I have generalized anxiety disorder. Well, That’s the primary condition. If I don’t manage it properly, other secondary mental health issues pop up like:
- social phobia
There is so much crap out there when it comes to anxiety and medication. Most of the people who post are the ones who have had bad experiences. I struggled to find rational and useful information from people who have gone through similar experiences.
Here’s the thing: you can have a great team of people (doctors, physchologists, etc). They can be useful in helping with specific issues related to management of symptoms. But they can’t talk to you about the little tricks they’ve used to make life easier. They can’t debate the pros and cons of different medication with you based from personal experience.
Professional support is great. Yet, having a mental illness – especially a severe one – affects your life in so many little ways. I can use positive self talk as much as I want but it wont stop me from feeling disappointed at how little I’ve accomplished since getting ill. I’m going to start by talking about the progression of my illness, chronologically, and in depth.
How Did I Develop Anxiety?
I believe I’ve had anxiety disorders my whole life. I didn’t talk to anyone outside my immediate family until I was 5. I couldn’t use the phone until I was about 13. I didn’t overcome my social phobia – intense fear during social situations – until I moved out at 17.
I had no-one to hide behind anymore. I moved out under difficult circumstances (brought about by my own paranoia) and was thrust into independent living. I was able to overcome many facets of social phobia by necessity, but life quickly became a struggle. I was diagnosed and treated for depression, but found it had little effect. I got into to uni and moved into a flat in someones backyard.
At the end of my first year, my grandmother was diagnosed with cancer. I’d never really experienced the prolonged illness of a relative, nor had I watched someone die. It was a stressful time for all. I have a reputation of being the reliable one in the family and was often called on to help out during this time.
I’d never been under this much prolonged stress before and started to experience these weird symptoms. I rarely cried during this time, but was having panic attacks constantly. I couldn’t sleep. My concentration and memory were shot.
I just put it down to the stressed and assumed that they would go away when my grandmother died. They didn’t. Instead, it just got worst. I stopped attending uni and only showed up to hand in assignments. I switched to off campus but found the workload overwhelming. The symptoms worsened and I had no idea what was wrong with me. By the end of the year, I could only manage to do housework once every two months. I started feeling dizzy and sick everytime I left the house.
The worst was when I started hearing voices. I started to have mild delusions and felt constantly on edge. I couldn’t calm down or take basic care of myself. I demanded to see a psychiatrist who said that a simple anxiety disorder can manifest in this way. It is only in retrospect that I could see that I had experienced a nervous breakdown.
What was it like having a nervous breakdown?
It was really nice. I was unable to do anything, but I didn’t care. I couldn’t open the mail anymore but didn’t care and just let it pile up. I wore the same outfit for two weeks – it didn’t matter, as I never left the house. I lost all independence. I ruined my budget. I lost my friends and everything that I held important in life. I was too depressed to care. Recovery, however, was the bitch.
In high school, I was diagnosed with depression. I would see a psychologist at school and get medication from my local Headspace clinic.
In retrospect, this wasn’t a good way. It’s a lot easier when the services are at the one place and, where necessary, different people can talk and worth with each other to help the patient. I’ve since learned that depression is secondary. The medication had very little effect on me and I would occasionally sneak off to the toilets to cry. I went off those meds as they had little effect and, post exams, felt a lot more confident and didn’t seek further treatment.
I was fine until my grandmother died at the end of my first year of uni. She had cancer and I watched her get progressively sicker. My mum was placed under a lot of pressure and I was asked to help out a bit. This means I was closer to a lot of the ‘bad stuff’ that was happening. I started having panic attacks and not knowing why. I felt calm and didn’t cry much mostly, except when I had this random bouts of hyperventilation.
She died and I tried to resume normal life. I went to uni for a couple of weeks and then just stopped attending. I couldn’t keep up with housework and stopped showering. Eventually I just stopped leaving the house and cut off all my friends. I was having panic attacks and getting sicker but was trying to keep everything together.
