Tuesday, March 29, 2016

Why April Fools Is Not Funny For Anxiety Sufferers

April Fools - a day of harmless pranks and possibly not so nice but short-lived jokes. All fun and games, right?  Except for some people with anxiety, it is neither harmless nor short lived. Perhaps it would help if I explained the physical symptoms of anxiety. First, your head races. Thoughts of "what am I going to do?" "What if x happens?" "What if y doesn't happen?". "What if, what if, what if..." Then your heart catches onto the uncertainty and starts pounding, racing. Which makes it feel difficult to catch your breath. You may start to sweat. All of which makes you more anxious, and it becomes a vicious cycle. Now this experience is difficult enough when something traumatic actually happens. But what if it was all a joke? What if the situation that caused this wasn't even real, and worse, the person who initiated this knows it's not real? What if you're having an anxiety attack for nothing? Is this funny to you?

Now, this doesn't mean we don't have a sense of humor. It also doesn't mean that we can't handle changes, or be spontaneous. But what it does mean is, if we do not have to go through severe anxiety, there is no point in us doing so. I work in a busy, client-driven industry. I get clients home who have fallen ill overseas. I change last minute business flights. My work schedule is liable to change daily. I'm used to change. I can handle it. I do handle it. Still, I've seen some pretty cruel April fools jokes out there. A friend of mine shared an article on Facebook the other day about how fake pregnancy posts are not a funny April Fools joke. I have just one question for people who have posted fake pregnancies as a jest. WHY WOULD ANYONE THINK THIS IS FUNNY?  Do you know how many people struggle to have a family? It's not remotely funny. Neither are fake layoffs. Nor fake breakups or anything of the like. It's not funny to tell people there was a mix up with payroll and they aren't getting paid this week - those people may rely on that check to pay the bills and buy food for their family. Nor that they suddenly have to work all weekend when they had to be out of town, or have some big event planned, as they try to frantically rearrange everything in their head. Neither is something as basic as fake-cancelling on plans that someone's been looking forward.  It hurts them, even if momentarily. Why would you want to hurt someone for no reason?  Yet I've heard of each of these being used as April Fools jokes ( luckily not to me, people know better by now).

You may think these things are funny, because you' know they're not true. In your mind, it's no big deal. You think, "What, I just told you I was joking? What's the problem?". The big deal is that it doesn't end for us then. It does for you because you knew all along it was a joke, and because you don't have a medical condition that it negatively impacted, even if for just a while. For us, our heart rate and breathing take a while to recover. Our brain continues to race with things like "but what if it's not a joke..." and "Ok false alarm but what would I do if...".

So please, be careful with your April Fools jokes. We all know google is going to "premier" some ridiculous feature, not because people will believe it but because it's almost become tradition. Surely some unsuspecting person will get their toothpaste or shaving cream replaced with something. But please, before playing some bigger joke where the person could truly be negatively affected, think twice. You never know what people are going through, and you certainly wouldn't want your "harmless" joke to land someone in the ER. That is not harmless at all. 

Wednesday, March 23, 2016

Cyclothymia: Having An Illness That Nobody Talks About

You may have heard the phrase "invisible illness".  Invisible illnesses those that are not (always) obviously visible at a glance. These include mental health, autoimmune, and digestive disorders, along with other illnesses in which we often hear the hated phrase "but you don't look sick". Having any chronic illness is difficult enough. Having an invisible illness, and the stigma often attached to it, as people struggle to understand how you could possibly be ill when you look so well, is particularly trying. But what if you struggle with a chronic, invisible illness that most people haven't even heard of?

I'll admit, six years ago when I was diagnosed with rapid cycling cyclothymia, I hadn't heard of it. And I minored in psychology. The last time I visited a new (non-psychology based) doctor and had to list pre-existing conditions, their system couldn't find it and I had to manually type the name into the computer myself, because the nurses had never heard of it. I had to then explain what it was, and still got bemused looks.

When you google cyclothymia, half of the resources call it "mild". Perhaps when compared to some other cycling conditions, including the full manic episodes and long-lasting depression of Bipolar I and II, it is mild.  But rapid cycles between depression and hypomania, and the anxiety that goes along with it, is by no mean mild compared to, say, life without those. In mentions of mental health conditions, cyclothymia is rarely included in the list. In searching for resources, it seems impossible to find anything that's not a medical source - nobody blogging or writing about it. There are few personal sites or forums dedicated to it. I have found no organization that focus specifically on it. In addition to cyclothymia being elusive, rapid cycling is particularly rare, as is having more hypomania than depression  (it's usually the reverse). Because of this, my medication, which is prescribed to help my hypomania and does not directly affect depression, is not as frequently prescribed for cycling. Which means that finding resources on my medication with the primary usage being cyclothymia, or any type of mood cycling, isn't particularly easy. (The primary usage is for seizures). And finding personal resources, information from others on my same medication for rapid cycling cyclothymia, seems downright impossible.

It's a lonely feeling. When people question that your condition is real, try to placate it with silly patronizing "advice", stigmatize you, to have such a difficult time providing legitimate resources, or finding health professionals that have even heard of it, is incredibly isolating.  I know that I'm not alone in this. I have friends and relatives with equally rare, if not more rare, conditions, and they too have to explain their illness at length, say "yes, I promise, this is a real thing".  They too have people question that it's not "all in their heads".  They too have to deal with assumptions and misconceptions. They too have to explain that they always have a condition, that they're always battling, even when you can't visibly see it.

