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.

my "safe foods"

I'm back from vacation. The rest of it was pretty much the same - seeing people and having fun, but all while feeling "sick" and/or anxious. Experiencing anxiety that high almost constantly for an entire week is unusual for me, and it's strange to reflect on it now. Every day I was at some point convinced I was going to throw up, but I didn't. So much of the trip spent worrying about something that never happened. Then I start thinking about how much of my life in general I've spent worrying about it. And it hasn't happened in 16 years. It blows my mind.

The drive home was especially bad. I forced myself to eat and drink much more than I had on the drive there. Which was a good thing. I didn't have to deal with the high anxiety that comes from being dehydrated and light-headed, where everything starts feeling surreal. Plus I'm sure it helped me readjust to eating once I got home. But in the moment, it sucked. I felt "nauseous" for most of the drive.

It's been four days since we got home, and I already feel completely back to normal physically, which is huge for me. I was half-expecting that I still wouldn't be able to eat an adequate amount for the first week or so. I'm still feeling anxiety when I eat, but even that seems to be going away much faster than I thought it would.

I wanted to write about the foods I usually eat when I am having really high anxiety and feel unable to eat. Not that I'm saying they make up a balanced diet. I'm the last person to give nutrition advice - I'm pretty terrible at eating healthy. It's just a list of foods that feel safe to me, because they are easy on the stomach:

1) An egg and cheese sandwich. I heavily rely on these during my bad periods. They're delicious. There are so many different options for the bread part: bagel, croissant, English muffin, toast, biscuit, waffles. If I am feeling really "sick" I usually just go for a plain bagel and sometimes even leave off the cheese. But bread and egg, easy on the stomach, plus (so important when you're not eating well) you're getting protein in there.

2) Luna bars. I ate a ton of these on the trip, especially when I had to eat in the car. I don't eat anything without washing my hands first, which is not really convenient on a long drive. But granola bars or nutrition bars you can hold in the wrapper without touching. With Luna bars, you're getting protein again and also vitamins. The only downside is they're not high-calorie. They're pretty small, which is partly why they always seem manageable to me. Mini-meals.

3) Cereal, toast, pasta. I love all of these simple carbs when I feel anxious. Cheerios has always been one of my super-safe foods. It used to be pretty much my only safe food. I remember one trip I went on where I only ate Cheerios the entire time. So unhealthy, plus everyone around me thought I was insane. Now I try to avoid eating only foods that fall into this category, since they are usually lacking in the protein area.

4) Bananas. I don't love the way they taste, but they're healthy and convenient / portable like nutrition bars. They're in their own little "wrapper" so you don't have to touch them. Plus they're dense / filling, and you can find ripe ones pretty much wherever you go.

PMS / vitamins / exercise

I'm heading into that PMS time of the month, so I thought I would write a little about that.

I used to be pretty unaware of how much PMS affects my anxiety, but over the past year, I've come to see how my anxiety always spikes at this time. I'll be doing really well, and suddenly it will feel like I've lost control over my emotions again. Last night I didn't feel well after eating dinner, and I became convinced that I was going to throw up, even though I really think this episode of "not feeling well" was no worse than usual. After I calmed down, I was kind of shocked that my anxiety had escalated so quickly. All signs pointing to "oh yeah, PMS." It's back, wreaking its havoc.

But even though it's still a tough time for me, it's not as bad as it was several months ago when I first started noticing the pattern.

For one thing, that in itself - being aware of it - has been a huge help. Now I am prepared for it every month, and when my anxiety starts to get worse inexplicably, or when I start feeling really upset/depressed or frustrated about my anxiety, I know that is most likely the cause. That knowledge helps me stay calm, because I can remind myself that it's temporary. I've started training myself to avoid thinking about certain topics, high-anxiety topics, during PMS. For example, my wife and I are planning a vacation for Thanksgiving. I am excited, but the thought of it also stresses me out a lot. During PMS, if I think about this trip, I usually feel none of the excitement and about ten times more overwhelmed than I do at other times. I start to worry and worry about every little facet of it, and it only ends up making me feel like it's going to be a disaster. So now, if I start to think about it during PMS, I just tell myself "you don't need to think about that right now" and move on to something else.

I also started taking a 100mg B6 vitamin every day in addition to the standard multivitamin I was already taking. This extra B6 has helped so much. I would say it's almost miraculous. Not only does it reduce my general PMS symptoms (including the intensity of my emotions, it seems), but it has made my menstrual cramps less painful. Cramps have always triggered emetophobic anxiety for me, and the more pain I felt, the more anxiety I felt. So that is a huge relief.

Yoga and/or exercise are also supposed to be amazing for helping with PMS. I have seen a little evidence personally, because I was doing yoga almost every day for a couple weeks, and that month I felt a lot better than normal during my period. I would love to be able to say more about this, but I have yet to maintain a regular yoga or exercise schedule. This is something I have been wanting to do for months, and I have made several attempts, but they always die out. Apparently the only exercise I truly enjoy is playing tennis, and for some reason, there are no free open-to-the-public courts in our area.

Anyway, even though I am not currently exercising, I firmly believe in its power to make things significantly better. For anxiety in general, not just PMS-related anxiety. I'm still hoping I'll someday motivate myself to start exercising again and to actually stick with it so that I can enjoy the (many) benefits of it.