in remission

Hello friends. How have the last two years been for you?

I definitely did not intend to stop posting here in such an out of the blue way. Life got very busy, or maybe I should say it's been one giant change after another. I feel like if I put the me who wrote the last post and the current me next to each other, in terms of anxiety, in terms of perspective on life, they would not be recognizable as the same person.

I moved to a new place. I started a new job. I met new people. I had to travel a bit for the job. I had to do public speaking for the job. I had to do a lot of things for the job that forced me to power through intense anxiety, which, as you might expect, has led to me being somewhat desensitized to a lot of situations that used to make me panic (or that I would constantly avoid).

My emetophobia is essentially dormant right now. It's still there, it will always be there, but it's the quietest it's ever been. It basically tells me to avoid sick people and make sure I have clean hands before I eat, and that's about it.

I'm summarizing, because this is a blog, and the actual details could fill a book. At least if I allowed myself to go on as long as I'm naturally inclined to.

But I don't want to give the impression that this muting of my emetophobia happened quickly or easily (or even that healthily). I pushed myself way too hard the past couple years. I powered through way more than I should have, for way too long, and the stress broke me down. I am still experiencing a lot of anxiety (it has just shifted and is currently attached to other things more so than vomit) and depression.

So, as much as I wish I could say this is a perfect success story, that I conquered emetophobia completely and am a role model for anyone still struggling, that is laughably untrue. I'll probably never be free of mental illness; it likes to morph into different forms year to year, but it sticks around.

That being said, emetophobia has been one of those forms for about two decades, and I never thought it would (or could) get to the point of having this little effect on my life.

I remain a walking encyclopedia of tips for coping with emetophobia (this will always be the case, I'm sure), and ... that's all. I'm around. I'm here if anyone needs anything, or if there is something in particular someone wants me to blog about. Email (lilandbody@gmail.com). Or leave a comment. Or contact me through tumblr. Hope everyone is well. Love to you all.

work trip

It’s been a while since I posted. I’ve been spending a lot of time thinking about posting. I finally went on that trip for work, and of course the plan was/is to talk about that – what went well and what didn’t. But it’s now been six weeks since it ended, and I wrote (literally) close to fifty pages in my journal about the experience, and I still feel like I don’t have a firm grasp on what I should or want to take away from the whole thing. The sort of “life lesson” – not that everything in life has to result in a life lesson, but this was so big that it feels like it should have changed me or my life in some fundamental way. Maybe that’s just a fantasy of the chronically anxious – “I did something terrifying and I handled it – aren’t I going to get anything out of it?!”

But nothing is really different, other than the fact that I’m not constantly thinking and worrying about this trip anymore. Which is strange in itself, because it took over my brain for so long. It was all-consuming. Almost every night before I fell asleep, I was going over some aspect of it in my head: imagining what I might say to people, what they might say to me, things I might have to do that I didn’t think I could do, what I’d wear, what I’d eat, how I’d get around, everyone I would have to see, how the flights might go, what the airports would be like, all the many ways things could go wrong. I probably should have attempted to stop obsessing, but it was so comforting, even something I looked forward to on some level. Now that I don’t need to do that anymore, it’s like there’s this giant void in my mind.

And I was prepared for that. I knew that when I no longer had this to dread and/or look forward to, I wouldn’t know what to do with myself. Part of me had been excited about it. It felt meaningful, to be forced by outside circumstances to live and interact with the world to an extreme. To an extent I could never force myself to. Now everything is simple again – calm and quiet, which is nice, but also dull. Time passing and normal routine and no Huge Event looming on the horizon to test my limits. I think if they had suddenly told us at the last minute to forget the whole thing, we weren’t going to do it anymore, I would have been miserable. Incredibly relieved, but also miserable.

In other words, I’m never satisfied. How can you be when you feel two completely opposite things at the same time? It reminds me (again) of what I’ve talked about here before, the connection between anxiety and excitement, between fear and the desire for what you fear. It does seem like the two frequently coexist in me.

I think if the trip had never existed, had never been proposed in the first place, I would be fine. I think I’m happier when my life is calm and quiet and dull. But with the alternative fresh in my mind, it’s very hard for me to let go of the fantasy of having a life that is non-stop excitement, intensity, and stimulation and becoming the type of person who can thrive in a life like that. I’m better off not thinking about it.

Anyway, now I’m home again, and I have all this restless energy left over, and I’ve been trying to direct it towards 1) being more productive at my job 2) writing and submitting poetry.

As for how the trip went, I would say pretty well, overall.

• The closer I got to the trip, the more I felt like the only way I could get through it was to be upfront with people about my anxiety and my limitations. Which I think is a very good idea in theory. Unfortunately, it got a little out of control to the point where I was probably revealing too much (and too quickly, since I was interacting with people who were essentially strangers). Which possibly means that a lot of people I work with now have a skewed idea about just how extreme my anxiety is. And it doesn’t matter that now my mind has settled down again and I’m behaving more normally, because that was their first impression of me, and it’s nearly impossible to correct a first impression.
• Other than that, I felt like the social interaction went better than I had expected. I’m not sure why I feel that way, because I avoided people and I was quiet and when I had to speak, I was almost always panicking that any second I would say something that would somehow ruin my entire life. But I didn’t say anything that ruined my entire life, and other people told me I was coming across as normal (because – see bullet point above – I wouldn’t stop talking about how socially awkward I was), so I’ll count it as a success.
• I had a hard time eating before or during work, which led to me feeling shaky and nauseous most of the time. In the evenings I would eat in my hotel room and feel a little better, then wake up the next morning feeling like shit again.
• Even with feeling sick so much of the time, I did not have any extreme panic attacks and only a couple minor (and short-lived) anxiety attacks.
• I slept better than I thought I would. I woke up early every morning because I was so paranoid that I would sleep through the two different alarms I had set. But it still worked out okay, because I was going to bed early too and didn’t have any trouble falling asleep.
• I was able to concentrate on training. That was one of my biggest worries, that I just wouldn’t be able to focus or retain any of the new information I was supposed to learn, so I was happy that wasn’t the case.
• I work with some incredibly nice people who (many times) went out of their way to make things easier for me. So I’m glad I was more honest about what I wanted/needed than I usually am. I just need more practice navigating the line between ‘self advocacy’ and ‘presenting my entire identity as Anxious Person.’
• There were no major issues with the actual traveling part. I still don’t like flying, especially taking off and landing. But by the time I was flying home I had gotten to the point where I almost felt at ease when we were actually up in the air. 12 flights in about four months, and I finally got a little bit desensitized.
• I’m alive? And still employed? And to my knowledge, I didn’t make anyone hate me. I’m pleased with that outcome.

self-advocacy

So you have anxiety. And that means for every situation you come across that involves other people and triggers that anxiety, you have to choose between two options.

One is that you power through it and endure the anxiety. The other is that you ask to be excused from it or to reach some sort of compromise where you still do it but in a way that is more comfortable for you.

This is also complicated by the fact that you want to get over your anxiety, or improve as much as possible in your ability to live the life you want, which usually involves some level of exposure therapy and challenging yourself. You know you should power through. You know you tend to feel good about yourself when you’re able to.

