Monday 14 January 2013

On Living With Anxiety and Depression


After writing the diatribe that was the 2012 Summary, I realised a few issues needed expanding on.  I'd just assumed that at some point in time I'd have written a post about anxiety and depression.  Turns out I haven't.  So thought I'd attempt to do that today.

So what causes people to have these things?  For some people it'll be purely chemical, possibly hereditary or even contributed to by hormones.  And for others it's as a result of some sort of trauma.  I was diagnosed with PTSD when I was twenty, and this diagnosis made complete sense to me.

I didn't grow up in what would be called a 'stable' living environment.  My parents continually broke up and got back together.  I moved homes often, and attended four different primary schools.  I witnessed violence within my family.  I was poor.  The thing that made this hardest was that I knew  this wasn't right.  From around the age of nine I felt like the only sane person in our household.   And I couldn't do anything about it.

When I finally escaped this situation I was fourteen.  Things had reached a point, partly to do with my father's mental health, and partly to do with me being a teenager, where I just couldn't do it any more.  Mum helped me to get to a friend's place on Christmas Eve and my Aunt picked me up from there.  Mum managed to get out a month or so later (I can't remember how long it took) and we got a little flat together with custody of my brother every other week.

Although it took years after leaving for Mum to realise that the situation we were in was one of 'domestic violence', she knew that I was messed up, and sent me off to counselling.  I've been in and out of counselling now for more than sixteen years.

I'm not going to give a history lesson on all the times things got really bad, or all the crazy things I consequently did.  I will summarise by saying that there was a half-arsed suicide attempt in my teens, there was a point where I was so unwell I couldn't leave my house, and I did a multitude of harmful things to myself and others over the years.  Now, through experience, I feel that things are more manageable, but this is something I can never be complacent about.

For people who haven't experienced anxiety I'll do my best to explain what happens to me.  First of all, it's actually a physical thing.  Usually something will 'trigger' a physical response (adrenaline).  My heart starts beating super fast.  I get flushed.  My hands get clammy.  My legs get shaky.  I feel like I need to pee.  I often have difficulty breathing.  And this starts what I call 'the head/body anxiety cycle'.  Whatever has triggered the panic attack is usually something I'll be aware of.  Once my body starts going crazy, my brain starts to catastrophise all the things I was initially a little worried about.  My brain catastrophising keeps my body 'triggered' and none of this goes away until the thing I was initially worried about leaves my immediate vicinity.

This is why anxiety/depression is a cycle.  It's chemical.  Once your body has run out of adrenaline and endorphins, there's not a lot of happy stuff left.   So then you get depressed.  Again, depression is a physical thing.  I feel exhausted.  Everything feels heavy.  I feel as though I am viewing every day life from afar, like watching TV - I feel physically distanced from my life.  It is this sensation in depression which is the most dangerous.  Because I just want to feel something, and will do harmful things to do so. 

While I've been in and out of counselling for a long time, I've been on and off drugs slightly less.  I OD'ed on prescription sleeping pills as a teenager, which made me really anti drugs (why give someone who's depressed something they can use to kill themselves?).  It wasn't until I got very ill in my early 20's that a doctor convinced me to try  SSRI's.  I tried three or four different ones over the space of a year and a half, and none of them helped.  I was regularly seeing a therapist at the same time which helped me through that particular time.  It wasn't until about four years later that I tried Fluoxetine (Prozac) and found it actually worked for me.

Fluoxetine is something I think of as a stand-by for when I can't stop my body getting to that dangerous state.  I want to be well, and I know that at certain points no amount of talking it out will keep me from going there.  I have had so many people say 'do you feel like a zombie' re: being medicated.  I feel like a zombie when I'm unwell and not medicated.  When I'm medicated, I feel like a normal, well adjusted person (with a dry mouth, side effects do suck).  I am not on Fluoxetine all the time.  I just use it when I feel it is necessary.  I've been off it for over a year currently.

The other thing I've found very useful is not believing in 'regret'.  For many people trapped in the depressive cycle, regret's an easy habit because there is so much you'd rather have not had happen.  But it puts you in stasis.  You can't move forward, and it's not possible to move back.  I acknowledge the things that have happened to me, and the things I have done, but I don't regret them.  Regret makes people bitter and miserable.  Being bitter and miserable doesn't seem very fun.  I do believe in mistakes.  I think of them as 'mis-takes', as in 'we're retaking this scene because it wasn't quite right', where you do it over, again, and again, learning each time how we can improve on the last 'take', and appreciating what we've learned from it.

Understanding why this cycle happens also makes it more manageable.  I do not think I can ever 'fix' this.  Basically, my body is programmed for 'fight or flight', which is why it reacts with the adrenaline so quickly.  This is because in the past, 'fight or flight' has been a necessary survival skill, and has often arisen out of seemingly banal things.  So when I'm feeling just slightly off kilter, anything which causes 'confrontation' will result in me having a panic attack.

This is what happened in November.  I was terrified about having to tell my new employer that I was pregnant.  This fear was impacted by the very rough year prior, which already had me frazzled.  I catastrophised that I would lose my job as a result.  Even though the reality is that this wouldn't be the end of the world, much of my esteem is wrapped up not only in my job, but it how it contributes to our household earnings.  So these feelings snowballed into daily panic attacks and the panic attacks led to a cycle of depression.  I genuinely thought my husband was going to leave me ('dangerous' point in depression aided by feeling worthless), and started to try and work out how I could live as a single mum...

It is ridiculous that things got to this point, but it is often difficult to see what point you're at when you're living in it.  And I still find it hard to ask for help, even from those closest to me.  Because you have to admit you aren't coping, and are being irrational, and you aren't a proper functioning 'grown up'.  And sometimes when things are really bad, it can mean compromising things important in your life.  Like your job, or your relationships.  That's bloody hard to do.  Once I did finally ask for help, things started to become more manageable pretty promptly.

I am certainly not a magically 'sane' person now.  But my life is 'manageable' and I've banished this particular fear by being proactive with my boss (which was terrifying, then a huge relief).  Chemically, things have reached a balance because I'm not having panic attacks any more.  And I got through this patch with my husband, home, job and everything, intact.  This is successful anxiety management.

And I hope that writing about it will help other people understand what it's like to live with this.  And for those struggling with depression or anxiety, to know that you can live with it.  Things will be ok.