To Medicate or Meditate

I’m not a big fan of pharmaceuticals. I feel more comfortable using alternative and complementary medical products. I have this idea that because it’s a natural product, it’s better for the body, supporting its own defences. I know that’s not necessarily the case. In fact, my husband worked in pharmaceuticals for ten years and tells me – repeatedly – that the criteria to be met are far higher with many more checks and balances.

So it was that I was dutifully downing St John’s Wort and Nervatona a couple of months ago in the midst of the hard time I was going through. I’d been through hard times before in my adult life and had gotten through with herbals. There was one glaring difference, however. On the face of it, this time may have seemed less stressful than some of the others. It’s true that there was something affecting every family member but I’ve had more to carry in the past. The difference was that I had my own health issue. I was so worried about what was wrong with me that I couldn’t cope with everyone else’s problems. That was why I was melting down on a daily basis.

It all came to a head one day. My symptoms were so severe in the morning I nearly drove myself to the hospital. Instead, I called my husband to come home and, by the time he arrived, things had settled enough to go to the GP instead. I couldn’t get in to see my usual doctor but the one I saw instead was even better. In no time, I had a prescription, a referral for an ultrasound and a referral to a specialist in hand. I started to stand to leave but sat back down again, began to cry and simply said, “I think I may need anti-depressants, as well.”

I began the anti-depressants that evening. I didn’t read the product information because I knew if I did I’d scare myself into not taking them. I noticed a small difference within two days. I had a fight with a family member during which I began to cry. (Surprise, surprise.) Instead of stewing for hours, however, I was fine five minutes later. I also knew that they would make my anxiety worse at first so I wasn’t concerned when I spent the first week waking up at 6am in a cold sweat, heart pounding and stomach filled with butterflies. The only lasting side effect has been nausea a few hours after my tablet. That’s around bedtime, however, and it doesn’t keep me awake at all. When I wake in the morning or even later in the night, it’s passed.

Apart from the nausea I’ve had no side effects. It hasn’t slowed my thought processes or changed who I am in any way. What the medication has done is turn the volume down considerably on the depressive and anxious feelings I’ve experienced most of my adult life. I guess, in that sense, they’ve changed me. The thoughts that trigger depression and anxiety still come. Thoughts create feelings but the feelings are so dampened down to be almost non-existent. Without the meds, more dark or anxious thoughts follow the feelings. The cycle goes on seemingly endlessly. By reducing the feelings, the second round of thoughts don’t come. I imagine it’s different for each person using them but that has been my experience so far.

I’m on the lowest dose available and I like how I feel. It’s going to read like a cliché but I wish I’d done it years ago. 

Day Surgery

Part of my anxiety - a huge part - is health anxiety. Even though that makes me something of a hypochondriac, I don't like doctors and medical procedures. They make me very anxious. So, you can well imagine how I must have been feeling about the prospect of day surgery. It was nothing too invasive but it did involve general anaesthetic. Yikes. That was yesterday and I lived to write the tale. *sigh of relief*

I was pretty cool about it up until the night before. I knew I needed it done and that the results would be immediate so I was actually impatient to go in and get it over and done with. I went to bed the night before and slept well ... for an hour. After that, my sleep was fitful and my anxiety levels really high. On a scale of 1 to 10 they would have been a 10. My heart was pounding, I was sweating and my mouth was as dry as cotton. Unfortunately, drinking was not an option after midnight so that exacerbated the anxiety. One of the first things I do when I'm anxious is have a sip of water. I also do it when I'm hungry to tide me over.

Morning came and being up and about calmed me and gave me a purpose. Even the traffic jam we hit on the way to the hospital didn't unduly upset me. It would have normally; we were stuck in traffic and behind a bus so couldn't see ahead. Once there at the hospital and checked in, the nurse had a long chat with me and took copious notes. After that she took my blood pressure and told me my surgery would be in two and a half hours. What????  My anxiety rose. I didn't know how I could go that long without eating or drinking anything. I'd really had to work to give her the wee sample she needed; there was no liquid inside me to come out. I was sooo thirsty.

I decided the most sensible thing to do while I waited was nothing. That way, I'd expend as little energy as possible. I began by staring out of the window. It was a beautiful, clear morning, and I could see across the green playing fields of Flinders University to Main South Road. Being 8am on a weekday, the cars were at a standstill, just as they had been when we'd taken the same route thirty minutes earlier.

Following that, I closed my eyes and listened to the sounds of the day surgery ward. The low hum of the air conditioner underpinned it all but was barely noticeable. The dominant noise was that of the voices drifting in from the nurses' station right outside my small cubicle. Blood pressure machines being wheeled across the lino floor occasionally competed with the voices. Every so often there was a bang or crash, the origin of which I couldn't begin to guess.

After awhile, the hunger and thirst began to make me feel nauseas but somehow I drifted off to sleep. The next thing I knew an orderly had appeared to take me to the theatre. He asked me for my full name, date of birth and the procedure I was having done. The ride through the hospital hallways didn't help the queasy stomach.

Once there I asked him the time and found out that I'd waited less that two hours. He left and my surgeon came in. He asked me my full name, date of birth and what procedure I was having. I knew it was protocol but I was sorely tempted to tell him that he should know since he was the one performing the procedure! He left and the anaesthetist came in and introduced himself and asked me to sign something to do with fees. I hope it was nothing too major because I was so hungry and thirsty I think I was too hypoglycaemic to be making major decisions. He asked a few questions, listened to my heart and lungs and asked me to tell him my full name, date of birth and what procedure I was having done. After he left, one of the theatre nurses came in and introduced herself and asked me to tell her ... I think you may already know by now.

Finally they were ready for me in theatre and in I went. They hooked me up to a blood pressure and heart beat monitor, put electrodes or some such things on my chest, put a line in my arm, and just as I was going under, another nurse asked me to tell her ... yep, again. I sped spoke because I was losing it by then.

When I woke up, my leg muscles were spasming wildly. The recovery nurse said it was the anaesthetic but got me a warm blanket which was really soothing and seemed to help. She also gave me a cold drink of water. I didn't feel quite as thirsty or hungry anymore. Then she took my blood pressure and I was wheeled back to my room.

