Good Morning, Depression

This post may be triggering to some individuals.

9am – My eyes open when I hear my husband rummaging around our bedroom, getting ready for work. It’s harder than usual for him to find clean clothes, our laundry is piling up precariously high in the hamper. My dog jumps on the bed and comes to greet me. My husband says, “good morning sleepy head”, while I unclip my CPAP mask and turn off the machine. He kindly avoids alluding to my break down last night. I know from him getting dressed already that I have slept-in past my goal time of 7:30am. One of my first thoughts is how disappointed my psychiatrist will be when she finds out I haven’t been keeping a consistent sleep schedule. I remind myself that’s irrational, she will know how hard I am trying.

I slowly pull myself up in to a sitting position, noticing a crick in my neck, no doubt the result of mounting tension in my shoulders from high anxiety. “Great”, I think to myself, “more pain”. I was supposed to go see a massage therapist to help with the muscle tension in my upper body but I still need to figure out if that treatment would be covered by my husband’s health insurance. That’s a problem for another day.

I reach for my phone while my husband brushes his teeth. Last night a fellow comrade on Twitter was in crisis, I am hoping to see good news. I fell asleep shaken with the possibility that he wasn’t safe. There is strength in connection over social media, but the distance can sometimes make me feel so hopeless to help. I don’t see any news, I hold out hope that he will check in to Twitter soon to say he is safe.

My husband is back from the bathroom. He comes and gives me a kiss, says he is on his way out and he’ll see me later. I can’t hold back the tears. For the next ten minutes he comforts me, reminds me he will be home soon enough and that he can call me on his lunch break. Every touch from my husband gives me strength and courage. I feel horrible, the last thing I want is for him to worry about me while he is at work. I have dealt with many trials from mental illness, but perhaps none so terrible as the dread of waking up and having to survive another day. I try to hide how much I am hurting, but I fail miserably at this practice. I calm myself down as best as I can and give him a final kiss. I don’t want him to be late.

After a few minutes of seeking strength from cuddles with my dog who so intuitively is clinging a little closer to me this morning, I get up to go to the washroom. Passing the vanity mirror I notice my reflection. Its distorted features bear a resemblance to Quasimodo. I had forgotten that I plucked my eyebrows out yesterday when the urge to self-harm was overwhelming me. My eyes are puffy from crying and dehydration, I must remember to drink some water today. My CPAP has left a distinct ring around my nose and mouth. My whole affect is droopy, the feeling of being weighed down that I have been dealing with for weeks can be read all over my face. “Invisible illness”, I say to my dog, “not so invisible today”.

The washroom is brighter than the bedroom. I wince as I enter it. I reach for a pill bottle, but I don’t have one anymore having come off of my last antidepressant just a few days ago. There have been many attempts to find a daily medication that works for me, so far, no luck on that score. I skip brushing my teeth and hair, they are a mess but I am already drained from the few minutes I have spent out of bed. On the way out of the washroom I check that our medicine cabinet is locked, it is. My husband holds the only key, a security measure we put in place at the urging of my psychiatrist after one of my suicide attempts last year. It has often crossed my mind that I could break the cabinet open if I really wanted to, but the superficial barrier of the lock gives me enough pause to remember that is a bad idea.

I change in to a fresh pair of pyjamas. I have steadily accrued a large array of sleepwear; my agoraphobia has been crippling for the last two years so I seldom leave the house. Being comfortably dressed in pyjamas just makes more sense. As I slip on my stained pyjama bottoms I remind myself that putting on day clothing might help me feel more put together; working from the outside in and yada yada. But truly, that’s a struggle for another day. I remember the counsel my psychiatrist gave me last week, “Your job for the next two weeks is to wake up at the same time every morning, eat all three meals and stay out of your bedroom during the day. The rest is gravy.” This is sage advice, focussing on anything else right now might stop me from meeting those seemingly meagre goals.

Pyjamas on, I succumb to the will to crawl back in to bed. My head is pounding and my breath quickening. I figure I’ll relax for a while to ready myself to walk downstairs. On a better day the walk downstairs would be nothing to me, but today it is daunting. In bed I scroll through world news, frequently thinking how messed up our current political climate is. I consider texting my friends, but really who wants to hear from me? I spot that thought distortion, my friends routinely try to reach out to me. Nevertheless, that sentiment feels real today. My dog whines, he wants to play – I respond by snapping at him. I lower my head in shame, am I really irritable enough to take it out on my dog today? I gather him up in my arms and show him love. I fall into a slumber.

