I promise I didn't forget my writing duties, I've just been busy with a hundred other things. I also started writing an extremely compelling post about a week ago which I abandoned about three-fourths through my train of thought. Maybe I'll resurrect it one day when I can think again.
It's been a successful couple of weeks for me. After about six weeks my medications all started working together the right way a couple of weeks ago. Since then I have flown cross-country and back and performed live. All of that with no panic, manageable anxiety, and no major depressive periods. I am extremely pleased.
Tomorrow I am off to San Antonio and back here Wednesday; Louisville next Monday. These travel days are getting long, but it is good preparation. I don't know if I've mentioned it, but many folks that read have surely heard I'm heading to Kenya in April. I think this would be a fair source of anxiety for most anyone, so for me it is something to consciously manage. Needless to say there will be a counseling session or two between now and then.
I'm not going to linger tonight. I really just wanted to process on 'paper'. I know it's not exciting, preachy, educational, or any of the other drivel you've come to expect from my posts; but going into this thing I warned you I might just talk life and, well, sometimes life's details are boring. Sometimes boring is good.
Monday, January 31, 2011
Saturday, January 15, 2011
...and Beyond
I know I cut the last post off rather abruptly. It was intentional, as the entire episode, while rather drawn out, took a very different turn after the hospital stay. Needless to say ending up in the hospital wasn't on my list of things to do. It did teach me and my doctor a big lesson- pills aren't always enough.
I said in an earlier post that my doctor prescribed me Paxil and, once I started feeling better, I thought it was enough. I was wrong.
My doctor thought pills were adequate since this wasn't triggered by some life event. I thought, since the doctor told me this was true, that he was right. Little did I know that, even throughout my stay on medication, my anxiety and depression levels remained above normal. That is because medication is not enough- if you want to remain at a place where you can 'feel' you have to combine therapies- both drug and talk.
A week after my hospital stay I had a sit down with a psychologist. I had seen counselors before, this part was nothing new. What was different is that this was not for life's events or stress, this was actual treatment for a mental illness. That was very different for me. This was not a nice little session about coping skills or working through interpersonal issues, this was psychotherapy.
The doctor started taking me through my issues using a method called Cognitive Behavioral Therapy (CBT). I'll give you the short version of how this works- instead of avoiding things you dislike or make you uncomfortable, you sort of say 'bring it on'. Now that has generally been my way of dealing with issues, but when something causes you to panic or be depressed you tend to do things to prevent that. I always felt like that was just good planning. Seems good planning is just a good excuse.
I have spent my life being prepared. I have rehearsed every line for every situation I would could ever be in. I have done very well in life being prepared. The problem with panic- you can't be prepared. The problem with being prepared is you expect perfection. The problem with expecting perfection- when you miss, and you always do, you end up depressed. My desire to never be surprised is probably the greatest exaggerator of my anxiety and depression. I have spent countless hours nervously working my way through tomorrow's scenarios just to end up spending weeks over yesterday's mistakes.
So now I am learning to be surprised. I don't say that to mean I've started going through life unprepared- I will never do that. What I am doing is learning that there is always the one thing you couldn't prepare for and it's okay if it happens; you deal with it when it does. The other thing I have started to recite is the Serenity Prayer. It's a little trite, maybe a little overused, and no, I'm not in AA or any other twelve step program. I do,though, think it is very appropriate.
I said in an earlier post that my doctor prescribed me Paxil and, once I started feeling better, I thought it was enough. I was wrong.
My doctor thought pills were adequate since this wasn't triggered by some life event. I thought, since the doctor told me this was true, that he was right. Little did I know that, even throughout my stay on medication, my anxiety and depression levels remained above normal. That is because medication is not enough- if you want to remain at a place where you can 'feel' you have to combine therapies- both drug and talk.
A week after my hospital stay I had a sit down with a psychologist. I had seen counselors before, this part was nothing new. What was different is that this was not for life's events or stress, this was actual treatment for a mental illness. That was very different for me. This was not a nice little session about coping skills or working through interpersonal issues, this was psychotherapy.
The doctor started taking me through my issues using a method called Cognitive Behavioral Therapy (CBT). I'll give you the short version of how this works- instead of avoiding things you dislike or make you uncomfortable, you sort of say 'bring it on'. Now that has generally been my way of dealing with issues, but when something causes you to panic or be depressed you tend to do things to prevent that. I always felt like that was just good planning. Seems good planning is just a good excuse.
