Sunday, August 24, 2008

A Trip to the Zoo

“This bridge freaks me out, Mama,” says my 6 year old as we get ready to enter the National Zoo.

“I know baby. Sometimes I get nervous on bridges, too. What’s going on?” I ask.

“It makes my legs feel funny. It feels like we’re high up in the trees and the water is so far below,” she explains.

“You know what’s cool about that? I ask, getting her attention, “Your body is real smart & that’s your body’s way of asking - Is this safe?

And, what’s cool is that you can look around, make sure you’re safe & give your body an answer.

So, what’s the answer? Are you safe?”

My big girl looks at me, and then all around. “Yeah, but I still feel funny.”

“Let’s look at the bridge,” I suggest. “Hmm - looks strong – lots of people are on it – cars, too.

Let’s check the railing (we try to shake it). Nice and sturdy.

What can we tell our body now?”

“It’s ok body. I’m safe,” she tells herself out loud, smiling.

“That’s right & that funny feeling in your legs & tummy will slowly go away. Maybe it has already. And, if it doesn’t for a while, that’s ok too.”

“It’s gone already,” she tells me.

“Alright, baby. Let’s go to the zoo!”

“Yeah! I want to go see the monkeys!”

Monday, August 18, 2008

Tunnel Vision

We were on vacation at the beach last week & I wanted to share a moment from the journey.

To get to the beach, our route takes us over a handful of bridges and a tunnel that goes underwater. I could have easily gotten my husband to drive, but I knew that I needed to "stir up trouble" for myself & this was a good opportunity to do so. "You driving today?" he asked. "Yeah" I responded & smiled, "No problem." Of course, it's easy to be brave when the offending bridges & tunnel are not in view.

As we approached the bridge/tunnel/bridge area, I started questioning why I was doing this, when a perfectly good, non-anxious driver was sitting next to me. I had to keep reminding myself to invite the symptoms - to try & make them stronger - to ask them to stay around - because, all of a sudden, I really didn't want to be driving & thought, 'Make them stronger? Are you crazy?'

As I descended into the tunnel, I started wondering how strong the walls were & musing about how this is really an unnatural thing to do - driving underwater and such. Before I knew it, the visual images were rolling in of water crashing in all around us as the light from the exit faded into darkness & I wanted to slam down the gas pedal and get out of there quick!

My 8 year old daughter must have known that I needed a reminder to invite in more sensation. Just as we were about half way through, she chimed in and asked, "Do these tunnels ever flood? What would happen if they did? Would we all drown?" My husband & I smiled at each other & her impeccable timing. We told her that, yes, it would be bad if the tunnel flooded, but that it was built to be extremely strong. And, besides, there are people whose only job is to check it's safety all the time. And, isn't it cool that someone came up with the idea to make a tunnel that goes under the water & boats can travel over? (More sensation thinking about being underneath a boat).

I drove us safely into the light and, after that, the bridges didn't phase me that much. We had a fun week in a beach house with 17 people & I decided that it was alright to take the passenger seat on the way home.

My Treatment Resume

Subtitles: No wonder more people don’t seek out help when they need it; and, What’s up with all the counselors pushing medication?

*Almost done with graduate school, having fun doing exploratory work in counseling (recommended for social workers) & I have my first panic attack driving on the highway in Colorado. Grad school counselor sends me to campus doctor to get a prescription for xanax. Doctor says to take it before driving (label says “don’t operate heavy machinery after using”) & to give up caffeine. Counseling stops with the end of school with the message, “you’ll be fine”.

*6 months later I receive a six week sample pack of Prozac. I take it for six weeks and then stop because of the side effects.

*About a year later, I try again & seek out an anxiety center in my area. The shrink is very nice, we have a great rapport, but he doesn’t really do counseling. He does a thorough social history, establishes that I have excellent memory skills in repeating number sequences and sends me on my way with one month worth of Paxil samples. He, too, offers me xanax & this time I say no thanks. As I’m leaving, he tells me that once I beat my anxiety, I should come back and talk to him about a counseling job. I take Paxil for one month and then stop because of the side effects &, really, this isn’t helping.

*A co-worker recommends her counselor. He says that I just need to relax & have a little fun, lighten up a bit. I say, “I have a great, happy life except for anxiety, which is a pain in the ass”. We try EMDR. I try to help the process along and bring my own treatment plans and info that I’ve gleaned from reading. After a few more sessions & more “relax more & just do yoga” messages, I know that this is not what’s going to help & give up on counseling for a while.

*After having my first two babies, I’m ready to try again. Anxiety doesn’t own me, but I’m not driving on the highway much. I still remember what it felt like before anxiety infringed on my territory and I want it gone. I find more resources & begin reading everything I can find on the subject of “how can I get over this”. I begin exposure work on my own & make progress “taking back the roads”. I set up an appointment with a recommended counselor & it’s not a great fit. I go three times & keep looking.

*Second try: nice lady, a little rough around the edges, but she goes out in the field with clients & I like her spunk. I tell her that I don’t want to do meds, but she says that if I go on celexa for 2 years & do behavioral work at the same time that my anxiety will be gone. I try it, but don’t like it. I switch to Zoloft & stay on it for about 6 mos. We drive a number of bridges and highway stretches together. She’s got the behavioral piece down. I say that I’d like to work on the cognitive piece, that in some places on the highway, I’m still feeling really anxious & there must be something I can be doing differently. She says, I’m not sure why the exposure isn’t working for you, keep trying & the anxiety will go away. We part ways & I keep working on my own.

*Third try: I contact a psychologist friend of mine & say, Look this time I really need to find someone who’s an EXPERT on this anxiety stuff, won’t push meds & is up on the current research. I find Dr. C. who is fantastic & I really like, but still encourages I try meds. She’s worked in anxiety for years & has trained most of the area clinicians in CBT. I go on Lexapro & do a lot of great work with her. She says that I’m a dream client, that no one works as hard as I do and that it’s part biology & that I really need to work on acceptance. “I know you don’t want anxiety, but you got it. You have to accept what is.” True, acceptance is important, but I’m still feeling like with all the work I’m doing, I’m still missing an important piece. After monthly visits for a year, I feel done for the time being.

*I go off Lexapro during my 3rd pregnancy, experience big waves of panic in my third trimester and it comes back with a vengeance at about 12 -14 weeks postpartum. I go back for 2 or 3 “booster sessions” with Dr. C. and go back on Lexapro (after getting the green light from my midwife & an international breastfeeding expert). Things get better slowly. I come out of hiding and begin telling everyone. This helps tremendously & others begin sharing their stories. I’m dying for community. I start up a workbook study group (with some very cool, fellow anxiety super heroes) that meets inconsistently for a couple of months & fizzles out.

*Currently – I’m “off the junk” & not seeing a counselor. I don’t have anxiety mastered as much as I would like, but I'm realizing that what I was missing was not just the acceptance, but inviting & provoking the symptoms and, yes, acceptance. Good practice means doing something that guarantees that I'll feel anxious. I wish I could transport Dave Carbonell, Reid Wilson or David Burns to my hometown so that I could work with an anxiety guru and kick this thing once and for all (well, at least feel stronger in my skills and ready for the expected ups & downs).

Looking back over all the steps it’s taken to get good treatment, I see why so many people can live with this disorder much of their lives and never learn to beat it. Access to good information, counseling & community (plus a big dose of tenacity) makes a huge difference. When I get to be an anxiety master, I am going to open my own clinic & help offer others a more efficient path. More about that later!