Once back in the room, I was fed and given a cup of tea and a bottle of water. They even brought me a second cup of tea. I was on some kind of a drip which I found out was fluid so, by the time I was unhooked and had drunk everything, I'd had nearly two litres of fluid. Yay!

After that I got dressed and waited the couple of hours for my husband to come and get me, passing the time crocheting. Once home, I ate lunch, had another cup of tea and crashed out!

The Light at the End of the Tunnel

You’re going through a dark patch in your life so you keep looking and holding out for “the light at the end of the tunnel”. No matter how hard you try to see it, however, all you see ahead is more darkness. You keep trying, though, expending loads of energy in the process. There has to be light; there’s always light, isn’t there?

Sometimes, however, the tunnel is far too long for the light to be even faintly visible. Sometimes you’re in a cave, not a tunnel. Either way, the solution is the same. Stop using up all your energy wishing and looking for the non-existent light of the future and all its false promises of happy outcomes and light up the long tunnel or cave you’re currently in. Carry the light with you and within you.

Many years ago, I used to think in terms of “when I’m better.” Rather than being a helpful goal, it was a carrot on a stick for which I was expending too much energy. I was chasing a false illusion and living in the future. Ultimately, the realisation struck me that I had a chronic condition which – as Dr Phil would say – could be managed but probably not cured. That thought did more for me than the thought of getting better; it liberated me. I was no longer bound to a false hope and could live my life realistically and more fully than I had since I began to experience anxiety. Each time I began to feel the crippling anxiety I’d tell myself that it was part of my illness and accept its presence rather than fight against it wishing it weren’t there. The energy I’d spent chasing an illusion had much better uses. In short, I’d had a life-changing “light bulb moment”.

I fell into exactly the same trap when my mother had cancer. She ended up in hospital following several rounds of chemotherapy because her kidneys had failed. She was in the hospital for five weeks. My sister and I both had young children at the time and were dividing our time between caring for Mum, and doing everything else we had to do. I clearly remember having the same light bulb moment in relation to my mother. I was thinking to myself, “When Mum’s better ...”, only to interrupt myself with the questions, “What if she doesn’t get better? What if this is your life for the coming months?” I understood in that moment that I had to stop trying to fit my life into my mother’s illness and try to fit her illness into my life instead. It was just as well I did so because she never did get better.

A few years ago, a cousin of mine, in his mid-forties, lost his life’s partner in sudden and tragic circumstances. In the wake of her death, he said to me that he was trying to find and coming to terms with a “new normal”. What I’d done twice suddenly had a label. I’d recalibrated to create a new normal in the face of both my and my mother’s illnesses. That’s what I’m referring to when I speak of creating light in the tunnel or cave. Sometimes life throws things at us that change our direction and, often, those things are unpleasant ones. Sometimes they’re long-term or permanent and we have to create a new normal.

Recently, several things have crept up on me. They’re circumstances that have entered my life to which I’ve been resistant. I’ve been trying to find the light at the end of the tunnel and wishing and hoping for speedy and positive outcomes. I’ve been using up a lot of nervous energy worrying about the situations and looking to the future. I realised the other night that they’re my new normal. They’re here to stay, maybe long-term, maybe permanently.

The night I had that realisation I slept better than I had in weeks. The following day I was tired and lethargic because my body was letting go after carrying around so much tension and resistance for so many months.

For the time being, darkness is my new normal and I don’t know yet if I’m in a long tunnel or a cave. I’ve stopped looking for the light at the end of the tunnel. I’m going to try to light my way from inside instead.

Statistically Speaking

I was in a car crash on Tuesday morning. Nothing major. I rear-ended someone. I didn't careen into them; I simply wasn't able to stop in time. Contrary to what you may think - given my anxiety - I'm ultra-cool in those situations. I swapped details with the man I hit, drove the children the rest of the way to school and then reported it. It wasn't until my husband, who was interstate, called that I burst into tears.

Since Tuesday, road safety has been on my mind. I feel more anxious each time my daughter drives away. I also feel more anxious as I drive. A car was tailgating me the other day and I felt extremely uneasy. After all, I hadn't been tailgating - the cars in front of me had stopped suddenly. I began to worry that, if I had to stop suddenly, there would be no way the car behind could stop without hitting me.

At the moment, I'm at a fork in the road with anxiety. I'll either be able to move on from the crash and the anxiety it's provoking or I'll have a setback and get worse after so much hard work. The latter is not a very attractive option. I like where I'm at right now. So, this is what I've been doing to try to prevent it.

Acknowledging the possibility of a setback is a good starting point. I'm on red alert for extra anxiety. For example, yesterday I was out grocery shopping and felt extremely fatigued. I decided to just do what I had to do and get home. I've had a genuine health issue for the past couple of weeks that could have caused it but, as soon as I'd finished the necessary shopping, I began to feel a lot better. If I were truly tired, the shopping would have exacerbated it. That being the case, I made myself stay on at the shops until I'd completely finished and was fine. I had a lot of running around to do in the afternoon and evening and was not left tired. Conclusion: anxiety (which, for me, can manifest itself in extreme fatigue.)

I've been playing with statistics, too. I like to bombard my mind with them when I feel nervous. Each time I've had to drive to my son's school (or anywhere for that matter) I've told myself that, having lived in the same house for over 17 years, I've done each drive countless times and only been involved in one accident in that entire time. Consequently, it's far more likely that I'm going to get from Point A to Point B safely.

Using statistics is helpful in general. I've got a greater chance of getting ovarian cancer because a first degree relative had it. Statistically speaking, what it means is that my chance of NOT getting it has gone down from something like 97% to 94%.

Basically, if the chances of something bad happening are far less than not happening I like to point that out to myself. I haven't done the morning school run since the accident but I have driven to the school three times since and have been reasonably calm. It was only the first time I had to remind myself of the statistics. My daughter has done it twice since then and I've been anxious but, again, I have to keep reminding myself that it's far more likely all will be well.

The Old School Tie

The city where I live is one of those places where there are probably only two degrees of separation between any two people that live there. That degree is reduced further when it's between people who've lived here all their lives.