Waking back up, I resolve to make my way downstairs. I can’t bring myself to prepare breakfast. Instead, I find my usual place on the couch, allow my dog to jump up on my lap and begin watching the same TV show I have watched over ten times in the past couple of years. The familiar story helps distract me from the agony of my own thoughts. It’s now just past 11:30am, two and a half hours down, far too many more to go.


Take care,

Fiona

Photo by Alex Boyd on Unsplash

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A “thank you” to the people who care

This is a thank you note to the people who care. To those whose kindness and compassion doesn’t end when their loved one’s mental health is at its worst. To the people who show their caring every day, or once in a while. To those who don’t always know how to help but do their best. To those who don’t always understand but strive to.

Thank you to the people whose love for us doesn’t waver no matter what. Who feel our pain so acutely and wish beyond all else that they could take it away. Who help build us up. Who support us. Whose constant care and affection gives us strength. Who get the brunt of our bad moods, who see the worst of it and are never deterred by it.

Thank you to the advocates and the researchers. The people who spread information, dig for answers, share their experiences and help combat stigma.

Thank you to the people who stay at our side through panic attacks, outbursts, suicidal episodes, hallucinations, etc. Thank you for helping us regain control.

Thank you to the people who send us letters, funny photos or tokens that comfort us. Thank you to the people who sit with us when we are low. Thank you to the people who help us keep up with our lives by running errands for us, joining us for outings or bringing us healthy food to eat.

Thank you to the people who bring us to the hospital when we are in crisis. Who visit us in our hospital rooms. Who feel uncomfortable in the psych ward but come anyways. Who sleep beside our hospital beds. Who bring us snacks because the hospital food tastes like garbage.

Thank you to the people online who offer words of hope and consolation even though you don’t know us personally.

Thank you to the doctors, psychiatrists, psychologists, occupational therapists, case workers, nurses, counsellors, pharmacists, social workers, personal support workers, etc. To anyone who care for us as a profession. Who face vicarious trauma, burn out, etc. in order to help people like me achieve health, happiness, stability and independence.

Thank you to the people who ask questions because they don’t understand. Thank you for allowing us the opportunity to vocalize what we are experiencing.

Thank you to the friends and family who never stop writing, calling or visiting. We feel less alone knowing you haven’t forgotten about us. Thank you for not judging us for not always being able to answer you, talk with you or see you.

Thank you to everyone who cares. I know you can feel hopeless too. I know you wish you had all the answers. I know want to know how to help. Thank you for caring, for trying, for reaching out, for helping, for your time and for your energy. Thank you for sometimes giving more than you receive when we aren’t in a place to give back to you. I know we don’t always make it easy on you. I know it can be exhausting for you. Thank you for caring. You are helping far more than you know.

Thank you. Thank YOU. Thank you.

Take care,

Fiona

Who would you like to thank?

This is My Story – #GetLoud for CMHA’s Mental Health Week

My name is Fiona and I am 25 years old. I have struggled with my mental health for as long as I can remember. Today I live with anxiety disorders and recurring episodes of major depression. This week is the Canadian Mental Health Association’s Mental Health Week and they are encouraging people to #GetLoud about what mental health really is. This is my story.

As a child I was always one of those kids who was more sensitive than anyone else. I was generally a happy kid but I could be provoked to cry or throw hissy fits much more easily than others. Probably for that reason, I was also a huge target for bullying which inhibited me from developing a positive sense of self. I was often very low and felt misunderstood when I was young. No one quite knew how to handle my big emotions. For many years it was assumed that I was intentionally attention-seeking and over dramatic. My outbursts and moodiness must have seemed like I was just being difficult. When my emotions were beyond my control I would pretend to have a cold or the flu so that I could stay home from school, a habit I kept for many years. Because my mental health problems were not seen for what they were, I went a long time before finally getting any treatment for them.

