exposure / limits

Some thoughts I had in response to this post on tumblr:


Love this. Super relevant to emetophobia and anxiety in general. I know it seems like every time you push yourself it has to go really well or else what was the point, but that’s not true. These experiences are still helping you recover and figure things out. If you think you can handle something and it turns out to be too much and causes an anxiety reaction, you will still survive it, and then you will know you need to take a smaller step first. Exposure isn’t an exact science; you won’t always get it right.

Also, sometimes when you have been anxious so long and have avoided everything, you’re not even sure what you like to do and what you don’t like to do. You could end up at an event where you’re not anxious, but you’re also not having a great time, and that doesn’t mean you made a horrible mistake. You could end up going to the movies several times and then realize ‘hey, I haven’t only been avoiding movies because of anxiety. I also find them really boring.’ It makes sense that you wouldn’t have known this before, because with an anxiety disorder you have this extra layer of fear obscuring your feelings. You have to work through the fear, and sometimes that means doing the same thing a few times until you are less anxious and can experience your true reaction.

work invades my comfort zone

It's been too long since I've written an actual post here. Sometimes I get intimidated by blogging and think I shouldn't bother unless I have something Really Important to say. Which just figures - feeling anxious about blogging about anxiety.

Things have been going pretty well lately. Today I spent hours hanging out in a nearby city (about a two hour drive from home) - walking, shopping, eating, shopping more - without any major anxiety incidents. I started feeling a little unwell towards the end, as I was heading back to the parking garage. But I knew it was dehydration. I am still having a problem with drinking enough when I am out places, especially when I am walking around outside, which unfortunately is when it is most important to do so. I guess it's a combination of 1) not wanting to have to use the restroom in case there isn't one around and 2) not wanting to use the ones that are around, because they are public and thus diseased in my mind. My same lifelong pattern of thinking it's better if I just "shut down" my body until I can be home and safe again.

Despite that, I feel today's outing was a success. And I've also been doing well with the more routine stuff - going out to restaurants, grocery shopping, going to the mall or other stores. I haven't been experiencing anything beyond the mild worry that I might have some kind of anxiety attack.

Since I'm getting more comfortable with these situations, I know it's time to push myself to do even more challenging things, but for the most part, I've been lazy about it. My wife and I want to take another trip to VA to see our families. It's something that has been on the back burner for a while. The last time we went was 2011, and it was difficult for me to handle the trip at the time. I know I would do better now. The only problem is that driving all that way is exhausting, so we are considering taking a train this time.

I don't believe I have been on public transportation since 2008, so pre-breakdown. I probably shouldn't think this way, dividing my life into "pre" and "post" breakdown, but every time something challenging comes up that I haven't done since before that period, I get scared I can't handle it as the "new" person I am now. It feels like that person from 2008 that was able to survive the anxiety of a long train ride was not actually me.

So my wife and I have been discussing taking a practice train ride somewhere closer to where we live (maybe 3 hours away) just to see how I do. Just to prove to myself nothing catastrophic will happen.

Which brings me to this past week, when I suddenly get an email from my boss saying the company wants me to travel to the office for a week for training on a new system (I work from home, but the actual office is in VA). They haven't decided exactly when they want me to come, but possibly as early as the last week of September.

So much for one step at a time! Plus this trip would be much more overwhelming than what I have been imagining. My wife probably won't be able to go with me. Since the company is paying, they will probably want me to fly. I will have to deal with rental cars and a hotel and seeing my family all on my own. I will have to go to work and socially interact with lots and lots of people, something I'm very rusty at. Basically, it's a terrifying scenario that I'm not at all convinced I have the strength to manage.

My current coping mechanism is to pretend it's not happening. And maybe it won't. They have wanted me to travel before and either changed their minds or asked someone else to go instead. So I suppose I shouldn't get all worked up over it until it's finalized.

This is what sucks about having anxiety issues but still being able to fly under the normal radar most of the time. I'm sure no one expected this to be a big deal for me. I mean, yes, my anxiety is always an issue at work because sometimes I'm afraid to make phone calls or to speak up in meetings, but that kind of stuff is manageable. I can be doing badly in those areas and still overall be doing a good job. But I can't flat out refuse to do something they ask me to do because of anxiety. It's not like I've requested any mental health accommodations at work (although this has made me wonder if I should have). Not to mention I just don't want to formally brand myself the problem employee, especially when I have a job that so rarely forces me into large-scale scary situations like this.