But that doesn’t mean you should or can force yourself through any triggering experience that comes up. For one thing, exposure therapy is supposed to proceed by gradual steps. It works best that way. Taking a step you’re not ready for can do more harm than good. Also, it’s exhausting. It’s so unbelievably exhausting to confront intense anxiety on a regular basis. If that means an experience comes up that you probably could handle, but you would rather make some adjustments to make it easier on you – solely because you’re tired of having to handle things that are super overwhelming – you shouldn’t be put down for that. It’s not the same as being constantly avoidant. It’s making a choice to be kind to yourself, to let yourself have a break from having to work so hard – in ways that are often not visible to the people around you, so even though you have to hear a lot about the ways in which you’ve failed to live up to the behavior of a non-anxious person, you rarely get any praise for what you do manage to accomplish.

I have such a hard time with self-advocacy. Trying to figure out whether it’s a good idea. Whether it’s okay. How long to cling to my “demands” before letting it go and accepting I’m not going to get what I want.

I don’t trust myself at all. I don’t like advocating for myself. I hate debating. I hate sounding defensive. I hate the thought that I’m being seen as a burden, someone incomprehensible and exasperating that has to be dealt with. I hate acknowledging the minor things I’m trying to avoid, and even more so, I hate the tone of voice the other person almost always gets that makes me feel ridiculous, the tone of voice that says ‘what is wrong with you? how can this possibly be an issue for you?’ I hate having to repeat myself over and over because people don’t listen, don’t take in things that don’t make any sense to them.

I hate the fact that other people are so quick to belittle me in subtle ways that it doesn’t take long at all before I am completely mired in guilt and self-doubt. I start thinking there must be something wrong with me to have even started this conversation. I wonder if I’m doing it to get attention. But I’m not, because I would much rather the person have just agreed to what I wanted from the start without acting like it was a big deal at all. I wonder if I really need what I’m asking for. I usually conclude that I don’t, because I decide I will survive whatever the situation is, even if it’s ten times more miserable than it needs to be. I decide I need to put the other person first, because this is obviously a much bigger sacrifice for them, even though they usually don’t have a full understanding of what I’ll be dealing with, because I’m not forthcoming enough about it. I tend to feel like I talk about my anxiety constantly, too much, and I don’t even think that’s true. For how big a presence it is in my existence, I’m sure I talk about it way less than I would be inclined to if other people didn’t respond the way they did (getting all uncomfortable, implying that I really need to do something about it because it makes me wrong, it makes me not fit in, and it would be good if I could fit in, conform to society’s model of success, etc.).

The whole process is unpleasant and I think there have been times self-advocating has ended up causing me more anxiety and misery than if I had just done the anxiety-producing thing.

Looking back over my entire life, I don’t think I have ever asked for an accommodation that extreme. I have asked for things that should be simple and easy to say yes to. For example, when I refused to do presentations in school. I went to my teachers and I told them I couldn’t do it, and it was fine if that meant they had to give me a zero for the assignment. I didn’t say they had to give me an alternate assignment. Or even imply that they would be a horrible person for failing me (although I do kind of think they were). All I said is that I would prefer failure to giving the presentation, that I was choosing the zero grade. That was my choice to make. And most of the time they were absolutely horrid about it – rolling their eyes or scoffing at me, pretending they didn’t hear me and then calling my name to present anyway (forcing me to go back up to them and insist again that I wouldn’t do it, this time with more people witnessing it), saying over and over again ‘no, you have to’ every time I said I wouldn’t, acting really angry about it for no good reason I could see.

I had one teacher who actually got it. Instead of making me present, he met with me one-on-one and we had an informal conversation about the topic of my presentation. Did this lead to the ruination of my education? No. He gave me a chance to get the grade I deserved, the grade that reflected my understanding of the subject matter. That’s all that happened. He encountered someone with anxiety issues and treated them decently. Shockingly, life went on and tragedy did not ensue.

Anyway, I guess I just wanted to explore my thoughts and feelings on this topic, because I am attempting to ask for accommodations at work. So far, it has not been going well, and as usual, it’s making me feel crappy about myself. And I know I shouldn’t feel that way. I’m not doing anything wrong – even if they end up denying my requests. Even if they get huffy and act like I’m deliberately trying to make their lives harder. Even if there is a part of me that thinks I could manage without what I’m asking for. I’m not a terrible person for wanting to eliminate a tiny fraction of the stress this trip is going to cause.

traveling yet again / exposure

The sick relative that I went to visit at the end of May died earlier this month. It was of course sad but not at all unexpected. She had been sick for a very long time and was continuously getting worse, so at least she is not suffering anymore.

I kind of had this idea that I wouldn’t go back down to Virginia for the funeral, since I don’t share the consensus that funerals provide closure. I had gone to visit her one more time while she was alive, and that was what mattered. I dreaded the thought of having to go through the anxiety of the trip again. But I couldn’t stop thinking about my family, imagining them all going through this awful process without me, and the more I thought about it, the more I realized I didn’t actually find that version of the future believable. It was a weird feeling, knowing I just had to be there. Even though I was still going through my usual indecisive back-and-forth, part of me knew there was only one option and that no matter what ended up happening on the trip, I would be more miserable if I didn’t go. Because I would no longer be the person I want to be (or the person I am?).

So anyway, I went back down there for another long weekend. And this time, I went alone; my wife wasn’t able to go with me. I took a different flight route and went through two airports I had never been to before. I stayed with my family, both to offer support to them and to try to save money and avoid the hassle of a hotel (which was a terrible mistake, and I forgot being around my family for extended periods of time has a horrible effect on me, but whatever). I went to a wake/viewing and funeral, something I had not done since I was 13 (before my intense fear of death developed). I socialized with a ton of people, family and strangers (and family members I hadn’t seen in so long they were essentially strangers). I hung around my young nephews again. All of these things made me nervous and tense, but I didn’t have any panic/anxiety attacks.

When I think back over the past few months, I’m amazed. It doesn’t seem possible that all this has happened, especially in such a short period of time. I am always trying to motivate myself to create an exposure hierarchy and actually stick to it, and I don’t do it - more out of laziness than the fear of it not going well. But life stepped in and did it for me, even proceeding from an easy step (slow-paced planned trip to New York City by train with my wife) to a slightly harder one (fast-paced last minute trip by plane to Virginia with my wife, staying in a hotel) to the most difficult/stressful so far (fast-paced last minute trip by plane to Virginia alone, staying with my family). Throughout all this, the trip I have to take for work (which probably will be the most difficult of all) has been repeatedly postponed and is currently scheduled for mid-September. I definitely feel a lot more prepared for it and confident that I can handle at least some aspects of it, like the traveling.

And it’s not even just that I “handled” all this. Some parts of it gave me such a high. Particularly the last most challenging trip. I feel bad saying that, given the circumstances of why I had to make the trip, but getting on planes and rushing through airports alone trying to find my gate tapped into this part of me I don’t usually acknowledge. The part of me that wishes I was the complete opposite of who I am, someone who exudes confidence and has everything together. It’s really rare, but every once in a while I feel like I am that opposite-of-me person for a little while, and I always, always love it.

