem with Coke; high anxiety, big problem with Coke.  Diet pills have the same effect:  they are typically stimulants.  Mix diet pills with caffeine and a person with an anxiety disorder is headed for disaster. 

The third thing I found that works is to deal with stressful situations immediately.  One day I came home from work in a good mood, checked my mail, chatted with my roommate, changed my clothes, started cleaning up around the house, and suddenly got hit with an attack.  I hadn’t had one in a while, hadn’t had any caffeine, and was unsure what it was about.  After the attack, I mentally reviewed what had happened in the hour before the attack.  I realized that as I went through the mail, I saw a letter from my student loan company.  My student loans were in forbearance.  I expected to receive a notice at any time that my forbearance had run out and I needed to start paying, but I had no money to pay them back.  I didn’t open the letter when I saw it because I didn’t want to think about my financial difficulties right then.  Rather than relaxing, my anxiety built because of what I perceived the letter might say.  How much longer did I have?  How much was it going to be?  Should I get a third job?  Should I look for a new full-time job?  Where would I have to move to make more money?  And so forth…  If I had opened the letter immediately, I would have seen that they were sending me a friendly reminder that interest was accumulating on my loan and they were happy to allow that to happen for quite a bit longer before they demanded payment.  I might have still felt some fear, but it would have been contained to the future and my naturally hopeful personality would have kicked in and the whole attack probably could have been avoided.  The point is, unknown fears tend to loom larger than reality.  When I deal in reality, I might still be afraid but the fear is typically manageable. 

If all that fails and I begin to have one anyway, they often stop within a couple minutes if I call a good friend and tell her what’s happening.  I have only tried this method with one very dear, very close friend.  Most people don’t want to hear from you when you’re hyperventilating in the bathroom!  I find it’s worth the embarrassment to make the attack stop. 

I wish I could tell you that anxiety attacks are a thing of the past for me.  I haven’t had one like that day in the office in years.  I haven’t had one in months.  I can even allow myself a little caffeine these days, but am careful about it.  One anxiety attack and I’m off it again completely for a while.  I haven’t taken Xanax in over three years.  Sometimes I miss the ease of popping a pill to avoid the attack, but not having it has forced me to find the underlying issue and deal with it.  It’s been a good thing, but as many good things go it has also been challenging. 

Learning the connection between my body and mind has been life-changing.  I went to a holistic doctor and discovered that my chronic back pain was largely due to stress.  I ignored what was bothering me because I didn’t think it should bother me or I didn’t have time to deal with it.  I was in constant pain.  I have been free from chronic back pain for over a year now. 

I’m so thankful for the resources I have had access to as I’ve learned to manage anxiety in a way that allows me to stay off prescription medication.  I’m also thankful I haven’t suffered things like physical attack or abuse, death of a parent, extreme poverty leading to starvation and homelessness, or anything worse.  If I had, I might still need the medication, and I’d gladly take it.  I’m so thankful I had it to get through the roughest times. 

In closing, I want to acknowledge the position many in church take on anxiety.  If a Christian can truly learn to trust God with his or her life, then all fear will leave and perfect peace will remain.  I believe that is possible.  I have found that as my ability to trust God increases, so does my peace.  I also want to acknowledge that many of us have been let down so often by those in authority over us, it is extremely difficult to trust anyone in a position of authority.  God, the ultimate authority-figure, gets tangled up in our minds with humans and we don’t know how to trust Him either.  It requires a major shift to our thinking to see God as totally separate, totally “other”, from human beings.  We are made in His likeness, but He is not like us.  He can be trusted, He can be relied up, but we allow the disappointment and hurt we feel from other human beings to cloud our ability to interact with Him.  We blame Him for things other human beings do, rather than looking to Him to help us through the difficult times.  These are natural reactions and typically very difficult to move beyond. 

In these situations, when those in authority over us condemn us for feeling afraid, it only increases our fear.  If you know someone struggling with anxiety, please pray for them.  Pray that they will be able to see God for who He is.  Pray that they will receive healing from the wounds they have suffered at the hands of those who were supposed to protect them.  Pray they will find peace. 

P.S. In case you’re wondering, I have a lot of respect for my ex-fiance today.  He was right to call off the wedding and although I’m sure we’d both do things differently if we had it to do over again, I honor him for speaking up.  It takes courage to say the hard things, and I’m grateful that he did.

