I just have to post this quote again. I am in the process of embedding this into my brain. The over analytical brain that always seems to conjour up the worse possible outcome. It’s like… More
Social Anxiety, another disorder I am familiar with.
It began in my earlier years, right around the time when the bullying began.
It instilled such fear that I refused to present in front of the class. My assignments would be presented in front of only the teacher at the end of the day. I become isolated, and alone. I was probably thought of as a ‘loner’ at one point. Eating lunch alone, even then I would sit there and worry about what the other kids were thinking about me. If they didn’t speak ignorant words, I knew they were thinking it; rolling their eyes as they walked by.
This fear has followed me throughout my life, and had affected multiple areas of my life.
My greatest challenge was in nursing school, and having to work in groups and present in front of the class, later it was working with ‘actual’ patients. Come to think about it, this is probably when the panic attacks started. Having to face my fears was terrifying, but I knew if I ever wanted to have a career in nursing, and practice safely, then I would just have to ‘suck it up’ and do it. I remember the first time I had to call a doctor. I wrote out everything, according to SBAR, quickly rehearsed it in my mind, then called the doctor. I maybe got 4 or 5 stuttered words out, panicked and hung up.
I made my preceptor call back.
With practice, it has got easier. I still get anxious when having to discuss a patients care with a doctor, but I manage (what choice do I really have?). I usually get anxious with anyone with higher ‘authority’. Probably because I am afraid of saying something incorrect, or not making sense, or afraid of what I ‘look like’. When I get anxious in social situations, I become flushed, I blush, and my body temperature rises. At work, I know I can’t avoid those situations, or else I could compromise the patient, and could lose my job.
The repeated exposure has helped drastically at work, but I still have avoidant behaviours in my personal life with family and friends. I have been known to avoid gatherings with large groups, including family functions. A “large” for me is any gathering consisting of more than 3 people. Usually when I gone out with friends, at most, it has only been with 2 other people. I have missed weddings, parties, birthdays, and random gatherings out of fear. It has affected my relationships with friends and boyfriend’s along the way, and made it difficult to make new friends.
A million thoughts will occupied my mind, and repeat over and over again.
“What if I say something silly? What if I look uncomfortable and awkward? Will they notice how nervous I am? What if my face goes red? What if my voice trembles? What if I don’t make sense or ramble? Will people ask me questions I don’t know the answer to? Will people think I am stupid? Will I have to initiate the conversations? What if I can’t relate to the conversation? What if people wonder why I am being so quiet? What if people think I’m wierd? What if?” Literally the thoughts never end, it’s exhausting.
And simply telling me, “I’ll be fine, suck it up, who cares what they think, or have a drink” or get angry or upset at me, only makes me more anxious. And it’s totally screwed up to think anyone could get upset at you over something you have no control over.
Imagine you are standing at the edge of a 100 foot cliff, and the only way back down is going over the edge, and climbing down a rope latter with some of the steps broken or missing. That is the same intensity of fear I get in some social situations. Sometimes it is easier to just sit down where you are (where you feel comfortable), and not move.
I definitely feel the most comfortable at home; I call it my safe haven. I do go out, maybe once every 2 weeks. Each time is always a struggle, my initial reaction is to cancel plans as the anxiety starts to build due to negative anticipations. It’s frustrating because I love my friends and family, and I should feel the most comfortable around them but my anxiety usually hinders over my trust.
I once had an ex friend get so angry at me because “I could go out with complete strangers (on dates), but I couldn’t hang out with my girl”. Anxiety is a weird thing, it is totally F’ed up. Meeting with strangers felt so much easier because they knew nothing about me, I had an opportunity to only allow what I wanted them to know, when I wanted them to know it. I could put an abrupt end to things if the relationship lacked a connection. I cared less about what they thought. I was in control of those situations.
With my friends, I am an open book. They knew every raw detail. I cared so much about what they thought. I valued their opinions, perhaps too much. I’m not sure why, but I felt like I always had something to prove. My mindset was very damaging to my relationships. Only the strongest relationships were able to survive.
I knew I wanted to change. I needed to changed. Cognitive Behavioral Therapy (CBT) and Exposure Therapy has really helped me gain back control, and is helping to change my way of thinking. I’m still a ‘work in progress’ but things are changing for the better. I also had to make some difficult decisions with ending some friendships. The purpose was to eliminate the people in my life that held me back, or no longer supported me or served me, grew with me, shared the same values or interests, able to understand me (or took the time to understand) or ride the highs and lows with me. Hardest, but best decision I ever made. Took a very heavy weight off my shoulder.