One of the first questions a native of Adelaide will ask is, "What school did you go to?" The question is partly to peg you socially. The other larger part, however, is to determine any mutual acquaintances you might have. And the chances are you will have some.

It's a question I love being asked. I loved my school when I was there and am still proud to have gone there. Every year it plays host to an afternoon tea for its "old girls". At that event, the prefects and house captains from fifty years before talk about their school days. It's always on the first Saturday of August and I've been going now for six years.

For me, the afternoon is an inspiration. I love the school and life stories of these women and I love being back in the school hall. The current women went to the girls' campus of the school before the school was amalgamated in the 1970s. I was in the last group of girls to enrol at the "Girls School". I spent Years 8, 9 and 10 there before we were moved to the "Boys School", completing the three year amalgamation.

It was - and still is - a very academic school. In those days we were streamed and I was in the top stream. There was an expectation of success at and from the school. There was never a sense of girls not being able to do as well as boys. (In fact, those of us in the top stream weren't able to do Home Economics. Hence my aversion to cooking.) The women that speak are testament to that. They often mention that the school motto, "Not for school but for life", stuck with them. They never forgot the school and its lessons and believe their success was because of the education and nurturing they received at high school.

I love their stories because they fill me with a sense of possibility. I look at these women and what they've accomplished and am filled with hope. They're older than me and are replete with life, passion and vibrancy. Rather than feel bitter that I've let my anxiety hold me back in many ways, I hear them speak and feel reassured that there is still much I can do and accomplish. We went to the same school and probably come from similar backgrounds. It's not as though I'm listening to some motivational speaker who's been paid to come and do it. I'm listening to women who sat in the same classrooms, played sports in the same fields and stared at the same school honour boards during assemblies in the same hall as me.

Being in the old school hall and seeing old friends triggers something else, as well. I'm with people who knew me before I was anxious, before I was someone's wife and before I was someone's mother. They simply knew me. I have trouble remembering sometimes who I was and what I was like so it's great to be reminded. Part of me and who I was walks invisibly through the corridors of that school and it's reassuring to get a glimpse of that "angelic rebel" sometimes.

Melting Down

I wrote a post quite early on about the "holy trinity" of self-care. On Monday I disregarded that. I went non-stop all day and fuelled myself with pizza, chips, chocolate and Chinese food. That night I slept poorly. And then yesterday morning I had a massive melt-down.

I periodically melt down. It's usually hormonal and that was a contributing factor yesterday. This was big, really big. This one saw me spending most of the day in bed in foetal position, covers over my head crying. The beds remained unmade, dishes unwashed until a family member took it upon himself to do them, clothes unwashed until late in the day, dog poop unscooped and pets' water unchanged. That may be the norm for some people but not for me; I usually have all that done by late morning at the latest. If it's not done, then either I'm very busy or something is wrong.

Of course, I'm not talking about clinical depression. I'm not even talking about depression really. If I were I might still be in bed today. I'm not; I'm feeling emotionally fragile and my eyes are puffy as hell but I'm up and about and not crying.

There were other contributing factors to yesterday which I won't go into. Suffice it to say, it's been a period of heavy stress for a few months.

What I found interesting yesterday was how I dealt with it. Or rather how I didn't deal with it. I have almost reprogrammed myself when it comes to anxiety. I have to be in a state of extreme agitation to be unable to use ACT, CBT or mindfulness. It's unusual to get to that point with anxiety these days because I'm attuned to it and on the watch for it so use the techniques as soon as I need to.

Not so with an emotional melt-down. A fog descends on my brain rendering me unable to have any thoughts except for the ones about how worthless and unloved I am and how much my life sucks. I know today that it's not true but yesterday was a different story. I was too agitated to be able to use any of the techniques. Maybe they're not effective for melt-downs anyway; I don't know.

The thing with anxiety is that everyone suffers from it. To have Anxiety Disorder simply means that the anxiety is out of proportion and affects the life of the sufferer. I don't really know if everyone has melt-downs or not. I do know people get upset. I can't tell you the last time I ended up in bed with one but I think it may have been in the wake of my mother's death six years ago. The melt-downs I usually have are intermittent and over quickly.

The point I'm making is that anxiety affects my day to day life and limits what I can do. It is crucial, therefore, that I use techniques that help me to live as fulfilling a life as I can. Sadness doesn't. It happens but it's not limiting my life in any way. Okay, so I didn't do the chores yesterday. I did them today. That being the case, does it matter if I'm in a fog of 'unhelpful thoughts' from which I can't escape. It passed. I could spend unnecessary time and energy trying to fix something that doesn't need to be fixed.

Obviously, if I were suffering from depression I would need to get help and anyone who thinks they are should see their doctor. I just had a bad day.

What Can I Do?

I write two completely different and unrelated blogs. The other day, however, they collided. A throw-away line by a friend had a big impact on me, both as an anxiety sufferer and as someone who is trying to live an alternative lifestyle. Yesterday I used her line in my other blog; today I'm using it in this one.

My friend suffers from multiple food intolerances and she said to me on Monday that she doesn't like to tell people what she can't eat, rather what she can eat. I found inspiration in that.

My relationship with anxiety has been up and down and weak and strong over the years. Five years ago, I went on a family holiday which involved two day cruises. There was a certain amount of anxiety but it wasn't insurmountable. Three months later, I crashed into a heap, after being well for five years, and could barely walk out the front door. Of course, I had no choice but to do so but, every time I did, I experienced severe anxiety.

At this point I don't think I could manage a day cruise but I can certainly leave home - especially to do routine things - without anxiety. To get back to my friend's point, there are things I can do now that I couldn't do four years ago. There are also things I'm yet to be able to do but I'd rather focus on how far I've come than on what I still have to do.

Like a lot of people I have a "bucket list". At the moment, there are a great number of things on it that I couldn't manage. My husband and I were chatting earlier today and he mentioned a restaurant in the city he'd like to take me to. As the conversation progressed and we talked about various things we'd like to do or try in our own city, I said to him that I'd like to create an "Adelaide Bucket List". Most of the things I'd put on there would be things I could do now.