On top of potentially having to do this trip, I hate being reminded that this is who I am. I feel like my life is set up in such a way that I can pass for being mentally stable most of the time. Then something like this happens, and it's like 'oh, right.' Other people can casually hop on a plane and go somewhere for a week - or casually tell someone else to do it - and think nothing of it. Whereas my first thought is 'maybe I should quit right now so I don't have to do this.' In general, most people can deal with so much more than I can deal with. I pass for mentally stable because I live in a tiny box where going shopping without getting panicky is a great accomplishment.

I know this shouldn't actually make me think any less of how well I've been doing. I'm just frustrated because I was planning on working my way up to this trip, and I should have been working faster. Whether this ends up happening or not, I should be working faster and harder than I am. I don't know why I expect that life will always proceed according to my super-gradual exposure hierarchy. 

obsessive thoughts

I can't decide if I'm doing a particularly good job lately of living by the "emetophobia shmemetophobia" motto. I guess in some ways. But I've been noticing many areas where I need serious improvement.

I volunteered to help out at an event at my old college this weekend. I was at a registration table for some of Friday and most of Saturday, which meant having to socialize with a lot of people (and reflect on how terrible my social skills are, but that's a whole other issue).

It was early afternoon on Friday when I first got there, and one of the very first things that happened - I mean, probably within fifteen minutes of me showing up - was that a janitor walked by and stopped to inform me that I should be glad I hadn't been around this morning, because someone had thrown up in that room. She of course didn't know about my phobia and was just following that weird custom of gossiping about any vomit one has seen or heard about recently. I don't quite understand why people love to do this - maybe they feel compelled to because of their own disgust over the situation. I've encountered it many times in my life, but this was probably the first time in several years. It gave me déjà vu, because it's always so similar with the person lowering their voice and giving you this sly and almost gleeful smile. I've got something good, it's really really good, it's going to make me super popular with everyone, because it's about vomit! It's stuff like this that makes me want to stay home and never interact with anyone again.

She didn't give too much detail except to say it was "gross" and that it had all been cleaned up, but after she left I could not stop thinking about it. Wondering where it had been. Was I sitting right on top of it. Wondering, of course, if it had been from sickness or drunkenness or something else. I couldn't let it go, and it tainted the whole weekend for me.

My one success is that I still ate, and I ate pretty normal amounts. I'm proud of myself for that, because having heard this story, I didn't particularly want to anymore. I also only had one brief period (about five to ten seconds) of feeling on the verge of panic because of imaginary "sick" feelings. The rest of the time I felt fine.

But I couldn't bring myself to eat in the campus dining hall (the closest available food) and walked to a restaurant in town instead. The dining hall is buffet style, and I kept thinking the most likely way to catch any sickness going around would be to share food with all the students.

What really bums me out about this is that when I was a student there, I ate in that dining hall almost every single day and usually didn't worry about it that much. Now it seems like a terrible and dangerous idea. I've been thinking about this and realizing that my germophobic tendencies have gotten much worse since college. I guess that makes sense, because these days I am usually at home, which means I feel like I'm rarely in contact with other people's germs. That's not true at all. I still go out places, and even if I didn't, my wife does, and other people come to visit here occasionally. I'm not at all isolated, I just have the illusion of being isolated. It makes me feel safer, and then on the other hand it makes me much more anxious about certain situations and places that I used to be able to handle.

Logically I know that someone has probably thrown up in every single room on that campus, and that it was even happening when I was living there. I lived there for four years and encountered plenty of illnesses. I caught a lot of colds but managed to avoid the stomach bugs. Possibly that was just luck. Either way, it makes much more sense that I would have gotten sick then, while living there, than now, when I was just working there for the weekend. But it didn't feel that way to me. I felt like I left the safety of my apartment and walked into a hotbed of various illnesses.

