Ramping

Hi there.

How was everyone's holiday? We went to Southern California to visit my family (6 days. 12 adults. 5 kids. 3 bedrooms. 2 toilets. 1 shower. No matter how you do the math, things don't quite add up. It's a good thing we get along rather extraordinarily well, no?).

Anyway: whatever holiday you celebrate, whether it's over or continuing or hasn't yet begun, whether you've been filled with the spirit, frolicking in sand or snow, or find this a joyous, pleasant, or just mildly tolerable time of year, I hope you and yours are well and your wishes have all come true. 

In the words of Charles Dickens, "God bless us, every one."

_____

I wasn't sure what I was going to write about today, so I went back and read my last post, and now I know.

I talked last time about that raw feeling, that in-the-moment feeling, that wow-I'm-really-doing-this feeling that I seem to get at the top and bottom of my med arc. 

I guess it makes sense for exactly the reason I said: it's the flip-side of the same coin. Feeling is feeling. Feeling bad, feeling good, feeling whatever. Whether I'm getting a tidal wave of chaotic emotion-salad or a clear channel of manageable micro-feels, being able to interpret and experience them in real time is something to treasure.

Well. At least appreciate on its merits. I mean, let's not go CRAZY.

So I try to do that. I do, don't I? You saw me. I do.

The middle part of the arc, though? SUCKS.

I am there right now.

I am not used to this. I've never been on the med circus train before. This ramp-up-ramp-down thing? Um, no thanks.

I feel foggy, exhausted, forgetful, creaky, vacant. I can't remember conversations. I can't remember things I did two days ago. I feel... like I'm on drugs.

The irony is that now that I'm back in the muddle of the ramping again, I realize that I'd actually begun to get to a good place with the Cymbalta.

Granted, there were many things about it that were not good for me. It was causing more problems than it was solving, although the problems it was solving, it was solving really well. I just realize that I'd begun to feel creative, as I said last time, I'd begun to feel motivated, I'd begun to make plans, I'd begun to get excited.

That was fun.

I want to get back there.

I don't feel like that now. I feel... well, I forget. Sigh.

Except.

Here are a few things that have happened since I started the ramp-down-ramp-up. I'll give you an abbreviated list in the order of occurrence, starting with a couple of weeks ago, when I first began. I detect a trajectory. See if you can spot it:

• Tired and muddled. Vacant. Forgetful. Occasional flash of hopeless overwhelm. Remember feeling like that all the time. Hope that isn't going to get worse.
• Tired and muddled. Vacant. Forgetful. Lorazepam not helping much. No more hopeless overwhelm.
• Tired and muddled. Vacant. Forgetful. Lorazepam helping. Need one every day.
• Tired and muddled. Vacant. Forgetful. Lorazepam helping. Prefer but don't need one every day. Occasional flash of creative enthusiasm.

It helped a lot to write that down. That shit is TRUE. I left out a whole lot of "tired, muddled, forgetful, tired, muddled, forgetful, irritable, tired, forgetful, what the fuck, tired, shut up, tired, leave me alone, forgetful, tired, muddled, tired, tired, tired."

But those are the main themes. That last one ALL HAPPENED TODAY.

Okay. Okay. Good. Yay me.

I've got a long way to go with the ramp-up for this Amitriptyline-- it doesn't reach full potency for 6-8 weeks, like most anti-depressants (because if there's one thing we depressives have, it's time to fuck around) (and okay, yeah, I've added depressive back to my resume, reluctantly, but with a lower-case r and in the fine print, because fuck you depression you're not the boss of me, that's why).

Ahem. Anyway, long ramp-up. As is to be expected. But there is more progress to report: 

Today was my second official "Day 3 of no Cymbalta" day, as I shifted from 20mg every other day to 20 mg every 3rd day.

And guess what? Unlike last time, I woke up this morning and I felt... 

Just fine.

I mean. Tired. Muddled. Vacant. Forgetful. 

But I've gone all day without a Lorazepam with no problem. And I've been feeling some genuine flashes of creative excitement about clearing out the room that is going to be my office and designing the DIY desk/storage system that is going to wrap around two walls in there and allow me to set up space for writing AND space for sewing projects in one room without having to set up and tear down every time I want to do anything.

Also:

I spent some time on the long drive from Southern California the other day thinking about paint colors for said office.