As a pre-teen I began experiencing panic attacks. However at the time I assumed they were asthma attacks because they felt startlingly similar to the asthma attacks I had when I exercised. Whether panic or asthma, I experienced shortness of breath, a sense of losing control and dizziness, but the panic attacks were far worse. One of the first times I can remember having a panic attack was at an away camp during the summer. I was so confused when my inhaler wouldn’t help me recover from what I assumed was an asthma attack. From then on I had panic attacks on an irregular basis, always assuming they were caused by my asthma until part way through high school.

In my teens I sought out romantic relationships as a means to feel better about myself. I thought that if guys could be interested in me than I must have some redeeming qualities. I had one relationship that turned toxic. The dynamic in the relationship was way off and it began to eat away at any sense of pride I had in myself. It’s hard to leave a toxic relationship, because it’s easy to tell yourself that you are getting what you deserve. When your self-esteem is low, it can feel like a blessing to have a boyfriend, even if they aren’t treating you with kindness. So I presented the relationship as a good thing to everyone I knew, I hid my suffering and the pain I was enduring. For all that anyone could tell, I was as happy as ever. But this was really the time in my life when I first knew that my mental health was not where I wanted it to be.

I first went to see a psychologist before moving away for college. A lot of changes were happening in my life and my worsening moods were apparent to my family. My mom helped me find a psychologist and set up an appointment. I met with her a couple of times and it helped me gain some understanding of what I was going through. Through various assessments she was able to tell me that it seemed I struggled with mood disorders, specifically depression and anxiety. She helped me put some of the more troubling events of my life in perspective so that I was more at peace with them.

I moved away to college when I was 18. I was looking forward to this fresh start. However, when I moved away, my ex-boyfriend moved to the same school and lived in the same residence. It felt as though my past was following me everywhere. Not long into the school year I experienced my first suicidal episode. With the encouragement from a friend from back home I approached a couple of my new friends at school about what I was going through and they brought me to the hospital. After a few hours in the Emergency Department I was sent home with an appointment to meet with a psychiatrist at the hospital a couple of weeks later. In the weeks leading up to the appointment I began to self-injure for the first time. When I went in to see the psychiatrist at the hospital I was frank about my state of mind and behaviours, and he immediately admitted me to the inpatient mental health ward.

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Being in a psych ward at 18 years old, far away from home, was terrifying. I wasn’t prepared for feeling caged up with a worn-down nursing staff, very ill patients and a frankly power-hungry and vindictive doctor. I was in the psych ward for over two weeks and I can say without a doubt that was the worst time in my life. That experience taught me to fear mental health care, which is really too bad because now years later I have interacted with several other hospitals, therapists and services and have never experienced anything even comparable to the toxicity of that psych ward. The only good thing that came from those two weeks was my first formal diagnosis which at the time was major depression, generalized anxiety disorder and insomnia.

After my stint in the hospital I moved back home with the intention of seeking mental health care before returning to school the following year. Well, it turned out that because I was hospitalized in another city, I wasn’t eligible for the outpatient psychiatric services at my local hospitals. I returned to see my psychologist but didn’t receive the kind of intensive therapy I really needed at that time. It was a desperate time, I remember feeling lost and hopeless. However about four months after moving home I started dating my now husband Tom, which was the start of a whole lot of healing. Tom helped me dispense of baggage and regain trust after negative relationship experiences. With time and effort I learned how to navigate a healthy relationship and begin to see myself in a more positive light.

I started school back up again the following year. For the past year I had been on a wait list to see a psychiatrist but only after moving away was I invited to go in for an appointment. I travelled back home to see the psychiatrist and was shocked when it was just a quick appointment to give me a diagnosis, with no follow-up plan. The whole time I was in college my mental health continued to deteriorate. My episodes of depression became more frequent and my anxiety more acute. I tried to call offices of psychiatrists and psychologists but none were taking on patients and I had no family doctor in that city to help refer me to them. Given my experience during my hospitalization I wasn’t inclined to try too hard to access services, I was petrified of receiving the same kind of treatment as I had in the past. So for the four years I was in school I didn’t receive any treatment for my mental health. I began to use maladaptive coping mechanisms as a way to get by like self-harm and an increase in overeating. Outside of my mental health my life was starting to take better shape, I was in a great relationship, had developed a really wonderful group of friends and was succeeding well in school.

