Archive for the ‘exposure therapy’ Category

I have a professor who qualifies as one of those rare people who is both impossible to please, but generally right, making it impossible to be legitimately angry with him. I feel like every time I turn around I’m doing something to make him mad, whether it’s failing to include the correct introductory sentence in my emails or needing to leave class thirty minutes early to make it to a funeral. There are many days when I feel like I can’t do anything right, and I’m not the kind of person who can manage to not let things like this get to me.

The disconnect comes from the fact that he has impossibly high standards, but they’re also legitimate ones, and the higher he raises them, the harder I keep trying to earn his approval. In some says it’s a throwback to my childhood of always seeking approval. On the other hand, there’s really nothing unhealthy about it, and as long as I remain aware of my tendencies of constantly seeking approval, I can keep them in check without too much trouble. This is a solid indication that my therapy is working and paying off, so in that sense it’s a good thing.

At the same time, it’s hard to reconcile in my head sometimes. The fact that I’m getting to a place now where I can start to manage these things without needing medication is a good sign.

When it comes to medication, I’ve tried a lot of them. The first anxiety-related medication I started taking wasn’t directly related to my anxiety at all…I started taking Detrol LA the summer I graduated from high school. I was teased for years about my tiny bladder, and by the time I made it to high school, I had a hard time making it for more than an hour without using the bathroom. It seriously impacted my ability to function – I couldn’t even sit through a movie most of the time without having to leave half way through. I was afraid I wouldn’t be able to make it through my college classes, so I asked the doctor for a prescription. I took it for a few years, and then finally gave up because I still felt like I was having to use the bathroom all the time. I also started taking Prozac in college, before a trip to Europe that I was terrified of going on. A few months after I got home, I stopped taking it because I didn’t notice much of a difference. I had rabid panic attacks the entire time I was away, and I still had to use the bathroom all the time, so I gave up on the medication all together.

When I went to Alaska, my therapist thought Cymbalta might yield better results, so I started taking that. It was then that I learned why the Detrol LA wasn’t working on my frequent bathroom trips – I had to pee all the time because I was anxious, and that affects nerves. The Detrol works by calming muscles, so essentially not only did I have to pee all the time, I couldn’t actually fully empty my bladder, compounding the problem. Before this takes a header off the diving board into the “too much information” category, I’ll just sum up by saying that when I stopped taking the Detrol and started working on organically managing my anxiety, my tiny bladder problem improved dramatically on its own. I still have issues when I get really anxious, but most of the time, I’m just fine.

I stopped taking the Cymbalta cold turkey [side note: bad idea. Never EVER stop taking medication cold turkey. In addition to mood swings and other side effects, abruptly quitting the medication causes severe dizziness in some people, as it did with me]. when I got back from Alaska. Though my panic attacks were better while I was in Alaska, I was tired of medication that wasn’t helping me control my skin picking and wasn’t eliminating my panic and depression entirely. After about a year off of medication, I decided to give it another try, because I thought it might help me while I worked through some underlying issues (which, as it turned out, went much deeper than I had imagined). After consulting with my doctor and my therapist, we decided to give Effexor XR a try.

The first few days I instantly noticed a difference in comparison to the Prozac or Cymbalta. I felt totally numb…a bomb could have gone off next to me and I probably wouldn’t have cared. I decided to trust the therapist, who thought we should give it two weeks – if I still felt out of it and disoriented, I’d come off of it. My mood balanced out after a few more days, and I began to notice that I felt more calm and was better able to think about what was happening in a situation before reacting out of anxiety or panic. I felt more in control and level-headed. It didn’t eliminate my skin picking or my anxiety, but it did give me some breathing room to work on deeper issues.

I’m now approaching a place where I’m ready to be off of all my medication and getting back into the real world on my own. I’ve stepped down to half the dose of Effexor I was originally taking, and I’m ready to phase off of it by the summer. Scary? Yes. But also exciting. I truly believe that medication is a great thing when used properly and under the supervision of a professional, like a therapist. On it’s own, it’s not a cure-all – I’ve learned that one pill a day won’t fix everything. When that was my hope, I was, of course, disappointed. But there is a place for medication, and in the right situation it does work. I’m living (and still imperfect) proof.

I’ve been meaning to write this down for a while. Back in September, I got a chance to meet a bunch of crew members from several different boats on The Deadliest Catch. It was a neat moment for me, not so much because I’m a fan of the show (I am, but that isn’t the point…) but because Alaska is ingrained into my getting healthy on many different levels.  I started watching The Deadliest Catch a few months before I moved to Alaska in 2007 to work for the Alaska State Parks system. I had zero interest in the first few seasons; it wasn’t until I signed the paperwork for my contract with the state parks and bought my plane ticket for Kodiak that boyfriend insisted I watch the show so I’d know which boats to look for and take pictures of once I got there. I relented and watched a few episodes.

Moving to Alaska was a huge turning point in my quest to get healthy. In a lot of ways, it was the moment after which I started making real changes toward getting better. It was the point where instead of giving up and missing out on an amazing opportunity because I was afraid of the panic, I took charge and sought help because I was tired of missing out on opportunities because of anxiety and panic attacks.  Instead of forcing myself to go to Alaska and spending several months being miserable the whole time, I made the decision that I wanted to go to Alaska and be capable of embracing the experience. Prior to moving to Kodiak, the last time I’d forced myself to suck up the panic and travel was to spend two weeks in Europe in the summer of 2004. I spent the entire time shaking – literally, physically shaking – and absolutely desperate to go home. I thought if I could just get through that one experience it would make all other travel experiences easier. It didn’t…it just made me fear the panic more. I did get a doctor’s prescription for an anti-anxiety medication before I went to Europe, but in the Catch-22 that is anxiety, I was too afraid to take it, so it sat unopened in my suitcase the whole time. In fact, it’s probably still in my medicine cabinet.