I have spent my life being prepared. I have rehearsed every line for every situation I would could ever be in. I have done very well in life being prepared. The problem with panic- you can't be prepared. The problem with being prepared is you expect perfection. The problem with expecting perfection- when you miss, and you always do, you end up depressed. My desire to never be surprised is probably the greatest exaggerator of my anxiety and depression. I have spent countless hours nervously working my way through tomorrow's scenarios just to end up spending weeks over yesterday's mistakes.
So now I am learning to be surprised. I don't say that to mean I've started going through life unprepared- I will never do that. What I am doing is learning that there is always the one thing you couldn't prepare for and it's okay if it happens; you deal with it when it does. The other thing I have started to recite is the Serenity Prayer. It's a little trite, maybe a little overused, and no, I'm not in AA or any other twelve step program. I do,though, think it is very appropriate.
- God, grant me the serenity
- To accept the things I cannot change;
- Courage to change the things I can;
- And wisdom to know the difference.
Tuesday, January 11, 2011
The Absolute End
I started to post yesterday and it completely fell apart. It's been a week since I wrote anything because I have been struggling where to take this next. I want to complete the story, but I want to share what's going on today. With that, I think it is only logical to complete one so we can move to the next.
So to really tell the story of my life and how I got to where I am today would take a lot more than what I have invested so far. I've shared the very abbreviated version of where I can first identify mood issues to the point where I thought I was past mood disorders. Yes there is a lot more to the story, and as I move forward with the present I hope to incorporate the greater details of my past. But to get to where that is possible I think I need to complete the short version.
I last left off the history with coming off of all medications. I also shared that I did that on my own and highly discourage anyone from trying it. It is unpleasant and can be extremely dangerous. I was very fortunate. As I said, it took me a couple of weeks to stop having the constant withdrawal symptoms. After the worst of the withdrawal I had some issues off and on for a couple more weeks, but by and large I felt fine.
There was no real struggle in the time following coming off of Paxil. I changed positions at work, up to a position with a good deal more responsibility than my previous, but it was in the same department with the same supervisor so I felt fairly comfortable. I guess all of that helped me, as I did not really feel a lot of anxiety in that period. In hindsight I will say I went through some periods of depression during that time, but I largely wrote that off as the transition from shift-work back to an eight-to-five.
The other piece of the puzzle during that time was medical. I had noticed a proliferation of lymph nodes on the right side of my body. I was concerned, my doctors were concerned, and my family was concerned. There were lots of tests, even a surgical biopsy- all clear. No cancer, rather it appears a lingering virus or an autoimmune condition. Neither are life threatening so we held at wait and watch.
I can't say that it was the first time I had faced or considered my own mortality. As part of my anxiety, panic, and depression I have considered my own mortality many times over the years. It was the first time in many years I had considered my mortality as an untreated individual and I did very well. I wasn't frightened, I was sad at times, and the uncertain moments were particularly frustrating. All of that said, I was able to handle it all with great amount of poise.
After all of that was over I fell apart. Just short of three months after my last Paxil I began to experience the overwhelming anxiety I had felt years before. Within two weeks of the anxiety I was having panic attacks followed by debilitating anxiety and deep depression. Two days following the first of those panic attacks began a cycle not unlike the one that caused me to seek treatment initially. Recognizing what was happening I immediately called my doctor who called in a prescription for Paxil.
The next three-and-a-half days are a bit of a blur. They are quite possibly the longest three days of my life, yet I remember very little of what happened. I know this- we were prepared for the initial panic attacks that come with starting the meds. We did it on a weekend knowing the kind of panic the first couple of days can bring. Shelly guided me through hell on Saturday, the day after the first dose. Sunday morning brought something much worse and we feared we wouldn't be able to shield the kids from my attacks, so we sent them to my parents' house. Monday morning I couldn't take it anymore.
Sunday afternoon I actually wanted to die. I was scared of dying but I didn't want to live. Monday morning I was scared. I was scared because I still had no desire to keep living. Uncontrolled thoughts of what the most painless way to stop living kept rolling through my mind. I didn't feel safe. I had a doctors appointment already set up for one that afternoon, but I had Shelly call to see if they could get me in sooner. They told us to come right away.
I came completely unglued in the doctors office. They hustled me into a patient room so I didn't have to hold onto the panic in the waiting area. I let go- tears, hyperventilation, rapid pulse, numb hands, all the classics. My nurse and doctor saw it all and knew what to do- he prescribed me another drug, Klonopin, to get me over the hump of Paxil ramp-up. I took my first Klonopin and felt like myself in less than half an hour.