And get this:

While I was down south I met with the friend I mentioned a few posts back-- the one who asked me to collaborate with him on the screenplay project-- and he very kindly and generously (not to mention handsomely and intelligently and hilariously) lent me his time and talent and did a photoshoot with me so I could have some real, live, grown-up head-shots for author bios, ahem, should the occasion arise.

Because I thought of it during my Cymbalta high-point (see? SEE?!) and immediately asked him and my uber-talented hair-and-make-up-magician sister, the newly-married Liz, if they'd be interested in helping me out, before I had a chance to second-guess myself or otherwise self-destruct.

I've learned to undermine my own efforts to undermine my own efforts. This ain't my first rodeo, people.

Whoa. You see that? That's two and a half goddamn years' worth of therapy co-pay well-spent. Damn. That's worth the price of admission, right there.

Holy shit. It's a Christmas miracle.

In the words of Charles Dickens, God bless us, every one!

Like a Woman Scorned

So, Cymbalta was not ready to break up and went all psycho on me.

BITCH!

Yeah, apparently, this is a thing that Cymbalta does. Did you know this? I did not know this. Apparently, neither of the doctors I was working with this past week knew this either.

Cymbalta, she does not give up so easily. She gets mad when you let her go. She takes her revenge.

But I get ahead of myself.

Let's back up a little.

Remember last week, that great week I had?

Well, this week was fine, too. Until. I tapered my Cymbalta as directed.60 mg to 40, 40, 40, 40, to 20, 20, 20, 20, and then none, none. I'd only been on it for about 2 1/2 months, so no big deal, right?

Enter day 3 of "none."

Before I go any further with that, I'll tell you that I met with the psychopharmacologist (or the "psychopharm," I'd insist upon being called if I were her), who gave me some DSM evaluations and determined that I should still be on antidepressants, even if anxiety disorder is my main diagnosis, which is fine (as long as I'm on something that is making me feel better and not making me endure side effects for no tangible benefit, I'm down. And as long as I have a doctor willing to manage and supervise my pharmaceutical "experimentation" so I don't have to figure this shit out myself by clueless trial and error, I'm even more down). 

So day 3 of no Cymbalta coincided with day 1 of amitriptyline, my new antidepressant, which also helps with chronic pain, insomnia, and is a migraine prophylaxis!

They're, like, bundling my services, now. Comcast, is that you?!

Ah, but I digress.

Anyway, I woke up yesterday, day three after Cymbalta and I bid our final farewell. I thought we were cool. I thought it had been an amicable split. I still had three 20mg capsules left, and I'd been planning to continue the taper by taking them every other day until they were gone, but Psychopharm (see?! I mean, really) said not to worry about it and just go ahead and stop.

And thusly I came to day 3, and thusly I awoke to a racing, raging attack of anxiety. Right out of the gate.

Not a good start to the day.

My husband was out of town. I got up, discovered that a colony of ants had found their way into the girls' bedroom overnight to escape the rainstorm, had a moment of panicked horror, had several minutes of homicidal ant rage, got breakfast for the girls, deposited them in front of a movie, and climbed back into bed to get some space and calm myself and figure out what the hell was going on.

I fell back asleep, hard, for another hour and a half.

When I woke again, my anxiety was still incredibly high. I kept crying. My skin felt raw. I was restless, uncomfortable, irritable. I kept snapping at the girls. My head was spinning. Completely out of character.

Also, the ants were back, and boy, did they regret it.

I took a lorazepam. A whole one. First thing in the morning. It did nothing.

I didn't take another. Didn't want to go down that road.

After lunch, we went to the airport and picked up my husband. He'd been in LA for three days because he had a gig at the House of Blues in Hollywood on Friday night.

(For those of you who don't know my husband, I told you he was cool, right? Did you know he was that cool? Well, he is. That cool. Aside from being the best husband ever, he is also, among other things, a bass player. And in his spare time, he does stuff like this.)

Oh, what the hell. Let's have a shameless plug for the man. Ladies and gentlemen, may I present: 

Uniform Standard

That's him, in the hat. My cool boyfriend. Hands off, girls. He's all mine!

_____

Okay, so anyway, I picked him up and as soon as he was there, things started to get better. He told me to call the doctor, which was one of those great ideas that never would have occurred to me.

While I was doing that, we started talking about whether the cause could be the introduction of the amitriptyline or withdrawal from the Cymbalta. Both seemed a bit extreme, considering, but he got online while I was on hold and started looking things up, and sure enough, Cymbalta is a notorious withdrawal monster.