When I went to see the doctor a few months before leaving for Alaska, something had changed. Instead of just saying “I don’t want to have panic attacks while I’m in Alaska,” I made the transition to saying “I’m tired of having panic attacks period. I want to learn how to overcome them. I just want to feel like a normal person for a change.” The doctor prescribed a different anti-anxiety medication (Cymbalta), but refused to send it through to the pharmacy until I made an appointment with a therapist. I kicked and screamed right up until the first appointment, because by that point I had very little faith in what simply talking to someone could do for me. I left for Alaska with medication in hand and a sense of trepidation. What if I really couldn’t be fixed? Then what??

I arrived in Kodiak terrified and homesick, but determined. A big reason why I credit Alaska as a major turning point is the length of time I stayed there – over the course of four months, I had to learn to face the anxiety because there was no imminent departure to look forward to. It was like a lengthy exposure therapy. It didn’t solve all my issues in one swoop (which I initially found disappointing) but it was a major turning point that opened me up to the idea that I could take steps to get better. I could survive four months in Alaska. On an island. Maybe I really could do anything.

That isn’t to say that Alaska wasn’t a struggle. It was – a huge, but very rewarding one. One of the things I did to calm myself down when I was having a rough day was to drive out to the Kodiak harbor and watch the boats come in and out. It was a strangely relaxing thing to watch them. I grew up near the ocean, but I was never a particularly huge fan of it. There was something cruel about it really, being dirt poor and living in a miserable home in an otherwise absolutely beautiful location. In Kodiak, however, I learned to really love the ocean for the first time. I found solace in the idea that the men who worked on these boats went out for months at a time, and for that time, the boat was home – that kind of strength can only be inspiring. In addition to that, it made me think of my mom, who worked on a processing boat in the 1970s during the Alaskan King Crab boom. Before she married my dad, she was a little bit fearless. She lost that by the time I was born, so in a strange way going to Alaska helped me reconnect with the woman my mother used to be. It’s hard to describe, but it’s a powerful thing.

Back to last September when I met Jake Anderson… For anyone who isn’t a fan of The Deadliest Catch and missed this story, Jake’s dad went missing over a year ago in the woods of western Washington and hasn’t been found yet. (You can read the full story here and here ) When I had a chance to meet Jake Anderson, along with Jake and Josh Harris and several other crew members from Deadliest Catch boats last September, they were collecting donations to try to find him.

I donated, of course, but something else was nagging at the back of my mind. As I left the craziness that was the autographs table, I gave Jake Anderson a hug and told him I hope he finds his dad. I told him I lost mine too, once, and he’ll find him. Then I rushed off and let 14 crazed screaming teenage girls behind me sweep in, cursing that I hadn’t taken an extra five seconds to clarify – my dad never went missing. But my Great Uncle, Jim did.

My Great Uncle Jim disappeared when I was nine. He had Alzheimer’s disease, and one day he just wandered away from my grandmother’s house, where he was staying, and never came back. There were a lot of days out on horseback searching through fields and ravines, and I remember being deeply impressed with certain aspects of the next few weeks – the rain and the rush of posting fliers and the crushing presence of search and rescue people. I remember most of all the uncertainty – the wanting answers. Did Uncle Jim just wander away? Was he kidnapped? Was he murdered? Was he still alive? A volunteer search and rescue worker found his body several weeks later at the bottom of a drainage ditch, under two feet of water. It was an El Nino year, and it had been raining for days. They only found his body because one of the members of the search team slipped and fell, and landed on him.

Most of all, I remember cleaning out Uncle Jim’s wallet. It had been under water for days, and everything in it was wet and covered in mud. It smelled like silt and decay…and death. I’m still not sure what my parents were thinking when they allowed me to be exposed to so much trauma without any consideration for what it might do to a little kid. (This is a big theme of my therapy lately…) When we cleaned out Jim’s house, a lot of his things ended up coming back to our hoarded home. For years, the comforter on my bed was from his house. It was impossible for me as a nine year told to separate these physical things from the idea of death, which I had trouble comprehending. (Again…this is a big theme of my therapy…)

Years later, I still think about my Uncle Jim and how traumatic it was to lose him that way. I wasn’t particularly close to him (then again, I’m not particularly close to anyone in my family) but it was a sudden and dramatic loss that was never mitigated for me. It was followed by more losses (Jim’s brother and sister) that were also never dealt with in a healthy way. Though my dad always claims that family comes first for him, he’s never followed through on what I’d consider a basic responsibility – getting tombstones for their graves. My Great Uncle Jim bought his own tombstone after his wife died. (My earliest distinct memory, coincidentally, is of her funeral, when I was three). Family legend is that he carried it around in the back of his truck and proudly to everyone before it was placed over her grave. My dad never had his date of death engraved on it.

So, Jake Anderson…I sincerely hope you find your father. I think the way your support your family is amazing, and I wish I’d had a big brother like you when I was growing up. You deserve to know what happened, and the comfort of finding out the truth. Wherever he is, I hope your father finds safe passage home.

My Great Uncle Jim's headstone, still missing his date of death.