It reminds me of this post I wrote a long time ago (see here) about the idea that anxiety is actually a projection of, or in some way related to, the feeling of excitement. I want so much to be able to face any person, any situation, any challenge (and come away from each encounter with the certainty that I succeeded completely) that it makes everything more terrifying. It means so much to me, that fantasy - an unrealistic and probably unhealthy fantasy, I guess - of being perfect and extroverted and effortless and charming. I know I’m never going to be that person, at least not to the extent I want to be, because I can’t change my entire identity/personality. But it’s nice to have those brief moments where I feel like I am coming across that way to the people around me. And it’s also nice to view anxiety as, in some way, an indicator of my dreams and goals and not just as the sick/defective part of me.

improvement

The trip to Virginia was a complete success! I seriously can’t believe how well I handled it, especially with all the phobia “triggers” it included:

• Flying, which leads to worries about motion sickness (something I never have a problem with, but I always worry I will), other people getting motion sickness, and catching some illness from someone on the plane.
• Socializing frequently with people who may or may not be sick. I was only hanging out with my family, and they don’t know and/or understand and/or care about my phobia (we don’t really talk about anything emotional, so I am unsure who knows/understands what). So I could not rely on them to look out for me by warning me that they were sick or had been sick recently. It seemed like one of them might have a cold, so that was a little stressful, but nothing came of it. For all I know, it was allergies.
• Spending a lot of time in a hospital. I was mainly there to visit a relative who has cancer, so I was in the hospital with them for a few hours each day. I knew I couldn’t catch the diseases of the people around me, but I still felt “contaminated” by germs. Even hugging my sick relative felt unsafe, but I did it anyway. My parents tried to harass me into eating in the hospital cafeteria, but that was something I could not bring myself to do.
• Hanging out with my very young nephews, a one year old and a four year old. This probably stressed me out even more than the hospital. They were all over me, and the one year old even put his hand right on my lips as soon as I walked in the door. Plus they unpredictably cough on you, and every time they eat, I can’t stop thinking about how they don’t know the limits of what they can consume without being ill. On the other hand, they are so adorable and sweet, and I really had a great time with them. I hadn’t met the one year old yet, and I hadn’t seen the four year old since he was a baby, so he didn’t remember me and was excited to “meet” me and show me all his books.
• Spending long stretches of time away from my wife and my “safe space” (usually home, but in this case the hotel room). I would leave in the mornings and hang out with my family most of the day, not getting back to the hotel until the evening. I don’t spend that much time out in public by myself anymore (since I started working from home). Usually when I’m out somewhere for a whole day, my wife is with me.
• Eating while on vacation. This didn’t go quite as well as it did in New York City, because I avoided eating while around my family. But during the times it was just me and my wife, I was completely fine and able to eat normally. We bought a few safe snacks from a grocery store to keep in the hotel room just in case, but we didn’t even eat most of them. We mostly went out, and I got to have all the delicious food I have missed from my hometown that I hadn’t had in SIX YEARS, because when we went down there in 2011 I could barely eat anything.

I didn’t have any panic attacks or intense episodes of feeling “sick”. No feeling dizzy or crappy because I couldn’t eat. No having to cancel plans because of that. No inability to sleep. And not that much holding back from what I wanted/needed to do. I’m so glad that I went and was able to offer some support to my sick relative and the rest of my family.

Compare this to the way the trip went in 2011 (see post here), and I’m amazed at how much has changed in four years. And I wasn’t even aware of it! It’s so weird to have actual strong evidence that all the work I’ve put into getting better has actually gotten me somewhere. I have often felt like I’m not doing enough, but it has helped so much anyway. I think it helped just to make the commitment to learn to think a different way, because now, even when I lapse into old negative thought patterns, there is that sense that I am doing something wrong which leads to the motivation to get back on track.

It also helps that I take better care of myself physically now, specifically when it comes to eating habits. Trying to eat healthier, plus forcing myself as much as possible to eat regularly, on a normal schedule, has cut down on instances of feeling “sick” so much, and that of course means I don’t get anxious as frequently. Seriously. My stomach used to hurt all the time from going long periods of time without eating, and I just kept telling myself it was better and it was safer not to eat, that not eating had to lead to less stomach pain, or would ensure I was safe from getting sick even if I felt stomach pain. The reality is that it made me feel terrible, and then I wondered why I felt terrible all the time and experienced near constant anxiety because of it.

So I’m super pleased. If I can take trips without having some kind of meltdown, even when they are stressful or short or last-minute trips, that would be such an incredible improvement to my life. I want to be able to travel. My dream of eventually getting to Europe is seeming much more within my reach.

more traveling

The trip for work got pushed back again. Now they are saying maybe it will be a few weeks from now. It’s been at least a year since they first brought it up. The other day I was trying to say that this trip would be hanging over me the rest of my life, but I accidentally said “lives” instead. And you know, I think that’s more accurate. I’ll be reincarnated, some confused little kid thinking “I don’t even have a job! Why do I have to go on a business trip?”

But now another situation has come up where one of my family members is in very poor health, so I am having to go down to Virginia anyway, this weekend, to see them. I mean, I don’t have to in this case. It’s my choice. But it still doesn’t really feel like it is, because even though I want to see them, I don’t want to make this trip and am dreading it so much. I want to stay home and have things be normal.

I just have to keep reminding myself it’s important and I can’t be selfish all the time.

Plus there is another bright side to this. The trip is going to follow the exact route I’ll have to take when I go on the work trip (if that one ever actually happens), and since this one is a short trip over a weekend my wife can go with me. So it’ll be like a practice run, which I think will be really helpful.

All signs pointing to this being the right thing to do. And yet it still feels like a horrible decision made by someone who isn’t me, and I want to crawl into a cave where no one will ever expect or need me to do anything ever again.

As usually happens, my brain has already started assaulting me with extra irrational thoughts. “Your hands will only really be clean if you wash them in THIS sink. The other one’s no good.” “If you wear mismatching clothes to bed, you’ll get sick.” Things that make no sense, just little things that I guess make me feel like I am in control. Or could be in control, I should say, because I’m doing my best to ignore these thoughts. But it’s strange how they suddenly appear and feel absolutely true even though I can see how insane they are.

I’m hoping I’ll feel better once we leave and I have to start going through the motions of getting through this. The anticipation is always the worst part. I’m so used to my safe routine and it feels surreal to even imagine doing something else. But in reality, it probably won’t be that strange.

I mean, the NYC trip went so much better than I thought it would. Maybe this will be totally fine. Sometimes I think I am stuck in this mentality of thinking my anxiety is still as bad as it was a few years ago. That’s obviously not true. I think back to things I said or wrote during that time period and can barely remember what it was like to feel that way. I guess that’s part of the worry - that things got so terrible so fast, and it was so unexpected, and I am still not even sure why it happened. Part of me wonders if something will set it off again, as unlikely as that seems.