Like, SERIOUSLY so.

When I finally reached the doctor on call (not my NP, to whom I will be speaking this week), he said to go back on 20 mgs and taper more slowly. 20 mgs for a few more days, then every other day, then off. Even that, at this point, seems suspect to me after what I've read, but then again my experience yesterday seems relatively mild and manageable compared to some of the ones I've seen in the forums.

Some people actually do something called "bean counting" with Cymbalta, where they take apart the capsules and count out the grains inside and transfer them to smaller capsules and gradually cut the potency by hand.

Of course, these are people who have been on it for years and taper off over 18 months or something-- I won't need to do anything like that. But it certainly gives one pause.

And it also gives me a new research variant to consider before greenlighting any new medication: what's it like to quit?

Because if the answer is "Worse than the reason you're taking the fucking drug in the first place," perhaps I will reconsider that particular option. As should you.

Down with Cymbalta!

_____

Here's something else that occurred to me yesterday for the first time, though: that hyper-emotional feeling, which I hate so much, has a flip side.

In the past few months, I've had moments of genuine excitement about things. Engagement with creative projects and partnerships with creative people, and getting my creative house in order, mostly. I've felt passionate about those things in a way I haven't felt in many, many, many years. And that is coming from the fact that I've torn so many of those emotional defenses down in therapy.

On the other hand, now that those defenses are down, when stuff like this Cymbalta thing comes up, it's harder to get through, more grueling and frightening, because I can't protect myself from it the way I used to. My lockdown box is broken. I can't just make it disappear anymore.

I think yesterday was the first time I experienced both sides of the coin in the same day, saw them for what they were, realized it was a tradeoff, and thought....

Yep. Totally worth it. I can do this.

Like I told the doctor on the phone, if this is a known thing, a finite thing, a period that just needs to be endured and gotten through, I can do that, no problem. If you can tell me I'm doing the right things to manage myself correctly during this transition, that's enough for me. I will handle it.

I'm just not afraid of that kind of thing anymore. I get it. It's going to suck and then it's not. Fine. It's happening because the drug is doing it, but also, I am experiencing it the way I am because I have worked hard to be able to feel this horrible shit when it happens, and despite how it sounds, that's actually a victory.

To feel crazy and anxious and terrible sucks, don't get me wrong.

But to feel crazy and anxious and terrible right now, while it's happening, and have actual, authentic, real-time reactions to those feelings?

Don't underestimate that pleasure, friends. I bet it's something that every one of you takes for granted every day, and you shouldn't. You shouldn't.

Not all of us get to live in our actual minds and actual bodies all the actual time. 

Realizing I'm doing it feels a little like the moment you're riding your first two wheeler down the sidewalk and you notice your dad let go two houses back and you are suddenly slammed with the knowledge that all the balance you've had for the past few blissful seconds has been yours and yours alone.

Does that knowledge make you freeze up with the burden of the responsibility and spill over on to the ground, or does it set you free, now that you're no longer held back and can go forward as fast as your feet will take you?

You have one, blinding second to decide.

NOW!

I Bought WHAT?!

Ever have one of those weeks where things are going along kind of normally/suckily and then all of a sudden you have what is probably THE MOST LIFE-CHANGING DOCTOR APPOINTMENT OF YOUR LIFE and then a few days later find yourself doing something you would, almost up until that very moment, have bet the entire farm that you would NEVER EVER EVER DO IN A MILLION YEARS?

No? Nah, me neither.

Oh wait. 

Yes. Yes I did. That is exactly the week I just had.

Check THIS out:

I told you a couple of weeks ago that I was going to find a new doctor, remember? I was going to bring my assertive husband with me, I wasn't going to take no for an answer, and I was going to get myself heard.

I also told you a while back about a psychopharmacologist I wanted to go see: a profession so mysterious I'd never heard of it. And neither, apparently, has my spell-check.

Well. I finally got all the information I needed to make that happen. It turned out that I needed to go to another doctor at this facility first and get a referral in order to see the psychopharmacologist. My friend had gone to a Nurse Practitioner that she really liked, so I made an appointment with her as well. As it happens, I'm dissatisfied with my current GP (as you might imagine) and am shopping around for someone new. This NP is in my network. I figured, what the heck.

