Thursday, February 18, 2016

Doctor Anxiety

With the amount of time that I spend going to therapy, getting blood drawn, taking meds, and talking about my health in general, you'd think that doctors visits and anything medical/health related would be a snap. And in theory, it is. I don't mind the actual appointments themselves. I have no shame about gowns with awkward openings, or being touched and prodded and poked (professionally). Needles don't bother me, nor does the sight of blood. I helped aspirate my own knee when I was 16. I don't mind CAT/MRI machines. I have had my GI system examined from every angle. It's not the actual tests that bother me - though that colonoscopy prep wasn't fun. It's the idea of doctors and tests that bother me, my therapy visits being an exception. Let me explain.

First off, my family are no strangers to health issues, numerous of which are genetic. On several occasions family members have gone in for routine visits and told they have stage 3 or 4 cancer. Crohns, colitis, and colon cancer are not strangers to our family. Neither are heart conditions. Or endometriosis. Two years ago when I was having dizzy spells I got examined/tested at length for MS and ALS, along with TIAs, which have taken lives in my family. And I realize all of this should make me more willing to go to the doctor. But this shit is scary. And you know what's also scary? The waiting period before you actually go, and the waiting period for the results. Because that leaves a lot of time for imagination, and my imagination likes to work overtime as it is.

For those that suffer from anxiety, you know what I'm talking about. Here's how it plays out in my head: I have this doctor appointment for something routine - doctor, dentist, OBGYN, routine visit, or something that doesn't seem earth shattering. I'm going to totally fine. But what if I go and they find some life- threatening illness. Oh no, what if it's this or that (insert scary illness here)? What will I do? My insurance wouldn't cover that! How will that affect the rest of my life? What will I do, I can't afford that! I'm going to die alone and miserable. Or worse, I'm going to live a long but ill life, alone, and in the debt of insurance and medical bills. This is literally what goes through my head for a routine physical. You should have seen me with the CAT scans of my head, or god forbid the pregnancy test they insist on giving you at the OBGYN every single time, even those times that you assure them it would have to be the second coming of Christ if you were somehow pregnant.

To clarify, I'm not a hypochondriac. I don't run to the doctor or ER for every little thing - far from it (because clearly I do not love going to either unless it's absolutely necessary). Nor am I the type of person that needs to be waited on hand and foot the minute I get a cold. In fact, routinely I'll casually mention, "oh, I have a migraine/sinus infection", or "oh yeah that time when I had encephalitis..." and people look at me like I have two heads. But it's anxiety. It's anxiety because I don't like the unknown even if I feel like it is known. I don't even like the suggestion of the unknown. Because even when I'm 99.9999% positive of the result -i.e. the immaculate conception pregnancy tests described above - I sit there driving myself crazy about what could possibly go wrong, even if it's something that has nothing to do with my original visit/test/etc (I'm not sure what else they'd find on the pregnancy test beside pregnancy, but you get the idea).

Partly, I think for those of us with anxiety and mental health conditions, we're always waiting for the other shoe to drop. Our lives are never free of anxiety, depression, hypomania, or symptoms of these. They're never going well for that long, as is the nature of mood cycling. You may be "up" for a bit, but you know the crash is coming. That makes it tough to enjoy the up at times, especially if you're rapid cycling and know it isn't bound to last all that long. And such it is when it comes to the rest of life. When things seem to be going well, no matter how hard you've worked or how much you feel, or others tell you, that you deserve to be happy, you're waiting for something to jump out from some dark hidden corner where you aren't looking and ruin it. Thus, in our mind, a well visit checkup to a doctor, or a dentist, or someone else we (should) routinely see turns into an impending avalanche in our heads for no reason other than the fact that we suffer from anxiety. Because if nothing else is going wrong, this must be it, just waiting for us, when we least expect it.

I don't know if others have this fear, or if it's just me. I find it ironic that the physical tests themselves don't bother me. And I think if I could go in at the moment, get any tests right then, and get the results immediately, I'd be a little better. Not great, but at least it wouldn't stretch the process of waiting out impossibly long. But knowing some sort of appointment weeks or months from now, and then you have to do all these tests and exams, and then you have to wait x number of days/weeks/hopefully not months because then someone's not doing their job for the results is torture. Because waiting means uncertainty, even when you feel certain. And anxiety and depression and uncertainty don't mix.