In 2007, I got a letter saying that I had failed all my subjects that year and that I had to talk to people at the uni. My landlord and friend came with me and we arranged so that I would attend uni part time over the next year. I went on medication but dropped it after 4 months as it was making me sicker. I tried seeing a counsellor but it didn’t work. I’m smart and if I couldn’t beat this, then just talking about it wouldn’t do anything. I didn’t show up the next year, either. I wanted to but I just… it was like my brain couldn’t function and I didn’t care what happened.
In mid 2008 I was kicked out by my university and got a letter from centrelink threatening to cut off my student payments. I explained the reality to them and was referred for a job capacity assessment. The idea was to see if I was eligible for a disability support payment. Untreated, I had no quality of life and don’t believe I was capable of working.
In March 2009, I started on the Personal Support Program. I had an awesome lady who I worked with to get support getting my life back together. She was the one that told me that I present quite well and make myself appear better than I am, and that makes people think I’m better than I am.
I owe a lot to this program. I had the support that I needed without the pressure of employment hanging over me. During this time I experimented with blogging and social media. One of the original recommendations was to try alternate medication. She knew I was scared – I’d experienced really bad side effects before and didn’t like the loss of control.
I went to the doctor and my mother came with me. I had a bit of a fight with her. She was reluctant to give me medication because I would stop attending appointments and wouldn’t take meds. I had to argue quite strongly for a blood test and different meds. I wanted a SNRI because SSRIs weren’t really working for me. I was so angry afterwards that I wrote this in my diary:
I know I’m sick. I know I’m not a good patient. At most, doctors and other professionals deal with me for 1hr a week at most. I have to deal with me the rest of the time. If it was possible to get a job, I would have. Poverty stopped being kinda quaint about two years ago. If it was possible to just change my thoughts to magically rid myself of the symptoms, I would have. I’ve pushed myself through the fatigue many times. Usually I come back, spend half an hour puking, then go to bed with a massive migraine/tension headache. Eventually, I gave up pushing myself because it wasn’t going away.
I felt better within hours of taking my first Effexor pill. It was fantastic. It felt like a blanket of calm. My heartrate slowed down. I didn’t have to pee as much and my head was clearer. I started seeing a fantastic psychologist who picked up that I intuitive understood my symptoms and we talked strategies. He let me know what I was doing right, like cognitive restructuring, and would recommend specific resources to help.
It was around this time I joined the NEIS program to build a small business. I increased my dose off effexor at this time. The increased dose gave me more brainpower, but it also made it more difficult to orgasm. This wasn’t a problem until I got into my first relationship later in 2010. After a few months, I made the decision to lower my medication. I did ask the Dr if I would go on Welbutrin, but it isn’t available in Australia.
The past year has been tough. I consider myself mostly normal, but I have to place a priority on my mental health. I’m okay provided I allow myself a certain amount of sleep and downtime. I can now work and socialize, and live a pretty normal life. I’m an introvert so most of the time is spent at home, with the boyfriend, or reading.
I believe that my anxiety is, partly, a blessing. It helped me figure what is really important at life. I feel like I’ve hit rock bottom and am no longer so afraid of what can go wrong. It’s been a really interesting journey.
The Symptoms of Anxiety
These are just detailed descriptions of what occurs when I experience a specific symptom. I wrote this a year after I was first diagnosed. Most of the symptoms are at a manageable level now. They are mostly cognitive – concentration, sleep issues and headaches. I get physically drained rather quickly
I thought I’d start with agoraphobia because it is the symptom that is misinterpreted the most. Heres the thing: I’m not actually afraid of people. I don’t like the majority of them but that doesn’t mean that the people scare me.
The fear is actually having a panic attack in a public situation. To properly understand this, you have to understand the symptoms. I can predict when I’m going to feel agoraphobic in a certain situation. Its often after a depressive episode when I still feel lethargic.