Klonopin is a wonder- in the right dosage. I had never taken Klonopin before and my doctor prescribed me 1 mg. I thought that was nothing, but obviously it's substantial. The Klonopin absolutely smashed the panic and anxiety, but by Tuesday it had me in the deepest depression of my life. We all knew something more had to be done.
I spent three nights in the hospital. The staff was great, the doctors were great. They kept me safe and they got my medicine straight. I got the dosages regulated, set up with a counselor, and set up with someone to manage my psychiatric medication.
So to really tell the story of my life and how I got to where I am today would take a lot more than what I have invested so far. I've shared the very abbreviated version of where I can first identify mood issues to the point where I thought I was past mood disorders. Yes there is a lot more to the story, and as I move forward with the present I hope to incorporate the greater details of my past. But to get to where that is possible I think I need to complete the short version.
I last left off the history with coming off of all medications. I also shared that I did that on my own and highly discourage anyone from trying it. It is unpleasant and can be extremely dangerous. I was very fortunate. As I said, it took me a couple of weeks to stop having the constant withdrawal symptoms. After the worst of the withdrawal I had some issues off and on for a couple more weeks, but by and large I felt fine.
There was no real struggle in the time following coming off of Paxil. I changed positions at work, up to a position with a good deal more responsibility than my previous, but it was in the same department with the same supervisor so I felt fairly comfortable. I guess all of that helped me, as I did not really feel a lot of anxiety in that period. In hindsight I will say I went through some periods of depression during that time, but I largely wrote that off as the transition from shift-work back to an eight-to-five.
The other piece of the puzzle during that time was medical. I had noticed a proliferation of lymph nodes on the right side of my body. I was concerned, my doctors were concerned, and my family was concerned. There were lots of tests, even a surgical biopsy- all clear. No cancer, rather it appears a lingering virus or an autoimmune condition. Neither are life threatening so we held at wait and watch.
I can't say that it was the first time I had faced or considered my own mortality. As part of my anxiety, panic, and depression I have considered my own mortality many times over the years. It was the first time in many years I had considered my mortality as an untreated individual and I did very well. I wasn't frightened, I was sad at times, and the uncertain moments were particularly frustrating. All of that said, I was able to handle it all with great amount of poise.
After all of that was over I fell apart. Just short of three months after my last Paxil I began to experience the overwhelming anxiety I had felt years before. Within two weeks of the anxiety I was having panic attacks followed by debilitating anxiety and deep depression. Two days following the first of those panic attacks began a cycle not unlike the one that caused me to seek treatment initially. Recognizing what was happening I immediately called my doctor who called in a prescription for Paxil.
The next three-and-a-half days are a bit of a blur. They are quite possibly the longest three days of my life, yet I remember very little of what happened. I know this- we were prepared for the initial panic attacks that come with starting the meds. We did it on a weekend knowing the kind of panic the first couple of days can bring. Shelly guided me through hell on Saturday, the day after the first dose. Sunday morning brought something much worse and we feared we wouldn't be able to shield the kids from my attacks, so we sent them to my parents' house. Monday morning I couldn't take it anymore.
Sunday afternoon I actually wanted to die. I was scared of dying but I didn't want to live. Monday morning I was scared. I was scared because I still had no desire to keep living. Uncontrolled thoughts of what the most painless way to stop living kept rolling through my mind. I didn't feel safe. I had a doctors appointment already set up for one that afternoon, but I had Shelly call to see if they could get me in sooner. They told us to come right away.
I came completely unglued in the doctors office. They hustled me into a patient room so I didn't have to hold onto the panic in the waiting area. I let go- tears, hyperventilation, rapid pulse, numb hands, all the classics. My nurse and doctor saw it all and knew what to do- he prescribed me another drug, Klonopin, to get me over the hump of Paxil ramp-up. I took my first Klonopin and felt like myself in less than half an hour.
Klonopin is a wonder- in the right dosage. I had never taken Klonopin before and my doctor prescribed me 1 mg. I thought that was nothing, but obviously it's substantial. The Klonopin absolutely smashed the panic and anxiety, but by Tuesday it had me in the deepest depression of my life. We all knew something more had to be done.
I spent three nights in the hospital. The staff was great, the doctors were great. They kept me safe and they got my medicine straight. I got the dosages regulated, set up with a counselor, and set up with someone to manage my psychiatric medication.
Tuesday, January 4, 2011
Say Peanut Butter and Jelly
I'm sitting here with my entire family squishing our faces while we say, "Peanut butter and jelly." It's dumb but it's fun.