At least this trip will give me plenty more opportunities to try out the CYEAT book’s special technique for fighting negative thoughts.

trip postponed

My work trip got postponed again! I shouldn’t be surprised, because they have been talking about this trip for about a year and keep pushing it back, but I was fairly certain it would actually be happening this time because the flights had already been booked.

At first I was incredibly annoyed, because I had gotten attached to the dates and had been planning non-stop and resigning myself to the fact that I would be doing this soon. I already went shopping and bought new professional clothes. I got my hair cut. I told my family I was coming. And then all of a sudden it was being called off. Now they are saying the trip might be in early June, but those sound like tentative dates, so basically I am back to knowing nothing. Which is frustrating.

At the same time, I’m now feeling so relieved I won’t be getting on a plane in a couple days. I was starting to have moments where I would be lying in bed in the morning, thinking “am I really going to be on my way to the airport one week from now?” and it didn’t feel real at all.

Anyway, it sounds like I have at least another month to prepare. Not that I can have any expectations, because hey, it’s much more fun for them to be unpredictable and wreak havoc with my stress levels. Maybe by Monday morning they’ll have decided it’s going to be next week.

But if nothing else changes, I’m sure I’ll be getting back to the CYEAT book in the meantime.

recap of NYC trip

I am home again - for the next week or so. First trip of the month completed, and it went really well. It went so well it was shocking and a little disorienting. Because one of the many downfalls of anxiety for me is that when I expect to have horrible anxiety during something and I don’t, it makes me feel strangely lost. I started feeling like I didn’t know myself, and then I started thinking really irrational things like “wait, do I even have anxiety problems? have I been exaggerating all this time? were all those terrible things I went through over the past few years lies?” And of course they weren’t - how could they have been? That doesn’t make any sense. I wish my mind didn’t only think in extremes.

The trip wasn’t perfect. I did experience some anxiety, but mostly in the realm of mentally obsessing over germs/contamination, which I see as better than intense emotional anxiety or physical symptoms like nausea. I was very aware all the time of the dirty things I was coming in contact with - cabs, public restrooms, train stations, etc. I’m used to feeling like my environment is very sanitized and I had to lower my standards and just try to get over the fact that I was not going to feel like things were clean enough for a week.

I had some trouble sleeping (thanks in large part to the hotel bed being incredibly uncomfortable). And there was one morning where I did feel really nauseous for a few hours and started to freak out. But I managed to calm myself down and decided I would relax in the hotel that morning instead of going out like I had planned. By the afternoon I felt fine again and we resumed our wandering through the city.

Not bad at all, considering what happened last time. I did not spend a night in the bathtub. I did not ever feel like I was going to legitimately lose my sanity.

But the biggest accomplishment is that I ate a normal amount for practically the entire trip. I don’t know if I have ever managed to do that before on a long trip like this. And that may be the main reason why the trip went so well, because when I don’t eat, it makes me feel terrible, and that makes my anxiety worse. Once that cycle starts, it’s hard to stop it.

All of this should probably make me feel more optimistic about the Virginia trip, but it doesn’t really. My stomach still feels like it’s dropping into my feet every time I think about it. I try to tell myself that since I was able to eat well in NYC, I should be able to do the same in Virginia, but then I think I can’t really compare the two. Virginia is going to be a lot more fast-paced and will involve tons of situations outside my comfort zone, and lots of social interaction, and I won’t feel as in control of any of it. I can’t exactly decide to take a morning off in the middle to regain my composure.

I talked to my boss about the social events, and she was really nice about it and said I could skip them if I felt like I couldn’t handle them, but she wanted me to be open to attempting to go to them, because it would be such a good opportunity to interact with everyone. So I guess I am going to try, at least for the first “welcome” event. I’m starting to wonder if it would just call more attention to me to skip them anyway. I don’t know. What’s more embarrassing, being noticeably absent from every social event, or going to them and being super nervous and maybe not being able to eat and having to come up with some excuse for why you’re not eating? I really can’t decide.

traveling

I keep trying to motivate myself to blog about the next chapter, but I think I’m going to have to accept the fact that CYEAT posts are going to be on hold until early to mid May. Because I can’t think about anything but the two week-long trips I am taking this month. So I’m going to write about that instead.

I mentioned in here a while back that my bosses want me to travel to Virginia for a week of training. It was originally supposed to be sometime last fall or winter, but it kept getting delayed. Now it’s finally happening, during the last week of this month.

Which is about the worst timing ever, because my wife and I also planned a week-long trip to NYC that starts at the end of this week and goes into next week. That trip alone was already stressing me out, and that’s going to be the easier one. The one where my wife is with me and we go at a slow pace and she makes sure I don’t get too overwhelmed.

No matter how carefully we navigate it, I know I will experience a lot of anxiety and it will really wear me out. And now I’m going to get back from that trip, have about a week and a half to relax and get back to homeostasis, and then have to leave for the training trip, which will be a thousand times harder. And I’m pretty sure I’ll be spending most of that in-between time obsessing over the second trip rather than relaxing. I already can’t stop obsessing about the second trip even though right now I should be preparing for the first one.

There are, I guess, three major concerns I keep going over:

- The actual traveling part. I hate flying. I hate all public transportation. We’re taking a train to NYC and that’s a little easier for me, but taking a train to Virginia could potentially take a full day (or night) and I don’t want that. So I figure I will suck it up and do the plane. But I have only flown alone once before, and it was in 2007. Pre-breakdown. I honestly have no memory of how I managed it. Everything seems so much harder now. So I will have to fly and navigate an airport, because of course there will be a layover, possibly more than one. Then once I get there, my boss has arranged that the hotel shuttle will take me back and forth to the work building. Screw that. I will probably rent my own car so I can have control over my coming and going. Oh, and also, as of right now, I can’t find a good flight connection, which may mean I will have to fly into an airport in a city a couple hours away and then figure out how to get to my destination from there. And I am not comfortable driving on the interstate. The only solution I can come up with so far is that my mother picks me up (and drops me off again at the end of the trip) because she lives nearby. But I’m not loving that idea either.

- Eating, drinking, sleeping. Any time I get really stressed out, I start doing all of these things less. This always happens to me on trips. I don’t feel well, so I don’t eat or drink as much. I get super dehydrated. My blood sugar is low all the time. I feel weak and shaky and sick and weird. Everything around me feels kind of surreal. But if I try to force myself to eat and drink more, that makes me feel nauseous, especially if I am trying to eat around other people or if I attempt to eat anything that isn’t completely bland. And it starts to feel almost physically impossible, since I have no appetite. After a day or so of that, I’m exhausted and it feels like an ordeal even to get out of bed. But I’ll have to get out of bed, go to work, focus on training, and socially interact with people. I’m thinking I will probably plan out every single thing I’m going to eat in advance and try to stick to that meal plan as much as possible, but I’m not sure how successful I will be.