My journey to self-improvement began with the formulation of specific goals.
1) Decrease social anxiety and gain control
2) Build and sustain meaningful relationships
Then I came up specific tasks to complete each goal.
An example could be, decrease social anxiety by challenging catastrophic or distored thoughts, or slowly integrating different levels of exposure. You really have to be your own cheerleader when it comes to purposely exposing yourself to anxious situations. I’ve had to force myself, but each time always got easier, and I always ended up having a great time. I use reflection to remind myself of the positive experiences I had.
Before you jump into CBT or Exposure Therapy, I would advise that you talk with your doctor to develop a plan together that would work best for you. If it is decided that you would benefit from this type of therapy, you can either purchase a self-help workbook, or you can complete a plan under the care and supervision of a psychologist or trained therapist. I would advise the latter for more severe types of social anxieties or phobias, especially if they are causing significant distress.
Going through the experience of a panic attack are some of the scariest moments I ever had to live through. Each time felt like the last time, and to think it was a ‘harmless’ event was impossible, at first.
I really believe it was my frame of mind that helped me to cope as well as I did, as best as I did. It was really mind over mood, so to speak.
The frequency of the panic attacks seemed to diminish once I graduated from Nursing School and eventually came to a point of being almost non-existent. It look accepting what needed to change, dedication, and a change in mindset to adequately manage, and mostly prevent the return of the attacks.
Nursing School created a high level of stress in my life, not only was I dealing with the usual and expected stress related to the volume of weekly readings, essays, exams and presentations, but I was also trying to manage the symptoms of Attention Deficit Disorder, Depression and Social Anxiety. Furthermore, I was dealing with the psychological devastation of a cheating partner, relationship conflicts with friends, and the death of family members. I believe it was a combination of these factors, fighting against each other, that led to the development of the panic attacks. I wasn’t diagnosed with Generalized Anxiety at this point, but I am sure my mental health history would have suggested it.
What coping mechanisms or techniques did I use to help manage the symptoms of, and prevent panic attacks?
I think the scariest part is the fact that you think you are about to die. The symptoms are very similar to a heart attack, which is why a lot of people will Dial 911 or go to their nearest Emergency because it can be difficult to decipher between the two if you have never experience either one of them before.
With both, you get chest discomfort, short of breath, dizziness, apprehension, and/or nausea. The difference is usually the intensity of the chest pain, and the duration. Please note that not everyone who suffers a heart attack or a panic attack will experience chest pain or discomfort. Working in Emergency, I have seen people come in with crushing chest pains to mild heart-burn like symptoms to vague complaints of “I am just not feeling that well, I am just more tired”. Panic attacks come on abruptly and are short lived, lasting only a few moments, and the pain DOES NOT radiate to the neck, back or jaw. If you ever experience chest pain and cannot contribute it to an exact ‘non-emergent’ cause, or when in doubt, call 911. Never EVER drive yourself to emergency if you think there is ANY possibly it could be a heart attack.
First and foremost, the biggest thing that helped me was when I finally decided to go see my doctor. It look me a few months to go, when the attacks were happening every other day, because I felt embarrassed over my lack of control over my own mind and body. Confiding and trusting my doctor provided me with a peace of mind that these signs and symptoms were being produced by my mind, and not something more serious. She sent me for a cardiac workup that included blood work, and diagnostic tests (ie. chest xray, ECG, and a cardiac holter monitor). All the reports came back normal, as suspected, and I was diagnosed with Panic Disorder. My doctor and I discussed my options for treatment, an developed a plan that best suited my life. I took a non-pharmacological approach.
Having a definite diagnosis, brought a sense of peace because I was able to know, without a doubt, that these physical feelings were harmless. The absolute worse that could happen is I could faint as a result of hyperventilation.
Which brings me to my next, very important, coping technique; the art of breathing.
Most often, people begin to feel lightheaded when they are breathing fast and heavily. When the panic attack comes on, you usually don’t realize that your breathing has increased, because you are scared stiff of what is lurking around the unknown corner of Doomsdale. That impending doom feeling, the feeling that something so horrible is about to happen. Your body is trying to figure out whether it wants to fight or take flight or play dead.