I don't want to lament all the things I've missed out on; I want to be too busy doing what I can do. Maybe one day I'll do the other things, maybe not. Whatever the case, I don't want to feel as if I sat around waiting for my life to begin or to get better. The most inspirational people I know are the ones who are restricted in some way but still fill their days doing what they can on that particular day. My friend's line of "I tell people what I can eat" is a metaphor for that.

Cheers.

Running Screaming from the Train

Last weekend, my husband, son and I went to The Ghan's open day. I'd long been curious to see this luxurious train.

When we first got to the train station we had to line up. It was a long line. It was even longer than it first appeared because it snaked around portable fencing. I don't like waiting in long lines; it makes me anxious. I don't like feeling trapped and waiting in long lines makes me feel trapped. On second viewing, it wasn't too bad because I could see an escape. No one was forcing me to go on The Ghan so I could get out of line any time I needed.

The time spent in line went quickly. They were getting people on-board efficiently. While we waited, we amused ourselves by flirting with the baby in front; my son and I were competing to see who could make him smile. My son won; babies like him. I also tried to observe the people in line in front of me; people watching is one of my favourite activities when I'm in public. A couple a few metres in front of us were having a quarrel.

One of my followers on Twitter asked if I could write more about mindfulness. Truly, I don't know if I do it "right" or not; I don't even know if there is a "right" way of doing it. Standing in line I was feeling anxious; it was low level but it was there, nonetheless. Consequently, I was making a concerted effort to stay in the moment. Anxiety is the fear of what may happen - a fear of something in the future. Mindfulness keeps one planted firmly in the present. "I'm quite nervous standing in line here so I'm going to put my attention into watching people in line." If I'm looking at what people are wearing, who's in which family, how many children each family has etc, I can't be thinking about the sick feeling in my stomach. I know it's more complicated than that and I use it quite differently when I meditate but when I'm anxious I use my own modified version.

We finally made it into the train. The first carriage was fine. It was red class; the least expensive. We sat in the big comfortable chairs and imagined what it might be like to travel that way. After the first carriage, things got sticky for me. The train was full of people, all of whom were sitting in seats, reading menus and looking into private rooms in the more expensive gold and platinum classes. And the train was full; there were people from start to finish. And we weren't moving. We were just standing in a claustrophobic narrow corridor in a stationary train, not moving a millimetre. A recipe for the mother of all panic attacks.

There were two things I needed to do immediately. The first one was to plot my escape. I know this is "safety seeking" behaviour and I shouldn't but I do. So there. I looked up and down the corridor. Chockers. There didn't seem to be a way to escape. I told myself that I was thin and that, if I really needed to get out, I could clamp my hand over my mouth, dash through the crowd, jostling people as I went, shouting, "I'm going to be sick!" I figured that would make people move. I knew, however, once I'd worked out an escape route I wouldn't have to use it so it was immediately labelled "Plan Z".

The second was to be mindful of where I was and what was happening around me. I began looking around, trying to notice my surroundings and listen to conversations and other noises. As I did so, I could feel the wave of panic subside into something less threatening. It was a bleak and rainy day so I watched the raindrops roll down the window of the carriage I was in and studied the carriages of the train opposite. As I did so, the line moved forward bit by bit.

Then I got a distraction I wasn't expecting. The man in line in front of me turned and remarked, "You wouldn't want to be claustrophobic, would you?" I'm sure he'll always rue the moment he chose to do that because I replied, "As a matter of fact, I am and am feeling very uncomfortable at the moment." Interestingly enough, the conversation that ensued between us, comparing our most claustrophobic moments actually settled my anxiety. The only explanation I can think of is that I was so caught up in the conversation I didn't focus on how I felt.

Anyway, The Ghan is awesome. I'd love to do a trip on it one day. I don't think I want to be cooped up in a moving train for the time it takes so I think I still have much ground to cover until the day I climb on-board, platinum ticket in one hand and champagne in the other.

Word Vomit

As you may have guessed from previous posts I spend a lot of time trying to control my thoughts. I’ve written about making up stories and about trying to change unrealistic thoughts into realistic ones. In actuality, I think it’s my thoughts that control me for the most part and not the reverse.

I can’t really call it an internal monologue because it’s more of a dialogue or conversation. If I’m not directing and controlling my thoughts, I’m internally reacting to the ones that come up. I’ve already given examples of that.

So, what happens when I just simply let go?

About a year ago there was something in life that was causing me stress and anxiety. It wasn’t the kind of agoraphobic anxiety of leaving the house or having a panic attack; it was the common anxiety of being unsure how to proceed in a certain situation.

I was really at a loss as to what to do to help myself. One day, almost in desperation, I grabbed an A5 notebook and pen and began to write. It was an unplanned, uncontrolled stream of consciousness pile of word vomit. I have a very colourful vocabulary at the best of times but I swear I was using words even I refuse to use. When I’d finished I felt purged and clean. After a couple more stream of consciousness writing sessions I began to learn and see things that I had obviously only been aware of at a subconscious level. It created a major turning point for me.

The other night I couldn’t sleep. Something was weighing on my mind. After 90 minutes of trying to sleep I decided to give up and do a stream of consciousness writing session. The problem was, even though I wasn’t sleepy, it was warm and cosy in bed and I couldn’t be bothered sitting up and grabbing pen and paper. I chose, instead, to try to have a stream of consciousness thought session. I’d never done it before and didn’t really know what to do. But I didn’t know what to do when I was writing either.  I simply let whatever thoughts came up do so without trying to harness, control, manage or plan. Interestingly, I fell asleep while I was doing it.

My mind – maybe most minds – seems to want to constantly engage with itself. Stream of consciousness takes away the dialogue. When I was writing I was simply the scribe. In fact, my hand was racing so quickly across the page trying to keep up, there was no time to think, judge or interact. It’s harder to do it without writing. Instead of scribing it’s like trying to just neutrally observe the disjointed thoughts that flash across the mind. Doing it the latter way is actually quite relaxing. Some really hateful thoughts came up and I didn’t have to censor or judge myself because they came and went. Sometimes I raised my eyebrows and thought, “Oh, I didn’t know that.” One very old hurt that I hadn’t consciously thought about for years cropped up and I found myself thinking that I hated someone. The thoughts just kept meandering and I ended up, through no conscious effort, understanding that my life had turned out much much better than the person who’d hurt me. That wasn’t an attempt to make myself feel better; it was a disjointed thought. It was also a very powerful one.