After school ended I tried but failed to land on my feet in the work place. My confidence was shaken and I was at a loss about what to do in the future. Tom and I got engaged right around this time and decided to move back to our home town. Initially upon returning home I continued to look for work, but soon it became apparent that I was not well enough to work and I had to seek mental health treatment. My anxiety was starting to manifest in ways I was unfamiliar with (severe agoraphobia and social phobia) and I entered a depression that was lower than I had ever experienced. I started to struggle to see friends and family or leave the house. At my lowest I wouldn’t get out of bed, even to go to the washroom, unless Tom was home to accompany me from the bed to the bathroom. At the height of my anxiety I wasn’t able to sleep and I was having as many as 8 panic attacks in a day. I wouldn’t go downstairs because there were windows without dressings and there was a chance someone could see me, and even if not I would have to deal with light. I was so desperately low and so easily provoked to panic. In my room I didn’t have to worry about interacting with the world. If the blinds were pulled shut and I stayed quiet no one needed to know that I was home. I ignored phone calls and texts. I panicked any time I heard a knock at the door or even just someone walking by outside. It was hell.

After being followed by my family doctor for a couple of months I got an appointment to see a psychiatrist through a friend of a friend of my mom’s. I was so lucky that I got to sidestep the waiting period that would have accompanied normal referral processes, it is seriously messed up how long someone has to wait to receive necessary medical attention for mental illness (but that’s a topic for another day!). Finally after basically my whole life of struggling with my mental health, I was being followed by a competent and kind psychiatrist. It was extremely difficult at first because I carried forward such strong anxieties from past experiences with mental health professionals, but it was well worth the effort.

That was about two years ago now. The past two years have been messy, difficult and uneven. I have seen tens of psychiatrists and other mental health professionals. I have struggled with self-injury, suicide attempts and more panic attacks than I could hope to count. I have tried out a wide variety of medications. I have been hospitalized several times and visited Emergency a handful more. I have progressed in some ways and regressed in others. Getting married and watching some of my friends succeed in their personal lives has been a real highlight amongst all the messiness. Most importantly, I am working with a compassionate team of mental health professionals and I have an amazing network of supportive family and friends. Slowly but surely, we are finding solutions that work for me.

Last year during a hospitalization I decided to be open on social media with my friends about what I was going through. For years I had touted the virtues of speaking out and sharing your story, but mine was kept somewhat private. As soon as I started sharing about my anxiety, depression and experiences in mental health care I received responses from people saying it was helping them. On such a core human level, we don’t want to feel alone in our struggles. I continued to shed the facade that I was doing great and replace it with a more honest account of how I was doing, my successes and my failures. That led to me starting up this blog. It hasn’t always been easy to be so open and vulnerable. But each time I receive a message from someone thanking me for being open about my experiences with mental illness because it helps them with their own challenges, I feel a renewed energy for it.

Given that mental illness has been a part of my life from the start, I expect it probably will be until the end. But now that I have access to treatment there is a far better chance that my life will continue for many years to come. If there is one thing I wish I could shout from the rooftops, it would be for no one to ever take their mental health for granted. Don’t wait to seek mental health treatment, the longer you wait the more your issues will compound in to a bigger mess that is harder to manage. I believe as long as I continue to gain the skills and strategies I need to live with my illnesses, I will be okay. I still struggle with guilt and self-stigmatizing over my mental illness, but the more I share and am open about my experiences the more accepting I am of what I am going through.

It’s mental health week friends, time to #GetLoud.

Take care,
Fiona

Exciting news! (Mental health progress)

I have some exciting news to share – after two long years, the depression has finally lifted!
At first I hesitated to say anything, I thought perhaps I was just having a good hour, day, weekend, week, month… I didn’t want to jinx it by celebrating it. But heck, it’s been a long couple of years and I am going to enjoy this break from depression, no matter how short or long it ends up being.
For about a month now I have felt much more like myself. I have felt motivated, energetic and have enjoyed things again. Perhaps most excitingly, I have LAUGHED. Like real belly-busting, think-you’re-going-to-pee-yourself laughter. I have seen friends because I wanted to, I have smiled authentically. It has been such a relief after a very dark two years.
The best thing about my depression lifting is that it makes my anxiety easier to tolerate. If I am entering an anxiety provoking situation when I am depressed I am unlikely to be motivated to work through the anxiety, social phobia and agoraphobia because I won’t feel a benefit from it because I am mostly unable to enjoy things. When I’m not depressed, I feel compelled to stick out the anxiety provoking situation because I might enjoy myself. Likewise, not being depressed makes me more hopeful that I can make progress with my anxiety. Also, I have a much more optimistic view of the progress I have accomplished so far. The scale has tipped towards being more proud of how hard I have worked instead of feeling ashamed of how much ground I still have to cover.