There are so many different ways to practice breathing techniques. Count to 4 or 5 or 6, or 10 (but don’t make yourself pass out), hold for x amount of time, breath out through your nose, or through pursed lips. Just pick what ever comes natural and easiest for you. The idea is you want to slow down your breathing and distract yourself by focusing on and counting your breaths. If you breath in through your nose the first time, but breath in through your mouth the second time, who cares…. just breathe – deep and slowly.
Just as important as breathing is relaxation. I know it seems impossible to be able to relax when you are in such a heightened state. An easy way to achieve this is to practice deep muscle relaxation. I often used this technique at night when my attacks were the worst. Get into a comfortable position. Start from one end of your body and work your way up (or down), tensing and releasing each muscle group. Tense as tight as you can, but without causing pain. The idea is to not only distract your mind, but it also helps you distinguish between what a tense body feels like, versus a relaxed one. I hadn’t known how tense my body really was until I went for my first massage, and the massage therapist expressed concerns over how tense I was. My neck muscles were the worse, which often brought about agonizing, frequent tension headaches.
If neither of those two did the trick, then I would depend on calm music and stretching, or endlessly pacing around the room until I tired myself out or forgot what I was pacing about. Keep in mind, although what seemed like forever, the panic attacks only lasted a few moments. Most of the time you spend is on psyching yourself out thinking about, instead think of something else, anything else (blue frogs, purple grass, pink sky, the smell of eggnog, a polka-dot pig; the more random the better).
Sleeping was(is) exceptionally hard because my mind likes to wander and worry at night, so I started creating a routine for myself, and never went to lay down in my bed unless I was tired and on the verge of falling asleep. This meant, laying on the couch, watching TV, and waiting for that moment my eyes would start to droop. Some other remedies that would help me were a warm comforting bath with Epson Salts, Chamomile tea, and Melatonin, but eventually I had to upgrade to a prescribed temporary sleeping aid. Do what ever you need to to ensure you get an adequate nights sleep.
During the day if a panic attack would strike, I would use those same methods as mentioned above, but I would also incorporate other options such as going for a walk, calling a friend or family member, or wrote my thoughts and feelings down in my journal.
I also used reflection as a key competent to my management regime. Reflecting on previous attacks, helped me to see that I was always going to be okay, and it showed me what worked and what didn’t. Being more aware of my body and mind allowed me to feel and anticipate when an attack was likely to hit. It provided me with an opportunity to intervene before it turned into a full blown fit of terror.
Eventually I started to hit the gym, and I think that is actually what pushed me over to the happier, calmer side of life. Some other things that helped were decreasing or eliminating the factors that were causing unnecessary stress, and simplifying my life.
Really, it is a matter of finding out what works for you. A lot of the time (especially in the beginning) you will spend your time trying to figure out different techniques that work for you. Don’t give up on this trial and error process. If you are having a hard time coping, and haven’t seen a doctor yet, I advise you to make an appointment. There is no reason anyone should have to suffer, and always know that you are never alone.
ℜachel ℘age ♥
Panic Attacks; unfortunetly, something I am way too familiar with. Worst moments of my life. I seriously thought I was dying every time, then the thought of dying would just increase the intensity of the attack. Out of nowhere, minding my own business and BAM. My body would start to feel really warm – hot, and I’d feel really lightheaded, like pre-syncope (pre-fainting). My heart would start to race (I could feel it pounding in my chest; I could hear the rhythm echoing in my ears). I would find it difficult to swallow, and sometimes it was like I would forget, for a moment, how to breathe. My chest would start to tighten. The world around me wouldn’t feel as “real” (very wierd sensation to explain; it’s like I’m stick inside my body, looking through these windows – my eyes). I really thought I was going nuts. I was certainly losing control, to the point where it felt like my life was being sucked out of me. Then… the impending doom. The ultimate panic. That moment of “I’m about to die, my life is now over”. Tears would start to roll down my face. What seemed like forever was probably only a few minutes, maybe 10 mins at most. They would happen at random, never triggered by anything in particular. They would keep me awake at night. For some reason, they were always so much worse at night. I would have to get up out of bed and start pacing my room. If I laid down, I’d hear my hear pounding, my body would shake with each pound. I’d often check my pulse, just to see how crazy it was going, or to see if I was dead. Worst mistake ever. Feeling my pulse, or envisioning my heart stop pumping in my chest, would freak me the (beep) out of me. Impending doom would hit me again. What is worse then dying, if you think you are always dying?