I think it’s unlikely that stream of consciousness would be beneficial in a panic attack situation. Sometimes, though, when I’m feeling too overwhelmed to try to change my thoughts I use mindfulness. I’ve written about that before, too. I suppose that sitting on the sidelines and observing thoughts without interacting with them is a form of mindfulness. It’s just more of an internal than external focus and the whole point of the external focus is distraction.

One thing is for sure. It’s never boring inside my head!

The Powerlessness of Positive Thinking

Yeah, you read the title correctly. We anxiety sufferers tend to be negative thinkers. So, why can't we just snap out of it and think positively? Because trying to think or be positive is like putting a bandaid over a gaping wound. It is futile. End of post. Right? Wrong!

Let me give you a little glimpse into my inner monologue.

Walking out the front door. Thinks to herself, "I'm going to have a massive panic attack and die when I'm out."

Uses positive thinking. "I'm going to be calm the whole time I'm out and have a wonderful time."

"Not on my watch, sunshine."

Of course, that was an extreme and fictional example. Anxiety sufferers have what psychologists term unhelpful thoughts. It's an apt name so I'm happy to use it. We also have a distorted sense of reality when we're panicky. We can't just snap out of it but we can change our perception which I think is more helpful and productive than spouting falsehoods.

Consequently, the monologue above would be more like this:

I'm going to have a panic attack and die.

How many times has that happened before?

Never.

So, why do you think it's going to happen today?

I'm extra nervous.

How likely is it that you'll die from a panic attack.

Not very.

Is it realistic to think you will.

No.

You can see where it's heading. Ultimately, the thought that I'm going to have a panic attack and die will be replaced by I'm more nervous than usual today but it's likely that it will pass and I'll have a good time.

The difference between the positive bandaid I gave myself in the first example and the end thought in the second example is that I would actually believe the latter and go on to have a more successful and less anxious time out and about.

My first reaction to any situation is usually negative. The negativity came before the PAD. I can't help it; it's part of my personality. It's not something I can change. What I can change is my reaction to the negativity. Being positive will never be second nature to me but I'm working on always challenging the negative. I hope that the challenging will, in time, become second nature.

Creativity, Imagination and Anxiety

For years I insisted that I didn't have a creative bone in my body. It was a lament. I honestly believed I had no imagination or creativity.

For whatever reason, I completely overlooked the fact that, as far back as I can remember, I've made up stories in my head. I control them and they play like movies. Doing so helps me make sense of things, right wrongs, change endings and make me feel better about things. The righting of wrongs and changing of endings is metaphoric, of course, but doing so really does make me feel better.

It never occurred to me to write many stories or a novel because the stories in my head were visual. About eighteen months ago, however, I realised I wasn't visualising but writing a narrative in my head. I jumped up and sat in front of the computer and began to write. I didn't know where it would take me at the time; I simply wanted to strike while the iron was hot, so to speak. The end result is a 90K word novel which I'm currently editing.

Over the course of writing the novel, I realised that I was a creative and imaginative person; I simply hadn't acknowledged it. I began keeping a diary when I was eleven years old and haven't stopped. When I feel particularly low, poems pour out of me. The poems and diaries are overflowing with images, metaphors and analogies. Not creative? What the hell was I thinking when I used to say that?

Yesterday I saw the dark side of my imagination. It's been there all along but I had an experience in which I came to fully understand the link between imagination and anxiety. Awhile back I blogged about the link between mindfulness, writing and anxiety. In fact, the SA Writers Centre has a workshop coming up, Writing in Flow, which looks as if it is going to expand on what I wrote. If you want to read that post, click here.

My son had a dental procedure done. He had a baby tooth removed and an incision made in his gum so that the adult tooth would come down. When it was done, the periodontist asked if I wanted to see it. I quickly replied, "No, I'm a fainter." And I am. Big time. I fainted once in a First Aid course when we were learning how to stem blood flow. The instructor asked me all kinds of questions as to whether I'd eaten, if I was sick, menstruating etc and I kept having to repeat that it was the subject that had made me faint, nothing else.

Saying no was of little use. I began to picture my son's mouth. Soon the taste of blood filled my own mouth, my bowel and stomach both turned, black spots danced in front of my eyes and my legs felt weak. I didn't faint or vomit but I became acutely aware of what my imagination was capable of doing to me. That is essentially what a panic or anxiety attack is. It's the mind creating a scenario which is unlikely to occur and the body following with its "fight or flight" response. Even as I write, I can taste blood in my mouth. (I guess I'd make a pretty crappy vampire!)

One of my friends was seeing a psychologist for her anxiety but stopped. She told me that he would mention situations she hadn't thought of and then she would add them to her list of anxiety inducing ones. It was probably not his intention but he fed her imagination and exacerbated the problem.

Many high profile creative people suffer from anxiety. It just never occurred to me that there might actually be a link. Maybe it's not random. If we have the imagination to create, surely we have the side of imagination which shows us dark and frightening things. Maybe some can assimilate it perfectly into their work and not be physically affected. Others can't.

Better, Worse, Medicated or Unmedicated

I know a handful of people who also suffer from anxiety. I'm always surprised when someone tells me; it's hard to pick.

Some of the people I know live seemingly "normal" lives. I'm pleased for them and envious at the same time. It's not a negative gripping jealousy by any means; it's just something I'm always working towards and wish I were there already. On the other hand, I know people who, at present, are able to do less than me. I suspect they're happy for me and envious at the same time. It's a personal journey and we're all at different places. I've been both better and worse than I am now.

Of the people I know, some are medicated with anti-anxiety meds or anti-depressants on a daily basis while some take them sporadically, as needed. Others don't take any. I fall into the latter category. I'm not and never have been medicated. That's not a judgement, boast or lament; it's simply a fact.