So what in the world does this have to do with panic, anxiety, or any mood disorder? Nothing and everything. I said I wanted to explore life in this blog too, and sharing that is an exploration of what life has going on right now. I also said I want to continue to explore the disorder, and sharing this is also an examination of how life gets all turned upside down when your mind is out of sync.
Children are miracle. Everything they touch is new and marvelous. They find even the simplest things magical and the most complex things simple. They see the best in everything and can always find comfort in the arms of those that love them. A child's eyes are absolutely a reflection of the light of the world.
Mood disorders are erosive. They slowly work at your foundation, chipping away slowly while you are unaware. You rarely have any idea there is a problem until your entire foundation begins to crumble.
As children, in the magic simplicity, we see the light of the world. The light in which our foundation is built upon. As adults we pile garbage on top of the foundation, occasionally dig it out, we see it being built in our own children, and we build everything we believe about life on top of it. No matter what we build our foundation on, right things or wrong, it is from where we draw our joy and reason for living.
The destruction of your foundation also brings the inability to understand how to rebuild the foundation. There is a depth of hopelessness in that no one else can understand. That is the moment, even though you know no one else can understand, you must reach out. When the magic of childhood is nowhere to be found, not to be dug up through the junk, but has crumbled, it is time to find a mason.
There are lots of options, and it really depends on the depth of where you are what option you take, but take an option. Family members, clergy, psychiatrists, psychologists, social workers, help lines, psych wards. Don't have anyone or anything? Go to the emergency room. Get help, get your foundation back. You can rebuild your life, no matter how bad you think it is, but you will never get it built without your foundation.
So what in the world does this have to do with panic, anxiety, or any mood disorder? Nothing and everything. I said I wanted to explore life in this blog too, and sharing that is an exploration of what life has going on right now. I also said I want to continue to explore the disorder, and sharing this is also an examination of how life gets all turned upside down when your mind is out of sync.
Children are miracle. Everything they touch is new and marvelous. They find even the simplest things magical and the most complex things simple. They see the best in everything and can always find comfort in the arms of those that love them. A child's eyes are absolutely a reflection of the light of the world.
Mood disorders are erosive. They slowly work at your foundation, chipping away slowly while you are unaware. You rarely have any idea there is a problem until your entire foundation begins to crumble.
As children, in the magic simplicity, we see the light of the world. The light in which our foundation is built upon. As adults we pile garbage on top of the foundation, occasionally dig it out, we see it being built in our own children, and we build everything we believe about life on top of it. No matter what we build our foundation on, right things or wrong, it is from where we draw our joy and reason for living.
The destruction of your foundation also brings the inability to understand how to rebuild the foundation. There is a depth of hopelessness in that no one else can understand. That is the moment, even though you know no one else can understand, you must reach out. When the magic of childhood is nowhere to be found, not to be dug up through the junk, but has crumbled, it is time to find a mason.
There are lots of options, and it really depends on the depth of where you are what option you take, but take an option. Family members, clergy, psychiatrists, psychologists, social workers, help lines, psych wards. Don't have anyone or anything? Go to the emergency room. Get help, get your foundation back. You can rebuild your life, no matter how bad you think it is, but you will never get it built without your foundation.
Sunday, January 2, 2011
Really, Really Broken
Having laid bare the fact I am completely nutty, I want to move more to the place that got me where I am today. I think in my last "history lesson" I left off at the beginning of my first treatment experience. With that, I want to expose some more of the journey to today.
As I said in the first post, I was first prescribed the drug Paxil in the fall of 2005. To be technically correct it was Paxil CR at 12.5 mg a day. After a month or so it was bumped up to 25 mg a day where things stayed for a pretty good while.
That first experience was a wild ride. The first two weeks were vicious. The second day of taking the drug I had the worst panic attack of my life. The fourth day I had a panic attack so bad Shelly called the paramedics and they rushed me to the hospital, pumping me with a nitroglycerin inhaler, thinking I was having some sort of cardiac event. Turns out, as I said, that it was another panic attack and I also had bronchitis. Antibiotics, Lortab, keep taking Paxil- golden. I continued to have more mild panic attacks and general anxiety until, after a couple of weeks, the panic attacks virtually vanished.
The entire condition was diagnosed and treated by my regular internist. I asked him if I needed any sort of counseling- psychologist, psychiatrist, stress counseling, anything. He told me it was a purely biological condition and as long as Paxil turned up to be the right drug we were golden. Since after a few weeks I had basically forgotten I ever had panic attacks I felt like he was right.
