As My 36th Year Comes To a Close

As my 36th year comes to a close, I'm faced with a range of feelings. First, there's the idea of getting older, which normally I don't mind particularly, but my 37th feels a bit rough. I think it's the whole "getting into my late 30's" (aka approaching 40) thing. Partly because I'm quickly approaching probably already past the age where I think "Man, I really should have my shit together by now, WTF happened?" Plus, particularly for women, as you creep into your late 30s you realize that, at least in certain arenas, time isn't necessarily on your side. For instance, my therapist recently asked me if anyone in my family had gone into early menopause (!!!). Which was actually a fair question, since anxiety can manifest itself in symptoms such as feeling hot/flushed/sweaty, dizziness, etc. She was trying to rule out other medical possibilities before she addressed what seems to have been worsening anxiety. Then my OBGYN gracefully told me, in nicer terms of course, that I'm no spring chicken as far as fertility is concerned, and if I want to have a biological child I should probably get a move on it. Again, when one is childless, hopes to still have a family, and 37, this isn't a huge shock, especially given that I have to go through the whole process of weaning off meds, which is kind of a crapshoot time-wise in that I have no idea how I'll adjust and this could cause setbacks. But I think it's the fact that these question's weren't unreasonable that got me. I can't say "Well, they're just being a dramatic, I have plenty of time for that!" I may, but I really don't know.

On the flip side, year 36 was a year of getting myself (a little more) settled. After the passing of my beloved Cinn a year ago, and a couple of months of mourning, I realized being dog-less simply wasn't for me, and I adopted Gracie. She's my wacky, funny, cuddly, overly enthusiastic three-year old pup that, despite not even having for a year, I can't imagine not living with. Our relationship is very different than mine and Cinn, but that's to be expected - if it were the same, she'd always be living in Cinn's shadow.  But she's so different, so unique - hairy elbows and all - that I can't even possibly compare them. And she's full of youth and excitement that keeps me on my toes and challenges me, which can be difficult, but also helps me from ever becoming complacent.

Last December, I went on a first date with a man that I had known a little, but not super well, in high school. We'd not kept in touch, but reconnected via a mutual friend on Facebook, and it has changed my life. In him, I have found the most understanding, loving, patient partner and best friend. Life with a mental health condition is not easy, and yet he knew all about it going in. He'd read much of my blog before he'd even asked me on date. The fact that he has not run away screaming, that we are actually planning a future together, to me is not much short of a miracle.

Shortly before Christmas last year, I bought a condo in Philly and I moved in at the beginning of April. After almost 10 years of renting, being a home owner again is a big change. My walled thinks so too. But in all seriousness, it's nice to feel that it's mine. It feels settled, and when you have a brain that is decidedly not, having grounding, settled pieces in your life is a huge help.

 So I approach this birthday with a mix of emotions. Mostly though, I feel lucky. I battle a good amount of crap with my brain, but I also have watched friends and loved ones battle much more. I have a loving family, partner, dog. I have a home, and a job (two, actually). And while I'm not one of those people tout positive thoughts and gratefulness as the cure-all, because they often aren't particularly possible when depression and anxiety rear their ugly heads, I am feeling thankful as I write this. I hope that in year 37, I can take this feeling of settling down (not settling, there's a big difference), stabilizing my life as much as I can, and continue to move forward with it. To all who have been with me through this incredibly topsy turvey ride of a year, thank you. I don't think I would have made it without you.

The only "family photo" we have to date. 

How Often Do You Have to Pretend You're Not Ill?

Imagine having a stomach virus, getting violently ill in public, and and having to pretend none of it's happening. This seems nearly impossible right? Chances are that, unless it comes on extremely suddenly, you wouldn't have to do this. One hint of "I think I am going to be sick to my stomach" and people scatter out of site to let you do what you need to, so long as you aren't anywhere near them when you do it. But nobody would expect you to cover it up, smile, pretend you weren't just vomiting in the corner, go on with your day as usual.

Sadly, for those of us with mental health conditions, and other invisible illnesses, we frequently have to deal with sudden onset of illness in public. I can't tell you how many times I have an anxiety attack or a panic attack and have to smile through it.  I talk to guests and clients, I interact with coworkers, I carry on throughout my day all while it's happening. I am nearly positive that people can see my rapid heartbeat through layers of bone and skin and clothes, though presumably they cannot, as nobody's ever said anything. I will the color in my face not to go white, and again, nobody ever seems to think it has. I have to calm my hands from shaking. I have to find tricks to slow my breathing - tricks that nobody will notice, I hope. I try quietly do my breathing exercises, while keeping my eyes up, a smile on my face. If someone happens along, I have to abandon these and hope I don't start gasping for air that it feels I am unable to get into my lungs. Because I can't sit there breathing in for 4 counts, hold for 7, out for 8 -  as instructed by my therapist - when someone asks me a question and is expecting an immediate answer.