The most recent help I sought used CBT and ACT rather than medication and no doctor has ever suggested it for me, although one wanted to give me anti-depressants for PMT once many years ago. I have to admit I love the idea of taking an anti-anxiety tablet when I'm overwhelmed by panic and have strongly considered asking the doctor. I haven't, however. First of all, if the doctor felt they were necessary she would have prescribed them. Second, I mostly feel that way when I'm going through a bad patch which means I'd be taking them often and they are highly addictive. I know people who only take them when they're travelling, for example. Unfortunately, my own anxiety is less specific than that so I wouldn't be able to limit them. That's my own story.

I also know people, however, who are so anxious they need one on a daily basis in order to be calm enough to function. They have tried CBT and/or ACT and it hasn't worked for them. As I wrote, it's a personal journey.

I'm really on here just to tell my own story. I thought it was important to qualify that by mentioning that everyone is different. We all have similarities that we can relate to and laugh about together but my story isn't anyone else's and I would hate it to be taken as such.

Strong Emotions

I had what Oprah would call "a lightbulb moment" yesterday. It happened when I went to see my mother's former house being auctioned. I sold the house five years ago. The whole process was conducted by an agent through telephone calls and face to face meetings. I never met the couple who bought the house and never actually witnessed the sale. I simply signed papers, packed things and never saw the house again. On settlement day, I felt vaguely sad.

Last weekend my sister called me to tell me the house was on the market again for the second time since my mother's death. I went to the open inspection. I thought I'd be wobbly but was fine. The house looked wonderful. Yesterday I went to the auction. Suddenly I got very wobbly. It was as though I were selling the house. The grief that never surfaced when I really sold it threatened to bubble up from deep within. I considered leaving before it even began.

It was then that I realised. When I experience very strong emotions - particularly "negative" ones - it brings on a panic attack. I remembered my mother's death. My sister and I were sitting in a lounge area at the hospice; Mum had sent us out of the room. The nurse came and told us our mother was passing so we headed back. I got to the door of the room and froze. My sister - my mother's baby girl - had lost it by that time and I knew she probably couldn't go back into the room. It was up to me. Panic washed over me. There is probably no greater "negative" emotion than the one you experience when you're about to watch a loved one die. I did exactly what I'd done on one of the happiest days of my life - my wedding day - when panic was triggered by strong emotion. I told myself I didn't have time for it and carried on. Of course, the anxiety still occurred but I didn't let it cripple me. The up (and down) side to PAD is that much of it is thought triggered.

My sister and I both managed to walk through the door that day. We're made of stronger stuff than either of us give ourselves credit for. I held my mother's hand as she left us and, as sad as it was, it was also a beautiful moment for me; Mum brought me into the world and I held her hand as she left it. Consequently, yesterday's auction really was a no-brainer. I stayed, as anxious as the grief had made me feel. (By the way, no one bid on the house so it was a non-event.)

Three years ago I attended the funeral of a friend who died of the same cancer as my mother. My friend was younger than me, however. Again, I was unsure if I could do it. I knew her through my children; she was the mother of two of their friends. As I sat there, panic rising, I looked over at both of my babies and saw tears streaming down their cheeks. Again, I knew I had to be the strong one. I took a deep breath and stretched my arm to reach across both their shoulders for comfort. We got through but panic was only a heartbeat away for me throughout the service.

Living with PAD is a lifelong learning process. I learnt something new yesterday. The important thing is not to avoid triggers but to boldly walk towards them. The next time I know I'm going to be faced with strong emotions I'll be on the watch to see what happens.

Seal(ed) With A Kiss

Last night I watched The Voice. The last contestant, a young man who had performed with The Ten Tenors, had a wonderful voice. Coach, Seal, however, could sense something beyond the voice and gently coaxed information from him. The young man confessed that he had suffered from severe depression two years prior. Seal then also announced - on national television in primetime - that he had had severe panic and anxiety in the past. If that wasn't enough, Ricky Martin, also said that he, too, had suffered from depression.

By the time the three men had finished sharing I had both hands clutching my heart and tears streaming down my face. It was one of the bravest things I've ever witnessed. For the purposes of the blog I'm going to focus on Seal but that, in no way, belittles the other two men or depression in any way.

Seal is an intelligent, successful, talented and highly respected musician. For someone in his position to do what he did "normalises" Panic and Anxiety Disorder. He reached more people in one night on television than I can hope to reach in a life-time of blogging and I'm overwhelmingly grateful to him.

According to the Australian Bureau of Statistics, Panic and Anxiety Disorder is the most common mental illness in Australia, with 14% of the population of 16-85 years olds affected. That means that, if you have 100 friends in that age group, 14 of them suffer from anxiety. I'm not talking about pre-exam jitters; I'm talking about anxiety crippling enough to limit someone's life. I imagine you're shaking your head and thinking that I can't be right. Let's look more closely at the people you know. There could be the friend who won't go out alone or the one who prefers to. Then there's the one who is always distracted when you run into them in public, their eyes darting all over the place. No, they're not bored or stand-offish; they're checking for escape routes. What about the one who won't take public transport or the one who refuses to drive. The one who always wants to eat the same meal at the same restaurant could be another. Then there's the friend who'd rather sit for hours in a car, bus or train than ever fly or their opposite, the one who'd rather fly than be trapped for so many hours in a car, bus or train. And my all-time favourite (not) is the poor stay at home mum that the other mums bitch about in the school-yard, saying how lazy she is and what a bad mum she is for not helping at her children's school.

I'm not saying all those behaviours mean Panic and Anxiety Disorder. My point is that you simply don't know because most sufferers keep that information hidden with their underwear. How, then, could you know? I can't even pick fellow sufferers. I guess I don't have a very good "PADar"!

So, when someone like Seal declares in front of a large viewing audience that he's had issues with anxiety we breath easier and think that, maybe, we're okay, after all.

Besides, "if we're ever going to survive, we need to get a little crazy."