To be honest, me typing out that last part made me feel a bit uneasy, a bit on edge. My pulse started to quicken. I closed my eyes, and I took a deep breath in…
Now I am back!
This happened for almost 6 or more months, my entire last year of nursing school. I was living in hell, so too speak. They started off gradually, one every 2 weeks, but increased to almost daily. I was living in complete fear – fearing when the next one might rip through me. Eventually it started to affect all aspects of my life. The only places I felt comfortable was at home with my head in my books, or at my boyfriend’s (now ex’s) home. I never really wanted to do anything or go anywhere, because I was deathly afraid of making an ASS of myself out in public (even around my own friends). I am surprised I made it through that last year of nursing school without having to pause my studies or repeat any course(s). (I’m very proud of myself).
I reached out to my doctor, and did a series of blood work and diagnostic tests (chest xray, ECG, cardiac holter monitor). To no surprise, all came back normal.
I was diagnosed with Panic Disorder.
My doctor advised against treatment in the form of medication. I know what you are thinking (WHY IN THE WORLD WOULD SHE NOT WANT TO TREAT YOU), but I agree with her reasoning based on the information I provided to her.
She felt the medication that is used to treat panic disorders, could really attack my ability to study. Plus panic attacks come and go so quickly, the attack would be over by the time the medication would kick in, and they aren’t the type of medications you want to take around the clock. They are sedating, and make you ‘too mellow’, and very addictive. Benzodiazepines are used on an “as need” basis (unless directed otherwise by your doctor). I was also against taking anti-depressants (at the time). So really my only option was to just ‘deal with it’, and I did.
Reflecting on that entire situation, I also don’t think I ever really told her exactly how bad it got, or all the dreadful details. Probably because I was scatter brained, and too quiet and timid – I didn’t know how to ‘speak up’. This is probably when the Social Anxiety, and Generalized Anxiety started.
I isolated myself so much that social situations made me feel incredibly uneasy. I didn’t want to hang out with my friends, and I even stopped showing up to family holiday gatherings.
The sad truth, I lost some of the ‘greatest’ friends due to my illness. Well childhood friends. BUT if they were truly meant to be in my life, they wouldn’t have gave up, they would still be here.
Hundreds of people will enter your life, lots more will exit. It will sometimes be a blessing, other times it will hurt. But everything happens for a reason, a life lesson. I have learned that as you get older you meet new people and start to build relationships based on similar interests, values, beliefs, and even mental illnesses (or mental wellness). The people in my life now have a very unique understanding of mental health, and can relate either on a personal (either they suffer from a disorder, or know someone close to them that does), or professional level. I find these ‘new’ friends can truly and deeply relate, and don’t take offense to my flare ups (moments where I isolate myself, and become MIA (missing in action) or non-existent; whatever you want to call it). I am truly blessed to have such amazing friends in my life, and I am so grateful for the friends I have yet to meet.
The great news is, I rarely get Panic Attacks anymore. Maybe one or two a year if I am unlucky. They pretty much vanished once I graduated from nursing school. I was able to spend all my energy on learning how to overcome those awful attacks on my own through relaxation, diet, and excerise.
I’ll be speaking more about treatment, and specific, yet simple, things you can do to help in another blog
Disclaimer: None of my information, education or personal stories are for diagnoses or treatment purposes. Mental Health Disorders are serious, and most of the time require help from a trained medical professional. If you think you suffer from one, and find you are having a really hard time coping…. please go speak to your doctor. Do not be afraid. Truly, they are only there to help you. It is very helpful to make a mood and thought diary, and write down everything you experience. When it is time to see your doctor, make some bullet points and some questions to ask to discuss with him or her. This will shed some of the anxiety. You can do it.
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Physical Health is just as important as Mental Health. You can’t have one without the other. In order to achieve an optimal level of health, these two factor must be working together in unison.
A major difference between my current lifestyle and where I was a year ago is the negative changes I am seeing in my diet and excerise. My routine went completely out the window when Major Depression started to creep into my life. *sigh*
I have been a bit hard on myself lately as the medication caused some unwanted weight gain. . I expected it to happen, and tried to prepare as much (mentally) as I could before the few pounds creeped in. I gained about 8 to 10 lbs. This may not seem like ‘a lot’ but it means a lot to someone who has struggled with a negative body imagine perception her entire life. I wouldn’t say I suffered from an eating disorder, rather weight gain or being over 120lbs would trigger the Major Depression. (There are multiple triggers for my depression, this is just one).