It's not just at work of course (I am lucky to work in a cool place with great coworkers). It's at the grocery store, at a restaurant, at the UPS store, and pretty much any where my good old anxiety and panic feel like it.  There's often not an external trigger. It's simply my anxiety, often I don't even know over what. It triggers an attack. I have to sit/stand there, pretending my body and brain don't feel like they're about to explode from the inside out. If I must show some sign, I turn away momentarily and make up an excuse... bad sinuses today, my allergies are killing me, that pollen count, long day and I'm tired, etc. I never say, sorry I'm just having an anxiety/panic attack because of my mental health condition, can you give me a few minutes? Because as much as I fight for stopping the stigma, we're not there yet. There is stigma. You can't tell your customers that you're having a flare up with your mental health condition. Maybe if you work as a peer counselor or something similar, where the whole point is that you also battle what those you work with battle. But that's about it. Otherwise, when people ask how I'm doing, it's put on the mask, smile, say "Good! How are you?" or the equivalent. 99 percent of people (especially those who aren't overly close to you) won't say "Really? If not you can tell me and I won't judge you" (and mean it). There are exceptions. I recently got an unexpected and very welcome hug the other day from someone who actually pays attention to my tweets and posts and knew I was having a pretty rough go of it. Hi five to that person (really, a heartfelt thank you) - if you ever need a hug, I owe you one.  I wish there were more people in the world like that.

I hope that one day, I can be as open about my illness with everyone as I would be if I had diabetes or cancer or some other "more socially acceptable" illness. I hope that I can say, "I'm having an anxiety attack. I need some time until it passes", as I would with any more visible condition. I hope I can call in sick with a mental health emergency as I would with a stomach bug, and it be completely acceptable. But that day isn't here yet. And I know that for most people, it's ignorance in the true sense of the word. They don't know what they don't know. They only know what they've been told, over and over, from numerous sources. Unless someone close to them suffers, how do they know the information they've been fed from so many sources is BS?  And so we go on, putting on a mask, smiling, laughing, having a "great day/weekend/month/year", even when we feel like we're dying inside.

So next time you're tempted to look at someone unable to get out of bed because of depression, who can't handle one more burden that causes them anxiety, who desperately, finally needs a day for themselves, pause before passing judgement. Remember what they have to do every day, pretending they don't have a chronic illness, smiling through anxiety and panic attacks, talking cheerfully through horrible depressive episodes, because they have no other option. We are not weak or lazy, or not trying hard enough. We are strong as shit, but nobody can be that strong, every single day, while ill, and never need a break. Give us some slack. We pretend we're not ill ever day, even in the midst of a horrible attack. How often do you have to do that?

Why Living In the Present Is So Difficult With a Mental Health Condition

We often hear encouragement (I think it's supposed to be encouragement) that most of the things people worry about don't come to fruition. Cliches are thrown around about how the present is so precious and we shouldn't worry about the past or the future. And I don't disagree with these, at least in theory. But I do think that they are spoken from a point of view of those who aren't battling actual anxiety, or for that matter other mental health conditions, and that for us, these "truths" might not always be accurate. Before you throw more cliches at me, hear me out.

The reason that most of the things people are worried about don't come to fruition is because they are intentionally, actively worrying about something. Now, I'm not saying they want to feel worried.  But their worry is caused by something external. They may be feeling stressed about meeting a work deadline, or about money, or about a fight they had with their spouse or whatever it is. But it's something that has a cause in the "outside world". Therefore, if they didn't think about it, it wouldn't worry them. Now, I know from much, much experience, that this is easier said than done. In fact, I'd argue that you must practically live in a vacuum not to worry about certain. While you might be happier in the present thinking that everything will work out and you have nothing to worry about, I'd suggest you might be painfully unprepared for what does happen, and your present happiness will be traded for difficulty down the road, instead of being prepared for obstacles ahead. But, my point is, the worry is caused by something that isn't intrinsic to you. The same could be said of when you're feeling sad or down. You are sad or down about something.