Adding Challenges

Before I start I need to share two facts with you. First of all, I'm currently learning French. Second, my daughter threw her French dictionaries in my general direction in a fit of pique at the end of her Year 12 last year, declaring that she would never, ever do French again and that I was welcome to the dictionaries which I'd been borrowing anyway. Never say never, my darling. Guess who's doing French at university and asked if she could have her dictionaries back?! By the way, I need to clarify that she wasn't throwing them at me. Hold that information.

I've just finished attending the Alliance Française Film Festival. Last Wednesday I had a ticket for one and, since it began at a similar time to my daughter's uni lectures for that day, she suggested we go into the city together and have lunch at Cafe Brunelli on Rundle Street. She further suggested I wait for her to finish uni and we go home together, as well.

Hmmm, I thought to myself. I'm not very good at doing multiple things away from home. It's okay if it's spontaneous but if I look at it as a whole to begin with I feel uncomfortable. The idea of lunch and the movie was bad enough but waiting around afterwards for another forty minutes??? So, I said I'd text her after the movie to let her know.

That was what my psychologist would refer to as "safety seeking behaviour" and those of us with Panic Disorder wrote the book on that one. It's different for each of us, of course. And it's never logical, except in our own minds. For example, if I leave home without a bottle of water I feel very uncomfortable because, of course, I can't buy bottled water anywhere so obviously I'll dehydrate and die.

Saying I'd text my daughter gave me "a way out". I hate feeling trapped in any way. What I should have done was say I would wait for her and only text her if I desperately needed to get home. Of course, if I desperately needed to get home I would be experiencing just the sort of symptoms for which  I actually need to stay in the situation. Go figure.

What did I do? I was fine so I spent time while I waited buying myself a French dictionary! After meeting up, however, we didn't go straight home. My daughter, you see, is a cougar. While she's in her first year of university, her long-term boyfriend is in his final year of high school and his formal is approaching. So, before leaving the city, she wanted to look in a vintage shop in the city for a dress for that. My time in town was prolonged as she tried on a dress. Had I known that was coming it would have sent me into a tailspin but I didn't so it was okay.

Five hours after arriving I left the city.

Cheers.

The Family

When one person in a family suffers from any kind of illness or disorder it is bound to have an impact on the rest of the family. How do my near and dear ones cope with my anxiety?

This is definitely not what my husband signed up for, that's for sure! When we first met I was very confident and outgoing. It strikes me as incongruous that he could possibly love someone so far removed from the person he fell in love with. The anxiety first manifested itself before we were married. It was actually in the lead-up to the wedding that I began to experience anxiety and panic attacks. I wonder why???!!! He certainly could have bailed at the time but he's been an absolute trooper with it all, I must say. He never complains and is super supportive. Over the years he's learnt how to deal with it and help me in sticky situations. He's still here and I'm very pleased about that.

One of my children simply cannot get their head around it. Usually a very sympathetic and empathetic person, they have little time or patience for me when I'm anxious. They cannot understand the fact that I have to pace myself and once even went so far as to tell me my reason for not allowing them to do something was "lame".

In a classic good child/bad child scenario, the other child is the complete opposite. My relationship with this child can be turbulent. However, when it comes to anxiety, they seem to have an innate ability to say and do the right thing. This child knows I get very anxious driving over a certain bridge and, each time we approach it, they begin a conversation with me that involves asking me a lot of questions to divert my attention away from the bridge onto the conversation. This technique was learnt after I was driving them to an audition about which they were very nervous. I used it on them at the time. Later I told them what I'd done and they must have filed it away under "useful information" and used it on me a couple of years later as we approached the bridge. (My fear of this bridge - which is not in Adelaide - developed after driving over it in a small car in roaring winds and feeling as if we'd get blown off. I know it's not possible but if my thought processes were logical I wouldn't have this disorder!) One time I had a full blown panic attack when I was with this child and they just calmly told me to breathe. Not bad for an eleven year old - at the time.

I make no secret of my disorder and have found extended family and friends very helpful and supportive. I think they see that I'm doing the best I can and trying as hard as possible to confront the anxiety and not become a slave to it.

A Trip to the Theatre - Then and Now

Late 2008 I subscribed to a few Adelaide Symphony Orchestra (ASO) concerts. I was fine then. Fast forward a few months to early 2009 and I was not doing well. I had to attend one of the concerts. Worse still, my seat was in the middle of a row. I couldn't do it. I froze. Everyone else walked in and I just couldn't. The worst thing I could have done was to not go in. The second worst thing I could do was to rush home. I did the worst but decided to see if I could calm down enough to maybe go in after the interval.

As I sat alone in the foyer of the Festival Theatre one of the ushers approached me to see what was going on. By that time I knew that PAD was like any other chronic condition; it wasn't something to be embarrassed about, it's just the way my brain is wired. So, I explained. He was brilliant. If you live in Adelaide, did you know that the Festival Theatre has a 'crying room'? I didn't but it does and the usher brought me up there. I was able to watch Ben Lee perform with the ASO! It was the best compromise for that situation and I walked away from the evening feeling triumphant.

Fast forward again this time to early 2013. We had tickets to see Tom Gleeson at the Adelaide Fringe. Our plan was to eat dinner in The Garden of Unearthly Delights and then see the show. The day was hot and humid and I had a small health issue bothering me. Nevertheless, we proceeded. We had to park a reasonable distance and, by the time we arrived in the Garden, I was hot and bothered. That was all, though. Health was fine, anxiety levels low.

After eating we lined up for the show. It was general admission so we had to sit where they told us. I could have explained that I needed an aisle seat but was confidant I could get through the one hour. We were seated in the middle of a row and the first thing I did was scan to make sure I could get out if I needed to. Part of my condition is to need to be able to get out of a situation quickly if need be. About fifteen minutes into the show a large wave of anxiety washed over me. I grabbed a hair tie and piece of paper from my bag and tied back my hair and gently fanned myself, thinking the heat may have brought on the anxiety. It made me feel nauseas and weak. I tried really hard to concentrate on the on-stage activity. I probably lost concentration for less than five minutes and then the wave passed. I don't really know because I was caught up in the show.

Cheers.

What Do Anxiety Therapy and Writing Have in Common?