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Enjoying dinner out at my favourite restaurant.

Because of this newfound happiness, motivation and energy I have been able to tackle a few major milestones. I went on a weekend trip with my husband Tom and we went out to several stores and restaurants within just a few days. Most excitingly, this past week I went to a gathering at a friend’s house, stayed the entire time and had a lot of fun (real honest to goodness fun!) in spite of how anxious I was for being outside of the house and in a group of people. My increased energy has also been great because I can do my fair share of households tasks and am able to do more than just sit on the couch all day.
I have lived with recurring episodes of major depression for many years, but usually it comes in waves of a month to a few months at a time. I think prior to this depressive period which spanned from about April 2016 to March 2018, my longest episode of depression was probably about 6 months long. I have become accustomed to the ebb and flow of my depression, and never before had I been so certain it wouldn’t eventually lift. I have been seeing a psychiatrist and a psychologist, participating in group therapy, completing workbooks at home, doing more intensive work during hospitalizations, practicing mindfulness and self care, etc. I felt that I was doing everything I could to no avail, which led to worse depression, self-harm and suicidal ideation. And yet, all of the sudden that all slid away.
So, what has brought on this change? It is hard to say anything for sure. But all roads lead to it being tied in to reducing the dose of my anti-depressant. I have already come off of several medications in the last few months to check whether or not they were effective but none of those medication changes had the slightest effect on my mood. So far I have done two phases of reducing my dose of Pristiq (desvenlafaxine), first from 150mg to 100mg per day, then to 100mg to 50mg per day. While I have been dealing with some dreadful symptoms of medication changes, my mood has been a lot better. I’ll just clarify quickly here though that the efficacy medications, particularly psychiatric medications, varies greatly from person to person – I’m just sharing my own personal experience.
There is no guarantee that this sudden change in mood will last but I have decided to embrace it while it is here rather than worry about loosing what I have gained. I am not under any illusions, I don’t think that I am cured of depression. I think that the medication I have been taking for about a year now was contributing to my depression and lack of energy. While I’m not looking forward to my next low, when I do feel it coming I am going to be a lot more certain that it won’t last for years on end. And that will make it infinitely easier to bear.
Take care,
Fiona

On Being Agoraphobic and Stir Crazy

A month or so ago I left my house to go for a walk. I made it four houses down from my house accompanied by my pup Midnight. My breathing became more rapid with every foot step, my mind started to blank out, the ground was moving under my feet, the cold claws were closing in around my chest, I felt feverish. I clung on to Midnight’s leash for dear life. I gave in to the incoming panic attack, recovered, snapped this picture and then ran home. Despite the panic attack, that was a victorious day. I had managed to leave the house alone. I haven’t gone for a walk by myself since.

For the past couple of years my anxiety has manifested into something new and most unwelcome: agoraphobia. For those of you who might not be familiar with agoraphobia, my (not at all professional) take on it is that it is an anxiety disorder which causes you to avoid certain places and scenarios out of fear of panic or discomfort. I’m far from an expert, here is a place to start your reading about agoraphobia if you are curious to know more. I struggle to feel safe when I am out of the house. My anxiety is particularly strong when I am in large open spaces, somewhere with lots of stimulus (i.e. a grocery store) or can’t escape/get home quickly. But most of all, I struggle to leave the house alone. This isn’t to say that I never do those things, the best known treatment for agoraphobia is exposure therapy. I have coping mechanisms I use to venture out in to the big scary world and have managed to expand the places where I feel at least somewhat safe quite a lot in the past couple of years. If I feel in control I am much more likely to try to push myself into an anxiety provoking situation. I never go anywhere without an escape plan and a little kit of anxiety coping tools stashed in my purse.