At my heaviest, I was about 135-140lbs (about 3 years ago). I ended up investing in a personal trainer – best decision I ever made. My confidence level went from 3/10 to an 8/10. I felt great both physically and mentally. Then, unfortunately, depression came rolling back in about a year ago, with Major Depression settling in 4 months ago and lasted for almost 3 months.
I noticed lately, despite feeling great, I have been struggling with getting back into my diet and fitness regime. The key culprit hindering my ability to succeed was a lack of a concrete plan and a routine.
A Plan really boosts productivity by taking the guess work out of what you will be eating and working on each day. Less of a hassle – so to speak. The other key components is consistentcy, and motivating yourself to do it. You are your best motivator. Just get up and do it. Eventually your routine will become habit, and will become a natural, effortless part of your life.
Here is my routine:
I will resume my workouts as before (with an emphasis of shredding fat, then I’ll gain muscle after summer).
•Workout 3 to 4 times per week.
•Rotating Upper and Lower Body + abs.
•4×20 with each exercise.
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When depression hits, it is easier to spend the days laying supine on the couch instead of facing the day and accomplishing your daily responsibilities.
Some simple advice: Get up anyways.
Do what you need to do, force yourself.
It is hard, seemingly impossible task. I know.
Being left alone with your thoughts only allows more negative thoughts to transpire. If you break the cycle by forcing yourself to get up, you may be able to find a bit of beauty throughout the day… beauty you would have otherwise missed. Small changes like this, over time, can pull out of the darkness.
This is why I always stress the importance of ‘self-care’.
Self-care is doing ‘anything’ for yourself that makes YOU happy.
Even in your darkest moments, there will allows be something that can bring a bit of light.
It could be as much as indulging in your favorite bowl of sorbet (Mango for me please), allowing your creative nature to flow through art, completing a DIY, a candle lit bath, snuggling with your furbaby, reading a self-help or a favorite book, getting dressed up to stay in (and perhaps take a bunch of selfies)…..
I just rambled off a bunch of things that bring a bit of happiness into my life, now it is your turn to think of the things that could make your day a little bit more enjoyable. Think about the things that once brought you joy before the depression hit? Perhaps you write poetry, draw, paint, crafts, do it yourself projects, writing, cooking, hiking…
Even if you don’t want to do it, do it anyways.
The second most vital part to ‘feeling your greatest’ is getting enough sleep.
7 to 8 hours is ideal.
If your having difficulties falling asleep, there are many remedies to help. For example, sleep routine, sleepy tea, rest and relaxation an hour before bed (no phone), a bath, stretching or mediation etc… and if all else fails, talk to your doctor. Perhaps a prescribed medication may help temporarily.
Have faith in yourself.
You can do it.
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It wasn’t until I relapsed with Major Depression, and experienced the troubles and triumphs, that I wanted to reach out to the world and share my story.
I hoped by doing so, I would be able to help others and provide some level of hope.
My story began. . .
Some people thought it was a wonderful idea, while others were a bit hesitant as they thought it would have negativity consequences on my career. Although, I was never really worried about that as depression is as common (if not more) as hypertension these days, it is just less talked about. I was more worried about what people would think, and the assumptions that would transpire. My personal stories that I blog about are open, honest, raw, and vulnerable.
I think my deepest anxiety came from my negative assumptions my coworkers would have, but that anxiety was quickly neutralized with their abundance of support. Many of my coworkers were quick to open up to me about their own personal stories regarding their struggles with mental illnesses. It only validated how common mental illnesses are, and how uneasy people still feel to talk about it.
I am showing people it is OKAY to talk about it. It is okay to be taking medication. It is okay to see a therapist.
I am still the same person I was before anyone knew I was diagnosed with Major Depression. By the way, I also have Generalized Anxiety Disorder, and ADHD. . And Joe Blow over there has hypertensive, high cholesterol, and diabetes (and no body thinks any different about him).
I honestly didn’t know the type of response I would, I was nervous and at times psyched myself out preparing for the worst. . .
My negative thoughts were quckily prooved wrong with an out-pouring of support from friends, family, coworkers, and from people all over the world. People started sharing their stories with me, some people turned to be for guidance and support. The next thing I knew I started creating social media platforms to provide my growing amount of followers a space where people could turn to for support.
This is still the beginning.
I only began this journey 2 months ago.
I am so excited for everyone to continue on this journey with me. ♡