(I don't know about you, but I have had excellent experiences with Nurse Practitioners in the past. I find them to be extremely thorough, caring, and just generally more human and humane than the average GP. I have never been let down by an NP. I've seen them for everything from gynecology to routine physicals. I would choose an NP over a GP every day of the week. If you've never seen one, give it a try!* Love 'em! LOVE!) *This statement reflects the author's personal opinion. The author has not been paid by any Nurse Practitioners to express this opinion. The author would express this opinion whether she were being paid or not. And since that is the case, would it hurt you to throw a little cash her way, Nurse Practitioners? I mean, Christmas is coming! "Tis the season of giving! God bless us, every one, or whatever!

Anyway. 

Where was I?

Oh yes, Nurse Practitioner.

So we all troop in there, me, the husband, the girls. 

The NP comes in, young, pregnant, glowing, adorable, perky.

 I am not sure what to think. I'm just there to give her my basics so she knows I'm not crazy so she can give me a referral to the psychopharmacologist.

She starts asking questions. I start telling her how I got to where I am. Immediately, it became clear that she got me. She picked up on every vibe, she heard every word, she asked every question I hoped for and wrote down everything I said even if she didn't ask for it.

I don't remember all the details of the conversation-- it was emotionally heavy, for me, so the fog has shrouded much of it; you know how I am-- but a few key moments are emblazoned in my memory for their singularity in my lifetime.

_____

Example:

Me: I've been going to doctors since the '90's, telling them that I can't breathe. I can't draw a full breath. I feel like I'm slowly hyperventilating, and it lasts for weeks, sometimes months, sometimes longer than that.

Her: (stares. blinks.) And no one. Has ever. Put you on ANTI-ANXIETY MEDICATION??!! HAS NO ONE EVER LISTENED TO YOU??!!

Me: (opens mouth. closes mouth. looks at husband. bursts into tears.)

_____

Example:

Me: I was diagnosed with major depression 13 years ago, during a time when I was definitely depressed because of a lot of things that were going on in my life, but I didn't know I had PTSD then and neither did anyone else, and I think it was an easy mistake to make, but I think it was a mistake. 

Her: You mean think your depression is episodic, but that your real diagnosis should have been anxiety disorder.

Me: Yes.

Her: Yeah, I agree. That sounds right. Let's correct that in the record here (types into the computer).

Me: It was an easy assumption to make at the time. I didn't understand the distinction between depression and anxiety until this past September, when I OD'd on Wellbutrin and had that huge anxiety attack. I had never felt it like that before, so I didn't know the difference.

Her: It's not your fault that you didn't know the difference. You weren't the one who was supposed to know the difference. Let's get you off these anti-depressants. They're doing nothing for you. Let's get you some anti-anxiety meds instead. Which one was the one you said worked for you?

_____

Example:

Her: What about drug use? Any history of drug use?

Me: Um. Yes. In the 90's. And... 

Her: Have you ever tried marijuana for anxiety?

Husband: She's tried some for migraines, and she says it doesn't do much for her, but the last time she tried it, she seemed to relax. I saw her smile. She doesn't do that very often.

Me: I'm not really much of a-

Her: It helps.

Me: I don't really enjoy-

Her: It heeeeeeeellllps.

Me: I haven't really found a strain that has worked for me. It hasn't helped with the migraines, and it hasn't really helped me feel relaxed, but I haven't exactly gone looking for my own medical grade stuff.

Her: I can write you a prescription right now.

Me: Are you kidding?!

Her: Nope. Want one?

Me: (looks at husband. husband grins hugely.) Um, sure. I'll try anything at this point.

_____

Forty-five minutes later, we walk out of her office, with a firm request to make another appointment with her within the next two weeks, before she's out on maternity leave. (Her: And there are plenty of great people here that you can see while I'm gone... but... (whispers) I'll make you a list of who they are.)

In my hand are the referral to the psychopharmacologist; the physician's statement that serves as a prescription for medical marijuana, which is legal in my state and plentiful in my vicinity (helloooo, Bay Area!); and a prescription for Lorazepam, the anti-anxiety medication that was so helpful to me when I needed it.

I'm being very careful with it, only taking it as needed, and usually only half a pill at a time. I'm quite anxious these days, but I'm not interested in forming a habit that's going to make it harder to learn what I need to learn to be less anxious in the future.