- The social interaction. I’m not around people much anymore, and it’s honestly a huge relief most of the time, because I have a very strong desire to appear perfect to everyone around me combined with an inability to stop being horribly awkward. Which I think usually comes across as me being rude rather than scared (ignoring people, nervously laughing at things I shouldn’t laugh at, blank stares, sarcasm, and general stoicism). My boss has planned five socializing meals for us to attend. They all sound terrifying. It sounds like a few will involve large groups of people, including many people I have communicated with for several years but who have never met me face to face, so they will probably want to meet me face to face, and it’s too much to even think about. It is my goal to get out of every single one of those. Especially because three of them are lunches on training days, and if I go to those and am not able to eat, I don’t know how I will make it through the afternoons.

Also, I have no way of knowing how many panic attacks I’m going to have while I’m around my coworkers. It’s funny, because I used to work in the building with them, so it’s not like I haven’t dealt with that before. I have had anxiety attacks during one-on-one face-to-face meetings with my boss and been able to hide it. So it’s likely I’ll still be able to hide it pretty well. But part of me worries. I’m out of practice. And then of course there’s the fact that I don’t want to have anxiety attacks, whether I can hide them well or not, because they are miserable and further contribute to me feeling completely exhausted and out of it. But I don’t think I’m going to be able to avoid that. I’m guessing I will have them during the training sessions, when I feel most obligated to be composed and focused, when I know it would be bad for me to leave the room because that is after all what I’m there for. To try to learn something in the midst of all this insanity.

I probably should have fought harder to get out of this trip. I did try to get out of it, but it was a pathetic attempt, because I get too embarrassed to lay out exactly how bad it’s going to be. And I get scared thinking “am I really going to bail on something else? am I seriously going to be this person all my life?” I want to be able to do things. This particular thing feels way out of my reach, but I don’t know. Maybe it won’t be as bad as I’m imagining. I just have to do it. I have to do it, because it’s even harder to handle the thought of saying ‘no, absolutely not, you have no idea what this is going to do to me.’ And part of me worries I would end up getting fired.

I have internalized so much mental health stigma and it makes me feel guilty to even be saying some of this, because I believe people should push back more in these situations and advocate for themselves. I just feel like I can’t do it anymore. I have done it so many times and gotten so many horrible reactions. I had teachers in high school who literally made me cry because they were so mean to me for refusing to give class presentations, even though I told them I didn’t mind taking a zero for the assignment. Wouldn’t it be nice if the automatic reaction was to say ‘that’s fine, there are of course perfectly valid alternatives to presentations (or intense week-long out of state training sessions) and this doesn’t make you a lesser person at all‘? I think society is heading more in that direction, but it’s taking a long time.

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. 

personality changes from anxiety

Can a period of severe anxiety (or a nervous breakdown, emotional collapse, whatever you want to call it) change who you are forever?

This is a question that has plagued me over the past few years. After my anxiety spiraled out of control in 2010, I felt like I changed almost overnight into a very different person. Other people didn't seem to agree with that assessment, which was comforting, but I was obsessed with the idea that I was different, that it had destroyed/ruined me, that I would never recover, never be "the same" again. And I kept focusing on every change I noticed and claiming it was proof or at least cause for concern, from completely minor changes that didn't even matter to the really big ones.

I expected these alterations in my personality / behavior to go away almost immediately. I definitely expected them to go away after weeks and months of anxiety-fighting work. What's funny is that most of them have gone away by now, but it happened gradually over about 3 years, and during that time it seemed like I was throwing my hands up every month and saying "it's been six months! It's never going to happen!" or "I've done everything I'm supposed to do and I'm still not myself again!"

Some examples (I do so love to make lists):

•  My entire life (for as long as I can remember) I have slept curled up on my side. After my breakdown (and even in the weeks leading up to it), I couldn't anymore. I started feeling like I could only sleep on my back. Whenever I lay on my side, I felt convinced I was hurting myself in some way, crushing my organs, or squishing some part of my body to the point that I would end up cutting off circulation, and this would cause me to die in the middle of the night. Even lying on my back, I had trouble falling asleep because I didn't know what to do with my arms. I didn't want them lying next to my body because when they pressed against me, I felt that same 'being squished' sensation. It seemed at the time that I could even feel the pain of this imaginary crushing.
  
  This went on for a very long time. I think it's only been within the past few months that I've finally started to go back to my old sleeping position. Also, I think it was one of the changes that freaked me out the most, even though it had no real significance. Maybe because it had no real significance. I couldn't understand why it had happened and just saw it as evidence that I wasn't me anymore, not even in the most relaxed scenario possible.
  
  
• When I was younger, I had problems eating in restaurants and usually would refuse. When I went out to meals with my friends, they all knew this and didn't expect me to eat, and even some of their parents knew and didn't push the matter. But from around the last year of high school up until the breakdown, I had made serious progress in this area. For example in 2009 (1 year, 2 months before breakdown) I went out to lunch with my boss. Ate normally, small-talked, no panic. After the breakdown, I lost my ability to handle restaurants again and frequently complained about this and how I thought I would never be able to eat normally in one again. I know I've mentioned this issue in a lot of my posts. I would say I'm still not fully back to where I was, but I was absolutely wrong about it being a permanent setback. It's obvious to me by now that I'm continuously improving in this area.
  
  
• Same for long car rides and vacations. When I took that vacation to VA in 2011, I was a mess. I wrote about it here and tried to put a positive spin on it, as I always do, but I was barely functional for most of the trip. I haven't taken another trip to someplace that far away since then, but I feel certain it would go better if I did. I've taken smaller trips since then. Stayed in hotels. Went to Warped Tour. I got through all of that while still feeling like a sane human being - even, I would say, feeling like myself.
  
  
• I had terrifying intrusive thoughts. It was very OCD-like, but I didn't have any compulsions. It may have been something I read about called pure-O, or just my brain's total meltdown. At first I was afraid I was going to kill my cat, and I was afraid to go near him. That only lasted about a week or so. Then that switched to being afraid I was going to kill myself, which lasted much longer. Several months. I didn't want to kill myself, but I thought I would anyway, that my body would just go on auto-pilot and do it, out of my control. I think it was because I was so anxious / unhappy all the time, and I worried it would never get any better. That caused a nightmare chain reaction in my brain. "Not happy --> things will not get better --> you will kill yourself --> oh my god, but I don't want to --> too bad, you won't have any control over it - after all you didn't have any control over this happening in the first place --> no I can't let this happen! must tell someone and/or have them watch me to make sure I don't do anything" etc. I got so panicked over this one day I called my wife and made her come home from work to keep an eye on me.
  
  This has gone away completely. It went on for about a year. I think the last time I had that thought was the end of 2012.
  
  
• I couldn't handle sad/dark books or movies or shows. This was a big adjustment for me, and I was incredibly frustrated by it, because most of what I liked to read was dark in some way. I couldn't read anything that referenced death or suicide. I couldn't read anything that was gross or gory (including things that aren't even that bad, like accounts of childbirth) or surreal or that caused any intense emotion (so that was basically everything). I even remember freaking out while reading a young adult book because of a part where one of the characters fused with a chair. The simple (but surreal) idea of someone becoming half-chair was too much for me.
  