On both days, the first thing I did when I got home was put my clothes in the hamper and jump in the shower. Then I thought about how that behavior has been gradually developing over the past few years, where I feel the need to get rid of all contact with the outside world when I come home from certain places that I feel were particularly dirty or germ-filled. In some of the books on OCD I've read, they talked about how people with extreme germ-focused OCD will have "outside clothes" and then have to change into their inside/home clothes as soon as they get home. This reminds me of that, and while the thought of me getting to that point seems ridiculous right now, I probably shouldn't dismiss the possibility. Which is unsettling.

All that extra anxiety just because I happened to hear about an instance of vomit that happened that day, even though it's likely happening all the time without me hearing about it. It's so difficult to get something like that out of your head once it's in there. It makes me think about how I watched the original short for the horror movie Mama on Youtube a few weeks ago and ever since then, I can't stop myself from imagining her standing behind me at night when I turn off the lights to go to bed. I normally don't let myself watch anything in the horror genre anymore. It was a tiny act of defiance (against my own limitations) that was clearly oh so stupid.

Sometimes I stop right before I flip the light switch and wait until I can think of something that is not scary that will hold my attention long enough for me to get to the bed. Sometimes that works. I wish that technique was as effective in the emetophobia situations, but there is no destination point (like the bed) where it feels like the obsessive thoughts can be let go, so instead I just have to keep reminding myself to replace them with positive thoughts, over and over and over.  

a month of nothing / thoughts on family

Last month was the (fun but crazy) Warped Tour, and next month is going to be busy-ish. We're going to have a friend staying here one weekend, and we'll be taking a little trip another weekend to go to a festival. Then I have a check-up near the end of the month, and going to the doctor always stresses me out. So I've been taking this month to relax and do pretty much nothing. Nothing big, anyway. No major challenges.

I got an email from my mother asking me if I would meet her in NYC sometime to hang out. She said she wanted to take me to a play. I know this is contradicting my last two posts, but this is something I can't say yes to. There is a difference between challenging yourself to move a little bit out of your comfort zone and attempting to do something so beyond your comfort zone that you know it can't possibly go well.

About five years ago, I took a trip to NYC with my wife. We spent five days there. She understands what I can handle, and we did everything as low key as possible - didn't plan a ton of things to do, took frequent breaks between activities, spent a ridiculous amount of time in our hotel room. Even though I was with the person who makes me feel safest, and we took all those steps to make it a calm trip, my anxiety was still a huge problem. I suppose I can say that I handled it okay for the most part, but there was one night where I got so anxious that I spent most of the night in the bathtub. I was watching episodes of Family Guy on my iPod trying to drown out the noise of rain hitting our hotel room's air conditioner, because I actually thought it was going to make me go insane if I had to listen to it for one more second.

Looking back on that now, it seems like such an obvious sign of the breakdown that was coming two years later.

I do feel guilty sometimes, because I've cut off my family in a way. It's too expensive and too much of an ordeal anxiety-wise to go down to visit them. I definitely can't go off to meet them in some big city for a Broadway play and a carefree good time. But also, I don't like the idea of them coming here unless I could convince them to do absolutely everything on my terms. I just feel like they don't understand anxiety or at least don't understand what my life is like because of it. I don't know how to explain it to them, and I worry that if I tried, they would think it was something that could be easily and pretty quickly fixed (such as by throwing some medication at the problem) and would see me as an idiot for not having done so already.

So I guess in general, it always feels like a bad idea to even be around them, because who knows what might happen? And then what? I wouldn't be able to explain and/or they wouldn't be able to deal with it. I'm sure it would just result in me feeling embarrassed. It's a weird situation when your family basically doesn't know you at all.

I've been thinking and thinking about this but haven't responded to my mom's email yet (which is about two weeks old at this point), because with all the thinking, I haven't figured out what to say to her. At some point, I have to give them something, so I'll probably suggest they come here. It seems like the easiest option. 

vacation update

I'm still on vacation. I have had Internet access but up until now have been either too busy or too overwhelmed to even think about what to write here. I'd love to make this entry have a coherent message, but I'm guessing it's going to be more of a blow-by-blow recounting of events. I haven't gotten the best sleep this week.