My Panic and Anxiety (PAD) has been off and on through my adult life. Just over four years ago, my anxiety levels shot up and remained so for over two years. In the past I'd always dealt with it on my own; I knew what to do. This time, however, I couldn't shake it so I decided it was time to get help. The first time I sought help it was for depression, rather than anxiety, and was twenty nine years ago; my GP helpfully told me to snap out of it. Many years later I went to a PAD workshop which was great and very helpful and I decided to follow it up with private help. That didn't go too well either, with the psychologist giving me the distinct impression he really didn't like me. What's not to like??? Needless to say, I preferred to fly solo when it came to dealing with anxiety (or depression for that matter).

The lovely GP I now see is wonderful and took my concerns seriously. She referred me to an equally wonderful psychologist who I credit for getting me back out and about. One time, when I went to see her I told her at the end of the session that I was anxious because I was attending a play later that week. In the brief time remaining she told me about mindfulness. I used it when I was standing in the long line for the toilet at interval and have been using it ever since.

I use mindfulness in the following way. I pick a sense, depending on the situation. On that day, I chose sight and began with the ceiling. I studied everything in that bathroom on that day until it was my turn to use the loo. I can still tell you that the sinks are pink and the mirrors above them have lights around them. My mind was actively engaged in what I was looking at and, therefore, wasn't telling me that I was going to faint, vomit or not get to the toilet in time.

Fast forward to yesterday. It was a hot and humid day, the kind of weather which can set me off to faint. I was going to attend a writing workshop in the city. As soon as I was getting ready to leave, the anxiety girl and the clever, mature woman that reside in my head got into a fight. Anxiety Girl told me I would faint and that it was best not to go. Clever, Mature Woman won that round because I spoke out loud and announced to thin air, "Stop being so silly. You're going and that's that. So what if you faint; at least you're going." That didn't stop the whoosh of anxiety that went through me as I got in the car.

Why? I've sat through countless workshops in my life. I've taught countless workshops in my life. The two that stand out in my mind, the two that my PAD-riddled brain has latched onto, however, are the one where I had to dramatically run out of the room to vomit over twenty five years ago and the one where I ended up on the floor in a dead faint because it was a First Aid course and we were discussing how to stem the flow of blood. (Blood also makes me faint. I'm so Victorian - just tighten my corset now!)

As I drove in to the city I heard an entertainer visiting Adelaide for the Fringe Festival say that he would rather look back on his life and be glad that he'd tried something and failed than not have tried at all. That made me smile, considering what I was doing. By the time I arrived at the workshop venue the smile had been removed from my face and my anxiety was heading towards panic.

Fortunately the workshop began and because it was a full day workshop condensed into three hours if you lost concentration for a nano-second you were going to miss valuable information. Needless to say, the presenter had my full attention.

One of the first exercises we did was using our senses to describe the room we were in. I was given sight and taste. I was on home turf with that exercise. I use mindfulness these days, not just when I feel anxious but in my writing and randomly just for practise. For example, just the other day I used it when I was scooping dog shit in the back yard. Believe me when I tell you that I now know that dog shit comes in a variety of shades, shapes and sizes! I do things like that because it helps me as a writer and as an anxiety sufferer.

I got through yesterday and benefitted greatly as a writer. I also benefitted as a person; each time I push myself and "prove" to Anxiety Girl that her fears are groundless, her hold on me loosens.

Cheers.

The Holy Trinity of Health Care

It's really important for everyone to take care of themselves. It's even more important for those with chronic illness to do so. I imagine you would agree with that in relation to a physical illness. What about anxiety, however? The answer to that is a resounding yes. My holy trinity of health care is diet, exercise and sleep.

Dealing with anxiety on a daily basis takes its toll on the body. Imagine those large amounts of stress hormones being released on an almost constant basis. At the very least, we're constantly tired. For that reason good nutrition is really important to replenish any vitamins and minerals depleted by the chronic stress. But there's another side to it. There are certain foods which I try to avoid. The biggest number one food I try to steer clear of is sugar. If I eat something sugary two things happen. A couple of hours later I either feel sick or extremely tense and jittery or both. While feeling sick has little to do with panic and anxiety, I'm less apt to want to leave home if I feel unwell and, if I do leave home, I'm more likely to have a panic attack if I'm not in tip top shake to put my brain and willpower into circumventing one.

Interestingly, I drink both tea and coffee. The former on a daily basis and the latter as a treat when I'm out. I feel the health benefits of tea outweigh the fact that it's a mild stimulant. In fact, a psychologist friend told me that research has shown that black tea aids the system to clear the stress hormones more quickly. Also, my tea drinking is a relaxing ritual; something I do when the morning rush is over and I'm at home alone (or with my husband). After my cuppa I hit the road or do chores. As for coffee, I think it, too, is relaxing because it's something I drink slowly and savour, usually with friends or after doing something fun. I do feel the caffeine rush straight to my knees but it doesn't seem to have an adverse effect on me; if it did I'd drink decaf on those rare occasions. Even the one spoonful of sugar that goes in is small enough not to bother me.

Exercise can also help clear the stress hormones. I have to admit I'm very hit and miss when it comes to exercise but I try. It also helps the immune system. As I mentioned I'm more apt to panic if I feel bad. Exercise reduces the chance of getting sick. It also improves mood and relaxes us so it's great. However, having a strenuous work-out causes the body to have the same symptoms as a panic attack and can bring one on for that reason. I prefer to stick to walking, especially on the beach. How can one possibly not relax on a beach? Walking is also great therapy for those of us who are uneasy about going out because we can gradually increase the distance from home or the car that we walk.

And finally sleep. With what our bodies go through every day it's essential that we get enough sleep to repair the damage. Furthermore, being refreshed and alert makes it easier to deal with the inevitable feelings of anxiety that pop up. The average requirement for adults is, of course, eight hours and research is showing that maybe less is even better. That's not taking us into consideration. I can't speak for other sufferers but my body operates best on nine hours. That doesn't mean I always get it but, like exercise, I try.

I don't always get it right with the holy trinity but, when I do, I feel far more able to get out and enjoy myself.