Wednesday, February 17, 2016

Things You Always Wanted To Know About Mental Health But Are Afraid To Ask - Part 3

I'm getting a lot of mileage out of this particular title. Pretty cool. But I feel that the list of things people don't understand about mental health seems to be growing by the day, and I'm giving people the benefit of the doubt that they'd want to know. And because every time I hear people make an ignorant comment I say to myself - hopefully to myself - uggghhh (or *%&$%&$%*%&$), if only they were educated on this topic and didn't have to be so ignorant! So, more things you always wanted to know about mental health but are afraid to ask.

Could you live life without your meds? I could. Technically. I did so for 30 years.  Could I live life at the same level of health and stability. That remains to be seen, but I'm going to say probably not - at least not personally. Because I know how it felt before, and it was rough enough to make me go on meds in the first place. Let me be very clear: This answer is for me personally only.  I'm not telling everyone with a mood cycling condition they should be on meds for life. But I've worked in health and fitness. I know how to exercise and eat right. I've done it with just therapy alone. I've done yoga and meditation. Those things all help. Collectively. Along with my meds. Are there situations in which I would go off my meds for one reason or another? Absolutely (i.e. when, all things willing, I decide to start a family). But just "to not have to rely on meds to feel 'normal'"? Would you ask a cancer patient to do the same? I rest my case.

How can I tell if you're depressed? Easiest answer in the world, if you're someone I'm close to: I'll tell you.  But everyone's different of course, and some might not feel so comfortable being this open. If you know someone who battles depression, ask them what theirs looks like specifically. It often manifests itself as lack of energy, exhaustion, apathy, feelings of hopelessness and worthlessness (note: it's not always that you feel sad; it's often that you feel nothing at all), but helps to know how theirs shows up. It may vary from one episode to another, though this should give you a better starting point for recognizing it.

How can I tell if you're (hypo)manic? With me personally, you probably can't. Unless I tell you. Which I probably will if I feel it's going to be obvious. I don't get "delusions of grandeur" (this is such a weird description) or go on shopping sprees or think I'm invincible or anything like that. I might get a bit more antsy and agitated. I might be more productive because I'm feeling more awake. I might seem like I drank an entire pot of coffee, though then again I might have drunk an entire pot of coffee. But I also might be this way because I'm stressed with work, or life, or traffic. Or I might be more productive or positive because I'm just having a good day or things are going well in life. It's not always hypomania, or anxiety, or anything related to my condition. I may just be having a "normal" reaction to life as anyone else would.

Does (hypo)mania feel good? This is, for me, a big myth, though I've heard others say they do feel better during the "up" cycles. I generally feel like I have a lot of nervous/extra energy. Sometimes it feels like I need to run miles and miles, or drive fast with the windows down until I run out of gas, or scream until I've exhausted every ounce of energy in me, or punch someone (I don't, don't worry). Hypomania creates a tremendous amount of internal energy for me, and while that can be harnessed for positive, it can also make me feel very on edge. So no, I generally do not think it feels good. At all. It feels like a lack of control over my brain.  And regardless of if that elicits "good" or "bad" feelings, I don't like not being in control of my brain.

How can I tell if you're actually mad/upset/etc at me or cycling?  Are you being a jerk? Then I'm  upset with you. But in all seriousness, trust your gut. Not your defensive reaction, your gut. Your defensive reaction will tell you it's me 100 percent of the time. But try to get past that. If it's a repeated pattern - i.e. I always get upset with you when you're a half hour late and don't call/text to let me know - then I'm probably upset at you. If it's not, then it's possible I'm cycling. It's also possible that I'm not that mad at you about this issue, but it's been building up and I finally boil over. Or that I'm not mad at you but I had a crappy day and you do something that ever so slightly irks me and you get the brunt of my frustration. I try not to let this happen, but I'm human and it does.

How do I know if you don't want to do something/go out/etc because you're depressed versus when you're just tired from every day life? Does it matter? I'm not trying to be a smart-ass. This is a genuine question. My condition isn't contagious, so it's not like you have to stay away from me in one situation vs the other. And sleep is important to my condition even if I'm not depressed at the moment. Plus, if someone, anyone, condition or no, is exhausted from a busy week, shouldn't you just respect that?