Because here's the thing:

I think what's happened is that I've had this anxiety disorder-- PTSD/PTSR-- running rampant in my body, unchecked, for the past 22 years, and while I've experienced a lot of it as stress and social phobia and shortness of breath and that sort of thing, I've experienced very little of the emotional side of anxiety because...hello... 

I experience very little of the emotional side of anything I don't want to experience.

QED.

But as I've gone through all this therapy and writing and work over the past two and a half years, as much as I've felt sometimes like I haven't gotten very far, I really must have, because I've been slowly but surely dismantling my ability to protect myself from the emotional impact of stuff like this. 

I've been breaking down those walls, bit by bit.

This is progress, people, don't get me wrong. This is all very good stuff. But all of a sudden, I've got only paper-thin layers between me and a twenty-two-years-strong anxiety monster, and I'm FEEEELING this thing, and my ability to cope with it has not developed at a comparable pace.

My survival instincts have quite heroically kept me from having to deal with all of that, for all this time.

So for now, and for a little while, I'm going to accept a bit of help in regulating my anxiety. I'm going to let that Lorazepam help me regulate my moods. And if it brings a few more smiles to my face than I usually manage on my own, well, I ask you: what could be bad about that?!

_____

As for that other thing, the thing I never thought in a million years I'd ever do, I bet you've figured it out already.

Yup. I--me-- I went to a medical marijuana dispensary. My husband, not having a physician's statement, was not allowed to accompany me inside. I went in, got approved, was given a tour and told the rules, and was shown where to go and how to choose and purchase medical grade marijuana.

I bought some. All by myself. Legally, after waiting in a roped-off line and being offered a "Black Friday Special."

I kid you not.

It was actually pretty cool there. They teach classes: yoga, tai chi, meditation, reiki, accupuncture. They teach you how to grow your own meds. They have support groups for seniors and cancer patients. The consultants are all very knowledgeable about the different properties of the strains.

Yeeeeaaahh... I will probably go full Sherlock if I find something I like about this. I'm not holding out much hope that I will, but you never know. At any rate, there's a lot of interesting science to learn.

I got tiny amounts of three different strains to experiment with, and see if any of them help. I figure, I can't really drink alcohol anymore, and now that pot is finally being legalized everywhere the reports are being released that suggest that it might truly be a miracle substance that we maybe can't afford not to use in some form or another, so what the hell?

I don't see myself becoming a regular pot-user, but a little vaporized anxiety-killer now and then, if I can find one that works, might be just the thing, especially since it isn't habit-forming. Beat that, Lorazepam, and then we'll talk.

_____

All in all, I have to say, it was a pretty good week, with a lot to be thankful for.

Casting off the mantle of "Major Depressive" is having a pretty profound psychological impact on me. Surprisingly so. It feels exactly right that it was wrong. And letting it go is transformative in a way that I didn't expect.

I feel lighter, somehow. I feel less encumbered. I feel like I've corrected my internal inventory and realized that I'm carrying 50 fewer pounds than I thought I was, and I've literally felt those pounds drop away.

Why is that, I wonder? Was it an expectation I was living up to? Or down to? Or something I felt I couldn't escape? 

I don't know. It's not like I traded it for something much better.

I think it's just... rightness. That was wrong, before. This is right. I know what's happening. I know where I am and what I'm doing. I know what I'm looking at.

The NP actually apologized to me, the other day, for that misdiagnosis, all those years ago, and the delay that it caused in getting me the right meds and on to the right path. 

"It's okay," I told her. "I didn't know what was happening to me back then. I wouldn't have known what to do about it. I know what I'm doing now. I know exactly what I'm dealing with."

And that's true. I'm sure I could muster up all kinds of regret over missed opportunities if I spent my time that way, but the fact remains that at this point in my life, I am ready for this healing, and I know how to go about it, and I have laid all the groundwork there is to be laid, and I have as solid a foundation as it's possible for me to have.

I am prepared. So I'll take my miracles now, please. Because I know exactly what to do with them.

_____

She said something else funny, the NP, before we said goodbye.

"I'm sorry this appointment was so long," she said. "I'm sure you have better things to be doing with your day."

I turned and looked her full in the face. "Are you kidding?" I said. "I have been trying to have this appointment for 20 years. You have just changed my life. Right now, you are my favorite person in the entire world. I would spend the rest of the day with you if I could."

She smiled. "Awww," she said. She thought I was joking.

She looked at me. I was a little teared up. And then she got it. She got a little teared up too. 