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Depression

I dealt with depression for the first time when I was fifteen.  To be perfectly honest, it started because I felt so guilty.  I had snuck outside after all parents were asleep to make out with the visiting missionary’s older, wild, green-eyed son when they stayed with us for a week on a fund-raising tour.  He tasted like smoke and his sister kept bugging us to stop.  (Definitely weird, but a good way to keep your purity…)  I felt so guilty for what I had done that I went into a depression that lasted for months, even making myself physically ill.  I listened to a Margaret Becker cassette tape non-stop, singing about how God wasn’t afraid of my honesty.  I didn’t know what was wrong with me and tried to smile and act normal around other people, but inside I felt dead.  God gave a prophetic word to a youth worker one night in Bible study and she prayed for me.  That night my illness went away along with the depression.  I felt like a wet, thick, heavy blanket fell off my shoulders.  That’s when I realized I’d been depressed. 

During my freshman year of college I lived in a girl’s dorm.  Horrible, unspeakable nightmares became a regular occurrence.  When I woke up in the morning, I was so upset and disgusted that I laid in bed, paralyzed, unable to face other people, unable to look in the mirror.  I spent many days in bed crying and worrying that something was deeply wrong with me.  I went to the college counselor and she was as wacky as anybody I’d ever met.  Among other things, before I’d talked for 15 minutes she told me that my parents were total crap and had done everything wrong.  I knew that my parents had done a pretty decent job and while not perfect, were definitely not total crap.  I never went back.  But I had a dull ache inside and didn’t know what to do to make it better.  I fell in love that summer and thought for sure that the ache would go away.  I was blissfully happy and sure that I’d be married soon, but even then I knew something was terribly wrong inside.

When the boy I was blissfully happy dating dumped me, the dull ache became a seething wound.  I worked at a Tex-Mex restaurant and most of my memory of that year involves all the food I ate.  After eating an early dinner, I’d work for five hours, forget the dinner I already ate and eat again.  Fast food and Tex-Mex did it’s work quickly and within a year I gained 50 pounds.  I listened to country music and cried nearly every moment I was alone.  My parents tried to talk to me, but they assumed I was so upset about the break up because we must have had sex.  Their suggestion offended me because it insinuated that I shouldn’t be that upset if I hadn’t had sex.  Not that I would tell them, but I was still a virgin.  I was a mess and the heart-break was the only thing I knew to cry about, but I was crying for the dull ache and the fifteen year old girl and other things I had no way to understand at that point.  The wet, thick, heavy blanket was back with a vengeance. 

Somehow I managed to graduate from college within the expected four-year time period.  I’m still not sure how I did that.  I’d graduated high school near the top of my class and in college lost my academic scholarship and feared I might not graduate because you had to have a cumulative 2.5 GPA.  I think mine might have been a 2.6?  I knew something in my life had to change, so I moved to Nashville after college to pursue music and book publishing. 

By the grace of God, I ended up at a church that had a full-service counseling center for their members.  My sweet aunt, a psychiatric nurse, listened to my woes and expressed her concern.  She suggested I get professional help.  I was skittish after my one and only experience with a counselor, but since the church fees were income-based, I decided to give it a try.  The counselor faxed me a form to fill out before I came in.  The form requested all kinds of personal information and at the very top it said something to the effect of, “If you want counseling to work, be honest.  If you aren’t honest, we can’t help you.”  Cringing, I filled the form out honestly and faxed it back.  I remembered that statement and decided I was going to do it right.  But for safety, one of my first statements to my counselor went something like this:  “I come from a very good, Christian home.  My parents are just about perfect.  They did a good job with me, taught me the Word, and I love them very deeply.  Whatever is wrong with me is not their fault.”

That was the beginning of six years of counseling.  This counselor was a gift from God – down to earth, honest, and extremely talented.  Those sessions absolutely changed my life.  It was hard work, but I got to the root of my depression and was able to work through it.  The seething wound, which had begun to heal a bit with time, cleared up. 

I had one more bout with depression near the end of those six years when the man whose engagement ring I wore decided he wanted to date indefinitely.  He wasn’t ready to get married after all.  I started having a hard time getting out of bed in the morning and my jaw ached all the time because I constantly clenched my teeth.  My lovely counselor told me about something called an anti-depressant and my primary care physician gave me a six-month supply of samples. 

I was still sad and I still cried, but my sadness became manageable.  I could get out of bed and get my job done and maintain my friendships.  The side effects were fairly mild – sleepiness and a foggy memory.  It wasn’t bad, but I noticed at times I couldn’t recall the word I needed or it took me a little longer to figure out simple math.  I took it for six months, as my doctor and counselor suggested, and then I quit.  I felt like I could handle it at that point.  My grandfather passed away within a week of going off it, but even with that I had a normal level of grief.

I found out during my next doctor’s visit that it’s dangerous to go off those drugs cold-turkey.  You’re supposed to wean off them.  Not doing so can cause serious side-effects.  My doctor freaked out when I told him.  Thankfully I never experienced any problems.