I've been lucky enough, in my focus on mental health support and advocacy, the "meet" (virtually) others who have cyclothymia, and a few others who have rapid cycling. I say lucky not because I'm glad that anyone else has it, but because at least if we have to have it, we have the opportunity to build a support network for each other. And because I do experience symptoms of other mental health conditions, such as Major Depression, Bipolar Disorder, and Generalized Anxiety Disorder, I have met many amazing people in the mental health advocacy community who can offer support and understanding, even without having my same illness. These people understand. But, for the general public, please be a bit more mindful when it comes to people's illnesses. Instead of screwing up your face and saying "Huh? Is that a real thing?" when they tell you of their chronic invisible illness, ask for more information out of genuine interest and concern. Something like "I'm not familiar with that, can you explain a bit more about it?" (but only if they want to, not everyone loves talking about their illness). If it's a close friend or loved one, see if they have resources. Or offer to help them find resources if they're getting frustrated at the lack thereof. Offer to go to a doctor appointment with them (if they want) in order to learn more. Sometimes a fresh set of eyes/ears can help.  But please, whatever you do, don't say "But you don't look sick." 

Wednesday, March 9, 2016

Your Reality May Not Be Mine

During my struggles with my disorder, I've been called a lot of things. I've been told I'm illogical, irrational, even delusional.  While I admit my creative brain may wander more to the depths of imagination than the logical line of thinking, and that in my worst moments I may not be thinking the most rationally, I have never been delusional, and I recover rationality quite quickly once I'm not in the midst of a hypomanic or anxiety attack. I've been accused of being unable to handle life. On the less damaging end, I've been told I'm being too pessimistic, that I look at the glass half empty, that I need to just focus at the positive side of things. I've been constantly reminded that people have it much worse (I would never deny this), and that I need to "get a grip". And when I insist that I'm a realist, an optimist even, people tend to get bent out of shape.  Because they don't understand that my reality may truly be different from theirs.

My reality is that I have hypomania, depression, and anxiety. I have panic attacks. My reality is what I experience with this illness. Which means that when I get anxious or depressed or panicked about something that seems insignificant to you, it does not feel that way to me. It's not me "getting worked up" or "blowing it out of proportion" or "being dramatic."  I physically, mentally, and emotionally experience the situation differently than others may.  The best way I can describe it in more "physical" terms is this: If someone has bad asthma, and you go on a hike together, what may seem like a slight, easily navigable incline to you may be a challenging hill for them. Telling them that it's not a difficult hike, or that it's only a small incline, won't make it any easier for them to breathe. In fact, in addition to their breathing struggles, they may now feel self-conscious or frustrated, because you've pointed out that it "shouldn't" be tough, further emphasizing their illness. They aren't "being dramatic" when they struggle to breathe. To them, it really is challenging on their system. It's the same with my illness, except that the organ affected is my brain. 

To help illustrate how things feel and appear to me, here are a few examples:
  • You see a slight glitch in the plan for the day. I see, and physically feel, that the entire day's schedule now has to be rearranged, and that I must frantically try to figure out how I'm still going to get everything done. In addition to my mental and emotional feelings of anxiety, my heart starts pounding and I having trouble breathing. 
  • You see a minor "road block" that you can reason your way around. I experience the panic of having to completely give up the task/project/whatever it may be because it'll never come to fruition. My brain bombards me with numerous other examples of when I failed at a similar task, or sometimes just any task, which makes it nearly impossible to concentrate on finding a solution. 
  • You see the positives of the day. I see those too, but my brain highlights all of the things that did not go well, because those are the things I will, at least according to my brain, still have deal with later. So those are the areas that it focuses on, hoping to figure out what to do. It makes it very tough to "look at the bright side" and focus on the positive aspects when your brain is continually creating a list of tasks, stressors, and concerns. 
  • You see obvious solutions. I see fears. Why don't you make a phone call.  You mean besides my hone anxiety? How about you collaborate with so and so.  Because I have social anxiety and they won't want to work with me and I'll just feel inferior and insecure around them and... and.. . It'll be fine, just go introduce yourself. "Hi...um... I ...uh... (looks at ground awkwardly)...yes... ok.. yeah... you too (to nothing in particular)." And yes, I can push myself. To a point. But there's a fine between trying to work through your fears and pushing yourself in the direction of a massive anxiety attack. 
I realize that because you can't actually see my depression, anxiety, and hypomania, and because there are people out there who actually enjoy making everything more dramatic than it has to be, many people have a tough time telling the difference. Still, I ask you to err on the side of caution. Because even that "drama king/queen" may be struggling with low self esteem and feelings of inferiority.  They maybe they're completely ignored at home/work/elsewhere and just desperately need someone, anyone, to take notice of them. They may be crying out for some sort of help in some way that you don't understand.  You never know what's happening inside the head of anyone but yourself, and I would venture to guess that each and every one of us has something we're struggling with or battling that isn't obvious to others. And none of us would want to be judged, criticized, or mocked for that. So please, stop using phrases like "chill out" or "calm down". Stop accusing people of being dramatic, illogical, irrational, delusional.  They probably aren't, but if they're ill enough that they actually are having delusions, shouldn't you help them instead of getting annoyed at them? In your criticism and your name calling, not only are you judging them without all of the information, but you may be stigmatizing them because of an illness which they have little control over and certainly didn't choose.