She nodded. I nodded. She smiled again.

"Thank you," she said.

Because what else can you do, when someone changes your life like that, but try to make them see?

And because she was just that awesome, she saw.

All This Work

I'm in another one of those stages, I think, where positive things are happening but my body is reacting in a negative way.

Here's how this sort of thing used to go:

CHANGE! AAAAHHHHHHH! RUN AWAAAAAYYY!!  

NOOOOO! WAAAAIITTT! I HAVE TO DO THIS BECAUSE IT'S MY JOB OR WHATEVER! 

FUCK! I HATE MY LIFE! I CAN'T I CAN'T I CAN'TICAN'TICAN'TICAN'TICAAAAAN'T!!!!

I WILL JUST GO TO SLEEP INSTEAD! RIGHT HERE ON THE SIDEWALK!!  OR MAYBE THIS BUS OR TRAIN OR PLANE I AM ON WILL CRASH AND I WON'T HAVE TO WORRY ABOUT IT! OR MAYBE I WILL FIND A CAVE I CAN LIVE IN!!

OR NO! WAIT, I GUESS!

 I WILL JUST SLOG THROUGH WHATEVER I HAVE TO DO TO GET THROUGH IT AT WORK AND THEN CRAWL UNDER A ROCK AS SOON AS I GET HOME AND SHUT DOWN COMPLETELY NOT TALK TO ANYONE AND HOPE THAT I SURVIVE IT! 

HOPEFULLY NO ONE WILL NOTICE THAT I AM FREEEEEAKING OOUUUUT!!!!

Yeeeeeah. That was pretty much my constant inner dialogue for about 15 years. Wildly abbreviated, of course. And the voice was whispering. But WHISPERING IN UPPER CASE.

Or, at least, that's how I think of it now. At the time, I did not identify it as a voice from elsewhere-- a voice from not-me. 

It was ME. I was IT. 

I was that person who simply couldn't. It didn't matter that the evidence didn't fit the profile. It didn't matter that my "just enough" usually put me at the top of the class. It didn't matter that managed to earn a living, receive promotions, gain a few college degrees, all with a higher-than-average degree of success.

I couldn't. I was freaking out. I hoped nobody would notice. All the time, every day, forever, sure that I just didn't have what it took, sure that I just wasn't getting it done, worried, worried, worried.

Worried about what? Who knows? Everything! All of it!

Now remember, being of the PTSR variety, I got better and better at compartmentalizing this stuff, and separating my conscious, functioning self from this awful, savage well of worry.

In order to maintain the charade, I had to divorce myself from the feelings, right?

So I floated above it. I'm picturing this as a physical separation, like the way liquids separate-- oil from water, cream from milk, fat from broth-- and one thin layer will float atop the rest.

Yep, that was me, floating on a thin layer of bland, boring congealed fat over a big pot of rich, tasty broth below. Missing all the flavor.

/soup metaphor

_____

But this ain't our first rodeo, is it? We've been some places and done some things, you and I, and these days, when I'm in one of those stages where positive things are happening but my body is reacting in a negative way, it looks a little something like this:

Me: Hmmmm... my anxiety is dialed up to 11. I feel very, very anxious.

Me: I will seek out a doctor and therapeutic methods and/or medications to address my anxiety.

Me: This anxiety is the result of my lizard brain's constant hyper-vigilance, which is the result of my PTSR, which I still do not have under control. However, I have done enough therapy work that I am becoming more aware of my emotional reactions and anxiety is one of those, so I am starting to feel the anxiety as an emotion, rather than just react to it.

Me: Anxiety feels really uncomfortable. I don't like this feeling.

Me: But I am feeling something. Feelings are normal. I might just be feeling uncomfortable because I am not used to feeling anything at all, not because this is necessarily inherently uncomfortable.

Me: Let's just sit with that thought for a while.

Me:...

Me: Well, it still sucks, and I'm all jumpy. Why might I be feeling anxious? What is going on that is new?

Me: Well, I'm doing all my usual stuff, but I am also engaging quite a bit with a few new writing projects, including one really cool one with a beloved friend, who has asked me to collaborate with him on a screenplay development project that is pretty amazing. 

I have never done anything like this before, and I don't really know what I'm doing, but it's about a subject close to my heart and it's a story that really deserves to be told, and it's rich and relevant and beautiful and full of such potential and it's inspired me to a new level of thought and creativity. 