A few years later when I was in seminary, I had another dark time.  I was sad and didn’t know why.  I did much soul-searching and wore out a good friend who is a therapist with questions and discussions.  I got to the bottom of the problem pretty quickly and dealt with it.  When I talked to my dad about it a few weeks after the darkness lifted, he said with compassion, “Oh Kimberly, it’s February.”  Huh?  He explained that the days are shortest in February, it’s cold and it’s been cold for a while, and the fun of the holidays has worn off, so many people get down in February.  Who knew?  My problem wasn’t simply the time of year, but that probably didn’t help.  Ever since then I’ve been on the look out for that wretched month and do my best to schedule fun, invigorating things then to ward off the blues. 

I read something in the book Hiding from Love by Dr. John Townsend a few years ago that has really helped my outlook on depression.  He basically wrote that depression is what happens when we get sad and can’t process the feelings.  Instead of dealing with the sadness, we get stuck, and that is depression.  Sadness is the antidote for depression.  When bad things happen, it’s normal to feel sad about them.  If we allow ourselves to feel the sadness and deal with it, then we move through it and return to normal.  When we don’t deal with it, we get depressed.   Sadness is a temporary, difficult feeling; depression is a black swirling hole of muck that tries to suck you in and hold you down. 

I had some sadness to deal with, but my experience of the world and normal human relationships was so limited that I didn’t know sadness was the correct feeling.  I acted like everything was normal and told myself I was fine.  But I needed to feel sadness so I could move on.  Instead I felt like the swirling black muck might suck me under.  My counselor helped me understand the way things happen in normal, healthy relationships and then helped me face the unhealthy, abnormal things I had experienced.  I got sad (and angry) for a while, but then I moved on.  I was able to forgive when I understood that my circumstances required some forgiveness and it was okay to acknowledge that fact.  In my case, the anti-depressant helped me function while I worked through some extremely sad and angry feelings.  Without it I’m not sure how I could have kept going to work and interacting with others.  I was thankful for it. 

Since reading that information, I have learned to allow myself to feel sadness when sad things happen.  I don’t like to cry because I really hate the cry “hangover” – pounding headache, puffy eyes, splotchy face, and blurry vision.  I also tend to think I’m strong enough to handle hard things and keep on going.  It’s hard to stop and let myself feel the sadness, to cry or scream or punch something.  But crying releases the stress and washes away the pain, so I allow myself to cry with a cold wash cloth and 2 Advil.  It helps.  And I allow myself to rest when I recognize that I’m in a stressful situation.  Oh, and I also exercise.  Boxing is really good to get out anger and long walks are good for clearing the head.  Long walks often help me to stop the tape playing repetitively in my head trying to make sense of something I don’t understand. 

The summer of 2009 was blissfully happy.  There was no underlying ache.  Life was simply good.  My relationship with God was thriving.  My job responsibilities brought me joy.  I had a lot of time with my incredible friends.  I even had a personal trainer.  I remembered when I got glasses in elementary school.  I hadn’t known how clear the world could look until it was suddenly clear and I realized how fuzzy it had been.  I hadn’t realized that some people go through most of their lives with this kind of clarity.  I savored it while it lasted.  The bliss faded as the temporary circumstances I was enjoying came to an end.  It was amazing while it lasted and I look forward to more times like that in the future.  Now that I know that it’s possible, I’m on the lookout for it. 

I know it’s not always that easy, but it’s my hope that throughout the rest of my life I’ll continue to learn and practice more effective ways of dealing with sadness and moving through it.  I hope I never have depression again.  I hope I never take an anti-depressant again.  But if something devastating happens and I’m struggling to get out of bed and take a shower, I’ll go back on them to get through the rough patch.  But if there is a next time, I promise to wean myself off them slowly.

I feel that it’s important to mention in closing that my experience is quite different from many people I have spoken with over the years.  I’m grateful that my depression has been treatable and manageable.  Unlike many others, I responded well to the first drug I was given.  The resources that were available to me to get the help I needed were priceless.  If you do not struggle with depression but know someone who does, I beg you not to tell them they simply need to pray more or should snap out of it.  If you feel it’s an issue of prayer, then YOU pray for them more.  If you feel they need to snap out of it, then be their friend and help them laugh and lighten their load in any way you can.  But please do not place a heavier burden on them then they already carry.  They would snap out of it if they could.  If they had the energy to pray more, they actually might.  Help them carry their burden and vent your frustrations to God.  That’s just my two cents, but of course this is my blog so you know that.  Thank you for taking the time to read my thoughts all the way to the end of this very long entry.  I welcome your comments.

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