  This has been gradually going away over the past few years and I think I am finally at the point where I can read/watch anything without having an anxiety attack over it. Except maybe horror movies. I'm still being super cautious with those. I'll probably never go back to watching the extremely scary ones I used to. 

This is getting long, so I'll stop. My purpose in writing all this is just to point out that everything did seem to change drastically, and (especially because the breakdown itself was so traumatic) it was scary to feel like I had lost myself, and I convinced myself I was irreversibly damaged. And that wasn't true. Now I'm seeing that it was all temporary. Of course it was hard to be patient and rational at the time, because everything was so unpleasant, but looking back on it, I can see that it was unreasonable to keep telling myself that because x amount of time had passed, I was clearly going to be this different person forever. As much as I wanted to, I didn't get to dictate how much time it would take to recover.

Maybe it is partially true that the experience forever changed me, but if so, it's in a more positive way than I am used to thinking. Yes, it was intense and horrible, and I'll never forget it completely, and I learned a lot from it. By that I mean I learned how to ensure it never happens again. I learned to take care of myself, both physically and mentally, enough to keep myself from a complete mental collapse. There's still a lot of room for improvement, but I have reached the point where my day to day life is manageable, and I have reached the point where I feel like I have my identity back. Those are both things I used to think I would never be able to say again.

mastering restaurants and other things

It's been way too long since I posted here. Last month I was working on another writing project and this month I've been preoccupied with Christmas, trying to think of what to get everyone. Other than that, not much has been happening.

I can only think of two emetophobia-related incidents that happened recently. One good, one not so good.

The not so good one was a couple nights ago when I went out to eat with my wife. I've got to say, I think I've generally been doing really well with eating out at restaurants. I finally figured out how to deal with the situation, because two things happen to me when I eat at a restaurant. One is that I switch over to my "restaurant stomach" or in other words, my stomach appears to shrink in size. I know it must not actually be shrinking, but because of anxiety, I can never eat the amount in a restaurant that I could eat at home. But I always used to anyway. Out of habit, I would eat the same amount of food I typically eat at a meal, and then end up feeling awful. Now I have caught on to this and am forcing myself to eat way less. It usually means I don't even come close to finishing my meal, but oh well. Then I have tasty leftovers to eat later at home when I have my normal stomach back.

The other thing that happens because of anxiety: my throat becomes tight, feels more closed up, and this is mainly where I am still running into problems. I don't tend to notice this sensation in my throat, because it's very subtle, and it's a symptom I'm not that anxious about. But then sometimes when I swallow a bite of food, it feels stuck or like it's going down the wrong way or like I'm choking. That combined with the worries in the back of my mind about throwing up leads to a giant spike of panic. Which is what happened the other night. I'm talking to my wife, everything is good, and then suddenly I get this terrified look on my face as I panic that I'm choking or am going to throw up. The panic was over within a few seconds (aside from my heart continuing to pound for a while) and then I just felt silly and embarrassed. I'm pretty sure no one but my wife saw that look on my face, but the fact that I could not control it made me think about how awful it would have been if someone else had seen it. And made me flash back to all the many, many embarrassing incidents in my past where someone else did see a look like that on my face, including people who had no clue what was happening to me.

I guess I just need to keep this in mind when I go out to eat. Chew more, be conscious of swallowing and such. Sometimes I wonder if it's a good idea to work around these sensations because it feels like I am working with my anxiety instead of against it. But I don't seem to have much of a choice. I regularly go out to eat and that anxiety (so far) is not going away. The level of anxiety varies, of course, based on a million factors from my mood to the weather to whether I watched a movie/show earlier that day that showed someone vomiting. But there is always some level there, so if I want to be able to go out to eat at all, I need to adjust to these two symptoms. And like I said before, I think my adjustments are working out and making it so I can actually enjoy going out to eat, and that's nice. Not something I'm used to being able to enjoy, ever. Even with the brief panic the other night, I feel like the meal was a success.

Now for the good emetophobia-related incident. A friend came to stay with us at the end of November. He visits us pretty frequently, and over the last few years, I have been having a difficult time with these visits. Just like with going to restaurants, having someone stay with us makes my base level anxiety go up, and what tends to happen is I start getting a lot of stomach aches, almost constant stomach aches, especially if we go out anywhere. And when your friend comes to stay with you, they don't want to just sit around your house the entire time. And to make things even worse, I find it almost impossible to hide the fact that I feel sick and miserable or to keep quiet about it. So this friend has had to hear about how I don't feel well a ridiculous amount of the time, and it's a wonder he still comes to visit.

I'm sure you know where this is going. This last visit was practically PERFECT. It was the best time I've had hanging out with him in so long. I can't even say for sure why it went so well. Probably because I expected it to. I was feeling really great physically before he showed up, and I just felt confident that I would continue to feel great, that I could keep up the momentum of feeling good, if that makes sense. I was determined to. I've been feeling very guilty about what a terrible friend / hostess I've been.

As soon as he arrived, we went out to eat, and I ate more than I think I have in several years while at a restaurant with someone other than my wife. After that, we went somewhere else before going back home, which would normally make me very anxious (I always want to go straight home to digest and recover from the experience), and I was fine. We also went to see the movie Catching Fire (second in the Hunger Games series), and it was opening weekend, which meant the theater was completely packed. I was sure I would end up panicking at least a little during the movie, but nope, didn't happen, and I even had some popcorn. Also, he takes a bus when he comes to visit, and the bus station where we pick him up is a long drive from our house, about two hours one-way. I got through all eight hours of driving without any high anxiety periods (seriously, a miracle)!

It was like I was a normal person for a whole weekend. He's coming to visit again in about two weeks, and I'm excited. Because now I know it's possible, that I'm capable of handling it without any problems. Maybe it won't be absolutely perfect again, but I'm at least positive that I won't be the complete downer I've grown so accustomed to being.  

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. 

warped tour!

Last weekend I went to the Warped Tour music festival for the first time ever. It's a pretty intense event and I imagine it'd be intimidating for anyone with anxiety issues. With my blend of emetophobia and social anxiety, I considered it a major accomplishment that I even made it inside the festival. Before it opens, a line forms outside that is not really a line at all, but more a gigantic chaotic blob of people moving every which way. It was the biggest crowd I'd been part of in a long time. I was lucky to have two feet of personal space in any direction. As it got closer to the opening time, it was more like half a foot as everyone started pushing forward and compressing.

Also during this wait, lesser-known bands were walking through the crowd asking people in line to listen to their music and buy their CD/mp3. Which meant having to talk to people I didn't know and use headphones that tons of other people had been wearing before me. 

Aside from the stress of interacting with the people, it was insanely hot, which was my main worry emetophobia-wise. I was very concerned that the heat would make me sick. I rarely spend that much time in the sun, and it was 80-90 degrees. I only had one bottle of water that I was trying to conserve while waiting in the line, but then the event workers made me pour it out on the way inside (only one water bottle is allowed, but it must be sealed if you want to take it in). Basically, they want you to buy the drinks and food they are selling inside that is mega-expensive. But at least their drinks are packed in ice, so I was happy when I bought my new water bottle. I could hold it against my neck and get some relief from the heat.