He asked me if I was interested in talking to him about it, and I started to reply with a list of disclaimers: I've never done this before; I might not be the best person for this; there are people far more qualified... and then I thought, he asked me if I wanted to talk to him about it, and I do. And I want to learn about this, and I want to contribute to this, and I want to help him capture his vision for this, and I'll answer the question I've been asked and see where it goes from there, and let magic happen, instead of hiding away before I even give myself a chance.

So I simply said yes.

And that, oh that, to be sure, was new.

Me: So. The parts of my reaction to this that are governed by my conscious and intellectual mind are excited and motivated. I'm brainstorming, researching, engaged. Because this is a positive development.

My lizard, brain, however, is sending up five-alarm disaster signals. RED ALERT! RED ALERT! SOMETHING HAS UPSET THE BALANCE!

Me: So my anxiety has gone up to 11, but the reaction is waaaaay out of proportion to the cause. I need to do something to try to bring it down to a more reasonable level.

Me: Oh god. Mindfulness. That's what you're going to say, isn't it. Shit. Not mindfulness again! But it's so haaaaaaaaard!

Me: Shut up and breathe.

Breathe...

Breathe...

Breathe...

_____

All this work? It's really working, you guys.

I Could Do That

The other day I was driving home from the headache clinic and I turned on NPR.

Fresh Air was on. Terry Gross was interviewing Allie Brosh, she of the Hyperbole and a Half blog fame, and now the Hyperbole and a Half book fame.

It was a good interview. Allie Brosh is candid, interesting, funny. Her blog is cool. Her comic is terrific. Her writing is great. Her story is compelling.

Her story is also pretty... normal. I mean, she has depression. Like a lot of people. But unlike a lot of people, she has been able to talk about it in an interesting, entertaining, compelling way.

And because of that, she drew a lot of readers. And she got a following. And she got a book deal. And she got interviewed by Terry Gross.

Cool.

And I was driving along, listening to it, and thinking, without envy or irony or even, I don't think, hyperbole (ahem)...

I could do that.

I mean. I'm already doing a lot of it, right?

My story is compelling. Even, if I may say so, a bit more exciting than hers in some ways. The movie of my life would have a bona fide action scene in it. A real, live near-death experience! Blood and gore! Hallucinations! Drugs! Intrigue!

No cartoons, though. Hmmm.

But seriously, I was just thinking that as far as stories go, I've been able to draw people in, and keep them reading. I am gaining more time in my schedule to figure out ways to draw more people in, and then to figure out ways to take my story to people who might want to help me make a book out of it. And to people who might want to help me get that book in to the hands of people who might be helped by it.

That's the real goal, after all.

So I came home, and I sat down at my computer, and I started a list of the things I could do to get started on that. Some of them are writing things, some of them are brainstorming things. Some of them are exposure things. 

The point is, though, I made a list. I set some goals. I haven't done that in a while. It felt good to do it. It felt good to really want to do it.

I put Get interviewed by Terry Gross on the list.

I mean.

Why not, right?

If You Peel The Onion Long Enough...

... eventually you start revealing some weird things.

I think I'm at that point now.

I'm beginning to question whether I've ever had major depression at all.

I think what I've actually had, all this time, is an anxiety disorder. Situational depression, surely, but I don't think depression has actually ever been my problem.

One thing that has been a problem is that I've never fully understood or appreciated the difference between the two until recent experiences demonstrated that there is, indeed, a very big difference, and they don't actually have all that much to do with each other, and seeing what anxiety looks like in me and how it works has given me one of those great cosmic clicks that you get when a whole bunch of things in your past suddenly shift into the right grooves and make perfect sense after years of confusion and angst.

CLICK.

OH.

Yeah, when I said, "I'm beginning to question whether I've ever had major depression at all," what I really meant was, "I don't think I ever did."

First of all, let's dispense with the obvious: PTSD is, first and foremost, an anxiety disorder. Of the extreme kind. Officially classified in the DSM. Boom. 

So I DO have an anxiety disorder. An anxiety disorder that would naturally have presented itself as depression and any number of other confusing things over the years, since I and anyone treating me had no idea that I had it.

Major depression would have been the obvious assumption to make. 

But anxiety fits so much better. It explains my general optimism, my lack of sadness, the persistent shortness of breath that has plagued me over the past 17 years. Those things never quite fit with the depressive profile, although the chronic exhaustion did; the lack of motivation and dulled senses and emotions did. 