Something that many people don’t get right about agoraphobia is that it doesn’t mean that I don’t want to go out. I get a lot of people telling me things like, “Come out tonight, it’ll be fun” or “just give it a try, you used to like it”. I want to get out of the house more than anything. Agoraphobia is an innately isolating disorder. I don’t feel like I can fully participate in my life and relationships. I feel confined to my house. I dream about hanging out at my friends’ houses without my husband present, going to see a play or musical, doing the groceries… The list goes on. Even just thinking about those things causes me to start feeling panicked, but I yearn for them. I feel blocked from accessing things that I love in my life like my friends, family, the outdoors and theatre. My number one goal right now is being able to feel independent again. I long for the day when I can go to appointments or even just walks in my neighbourhood without having one of my trusted support people with me. Right now doing those things, even when accompanied by people like my husband or my mom, is extremely difficult and draining.

I have adapted a lot to this disorder. At first it was incredibly distressing and I carried a high level of anxiety with me all day every day out of pure confusion and guilt over these new feelings. I still resort to beating myself up about my agoraphobia more often than I should, but I am generally more accepting of it. I have become more accustomed to my isolation and have found things to occupy my long days spent at home alone. It isn’t easy though. There are days when I hear the mailman delivering a package to my door and can’t stand to open the door to retrieve the package. Feeling this incapacitated is exhausting, it’s humiliating, it’s often more than I can handle. Other days, I decide enough is enough. I grab my dog’s leash and I head out the door, determined that my pure strength of will is enough to conquer my agoraphobia. You might remember from my opening story, that doesn’t always go so well for me. 

 

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Me as I post this blog: Another day, another Netflix binge

Sometimes I become so stir crazy that I can hardly handle it. It can feel like an itch I can’t scratch. I am currently trying to navigate one of those times. Yesterday was a crazy day, I had to rush my dog to the vet in the morning and then went downtown to my favourite restaurant for lunch with my mom to help pass the time while he was being treated. I was proud of how well I coped with the anxiety of my dog being in danger (he ate a couple of grapes – not to worry Midnight lovers, he is back to his normal self now!) and going fairly far in the car to a busy part of town for lunch. I hadn’t been to my favourite restaurant in well over a year. I probably should have taken this in as a victory – but instead it made me focus in on what I am missing. My mind went straight to longing for these sorts of outings to be more frequent and less painful. I started thinking about all of the things I want to do and can’t. Instead of being happy that I succeeded, I started to beat myself up for how often I fail.

I became restless thinking about all the things I haven’t been able to do and places I haven’t been able to go. I was exhausted at 9pm, but couldn’t bring myself to sleep until 4am. I kept thinking about all of the things I feel I have had to sacrifice for agoraphobia. I changed our honeymoon plans from a Caribbean vacation to a trip to Quebec City, I have rarely been able to walk our dog, I had to step down from being a bridesmaid for my best friend. It is the excuse I never want to have to use. I had a definite “woe is me” moment. Forgive me, self-pity isn’t pretty, but it’s a reality of life sometimes and I try to be honest here. I struggled with the injustice of it all in the early hours of the morning until I burst. I decided I was going to go for a walk at 3am, walked down to the front door, opened the door and fell into the inevitable panic attack before I even felt the cold air nip my face. I dragged myself back upstairs and in to bed. This morning I hadn’t yet given up my resolve. “Take two weeks off of work”, I said to Tom, “we’re going on vacation”. Never mind that we don’t have the savings right now for a vacation, I would likely struggle through the whole vacation and Tom obviously can’t book time off of work with no warning. It was going to happen. It had to happen. These days I feel like I need a change of scenery as much as I need air to breathe and water to drink.

This afternoon I feel subdued. This is my life right now. That isn’t to say that I can just give up on trying to push my boundaries, which is another thing that I resolve to do more frequently than I care to admit. It means that some of these things I want aren’t attainable, not right this minute anyway. Beating myself up about that and fixating on all the things I am not able to do isn’t helping anything. It just feeds in to the perpetual cycle of depression and anxiety I am stuck in. Hopefully this weekend I will push myself to go swimming, maybe go out to a restaurant or see some friends. Maybe I will spend it caged up in my house. Maybe I will give in to this stir crazy feeling and book a vacation to Florida. Who knows!? All I know right now is that I want this feeling to end and I want people to understand that being afraid of leaving the house doesn’t mean I don’t want to.

Take care,

Fiona

P.S. I keep meaning to share this for all those who also suffer from anxiety disorders. This song really resonates with me, a doctor in Emerg showed it to me last year. I hope you like it. Waving Through a Window – Dear Evan Hansen