Do you ever wish you were normal? Do you ever wish you were average-looking?  This is a tricky question (the former, not the latter). There are moments in which I wish I didn't have my condition, or that it wasn't acting up. I dislike the way it affects those I'm close to, and there are certainly times that I wish I didn't have to stop whatever I was doing to eat something so I could take meds, Or days I wake up depressed that I really, really need to not feel that way because I have to be "on" all day at some major event. Or moments when I can't stop myself from talking that I really wish I'd shut up. But no, I do not, overall, wish I was normal. Partly because there's no point. Wishing won't change it. Partly because, as my grandma used to say, "if it ain't your ass it's your elbow." Meaning, if it wasn't this, it would be something else. Nobody has a perfect life. My condition is part of what makes me, me. I wouldn't know what to do with normal if I tripped over it.

Have a question? Go ahead and ask. Be warned, it may well turn up in a future post. But that's a good thing (don't worry, I don't use names). It helps people understand me, and those with similar disorders, and to me, that's always a positive.

Wednesday, February 10, 2016

Loving The Curves You Have, Or Don't

I haven't written much here about my prior body image struggles. While I was never directly diagnosed, I was more or less told by my therapist that I had Body Dismorphic Disorder, or BDD, which contributed to some pretty bad eating issues. With the help of therapy and loved ones, I recovered, and quite well I might say, but I still occassionally get flashes of insecurity surrounding my body, especially when surrounded by those who are in better shape than myself.

If you're unfamiliar with BDD, in a nutshell it means that you physically see your body differently than it is. It's not vanity or superficiality. It's an actual distortion. Imagine looking at yourself in a fun house mirror. Now obviously it's not distorted in those same proportions (I think that even for those with BDD, if our nose looked five times the size of our hand we'd realize that the image wasn't entirely accurate). But we look different to ourselves, and notably so, than we do to others. It can cause almost antisocial behavior for fear of others seeing our flaws. Now to clarify, I think many of us are our own worst critics, and sadly I think that's particularly true of women. And perhaps it's true that the majority of people don't see their own beauty the way their friends and loved ones do. But for those with BDD, it goes beyond being tough on yourself. It's a physical and mental contortion of body image that's downright dangerous.

Recently I was in a situation in which I felt a twinge of my former insecurity return. In the presence of someone who is technically in much better shape than I am, and in a situation in which I really felt I needed and wanted to look my absolute best, I felt inferior. Briefly, I let it get to me. I momentarily scolded myself that the workouts I'd been doing clearly weren't enough, and ridiculed myself for the way I've been eating (admittedly I genuinely could be eating healthier). But then I took a good long look at the other person and you know what? I don't give a flying f*ck what other people think about how she looks. I look better. And you know why? Because I'm real. I'm not perfect, nor am I spending massive amounts of time trying to be. I am muscular enough - sometimes to my detriment when it comes to dresses with zippers up the back (athletic ladies you know what I'm talking about). I have maybe a two pack, four pack on a good day. I'll never have a six pack unless it involves craft beer because I have a weirdly high belly button and gives my ab area a funny shape. I'm short. That's genetics - I'm 5'0 and one of the tallest women in my family. Not much I can do about that and I'm not going to break my ankles in stilettos because... why should I? I have curves. Particularly extra on the lower half of my body and not quite enough on the upper half, but enough that I clearly am curvy. The thing is, women's body's weren't made to look as muscular as a mans with few curves. We have hips for bearing children, for those who would like to. We have breasts for feeding those children, for those who choose to go that route. And when I have a child/children one day... well I certainly won't be any closer to looking like perfection. Because, while I'll try to keep healthy and exercise regularly, I'm not going to have the time to spend hours a day trying to look like I'm on the red carpet. I'll be too busy spending time with my family. Making memories that don't involve a treadmill or a weight stack or some horribly unhealthy fitness/diet trend that people swear by that I won't even get started on.

Now, I'm all about being healthy and having fitness goals. Whether you play a sport or run marathons or do zumba in your living room, as long as it's a HEALTHY lifestyle, then I say go for it. And if your body isn't curvy, or your goal is to bulk up, then that's fine too. You don't have to look like me just as I don't have to look like you. You can love your body as much as I love mine. Because it's yours, you've worked hard for it, and it's perfect for YOU.  Trying to (metaphorically) wear someone else's body because you think that's what people like is like trying to wear a pair of shoes that everyone's gushing over but are two sizes off. They might be perfect for them, but clearly don't fit you, and eventually you'll probably end up hurting yourself. 