It takes a lot of mental energy to manage my various symptoms. My brain gets foggy and slow during depression which makes it very difficult to distance myself mentally from my illness. Usually, I get about 200 meters from my house and start to feel a bit light headed. I get increasingly sensitive to all lights, sounds and movement. This is mildly distressing.
If I’m not careful, I can experience depersonalization, dissociation and derealization which I have previously discussed. These are the most distressing to experience in public places. I hate public places due to the lack of control over external stimuli. I can’t control how loudly the kids will shout, nor whether or not they will run in front of me. I can’t prevent the cars from screeching. It is really overwhelming and can trigger the next stage of anxiety.
I call this my spidey – sense. I honestly feel like my senses are in overdrive. Noises seem louder, movement goes quicker and being physically touched is unbearable. This often occurs just before an acceleration of my anxious symptoms. It is also a symptom that makes me feel agoraphobic, because it is very hard to cope with. Breathing exercises and positive self talk don’t make them go away.
I like hiding in my house when I have this symptom simply because I’m removed from external stimuli. Even then, a door knock or a dog barking is enough to make me feel ill. This is a long lasting symptom. It usually lasts hours or days. There have been times I’ve skipped meals rather than leave the house to do groceries when experiencing this symptom.
When I first started having dissociative episodes, I thought I was going insane. Its like your life is a DVD and someone just pressed ’skip’.
Technically, dissociation is your brain protecting yourself from perceived threats by blocking out parts of your memory. I can understand the need for your brain to do that should you actually be under threat. Not in normal situations.
You can usually tell when you’re close to dissociating because you get into a trance. I’ve found that staring into space can be a trigger. Showers also trigger the trance state, which is why I avoid them when tired. They used to happen quite often. Now, I often stop them while at the trance stage by doing grounding techniques my doctor taught me.
They are very disorientating to experience. I don’t drink alcohol, but I imagine its like being drunk. You lose bits of your memory. When you come out of it, you feel a bit dizzy and uncertain of where you are. Your aware of the passage of time. Often, i’ve missed entire conversations and have been worried about what I may have done or said.
These are dissociative symptoms that are really disorientating. I feel completely disconnected from reality. It is often accompanied by a tingly feeling. I am aware that its a symptom while experiencing it, but my body still perceives the symptom as a threat and brings on further anxiety symptoms. This one nearly always brings on a panic attack. Grounding techniques rarely help. I found that avoiding social contact helped. This flared up last Christmas and has been barely experienced since. I assume this is due to my strict routine to minimize the effects of anxiety.
This symptom is the one that is misinterpreted the most by my peers and causes me great frustration. I’ve been told I’ve brought them on myself and am overreacting. This section, while slightly acerbic, aims to provide a realistic view of what a panic attack is like.
News Flash: panic attacks are not always controllable. They may not be event specific. You might not even be aware that your about to have one until your on the verge of hyperventilation. I’ve often woken up from nightmares on the verge of a panic attack. Panic attacks leave me tugging at my throat, clothes and skin in an attempt to get air. I’m often crying as I hyperventilate because I’m so desperate. This lasts for about 10-15 minutes. I usually fall asleep afterwards.
Sometimes, I can have multiple attacks right after another. I hate it. During an attack I feel dizzy and faint. If I have 2 severe or 3 mild attacks in one week, I know I’ll definitely have a depressive episode. I know that within hours, or days, I will feel so physically lethargic. I often feel like this before I have a panic attack. I’m aware that the stress and fear isn’t real. Awareness and self talk can’t stop it. Its a physical reaction and needs to be physically let out.
If a stressful situation occurs or I have physically exerted myself I get tension headaches. These are mildly painful, but are more of an annoyance. I have to wear a blindfold and often wear earplugs to block out noise and light. I never sleep during the day, so I’ve often laid in bed from 3pm in the afternoon until I’m able to fall asleep at 7-8. They are accompanied by general body fatigue and lose of appetite.
