Challenging Assumptions: My Anxiety Triggers

Anxiety is complex. You may not know what it means when I tell you that I have Generalized Anxiety Disorder, Agoraphobia, Panic Disorder and Social Anxiety Disorder [click the links to learn more]. In short, my anxiety disorders lead me to react with excessive anxiety to triggers that do not always merit an anxious response. Anxiety permeates every aspect of my life, it is far more than a desire stay home and avoid social gatherings. I hope that in sharing my list of anxiety triggers I will help shed some light on how debilitating anxiety can be and hopefully challenge some false assumptions along the way.

The triggers listed below are my own – anxiety triggers differ greatly from person to person. The items on this list vary in their severity and the frequency at which they provoke my anxiety and panic. They are not all things I dislike or am afraid of, in fact many of them are things that I really like. In some cases I have a good understanding of why these triggers cause me distress, in other cases I have no idea. With all that in mind, here is a list of some of the things that trigger my anxiety and panic.


The List

Appointments

Being far from home

Being in the same space as other people

Caffeine

Cars

Changes in plans

Changes in temperature

Clicking publish or send on any form of online communication

Conflict (even if I’m not involved)

Discussing finances

Elevators

Excess stimuli

Feeling as though I can’t escape

Grocery stores

Hospitals

Intense sensations

Lack of sleep

Large groups of people

Leaving the house

Making mistakes

Malls

News (good or bad)

Not having a plan

Open spaces

Parties

Phone calls

Portrayals of suicide in media

Scary fictional stories

Seeing neighbours through the windows

Showering

Small groups of people

Talking in person

The dark

The outdoors

Unexpected noises

Walks


You may now be wondering how it is possible to be so sensitive and easily provoked to panic. I wish I could explain that to you. If you haven’t experienced an anxiety disorder you probably won’t understand what it is like to feel anxious, as though something truly awful might happen, in response to mundane things in your daily life. I have had Generalized Anxiety Disorder and Panic Disorder for many years, Agoraphobia and Social Anxiety Disorder are newer to me. I am still learning to understand my own anxiety and how to best manage it. It makes very little sense to me that I can become dizzy and hot, hyperventilate, have chest pain, feel weakness in my legs, shake, be disoriented and feel as though I am in imminent danger as a result of things as unthreatening as reading positive news articles. Being constantly anxious has had negative impacts on both my physical and mental health. Irritability, weight gain, hair thinning, moodiness, headaches, seclusion and muscle tension are just a few of the negative changes that my anxiety has contributed to. Anxiety has hugely impacted my life and my relationships.

Even if I employ as much planning and as many coping tools as possible, it is inevitable that I will come in contact with my triggers throughout my day and respond with anxiety. I have lived in near-constant anxiety for a couple of years now, because there is always a chance that one of these many triggers is just around the corner. The anticipation of something anxiety-provoking is often just as bad as the thing I am anticipating. Additionally, I still frequently experience increased anxiety or panic attacks without any identifiable trigger. I am slowly learning to tolerate my anxiety and panic, but my anxiety remains exhausting and incapacitating even as my ability to withstand the distress increases.

I write this because anxiety is misunderstood. When most people think of anxiety disorders they likely don’t imagine someone having a panic attack every time they shower without understanding why. You may not know that there are people like me who have been working for years towards goals like going outside for walks. The best way to understand how anxiety disorders affect someone’s life is to ask them about it, anxiety is a deeply personal experience. It can be easy to reduce anxiety disorders to chronic fear or nervousness: emotions that we can all understand. Anxiety is so much more than that, even I don’t fully understand it yet.

Take care,

Fiona

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maybe someday…

I find myself repeating “maybe someday” an awful lot recently. My mental illnesses are currently making it difficult or even impossible to do things I wish I was able to do. Will I ever be able to go for a walk on my own again? Maybe someday. Will I ever work again? Maybe someday. Will I ever perform in community theatre productions again? Maybe someday. Will I ever be able to see my friends and family without discomfort? Maybe someday.

“Maybe somedays” are hopes, dreams, goals, aspirations. Sometimes maybe somedays are desperate answers to prying questions (i.e. “are you working again yet?”) that highlight things I can’t do that I feel sensitive about.

The hard part comes when I have to accept that despite my best efforts my “someday” hasn’t arrived yet. Last week I had to cancel my trip with my husband to Stratford, Ontario for next month. Stratford is my place. If you dissected me and turned my contents in to a city, it would be Stratford. Theatre (musicals! Shakespeare!), music, art, cute shops, restaurants, friendly people, parks, water, mature trees, etc. Whenever I go to Stratford, I feel like I am connecting with something that is truly a part of myself. I used to go every year. I haven’t been able to go since 2015, since my depression and anxiety worsened. I dared to dream I could manage the trip this year. There are no words to convey how sad I am that I can’t.

Maybe someday. Maybe someday I will return to Stratford.

I digress.

Maybe somedays can be uplifting or heartbreaking, it all depends on perspective and circumstance. Maybe someday means that there is hope, but not immediately. I know I’m not alone here, I know that many people with illnesses of all forms are torn between hope and desperation over the things they are currently unable to do.

I try goal setting, I try to gradually work towards being able to accomplish what seems so out of reach. This too can be either motivating or discouraging. I can see myself making progress and rejoice in small victories. “I left the house! Take that agoraphobia, that’s what progress looks like!” I can also see how very inconsequential my progress is, fixate on how many more small steps there are before I reach my goal and how these steps continue to be so draining. “So what if I left the house? Most people leave the house every day and most of them can do it alone without panicking.” Don’t even get me started on how it feels when I compare my current goals to the ones I had a few years back when I was unknowingly blessed with decent health. Comparison is fuel to the fires of depression and anxiety, and those fires are already burning me too much.

Lately I feel like I am being suffocated by my maybe somedays. They seem unachievable, completely out of reach. I’m not blind to my progress over the past couple of years, but there is far more ground ahead of me than what has been covered.

I could fill thousands of pages with my maybe somedays. I cower under the magnitude of the things I can’t do but wish I could. My maybe somedays range from things as seemingly small as, “maybe someday I will be able to do the groceries” to, “maybe someday I will be healthy and stable enough to be a mother”. They can be both things that others take for granted and things that are a challenge for anyone. It can be incredibly tempting to just stop trying. My husband has heard me more than once contemplate whether I would be happier if I just gave in and lived like a hermit, if I just accepted my limitations and stopped trying to overcome them. In my more rational moments, I recognize that I can’t expect myself to do everything and that balance is important. In my less rational moments I wonder whether there is even a point of being alive with so many road blocks ahead of me. Is the amount of progress I need to make to be a functional human even attainable?

I don’t have answers. I think maybe the best thing is to try to focus on what I am able to do and try to build mastery of things, one at a time. Perhaps trying to quiet the looming thoughts about the bigger more heartbreaking maybe somedays would help me focus on more achievable short-term goals. All I can tell you with certainty is that I have been working tirelessly to improve my mental health for over two years now and as time goes on it feels like I am accumulating more maybe somedays than I am accomplishing.

Will I ever lead a full life unencumbered by illness? I don’t know, maybe someday.

Take care,

Fiona

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. I wish I could cry elegantly like the ladies in romantic comedies. 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. Every time he lets go I begin to sob all over again. 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. I suppress my sobs as he walks down the stairs, grabs his lunch and closes the garage door behind him.

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’d say that depression makes me feel like a non-violent vampire, but my affection for garlic denies me that claim. 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. My bathroom routine takes longer than usual, mental illness at its worst wreaks havoc on my digestion. 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

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