Friday, February 5, 2016

A letter to women: Self-Esteem, Social Media, Attention Seeking Behavior

Dear women suffering from low self-esteem who constantly need attention,
I know what it's like to have low self esteem. I've been there. Truly. Most of my life. And let me tell you, it sucks. It sucks to feel like everyone is smarter, prettier, more successful. It sucks to take every cancelled plan or bad date or rough day at work as a sign that you're not good enough and you'll be alone forever. It sucks that no matter what you try, it doesn't seem to make you feel better for long. It sucks that nobody understands. I know this. And it makes me so sad that you feel that way.

I also know that we aren't all playing with the same deck. I am in no way an "everyone should be able to pull themselves up by their bootstraps because I could do it, or because "Mary Smith" (random name) over there could do it." That would assume we're all the exactly alike so should be able to handle everything precisely the same way. Our low self esteem can be the result of a great many circumstances, and even if the circumstances were identical our personalities and our DNA are not. So it's probably impossible for me to give you some sort of formula that will absolutely work.

But I can tell you this:  no amount of pretending, no amount of material and superficial things, no amount of attention from others, is going to help your self esteem in the long run. Because ultimately, low self-esteem is our own vision of who we are at the core, unfairly distorted, through no fault of our own, by life experiences or genetics or abuse or some combination of circumstances that doesn't allow us to see ourselves as we truly are. All of those superficial pieces -what we have, what others say about us - are just the external pieces that we see as affirming our internal feelings of ourselves. They're a self-fulfilling prophecy. The more you listen to them, the worse you'll feel, the more you'll see them, and it goes on and on. Now I'll admit, I'm the first person to change my hairstyle or my wardrobe when I feel like I need to get the current of life moving in a more positive direction. But that's because I know it's within me to continue that movement. I might desire a fun jump start, but I don't truly believe a new hair style is going to fix my problems or make me better, more likable, more successful. Nor does it matter if every one of my Facebook friends makes positive comments on my profile picture with said new hairstyle. Because if their affirmations "make me beautiful", their criticisms can just as easily plunge me downwards. It gives them control over my emotions instead of me. Why would I want that?

So please excuse me well I tell you something you probably don't want to hear: no amount of external praise or social media likes or retweets or shares in which you tag your boyfriend/girlfriend/favorite favorite friend of preferred gender(s) to make your presence known on his page daily is going to make you feel better about yourself. Even if he likes and comments on every f'ing one of them.  This isn't to say that you shouldn't share your successes or your great new look, or that you shouldn't tag friends in something that you legitimately think they'll enjoy. But before you do so, ask yourself this. If a day, a week, a month from now, nobody's liked or commented on that selfie, if you've posted a picture saying how fat or ugly you are and nobody's reassured you you're not, if said targeted person above doesn't profess grandly how great every one of your posts on his wall is, will you care? Be brutally honest with yourself.  Will it piss you the *$& off? Will you complain to your friends "I don't get it, suddenly he/she isn't liking or commenting on my posts"? If you don't will you secretly want to? Don't judge - there's no right or wrong here - but be honest. If others' affirmations or lack thereof influence it, don't post it. Because you've just handed them that power. It goes the same for what you wear, your hairstyle, etc. If you're doing it for them, don't. It will hurt you in the end. Because there's always some dissenter out there. Always.

I know this is difficult to hear for several reasons. First off, it can be tough to acknowledge that you have low self-esteem. Furthermore, nobody wants to discover, or admit, that they're attention seeking. And I know that you want to try to control external factors that make you feel better, because you feel no control over how you feel about yourself internally But it doesn't work in the long run if you're truly suffering from consistent low self-esteem. The only thing that will help you feel more control over your self-esteem is to be honest with everyone, and most importantly yourself, about who you are. Nothing diminishes self-esteem further than trying to be someone you are not. Eventually, you feel hollow, and hollow does not lead to feeling positive about yourself. I speak from experience. Things might get worse, externally, before they get better. I won't lie and say that being open about every bit of who I am, including my mental health condition, was a cake walk. But when things get better internally it matters less what people think externally.

So go ahead and post pictures of your abs or your new haircut. But don't pretend you don't think you look good. If you really don't, then by all means don't give others the opportunity to shoot you down emotionally after you've worked so hard to come up. But if you do, own it. Be proud. Is it everyone's top choice to see pictures of your abs? No, assuredly not. But so what? Maybe it's not your top choice to see pictures of the meal or their dog or their kid. It doesn't stop them. And the physical and virtual clinging to your boyfriend/girlfriend/favorite friend? You'll need that less too. Because the better you feel about yourself, the less you care about people who will only pay you attention if you practically give them no choice. And you deserve so much better than that. Confident people don't want to look desperate. And when you get like that, you do. I'm sorry. We all can see it.