For those who suffer from anxiety or depression, though, this is not always the case. Of course, I do have anxiety about external situations. But my anxiety and depression isn't always caused by something in the outside world. It's not always situational. Often, I just wake up in a state of anxiety or depression. There's no cause other than the fact that I suffer from anxiety or depression. When you've woken up in a horrible depression and have to drag yourself out of bed against your will, when everything feels hopeless and you feel worthless, the very last place you want to be is in the present. Because the present feels virtually unbearable. It would be like telling someone who's just fallen and broken their leg in three places to focus on the present. They're lying on the ground in excruciating pain with their leg sticking out in weird places and you're telling them to just focus on the moment. Why would they want to do that? They want to focus on anything else - when they get help and the leg is set and they can take something for the pain and don't feel like they're ready to die. When they recover from the injury and can move normally again. They don't want to lie there thinking about how much pain they're in. This is exactly how it feels to those of us with anxiety and depression that comes on out of "nowhere" except our own brains. People ask us "what are you depressed about? Why are you depressed?" And the answer is simply "because I have depression." In fact, the only thing that gets us through those moments is thinking about the future, when this passes. Or perhaps, remembering a wonderful moment in the past, when we didn't feel this way, so that we can remind ourselves that it's not always like this. What sinks us is focusing on the now, because it feels like it will never, ever pass, like you've never felt any way but how you feel right now, like it's hopeless.

So please, unless you've experienced what we're going through, don't pretend you know how it feels. Don't give us platitudes or cliches. If you think that just focusing on the present moment will make us better, then you clearly do not understand. It's fantastic that this works for you. But it doesn't for us. It only makes us feel even less hope, more anxiety, more despair than we already do. Instead, just be there for us. Try your best to truly understand what we're going through. We may at not even want to hear that it gets better, because our brains may not let us think that way, and it sounds like you're just throwing cliches at us. We may not want to think about the present or the future. We just want someone to truly understand us in that moment, right there. It sounds like a small thing, but it goes such a long way. 

The Episode That Started My Cyclothymia Journey

Seven years ago today, I was hospitalized. A few months prior, I had gone to my GP to discuss what seemed to be depressive symptoms. Why I didn't make an appointment with the most recent therapist I'd seen on and off over the years, I'm not sure. But I didn't, and therefore was given no diagnosis, just a mild dose of antidepressants. It had taken me a lot of courage to accept the medication. For years, despite going to numerous therapists, I'd never been prescribed medication. All but the most recent (who is still my therapist today) had told me the opposite - nothing was wrong, I was just going through "life stuff", more or less. It was entering the "real world" after college, planning my wedding, my marriage, my mother-in-law (this could have been legit),  etc. It didn't matter that some of the emotions I'd experienced were far from what I felt was "normal". It didn't matter that at times my then-husband, much to his credit and my amazement, would hold me so that I could punch and kick the air to release anxious energy to the point of mental and physical exhaustion. Only the most recent therapist had taken me seriously and to be honest, I hadn't done her justice. When I'd begun going to her, it was both for some body image issues/discorded eating, and in the wake of my divorce. When I'd entered my new relationship, I'd felt better on both accounts for quite some time - a "love high" so to speak - and figured maybe everyone else was right. So I kind of fell off the therapy wagon.  It had only been recently, as life settled down a bit, that the darkness had begun to seep back in, and I'd made the appointment with my GP.

The antidepressants seemed to work, at first. I didn't have the looming heaviness that seemed to continually be there, even if in the background. But lately, I'd been having an increasing amount of, what seemed like at least, anxiety. The feelings of needing to desperately release anxious energy had returned. I was starting to have an increasing number of what I thought were anxiety and panic attacks. Finally, on Labor Day 2009, I could no longer stand it. I knew something was wrong. My then-fiance took me took me to the ER. We thought perhaps they could give me some sort of an answer, or at least point me in the right direction. In a round about, convoluted way, I suppose they did.

At the time, they were of absolutely no help. They told me they could do nothing. When I said something was quite wrong, they replied that I could stay overnight if I wanted, but they didn't have room so they'd have to send me to a sister hospital. I was at Virtua, so while I didn't love to have to go elsewhere, I figured there were enough Virtua hospitals and it had to be nearby. Why I didn't ask, before I signed the papers, which one, I am not sure. In the throws of a severe anxiety attack, I simply agreed. I needed someone to help me, and if that meant I had to sleep there overnight to be seen further so be it. What they did not tell me, in my confused and ill state, was what that actually meant. They simply gave me some papers to sign and dutifully, I did. As the process for me to move began, I realized something was terribly wrong. We asked for the location, so we knew where we were headed, and they told me that they had to take me themselves. In an ambulance, on a gurney. They assured me it was procedure. My fiance followed in his car, thinking he'd be able to stay with me, or at least see me settled in if he wasn't allowed all night.