These are so many ways that anxiety can disrupt my sleep. There are the nights when you can’t get to sleep because your mind is constantly racing. I have to force myself to go to bed at 7 and hope by midnight that I will calm down enough to fall asleep.
There are the nights where you nightmare so frequently you only get 5 or 6 fragmented hours of sleep. This is worse when you have panic attacks while sleeping. There are the nights where your so exhausted you sleep for 12 hours and still wake up unable to function.
Its really hard to manage because sleep is based on the feelings I have in the hours before going to bed. I’m usually not aware until the last minute and therefore am unable to use any of my relaxation techniques in advance.
I call this ‘Jelly Legs’ or ‘Mind Mush.’ I suffer from physical and mental fatigue. Physical fatigue interferes with my ability to take care of myself. Its similar to being knocked about by a bad flu. Its very hard to move, let alone do everyday tasks like cleaning and bathing.
Fortunately, I’ve got a grip somewhat on this symptom. Mental fatigue is horrible. Its similar to having sinus problems that make you feel like your in a ‘mind fog.’ My mental clarity is gone and I’m unable to put sentences together. I forgot what I’m talking about mid conversation and have to have a notebook on me at all times. I discuss these symptoms further in the below two sections.
Lack of Concentration
This occurs during times of extreme anxiety. Your body feels ‘wired’ and I get skittish. My mind also is. I can’t concentrate because my mind is going way too fast. This also occurs during times of depression. In this case, I am so mentally sluggish I cant pay attention because it takes too long to comprehend information
I often forget what day it is. I don’t remember if I have eaten, so may have two dinners. I forget instructions, forget to pay bills. This particular symptom is what gets me into the most trouble especially when it is misconstrued as laziness. My handy notebook saves me. I have everything written in there – plans, daily schedules, budgets etc. It has proved immensely useful.
This usually occurs during times of social phobia. I can feel my palms get sweaty when I’m really nervous. It rarely happens in relation to Generalized Anxiety Disorder.
Negative Self Talk
Honestly, the negativity and constant hatred are symptoms that are perfectly manageable. While I am aware its not healthy, it causes no problems for me to believe that I’m a worthless sack of poopy that deserves to die. When in high school, my constant self deprecation was considered a cute quirk. What people didn’t know was that I genuinely believed all the negative things I was saying about myself.
The main problem I have with this symptom is censoring myself so that my negativity doesn’t interfere with others. I’m aware that it can be tedious and annoying to be around a person who is constantly bagging herself. I’m also aware that this can be seen, by some, as an attempt to get attention.
The self talk is separate from the depression itself. I can tell whether I am anxious or depressed by the specific type of negative self talk I use. If its generic put downs, it’s anxiety. If I link my non existent self worth to my right to live then its depression.
The majority the symptoms of depression are quite tolerable. They are annoying, and really interfere with my quality of life. However I have learned how to distance myself from my symptoms. I am able to recognize the symptoms that signal the onset of a depressive episode and then create plans to make life easier for my while I’m sick.
I find I often have depressive episodes after a panic attack. They start between 1-5 days after an attack. The severity depends on the severity of the initial panic attack. If it was just a mild attack, then I feel a bit lethargic and bummed for a couple of days. If I have multiple panic attacks in the same day, I can lose weeks.
This symptom is the one that scares me the most. You are not in the right state of mind to even be contemplating such a thing. However if I have severe anxiety and depression concurrently, then I get really concerned for my health.
When I have depression my self worth plummets. I believe that I will never make a positive contribution to society because my illness makes my day to day life so hard. I wonder how I’ll be able to accomplish any of my goals if I can’t even do the dishes.
When I’m anxious, I’m desperate. Desperate to remove myself from the situation that is causing me stress. Desperate to prevent a panic attack because a full depressive episode is so debilitating. I know I wouldn’t act on any of these thoughts.