The first two days were the traveling days. We drove for six or seven hours each day. We got lost twice, once around NYC, once around Philadelphia. I managed my anxiety pretty well while in the car, except for the fact that I hardly ate or drank, because I felt "nauseous" a lot of the time. It was the first nights in the two different hotels that really threw me. It took hours of reassurance from my wife (that I wasn't going to throw up, go crazy, die, or always be this way) before I felt okay enough to get any sleep.

As is usually the case, two days of bad sleep and inadequate eating/drinking led to me feeling horrible. When I woke up Tuesday morning, I felt slightly less anxious but couldn't get up and walk around without feeling nauseous and dizzy. I decided I needed to cancel all my plans for that day and just spent the day in the hotel room forcing myself to eat and drink as much as possible. It was upsetting / frustrating, but necessary. Sometimes the hardest thing about all this is having to accept that I can't do whatever I want whenever I want. I get jealous of other people who can keep pushing themselves without taking a break, who could have packed a million activities and social interactions into a vacation this long. Sometimes I have to work within my limits, and for now, sometimes that includes missing out on things I was really looking forward to. But I'm sure that won't be the case forever.

I did visit my family briefly that night, because I thought I might get a guilt trip if I didn't make it to their house within 24 hours of arriving in the city. That went well, no anxiety attack there, so I knew I was heading back in the direction of normal.

The next day, finally, was like actually being on vacation instead of in hell. I felt almost 100% better physically. First thing in the morning, I went back over to my parents' house, because now my older sister was there with my 15-month-old nephew. I got to meet him for the first time. He wasn't sick at all. I still worried he might throw up on me whenever he coughed, but he didn't. I spent a couple hours with him, and we played with all his toys together. He is adorable, and I love him so much. Spending that time with him really cheered me up.

I also went to the company I work for and saw all the coworkers I haven't seen in two years, which was awesome. I love them all too and have missed actually being around them. My anxiety got really high again though. I think it was partially because I'm not used to being around so many people who know me and are all looking at me, and partially because I knew some of them had been sick recently. I ended up spending a few minutes hiding in the bathroom until I didn't feel so nauseous and shaky. I didn't even really care though. I was so happy to be there that I couldn't muster up the usual annoyance I feel at myself. Seeing them plus seeing my nephew made me feel certain that this trip was a good idea, that it was all worth it, even though it has been challenging. Besides, I'm almost positive I'm not going to get sick. I took Emergen-C for a few days before we left, I take a regular multivitamin every day, and I'm generally very physically healthy and have a great immune system.

The afternoon was a lot of fun too. I hung out in the hotel room with my wife and an old friend of ours from high school. I went to see my grandmother, who is the sweetest woman in the world. I don't think I know anyone who knows how to love people as unconditionally as she does. In the evening, I went back to my parents' again to hang out for a while. Despite doing all these different things, I managed to eat well the entire day!

Today I'm "embracing" my limits again. Both my family and my wife's family are having Thanksgiving meals / gatherings, but I decided not to go to either. I really wanted to go to the one with my wife's family, because I haven't gotten to see my sister-in-law or mother-in-law very much while here. But both gatherings are in another city, and I know a long drive, lots of people, and pressure to eat is likely going to result in me feeling "nauseous" for hours. I know I could handle it, but I really don't feel like forcing myself to get through something else. So I'm hanging out in the hotel for most of the day and seeing my family one more time tonight after they get back from their party. We're leaving early tomorrow morning, and possibly these last two days of driving will be just as bad as the first two days, so I'm sure it's a good idea to have a "chill day" before that.

This trip has really driven home the fact that there is a lot more work I need to do in order to get to the point where I can function the way I want to. I'm definitely going to be recommitting to recovery hardcore when we get home. Less thinking about and resenting my anxiety all the time and more actually doing the things that will help.

Oh, but the good news is that I didn't take any anti-nausea, anti-emetic, or anti-anxiety medicine on this trip. I either talked to my wife or used word searches and crosswords, my emWave, and affirmations to calm down. I'm really proud of that, and of how well I managed to eat overall despite feeling "sick" for hours every day. I suppose I can go as far as to say that this trip has been a good representation of the "emetophobia shmemetophobia" mentality. Not everything went perfectly, but I bounced back like a badass.