When we arrived, I was given a set of instructions:

• Visiting hours were strict, and not often. 
• No cell phone use was permitted, at all. To call anyone I needed to use the house phone. 
• I had the right to leave, if I chose, after two nights, because I was a voluntary check-in. 

Now, I knew something was very wrong. I asked, for the first time, where I actually was. I was not in another branch of Virtua. I was at a mental health hospital that yes, did have some connection with the brand, but it certainly wasn't what I'd been lead to believe.  I told them I'd change my mind, I didn't need to stay overnight. They replied that I'd already signed the papers, so they could send me back to the ER, but if the ER decided to admit me involuntarily then I would have no say over when I left. My fiance and I discussed the options. The thought of being trapped against my will for any longer than two days, when I had not actually agreed to be there in the first place, was unbearable. I agreed to be 'voluntarily admitted'. I figured perhaps, after all, they would be able to offer me some help - to figure out, finally, what was going on. 

I say, "I decided to go", but really, I made big fuss about it, once up in the actual hospital. They confiscated my purse. I would get it back when I left. They took my belt. They then told me I needed shorts that fit better (I told them they had, before they took my belt). I'll admit, I probably didn't appear the most promising patient. But I was still battling the anxiety and panic that had sent me to the ER in the first place, and now had been coerced here against my will. I felt like a trapped animal. 

They had me sit down with a completely uncooperative therapist, who basically wouldn't listen to anything I said. He insisted I was battling depression, upped my antidepressants, and labeled me a suicide risk. I asked why, since I'd come in with anxiety attacks.  Apparently, they'd not liked the answer to a leading question they'd asked in the ER. I found it ironic that they'd labeled me a suicide risk at the ER, yet had been ready to send me on my way, with not so much as asking if I planned to follow up with a therapist, or even had one, until I told them I really needed to at least be seen further (which was when they told me I could stay overnight and the rest began). 

All of this said, my time in the hospital - I did leave two days later at will - did help me in a few ways. 

• I learned that there were a lot of people there just like me. There were people misdiagnosed or undiagnosed but seeking some help; persuaded against their will by the hospital; people battling extreme grief (luckily this was not me). Most of us were drastically far from what the movies portray as "mental hospital patients".  We were "normal" people battling something medical, known or unknown and looking for help in treating and living with it. 

• I had the experience of group sessions. While it's not something that I traditionally do, it gave me a different perspective, and I got to know the others there. 

• I reconnected with my therapist on the outside world, and began seeing her again. It was she that realized shortly after that my antidepressants had thrown me into hypomanic episodes, not anxiety or panic as I'd thought, and that I actually had the rare diagnosis of rapid cycling cyclothymia. She weaned me off of the antidepressants, and slowly introduced me to a mood stabilizer. I've been seeing her regularly, and taking the mood stablizers ever since. 

I don't share my story to discourage people from seeking mental health help. In fact, it's quite the opposite. This visit to the ER, despite how much I despised the staff at the time for tricking me, and despite the fact that I did not like the specific doctor on staff, ultimately helped me. It got me back to my therapist, who I should have been going to in the first place, and therefore allowed me to be diagnosed and begin treatment.  I also learned some valuable lessons along the way:

• Ask questions. It doesn't matter how silly you feel, or how many you ask. Never assume. 

• Insist on a diagnosis,  prognosis, or at least next steps. If they don't have a diagnosis yet, make sure you know what they plan to do every step of the way until they have one. Ask for a plan in advance before agreeing to anything.

•  Have a plan for your mental health care and make sure that a few trusted loved ones know of it. You may not be in a state to ask questions, to properly sign documents, to discuss your plan with the doctors or medical professionals at the time. Have people assigned, in advance, who know what you want. Make sure they know who each other are, and what each person's role is. You don't want them to guess or put them in the position of arguing against each other, each suggesting what they think you'd want them to. 

• There are other people out there like you. You are not alone, no matter how rare your disorder is (the prevalence of rapid cycling cyclothymia is something like .04% of the US population). Seek out those people, who can give you something to hold onto, when nobody else can understand what you're physically and mentally going through, no matter how hard they try.

• You can get through a hell of a lot more than you think you can. This was not an easy time for me- the hospitalization, the diagnosis, weaning off one med, starting another that made me horribly ill initially, adjusting to learning that I have a life long mental health condition. But I got through it. 

• It is worth it. By it, I mean pushing through these episodes, these awful times. My life has changed drastically since then, in just about every way. But I am still here, and I decide to wake up every day because it's worth it, no matter how hard it gets. 

• Being diagnosed with a mental health condition does not take away your voice. It gives you one. 