For starters, my anxiety makes me fully aware of the many ways suicide can go wrong. I usually have just enough awareness of the situation to realize the thoughts are not real and are a manifestation of an illness. It doesn’t make the symptoms any less distressing. The feelings can extend the physical symptoms of a depressive episode.
This is probably the main symptom that makes me avoid any situation that could trigger the immediate feelings of anxiety.
This symptom may be a bit graphic but its one I’m glad I have under control. Most people, when nervous, have to go to the toilet. That is understandable. At the height of my anxiety, I would go to the toilet about 10 times before leaving the house. I’d wake up multiple times during the night to go and wouldn’t be able to get to sleep without another 10 trips. This symptom was more annoying than anything else. The lack of sleep was more severe.
Effexor has been a lifesaver. Here are some notes from diaries I kept at the time: 5 days in:
I’ve been taking Effexor since Wednesday – a total of about 5 days. The first day I had nausea. Now i haev little appetite. The other side effect, which I’m LOVING, is that it makes me really sleepy. I know its early days but I believe its helping. My brain isn’t going ‘chatter chatter chatter’ at me like it normally does. I’ve yet to notice any difference to the physical effects of anxiety. I’m also unsure whether it has helped my cognitive symptoms because I haven’t really interacted with people and have been feeling really drowsy. I’m not sure how long the side effects would last. I’m not sure if its working and if i should adjust the dosage.
Two weeks in:
I’m in love. I used to be very anti drugs (as even caffeine used to make me crook as) but now, I am really appreciative off Effexor. I got my bounce back. I’m singing (off key and inappropriately) again. I can feel the anxious process occuring, but very much notice that the severity has reduced. A fucking lot. Ok – so something happens. I get startled, or shocked, or dissapointed. Anything mildy stressful triggers a fight or flight reaction where adrenalin just soars through my body. This used to start a shitty panic attack or dissociative episode but now just makes me sick, and tired. When something happens, I first feel it in my head. Its like a wave of mildly painful energy that starts at the front of my head, and makes it slightly harder to breath. I’ve had things that have triggered that response. Dogs unexpectedly barking, traffic not slowing in time. I feel the headrush but the symptoms don’t go beyond that. No nausea, no headache. It was the secondary symptoms that made me so flippin’ exhausted so I’m all YAY. Cognitive functions a bit off – I haven’t really had the chance to test it yet. My personality has changed since getting sick, along with my attention span. Yesterday the doctor asked when I wanted to make my next appointment, and I said ‘I can’t think that far ahead’ and she told me what people normally do, which was embarrassing. Its something I’ll be monitoring closely. I still feel the nausea but its not as bad. I have trouble eating the same amount of feels, and find i feel nauseaous when hungry. I’m thinking I’ll just change the size and frequency of my meals. some people lose weight on effexor, some gain weight. I’m hoping i’ll lose it
The Side Effects
My main side effects are weight gain and sweating a lot easier. The weight gain is the most annoying. I’ve never been this large. Eating healthy and exercising regularly has little effect. It is frustrating as I know what people think when they see a larger person. I struggle with it, but I also know what I prefer being fat and happy to what I was like when I was depressed. I’m mostly self conscious about my weight when I’m around my boyfriend, but he has been incredibly supportive. My previous side effects included constipation and difficulty achieving orgasm. They stopped being problems when I lowered my dosage.
Where am I now?
When I was sick, I wrote this:
It is contradictory that ones anxiety prevents ones own death. Are you aware of how many ways a suicide attempt can go wrong? I’m doomed to live this fractured shell of an existinance. It doesn’t mean that I cannot enjoy the satires and ironies of ‘life.’ I may not be able to function, but that does not mean I am any less of a person. Mediocritity befell not I. With broken solitude, I go forth.
I’m glad to say I’m not in that headspace anymore. I see myself as a normal person, albeit one that encounters more challenges then the average bear. I really enjoy life and I’m so glad I persevered for so long. It was worth it