Even though there was a lot more space inside the festival, it was still super crowded with people everywhere. Bands were playing all over the place, so loudly that I could feel the beat in my stomach, which made me worry for a moment that this would cause me to feel sick or panic. But with all this going on, I managed to keep it together and felt really calm the entire time I was there.

I only stayed about two or three hours, because it was just too hot and after a while I felt like I couldn't stand it anymore. I was all sweaty and sunburned (I wore sunscreen but didn't put enough on my face/neck) and started to feel dizzy, probably from hunger and dehydration. They don't let you leave and then come back, so I knew that if I stayed for most of the event, I would have to eat and drink while there. But still I let the habits of my anxiety take over and avoided anything but water, partially because I was afraid of getting or feeling sick and partially because I didn't want to use the public restrooms that were constantly packed with people. I'm sure this contributed to the dizziness/exhaustion I felt after a while that prompted me to leave much sooner than I would have wanted.

Still, I'm thrilled that I went and was able to have a good time for the most part. I can hardly believe how chill I was, especially considering how nervous I had been in the hours, days, weeks before I went. I had been obsessing about this for so long and feeling like I probably couldn't handle it at all.

But as I said in my post last month, I am trying to say yes to whatever comes along and to try things, even if I think they won't go well. There were many times I desperately wanted to back out of going. I was able to get through this because I kept saying to myself "maybe I won't be able to handle the whole event, but I can at least do this next small step." When I thought about calling it off in the days before I left, I told myself there was no need to make that decision yet. When I thought about turning the car around and driving back home while heading to the event (which was about three hours away), I told myself I would at least make the drive, and I could always turn around once I got there. When I thought about walking away when I saw that giant crowd of people standing in line, fanning themselves, I told myself I could at least try joining them and see how long I could deal with that. On and on, until I was inside actually enjoying myself.

Plus, now that it's over and I have a clearer idea of what it's like, I imagine I'll be able to handle it even better if I go again next year. I will definitely make sure to eat and drink more so that I have more energy and can stay longer, enjoy more bands.

when in doubt, say yes

There hasn't been much change with my phobia lately. I still feel "sick" at least once a day, usually when I know I have to go somewhere soon or I'm already out somewhere. Or when it's early morning and I've woken up for some reason and want to get back to sleep.

For the most part, I don't feel a lot of anxiety, and I've also gotten way better at ignoring the fake sick feelings and moving on. But it feels like I've hit a plateau and can't get to the next level. I never want to do anything but sit around at home. I have to be talked into going anywhere. I'm even anxious at the thought of going on a walk around the neighborhood, because what if I start feeling ill and I'm several blocks away from home?

I have to keep reminding myself that this isn't new at all. I have been reluctant to leave the house almost my entire life. My friends in middle and high school usually had to talk me into going to the movies with them. I would always worry about it, especially if there were going to be people there who didn't know me that well and didn't know about my anxiety issues. What would they think if I started panicking? In other words, it's an ingrained habit to want to say no, one that may take a long time to change.

I guess I'm lucky in that I've always been aware that if I didn't keep forcing myself to do these things, day after day, year after year, it would quickly lead to very bad consequences (as in being unable to even walk out my front door). I've always told myself things like "you have to do this. You didn't do the last three things. Now do this one because none of them are ever going to be safe enough."

I do feel like I've gotten worse with regards to my tendency to want to be home. I lost the momentum I had in school, having a larger circle of friends, people who always wanted to hang out, events to go to, classes to attend. I started working from home, and now it sometimes feels like I don't even know how to be in public anymore.

But I also think I've gotten better in the past couple years at forcing myself to go out when the opportunity arises. It's definitely been my mantra this year - "when in doubt, say yes." If I'm unsure about doing something, if I'm thinking things like "I'm anxious about the idea of going to hang out with people" or "what if I get sick on this car ride?" or "what if this other bad thing happens?" then I take that as a clear sign that I have to go. That it would be bad for my mental health if I didn't. I don't want to let any of those thoughts dictate what I do, especially when it means I'm going to end up sitting at home watching TV some more. Even though I feel like that is what I'd rather do, and forcing myself to go somewhere else feels like self-punishment, I usually end up having a good time and am happy I went.

It's hard to work up the courage, and I've been forcing myself to think things like "so what if I go on this walk and end up getting sick three blocks away from home?" and trying to convince myself that I believe what I'm telling myself. I know I don't actually feel nonchalant about the possibility of that happening, but it works well enough for me to take the small risk of walking out the door. It works well enough for me to focus on the fact that I don't feel sick at that moment, and if I feel sick a few minutes later, after I've already left, oh well. I'll deal with those moments when I get to them.

It works for other situations too. Like sleeping. Sometimes I will be afraid to go to sleep because I don't feel well. It used to be that I would take that as a sign that I should stay up and wait until the "sick" feeling passed and I could be sure it was safe to sleep. Now I will go to bed anyway, and I tell myself that this doesn't necessarily mean I have to go to sleep. I'm not going to sleep, I'm just going to go lie in bed and see what happens. But once I'm lying in bed, in the dark, tired, I can't stop myself from drifting off even if I'm still half-worrying in the back of my mind.

And eating. I used to refuse to eat if I didn't feel well, even after I realized that lack of eating (low blood sugar) can also make you feel sick. Now I'm training myself to go get food when I don't feel well and haven't eaten in a while. It could be low blood sugar. Maybe not, but I'll eat at least a few bites of something and see what happens. Usually it starts to make me feel better and I eat the whole thing.

So basically, whatever my phobia is telling me I shouldn't do, I am doing. I think it's working out pretty well. I went on a weekend trip recently to a place that was a 3-hour drive away. I went to game night at a friend's house. I've been taking walks regularly. I've been saying yes to whatever comes up. I still wish I could get to the point where I actually wanted to say yes, but I may be far away from that point, and in the meantime, I'm happy to report that most of my yes-es are turning out to be fun enjoyable experiences.    

two years

Today's the anniversary of my "breakdown." Actually, I guess it really started the night before with the first of the panic attacks, but this was the date where I was in the hospital all day, so I consider this to be The Infamous Day.

I never thought I would feel like myself again, but I do. I can now say I feel like my anxiety is under control, at least as much as it can be while still having a phobia. It's just exhilarating to know that. Two years ago I was such a mess, and I had never imagined that things could get that bad. And then I couldn't imagine that they would ever get this good again either.

In celebration of this, I'm posting the timeline of my improvement. This is pretty much how the last two years went:

September 10, 2010: I was in the hospital most of the day discussing my non-stop panic attacks with various people. Then they gave me Ativan, and I went home and took that immediately, and then one or two other times in the next few days.

September 11-19: I went to the doctor three times. The first time I was given Lexapro, which made me feel sick, so I only took it once. The second time I got my thyroid tested (problems with it can cause anxiety issues), and nothing was wrong with it. The third time I was given Cymbalta, and I only took that once too. It didn't make me feel sick, but it did have minor side effects that bothered me (like restless legs).