Having a Brain That Nobody Understands

I'm used to my brain playing tricks on me. When I'm in a depression, it tells me I'm no good at anything, that I'm worthless, that I'll never be successful. When I'm battling anxiety it tells me that nobody likes me, that I can't handle difficult situations. When I'm hypomanic, it convinces me that I have more energy than my body will physically allow, and runs faster than I can process. They can be awful, but I'm used to them. I recognize them.

Then, there are times that my brain feels "normal". I'm finally experiencing thoughts and beliefs that seem so obvious to me, so natural. I'm not experiencing crushing depression, crippling anxiety, jittery hypomania. I'm just... me.  And yet still nobody else understand what's going on in my head. Everyone, including my therapist, suggests that I  change, or at least moderate these, so I suppose they must not be "normal" thinking, and yet I struggle to understand why.  It's a horribly lonely feeling. Not because you're physically alone (though you may be) but because you're isolated.  Picture this: you're standing in a room and a dog walks in. It's clearly a dog. You can even identify the type of dog it is. You say "look at that cute dog," and every single person turns and give you a funny look and says "that's a cat!"  You ask person after person about the dog and everyone tells you it's a cat. Never mind that it's at least two feet tall and 60 lbs. They're convinced it's a cat. No matter how many people you talk to, you're the only person staring at a dog. Yet you absolutely, positively, 100 percent see a dog. In no way can you see a cat.  Now, there is, of course, the option that you're hallucinating or having delusional thoughts. But even that isn't a very comfortable explanation, and if you have no history of it, nor does your condition generally contain anything like that, it's probably not the correct answer. So what is? Why does everyone else see a cat and you alone see a dog? I don't know the answer. Bu that's exactly how it feels for me. Every day.

I don't know if other people feel this way. I don't know if others feel an urgency about certain things that nobody else can fathom. I don't know if people get filled with anxiety, panic, darkness, even anger about pieces of life where others can't understand it. I don't know if anyone else hangs on to plans and timelines, completely lost without them. I don't know if others fail to understand what is so bad about sticking to these plans and timelines when it's at all feasibly possible. But I do. And it's the loneliest feeling in the world, to be isolated when surrounded by people, either physically or emotionally. But if you do feel this way, know that you're not alone. Know that there are others out there, at least one other, who gets what it's like to have a brain nobody understands. To see things a way nobody else sees them, as clear as day. To be horribly frustrated, even angry at times, at living a life full of this. And if you need to, reach out. Because I understand. And even if I don't understand every specific feeling, I won't try to change you (assuming what you are thinking isn't horribly illegal or dangerous to others). Even if everyone else sees a cat and you see a dog and I see a miniature pony, at least neither of us sees a cat, and we can at least commiserate in that. I'll listen, and understand that you, too, live a lonely isolated existence And at least now now, even in just the knowledge of each other, we can be slightly less lonely. 

How Much Do You Know About Me - A Fun Quiz

Over on the Northen News blog, my dad has been doing some fun family quizzes. It's been a cool way for us to interact and discuss the family, and provide some tidbits of information to those who didn't know us as well as they thought they did. I have done a few quizzes in the past, but it's been a while, and I thought I'd try to break out of this funk I've been in by writing something more light-hearted. Enjoy! (Answer key at the bottom).

1. Throughout my life, I've had dogs named after all of the following foods except: 

a. Eggnog    b. Cheese-itz  c. Cinnamon  d.  Biscuit 

2.  When I was 4 years old, I wanted to work at which food chain?:

a. McDonald's  b. Friendly's  c. Dunkin Donuts  d. Wendy's

3. In the third grade, I had the lead role in the school play. What was my profession in the play?

a. Teacher   b. Nurse   c. Doctor  d. Scientist

4.  I am severely allergic to which vaccine?

a. Chicken pox    b. Measles    c. Tetanus   d. Whooping Cough 

5.  In college, I studied abroad in which country? 

a. England  b. Italy  c. Germany  d. Australia 

6.  My favorite subject in high school was:  

a.  Biology  b. English  c.  Psychology  d. History

7.  My freshman year college roomate's name was: 

a. Maddie  b. Jaime  c. Jenny  d. Becky

8.  I have been to every state on the US East Coast except: 

a. New Hampshire  b. Maine  c. Vermont  d. North Carolina

9.  I'm a pretty adventurous person. But I'm afraid to ride on which animal? 

a. Horse  b. Camel  c. Donkey  d. Elephant

10. I have a tattoo of:

a. A lily  b. An elephant  c. A sun  d. Cinn's paw print

Answer key: 

1.d

2. c

3. a

4. d

5. d

6. c

7. d

8. b

9. a

10. c