It was never a clear picture, really. It didn't seem to matter all that much, because anxiety and depression didn't seem all that distinct.

They do now. It matters now.

I think another big problem has been that until I began the work for PTSD/PTSR, I considered myself a depressive and I'd been treated as one. I'd taken antidepressants and I'd gone to therapy as a depressive and I'd worked on my depression.

But I wasn't depressed.

I'd been treating the wrong thing.

I still am.

Over the past two months, it's become very, very clear to me that anxiety is at the root of most of my problems. Sleep trouble. Muscle tension. Migraines. 

Migraines! Some of them, anyway! 

In the past two weeks, I have had three separate migraines which have, after not responding to prescription migraine meds, OTC migraine meds, trigger point massage, or various other methods, respond immediately to a very small dose (1/2 mg) of anti-anxiety medication.

Well, I should say 2.5 migraines. The third one is in progress as we speak. :/

Something is happening, folks. I've had to figure it out myself (with the help of my husband, who of course called it ages ago and I'm just catching up), but I'm figuring it out.

The problem I face with this is that my doctors have never taken my questions and complaints about anxiety seriously. I'm too tentative an advocate for myself, I guess, when it comes to these things (goes back to my "hypochondriac" childhood days, I suppose). 

I brought it to my migraine doc last week and he literally gave me a brushing motion with his hand (in case I didn't pick up on the verbal brush-off), and handed me a flyer for a "How To Cope With Stress" workshop.

I understand that "anxiety" is a broad subject, and coping skills are definitely an important part of dealing with it. Totes get it.

What Migraine Doc doesn't know about me is that I am Homework Girl. I am fucking SHERLOCK. 

OF COURSE I'VE TAKEN THAT CLASS ALREADY. 

I've taken ALL of them. I've done ALL of it. I had a career as a coach helping others learn ways to manage their own stress. 

Coping with the dangers I see is not my problem. As a stay-at-home mom and a highly-compartmentalized PTSR pro, I am so fucking proactive with the coping as to have rendered it mostly obsolete. No need to cope with crises that do not happen in my regimented world.

(Okay, that's not the same as coping, I realize. But that has definitely been my Plan A for a long time and has worked shockingly well. Fortunately for me, I'm also quite good in a crisis, so Plan B goes very well, too. I cope. I'm a coper. Look at me, coping away. I just don't like to have to do it, so I endeavor to avoid having to do so, and I'm even better at endeavoring. MAD SKILLZ, I got.)

It's escaping the impulses of my lizard brain that I have trouble with, and that's where I need help.

That's why I've been on antidepressants. I can tell there's a chemical imbalance, one beyond my ability to control on my own, and the antidepressants haven't helped the way I'd hoped, and now I might know why.

We've addressed a problem that doesn't exist. It's not depression, it's anxiety. We need to take a look at the undercurrent of anxiety in my psyche and see what we can do to mitigate it until I can get a handle on it.

I hadn't known it was there. I didn't know until I experienced those few glorious hours without it at my cousin's wedding. I didn't know it was there until it was missing, and now that it's back I can really see the impact it's had on me.

But that is about to come to an end. If I have to, I'll take my husband with me. Tentative with doctors, he is not.

I am going to do a major reshuffling with my medical staff (excluding the wonderful Dr. Oz, of course), and I am going to get my anxiety addressed properly. Now.

I'm not looking for miracles, but man, it would really be nice not to feel like I have to figure this stuff out for myself. I just want someone to take me seriously, you know? 

Someone who hears "PTSD" and "anxiety" and doesn't immediately label me a hysterical female and hand me a fucking flyer.

I've done my homework. And I'm doing my legwork. And I'm going to continue to do it. And I'd like an astute collaborator in the medical profession who can recommend the right medications for me at this point in my work that will help me get to the next stage.

That person had better be prepared to fucking bring it, though, because I'm not in the mood to waste any more time waiting for them to catch up. 

Listen up, doc: I'm going to tell you what I've done and where I've been, and you've got one chance to respond in a way I deem appropriate: with curiosity and agency. If I catch one whiff of condescension or brush-off, you're fired. 

To the left, to the left. Next! 

Let's do this. Operation Monkey Off My Back 2.1: Anxiety Attacker.



UPDATE: Make that 3 migraines, gone, from anti-anxiety meds. OMG. O.o