I missed a lot of work. I couldn't eat or drink much. Everything I ate made me feel nauseous; I was taking a lot of Zofran during this time. I couldn't sleep and basically spent every night in the living room, dozing with the TV on.

I started seeing a therapist and doing breathing exercises, and I listened to a guided meditation CD every day and tried to meditate as much as possible. It was not something I had done much in the past, but it helped immensely anyway. Just made me feel temporarily calmer.

September 26: I started working through The Anxiety & Phobia Workbook. I know I've talked about it a lot, but I'll say it again. It's an amazing book. It helped me so much.

October 5: I joined a gym and started exercising more to see if that would help. It does help, but I still have a hard time sticking with the habit, even now.

October 8: By this point I was doing word searches almost constantly, especially when I woke up in the middle of the night (which was almost every night). They really helped me calm down when I was anxious.

October 16: I wouldn't let myself watch anything (on TV or in movies), read anything, think about anything upsetting or anxiety-producing. I felt frustrated by having to hide from negativity, but now I think it was the right thing to do. It helped me get better faster, and obviously I no longer have to do it. But I still don't watch horror movies. I used to watch them all the time and now don't let myself, because they have too much of an effect on me.

October 20: I had gotten a little notebook and was writing out affirmations in it every day. I would pick one from The Anxiety & Phobia Workbook and write it out five to ten times in a row, pausing in between to reflect on what it was saying and really try to believe it. I did this at least once a day, but more if I was really anxious. It was another activity that calmed me down.

December 4: I started noticing that PMS always made my anxiety issues much worse. I began reminding myself of this every month around that time so that I wouldn't take my thoughts and feelings so seriously.

February 3, 2011: I started doing yoga. I don't do it much anymore, but it was helpful and calming at the time. 

April 30: I printed out some of my favorite affirmations and would tape one to the wall above my desk so that I'd be reminded of it frequently throughout the day. Every so often, I'd switch to a new one. 

May 9: I was still seeing that my anxiety got significantly worse and hard to deal with during PMS, so I started taking 100mg of B6 daily (on top of a multivitamin) to help with that. It seemed to work wonders (after a couple months I think). I still take it. 

July 23 - 26: I started having bad panic attacks again. It felt like a repeat of the initial "breakdown" only to a much lesser degree. But again, it was extremely difficult to eat or drink for a few days, and I felt horrible all the time. I'm not sure what caused this relapse, but I got it under control much faster than I had the first time, mostly through forcing myself to eat as much as possible, which kept me somewhat stable. This gave me hope that I was moving in the right direction. 

August 29: I started taking a class at a college nearby. This forced me out of the house on a regular basis, forced me to interact with the world again, which was something I really needed. I had gotten pretty homebound. 

September 10: I tried hypnosis for the first (and only) time. I felt slightly better for a few days after it, but I have no idea if it was the hypnosis that caused this. Or the placebo effect. Or coincidence. 

November 22: I took a trip to see my family for Thanksgiving. This was very stressful and didn't go as well as I had hoped. Again, I had problems eating, drinking, and sleeping. I felt sick almost constantly. But I did manage to get through it without any medication (psychiatric or anti-emetic). I used affirmations that I had written out on index cards and the EmWave2 I had just gotten.

February 19, 2012: I did an online emetophobia study which started around this time. It involved a lot of CBT and exposure work that was helpful.

May 1: I stopped going to therapy, because I felt pretty confident that I knew what to do when I was anxious. Most of the time I could calm myself down by countering my negative thoughts and focusing on more positive ones.

That's about it. I've been doing really well this year. Basically, the Thanksgiving trip was the last "crisis" period I had, and I am sure that if I took that trip again this November, it would go a lot better.

Speaking of trips, I am taking a small one later this month. I won't even be leaving the state, but I will be staying in a hotel in another city. I'm excited. For the first time in a long time, I feel excited about a trip. I'm not dreading it! I think it's going to go really well and be loads of fun.

signs of emetophobia as a child

I haven't ever known someone else with emetophobia in my "real life" (offline). I did have a strange indirect encounter with it several years ago when I happened to hear one of my bosses talking on the phone about her seven year old niece being hospitalized for refusing to eat while sick, because she was terrified of vomiting.

I don't really like telling people about my phobia in detail, and it especially seemed weird to tell my boss, but after hearing that, I couldn't resist emailing her and attaching some websites with more information. She thanked me for the information and said she would pass it on to the girl's mother. We never talked about it after that (which was a relief to me), so I don't know what happened with the girl, but I hope that if she did have the phobia, she got help for it early on. I know from experience that it only gets worse and more ingrained as you get older - you keep developing more and more avoidance behaviors.

I can think of so many obvious red flags from when I was younger that I'm sometimes shocked my family missed them:

• The biggest one, of course, being that whenever someone around me vomited, I would become upset or panicked. When I was very young, this usually bordered on hysteria. I can remember one time in a restaurant where I catapulted over a chair and ran out of the building to escape (and refused to go back in). As I got older, I tried to hide the response more, but I still would usually walk away quickly, avoid looking at the person, and then get extremely upset if I had to be in a confined space with them. I would try not to breathe or would bury my face in something thinking that might protect me from the germs. I would cry or sulk. Sometimes I would get really angry and be hostile to everyone around me.
• There was a time period (not sure how long it lasted) where I decided it was not safe to touch my food at all and would lift my plate or bowl to my mouth and eat like an animal.
• If anyone in the house was sick, I stayed in my room as much as possible. I tried to eat very little. I would sneak "safe food" into my room like individually wrapped packs of crackers. I was afraid to use the bathroom where someone had vomited, which usually meant I would start using my parents' bathroom, because the sick person was almost always one of my sisters.
• I can remember at least a couple freak-outs over me getting a little food stuck in my throat. It wasn't even enough to make me cough, but I still feared it meant I was choking, and that could lead to vomiting. One day my mom explained to me that I wouldn't be able to breathe or talk if I was choking, so then those panics stopped.
• I became extremely opposed to taking vacations with my family, because someone would usually get sick on them. When I vomited last, I was on one of these vacations. I also once had to spend eight hours in a car with my family after one of my sisters had almost vomited that morning.
• I would miss school because of my stomach hurting. From second to fourth grade, this happened rarely, about twice a year. In fifth grade, I had a period of about two weeks where I went home or stayed home every day. Each time I tried to go back, my stomach would hurt again as soon as I got into class, and I would have to leave. Since I was perfectly healthy, people were all over me asking what was "really" wrong, but I didn't know what to tell them, because I had no knowledge of anxiety at that point. In the years after that, I still sometimes went home "sick" because of panicking about something I imagined I felt, but never that many days in a row. I would say it was probably about seven days a year, spread out.

Those are all the signs I see looking back, and I imagine they'd be similar for any child developing this phobia. Not that I'm in a position to give parenting advice, but I would hope that any parent who saw their child exhibiting such irrational and anxious behavior would sit down with them and try to talk to them about it. And then if it does turn out that they fear vomiting, get them some counseling. I'm sure it's much easier to get something like this under control at a young age, maybe even cure it completely.