So please, from the bottom of my heart, look inward. If you need to discuss your self-esteem issues, talk to a trusted friend or find a support group. Hell, I've been there, talk to me. I don't care if I know you or not - I help people I don't know in person through mental health struggles all the time, because I truly want to help. If you have to, speak to a professional. But don't speak to those people who will only notice if you continually throw yourself in front of them either on or offline, striving for their attention. Quite simply, once you are able to focus on your own positive opinion of yourself, you won't need theirs.

Wednesday, February 3, 2016

That Won't Happen To Me - Continued Indifference to Mental Health

I've been thinking more than usual lately about the advocacy and fundraising work I do in mental health, the degree to which my efforts struggle to make headway, even within my close circles. I'll be honest, I get incredibly frustrated when people I consider close won't sign up for, or even read, my blog. I get equally as annoyed when I make countless attempts, practically begging these same people, to donate even one dollar to my Out of Darkness Overnight Walk for Suicide Prevention.  Especially when they turn around and ask me to support their charity event or, better yet, spend 50 times that amount on a "all you can drink" cheap beer drinking event that following weekend, touting it as a great deal. Sometimes, it physically hurts my heart to feel ignored this way. After a significant thinking, I've come to the only conclusion that makes any sense: those people don't care.

I need to clarify. For years, and until recently, I took it highly personally. Which is to say that I thought to myself, "These people must not be real friends. They don't want to help me out. They don't care about me." But now, I don't believe that's entirely true. What I believe is, they don't care about the cause. I'm not trying to make them sound cold-hearted. The bottom line is, mental health is something that, unless you struggle with it or have actively watched someone do so (not as in "know they have it" but physically watched them in the midst of battling it acutely), it's not something that people think affects them. It seems like some sort of foreign world that they can't fathom, completely out of reach.  In part, this is a mindset. People don't want to understand. Because if they understand, they feel closer to mental illness, and they don't want to be lumped in with those "crazy people".  It's an us and them mentality, and not one that I believe is always a conscious decision. People think, "I would never take my own life; I can't imagine that." "I never get anxious or depressed like she does." "I'm laid back and chill, I don't swing between moods like she does." People who haven't experienced it truly cannot understand that mental health conditions can affect anyone - between one quarter and one third of the U.S. population, to be exact. Illnesses such as cancer and heart disease are more tangible illnesses that people can envision getting, maybe even have a family history of, and therefore want to do all they can to support treatment, prevention, and awareness for. But getting diagnosed with a mental health condition "won't ever happen to them". So they see my request and they look the other way, almost instinctually. They don't need to read my blog because it's not about them and won't affect them. They don't need to support the cause, because it's not one that's close to their heart. They don't bother to educate themselves about it because "what's the point?.  

When I look at it this way, the lack of concern and support does still bother me, but not quite so much. In part, I still don't understand it, because I'm the type of person that, if we're close and it's important to you, even if it's not to me, I'll do my best to help you out. If you're asking for $1, and I have the money to buy a beerfest ticket for $50, I'll give you the buck. Probably even five or ten, but at least one. On the flip side, I know that you're not intentionally being hurtful. To you, it's practically like my posts, emails, messages, whatever it may be aren't there. You scroll past it the way I scroll past a recipe for pork chops because I'm a vegetarian and never see the need for such a thing. So I'm trying to learn that it's not intentional. You aren't snubbing me and my hard work for beerfest tickets. You just can't find a way to relate, and when you don't relate to something, it doesn't hit home. And when it doesn't hit home, people don't donate or offer support. It's just another cause asking for money, and you've already donated your fair share to those causes close to your heart. Still, it would be nice if, because I am relatively "close to your heart", based on the fact that we're good friends or blood relations, you could offer some support, even if it were in the form of sharing my posts on your social media to see if it hits closer to home for any of your friends than it does to you.

To all of you who  read, share, post, donate, and otherwise support at every opportunity, thank you for making my efforts, and mental health, a high priority. Thank you for staying away from the "us versus them" mentality. Thank you for realizing that it is a worthy cause, even if it "won't happen to you". Indeed, I hope it that never does.