Apparently I'm Moderately Depressive

At my last scheduled appointment with the psychologist a couple of weeks ago, she got me to take a DASS survey. I did it and, after collating my scores, she said, "That's funny. Your anxiety levels are much lower than when you were first assessed in February but you're moderately depressive now. Get another referral from your GP so we can keep working."

I went to my GP and told her what my psychologist had said so she got me to take a K10 test. I did it and, after collating my scores, she said, "That's funny. Your anxiety levels are much lower than when you were first assessed in February but you're moderately depressive now. I'll write that referral and I want to increase your dose of Lexapro. It may make you feel emotionally numb; if so, decrease the dose again."

"That's funny," I thought to myself, "I'm already emotionally numb and it has nothing to do with the Lexapro."

Right now I feel like I'm marking time as I make the long slow walk to the grave. I look forward to nothing. It's not so dire that nothing gives me pleasure. Once I begin doing something I'm fine; I simply lack all interest and/or enthusiasm for anything. I simply can't be bothered. My care factor is zero. I pay lip service to everything at the moment and go through the motions.

I'm well aware that these are classic signs of depression. I have no desire to hurt or kill myself or die; I have no desire for anything really. I know people who struggle greatly with depression and I feel like it would be an insult to them to label myself as depressed. I'm not depressed and I'm not in denial about it.

The last year has been very hard emotionally. When I really think about it, however, the last ten years have been an emotional roller-coaster. High highs and low lows and not much in-between. Each time it looked as if there might be a period of respite, it didn't come or was short-lived. It feels as if it's been one thing after another after another, and that it's not over and maybe never will be.

Sometimes, if you're running too many things at the same time on the electricity grid, it burns out or shuts down. I believe that is what I'm experiencing. My metaphoric circuits have been overloaded for so long that they've burnt out. I'm having what I'd call "Emotional Burnout". I'm not doing it purposely but I've simply shut down, gone numb.

According to the Book of Ecclesiastes, there is a time for all things, a season for everything. I wonder if it's an accident that, while my world is buried in the cold of winter, I've gone fallow for awhile. I can live with this. I use Acceptance and Commitment Therapy for my anxiety but the "acceptance" part is helpful with the way I feel now. I accept that I'm numb. I accept that I need to be numb for awhile to heal from all that's happened over the past ten years.

In the meantime, however, I'll take my meds and see my psychologist, just in case.

Here is the late, great Pete Seeger singing about a time for everything.

From "Helicopter Parent" to "Free Range Kids"

Two of my children were discussing depression in the car the other day. One of them asked me if young people were as depressed when I was young as they are now. I said I didn't know because when I was young it was a stigma to have any kind of mental disorder so, if as many people were depressed, they did a great job at hiding it.

The other day I read somewhere on-line that more young people do suffer from anxiety and depression, and perform acts of self-harm now than they did thirty five years ago. Again, I don't know if there is a real increase or a seeming increase due to the fact that more people are seeking help. One of the reasons suggested for the increase is the fact that modern parents over-protect their children.

I can't speak for all parents; only for myself. Yes, I was an over-protective "helicopter parent". I wrapped my "babies" up in cotton wool in order to protect them from all the evils of the world, from predators to accidents. This style of parenting came crashing down around me, however, when it became obvious that it felt like a noose to one of my children and wasn't helping that child to develop independence. That was when I reluctantly let my child become a "free range kid."

For years, I tried to be the perfect mum. I worked hard on helping my children to develop resilience. At least I thought I was. I was paying lip service to it and telling my children what great problem solvers they were, all the while trying to solve all their problems for them. Of course, because I was doing so, they weren't becoming resilient. Every time there was a slight issue, Mum stepped it to try to fix things. Actions speak louder than words and the message my "hovering" was sending them was that they were incapable of solving their own problems or dealing with the world effectively.

These days, as hard as it is, I try to sit back and observe. When there is a problem, I ask, "What are you going to do?" I'm happy to offer advice and suggestions but I try to wait until I'm asked. It's really hard; my first instinct is to fix it. I'm learning to trust that my kids will make good choices and, if they don't, that they'll learn from their mistakes. I'm learning to bite my tongue and sit on my hands because part of growing up is learning the hard way and we can't protect them from that. And, if we do, how will they learn and thus become resilient adults? It is the idea that, by protecting them so much, they can't cope with things and, thus become depressed and anxious. I don't know if that's true but I do know that I was sending my kids a clear message without realising it.

I'm not advocating letting go of parental responsibility by any means. I'm just in the process of learning for myself and my kids what to let them learn for themselves and when to step in. It's the same for my husband, the archetypal "rescuer". One of the kids even told him the other day that by rescuing he made that child feel incompetent. "No good deed goes unpunished!" 

Another Glitch

I had to go to the airport on Sunday. That's not unusual; I go there a lot. I seem to always be seeing people off or welcoming them home. And by "people" I mean the people in my immediate family. Consequently, I'm familiar with and very comfortable at the airport.

Sunday was different, however. I was anxious. Very anxious. It was by no means enough anxiety to lead to feelings of panic. It was more that feeling in the pit of one's stomach - that cross between butterflies and nausea that just won't go away, no matter what "therapy" one uses. And therein lies part of my problem. I'm at a stage in my recovery where I can lead an almost "normal" life. When I feel the sort of anxiety I felt on Sunday I want it to go away. I'm no longer used to it when I go out; it's not there all the time any more. That's a good thing, too. When it does happen, however, it catches me off-guard and I want the feeling to go away; it's unpleasant. That's when I need to back up and remind myself that it's just a feeling. Yes, it's unpleasant but I can get on with things anyway.

