Saturday, September 10, 2011

celebrating progress

I am usually hard on myself. I think all the time about things I do that I shouldn't be doing, things I avoid that I shouldn't be avoiding, etc. I try to pin down every single way that I am failing to function as a "normal" person due to anxiety so that I can fix it all. I'm not doing that today.

One year ago today, I was in the hospital for almost the entire day because of panic attacks. I knew that was what was happening; I've had anxiety my whole life, so I was familiar with the symptoms. But this was different than anything I had experienced, panic attacks that were hitting me from out of nowhere - while I was sitting safely at home - and lasting for hours. I really thought I had reached the point where I was going to lose my sanity. I couldn't stop thinking about those brief biographies that are written about authors like Poe or Plath or Hemingway, the kind that paint them as people who were doomed all along to a life of insanity, and it was just a matter of waiting for that final blow, the last nervous breakdown or institutionalization.

The panic attacks didn't start from an emetophobic place, but of course they ended up there. Before I even went to the hospital, I had gotten to the point where I wasn't eating much, because I was so overwhelmed. Then that turned into (what felt like) an inability to eat anything, which lasted for about two weeks. I did eat during this time, but only because of my wife. She would bring me something and insist that I eat it. I never once felt aware of being hungry, and everything I put in my mouth, including water, made me feel so "nauseous" that I was terrified of swallowing. I remember her bringing me a small bowl of dry Cheerios one morning, and after one or two bites I started sobbing, because it felt impossible to eat the entire bowl. I was scared I would never want to eat again and couldn't imagine a lifetime of forcing myself to do it every day.

I know the anxiety set this off, and taking Ativan one day, attempting Lexapro another day, and then trying Cymbalta on another, all on a practically empty stomach, can't have helped the situation. Especially when it was my first time ever taking psychiatric medication (I didn't end up sticking with any of them). But I think what caused it to last for so long was my own inaction. I was clinging to my long-held belief that 'not eating is the best defense against feeling bad,' even though I felt absolutely horrible, and it was clear that not eating was perpetuating that.

But since I'm celebrating progress here, I'm not going to talk about how I should have handled that better and could have gotten myself accustomed to food again much faster. I'm going to talk about how I did handle it better the second time around, because about two months ago, this happened to me again. I had a few panic attacks, and once again, I felt like I couldn't eat.

I'm really glad this second bad period happened. At first, it shook me up and made me feel that in spite of all my hard work, I hadn't gotten anywhere in the past ten months. But it became obvious, from the way things played out, that I had changed. There was no hospital trip. Instead of missing about five days of work, I only missed two. I still had some Ativan, but I didn't end up taking any. I increased my focus on affirmations and practiced breathing / visualization exercises. Most importantly, I made it one of my top goals to eat as much as possible. I still wasn't consuming anywhere near the amount I should have been, but I was at least having enough every day so that I didn't get into that emetophobic cycle where it just gets worse and worse: hunger = nausea = don't eat = more intense hunger = more intense nausea = still don't eat, etc.

I was back to eating normally within a week, and it never got so bad that I was crying over a meal. I was able to drink water the whole time. Plus whenever I did eat, I actually thought about what would be the best choice, given that I was somewhat malnourished and might not be able to eat a sufficient amount. I tried to choose what had protein and actual substance, versus a year ago when I only went for "safe" carbs like crackers, toast, cereal.

So looking back over this entire year now, I feel like I've come so far. It's strange even to remember being in the hospital and how I was desperate for them to send me home with some drug, because I figured it was all over for me, and that was the only way I might possibly be able to live a normal life again. It's incredible to know that when these bad anxiety periods happen, I don't have to just fall into that state of helplessness and passivity. I have some control and can do things to reduce both the level of anxiety and the length of time I feel that way. I've been trying to convince myself of this for the past year, and I am finally at the point where I believe it most of the time. Now I just have to figure out how I can prevent these bad periods from happening in the first place.

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