I must admit, in hindsight, that all wasn't completely well. It took months to get the general anxiety under control- if it ever completely did. Since I really didn't know what Generalized Anxiety Disorder was and its effects, and I wasn't having the awful panic, I was happy to say I was fixed. Nonetheless, after a time I realized my thoughts were pretty well under control and I could enjoy things I had never been able to attempt before.
In late winter 2009 I had surgery which caused me to go off of Paxil for three days. This was my first experience with Paxil withdrawal. Thankfully I was in the hospital receiving aftercare from the surgery and I was so doped with pain medication I really had no clue what I was going through. I do know this- I was so tied up with anxiety my nurse sat in the room with me for nearly two hours while Shelly went home and took a bath and did other business. I was literally scared to be alone. I have no idea what I was afraid of, but I was certainly afraid.
When they allowed me to return to taking my medication post-operatively, they moved me to the immediate release version of Paxil at 20mg a day. After two or three days I was right back to good again.
I chugged along with things for another year-and-a-half. I felt great. All of my panic was gone, my anxieties were at a normal level, and I was really progressing in my career. Things were going perfectly and I though I was fine. My Paxil prescription ran out and I took myself off of the drug. I must highly recommend against this to anyone who may be thinking of it.
About two weeks of dysphoria, wild dreams and nightmares, suicidal ideations, and a little something folks refer to as brain zaps- all very unpleasant things. That was true, hardcore, Paxil withdrawal. It was no fun, but I had read up on all of it and was ready. I did it and made it through with flying colors. I was on my on and feeling fine.
For about three months everything was great. I dealt with a lot during that time and I didn't need any help doing it. I knew I was fine. What did I know?
As I said in the first post, I was first prescribed the drug Paxil in the fall of 2005. To be technically correct it was Paxil CR at 12.5 mg a day. After a month or so it was bumped up to 25 mg a day where things stayed for a pretty good while.
That first experience was a wild ride. The first two weeks were vicious. The second day of taking the drug I had the worst panic attack of my life. The fourth day I had a panic attack so bad Shelly called the paramedics and they rushed me to the hospital, pumping me with a nitroglycerin inhaler, thinking I was having some sort of cardiac event. Turns out, as I said, that it was another panic attack and I also had bronchitis. Antibiotics, Lortab, keep taking Paxil- golden. I continued to have more mild panic attacks and general anxiety until, after a couple of weeks, the panic attacks virtually vanished.
The entire condition was diagnosed and treated by my regular internist. I asked him if I needed any sort of counseling- psychologist, psychiatrist, stress counseling, anything. He told me it was a purely biological condition and as long as Paxil turned up to be the right drug we were golden. Since after a few weeks I had basically forgotten I ever had panic attacks I felt like he was right.
I must admit, in hindsight, that all wasn't completely well. It took months to get the general anxiety under control- if it ever completely did. Since I really didn't know what Generalized Anxiety Disorder was and its effects, and I wasn't having the awful panic, I was happy to say I was fixed. Nonetheless, after a time I realized my thoughts were pretty well under control and I could enjoy things I had never been able to attempt before.
In late winter 2009 I had surgery which caused me to go off of Paxil for three days. This was my first experience with Paxil withdrawal. Thankfully I was in the hospital receiving aftercare from the surgery and I was so doped with pain medication I really had no clue what I was going through. I do know this- I was so tied up with anxiety my nurse sat in the room with me for nearly two hours while Shelly went home and took a bath and did other business. I was literally scared to be alone. I have no idea what I was afraid of, but I was certainly afraid.
When they allowed me to return to taking my medication post-operatively, they moved me to the immediate release version of Paxil at 20mg a day. After two or three days I was right back to good again.
I chugged along with things for another year-and-a-half. I felt great. All of my panic was gone, my anxieties were at a normal level, and I was really progressing in my career. Things were going perfectly and I though I was fine. My Paxil prescription ran out and I took myself off of the drug. I must highly recommend against this to anyone who may be thinking of it.
About two weeks of dysphoria, wild dreams and nightmares, suicidal ideations, and a little something folks refer to as brain zaps- all very unpleasant things. That was true, hardcore, Paxil withdrawal. It was no fun, but I had read up on all of it and was ready. I did it and made it through with flying colors. I was on my on and feeling fine.
For about three months everything was great. I dealt with a lot during that time and I didn't need any help doing it. I knew I was fine. What did I know?
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