Panic is entirely different. A Panic Attack takes over one's rational mind and any kind of "self-talk" is much more difficult. I wasn't panicking, however. I simply had an uncomfortable feeling in my stomach, jelly legs and a light-headed feeling. So now I could be at a crossroad. It would be tempting to associate the airport with anxiety and begin avoiding it. An isolated incidence of anxiety is fine; it's what I let it lead to that is a potential problem.

Fortunately, as I drove home from the airport I had a moment of insight about the trigger. It was only indirectly related to the airport so it's unlikely - though not impossible - that I'll avoid the airport. (I'd like to see myself try. It would be nigh on impossible!)

It's not a case of "all's well that ends well". I have another issue to tackle - the trigger. That, however, is for another post.

Victories

I have a friend, S, who also suffers from Panic and Anxiety Disorder. In fact, I met her in a PAD support group over ten years ago. It turned out our children went to the same school at the time. Hers were in upper primary school and my elder child was in Year 3.

About eighteen months ago I had a long visit with S at her house and it was then that the idea for this blog was born. We had so much fun comparing notes and laughing at ourselves and our rituals that I was sure other people with the same condition might benefit from an on-line discussion of what it's like to have PAD.

PAD has manifested itself differently in the two of us. Mine tends to be cyclic. I go through periods where I'm as "normal" as I'm ever going to be; I go out and about with ease. Then something triggers a setback and I can barely walk out my front door without intense anxiety. I then spend months to years clawing my way back to my "normal". S has rarely had gaps in her PAD. It's something she's had to deal with on a daily basis for quite a number of years with no break, despite treatment. Furthermore, I like to be out and about either alone or with close family. That way, if I have a panic attack I can hit the ground running and get out of wherever I am without having to give an explanation or excuse. S, on the other hand, feels safer being with other people - ones she's close to who know about her issues. Up until recently that did not include her daughters; she didn't want to saddle them with mum having a panic attack.

The other day, I ran into S at the local shops. She was there with her daughter and new grandson. S told me that, when her daughter was pregnant, she decided that she needed to be able to go out with her daughter so she could better enjoy the whole grandmother experience. Once she felt safe with that daughter, however, it extended to her younger daughter, as well. S was really proud of herself as she told me this; it was obvious how much it had enhanced her life. Going shopping and having a coffee with either of my children is something I thoroughly enjoy. Now S can relish the experience, as well. It's also really helpful for her daughter to have S there when she takes the baby shopping. I shared S's joy and was very proud of her, too.

With PAD small victories can lead to other small victories. S also told me that she wants to reduce and eventually stop anti-anxiety medication. The victory of going out with her daughters has given her the confidence to take the medication step. I haven't taken anti-anxiety meds (yet) but I understand they are difficult to come off of so I applaud her decision and am proud of her for that, as well. The issue isn't whether or not she goes off her meds, it's that she's currently got the confidence to try. Confidence is in short supply in the personality of a PAD sufferer.

I wish her all the best and look forward to catching up again, preferably one day when she's looking after her charming grandbaby!

Being Kind to Oneself

How many times have we heard or said the expression, “Be kind to yourself”? We say it a lot to each other. I used to think it meant doing something or not doing something. For example, having a massage or not doing a particular chore. Let’s face it, though, we’re busy and sometimes stressed people who don’t always have the time or money for a massage or the luxury of letting things pile up, only to have more to do later. I realised recently – quite by accident – that being kind to oneself can mean something entirely different, simpler and more powerful.

Being a parent can be wonderfully rewarding. I have quite a collection of handmade gifts and cards in childish scrawl declaring undying love for me. For a time, however, those expressions of love can be few and far between. That time is known as the “teenage years”. Some children never stop being both physically and verbally affectionate; others fight strongly to separate themselves from their parents to create their own identities. The latter can leave a parent feeling lost, grieving, undervalued and unappreciated. Then parenting can feel thankless. I mean that literally. There are few “thank yous” and little appreciation. There are other situations that can create the same feelings. People prone to anxiety and depression can personalise the behaviours and feel worthless at those times.

You’ve probably guessed by now that I was feeling quite low. One day in particular I was feeling worthless and superfluous. I felt as if I was doing a lot and that one of my children didn’t seem to respect or even like me. I thought about what I wanted from that child. I knew that I couldn’t force them to act in a certain way so I decided to give myself what I wanted from them instead. I wanted thanks and kindness. I spent the day thanking myself for each task I performed around the house or each errand I ran for the family. I even looked in the mirror and told myself I looked pretty. It felt stupid and contrived. Be that as it may, I also felt happier and lighter as I went about my chores.

It was then that I realised that being kind to oneself had a lot to do with one’s internal monologue and self-belief. I love having massages; I love it when the kids do the dishes. I can relax and have some time off. If I’m still telling myself that no one appreciates me, however, I’m not really being kind to myself, am I?

I’d love to be able to end this post with some sort of “happily ever after” ending about how I always thank myself and feel great. I don’t and I don’t. For the most part, my internal monologue is pretty toxic. What I’ve learnt – at an intellectual level for the time being – is that being kind to oneself doesn’t consist of single, discrete acts of random kindness. Rather, it is an on-going process of actively trying to change one’s inner voice to one of love and appreciation. The massage is just the icing on the cake!

(Let me clarify that I don’t expect thanks and love for the things I do. This has been part of an on-going situation that is complex and multi-layered.)

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!