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necessary whispers

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Month

October 2015

Depression and Anxiety: Taking Medication Does Not Make You Weak

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As I was making my decision as to whether I should take medication to allay my symptoms of anxiety in 2012 I received two pieces of advice that stood as tent poles to my ultimate decision:

  1. From my medical doctor, “It sounds like this anxiety is disturbing your quality of life. If that is true, why not try the medication?”
  2. From the most influential psychologist in my life, June Hunt, “If you do decide to treat your anxiety with medication make sure to do it in conjunction with counseling so you can get to the root of the issues that are causing the anxiety. The medication can help your mind focus on what you need to discover.”

And so, with the help and advice of these and others in my life, I began to take Zoloft, as well as three doses of varying milligrams of Xanax throughout the day. Zoloft is a medication that does not fully take effect until week 8, so the Xanax was meant to give me some peace of mind until the Zoloft kicked in.  At 8 weeks I was able to wean off the Xanax entirely with relatively inconsequential added side effects.

I began taking both medications in the middle of January, 2013. Before and during the beginning of this journey I scoured the internet looking for any and all information I could find about Zoloft for the purposes of monitoring my own improvement—or lack thereof—and so I could be alerted to any negative side effects of the drug. For me, knowledge is power, always. For example, if I am sick and I am experiencing some symptom that seems out of the ordinary, I tend to focus on that symptom until I can find information as to why it is occurring. Once I know that the symptom is “normal” I can stop worrying about it and allow nature to run its course without the benefit of my overly attentive eye. I call this being a responsible patient. Others might call it paranoia. Still others might call it good ol’ fashion fear. Whatever the correct term, my watchful eye continued to scan the message boards for several weeks until I felt the medication begin to take its full effect.

I would like to provide two things throughout the remainder of this post:

  1. With the objective of offering hope to someone else who may be scouring the internet looking for answers to the question, “What can I expect when I begin taking Zoloft?” I would like to share my personal experience.
  2. There is a stigma related to depression and anxiety, as well as the medications that are meant to restore some semblance of normalcy to those who take them. I believe the stigma is born of a lack of understanding concerning the chemical results of stress in a person’s body and the general labeling of legal drug use to treat depression and anxiety as “weakness.” I would like to address the stigma.

Incidentally, I am in no way a doctor so everything I share here is based on my own personal experience, as well as the things I have learned from authors, doctors, other people who have walked similar paths to my own, and counselors.

When I first began taking the Zoloft/Xanax combination my anxiety was at an all time high. For me, anxiety during that time felt like fear, foreboding, a sense of impending doom, a complete loss of joy and a disconnectedness with the outside world. It also manifested itself in physical ways: wringing my hands, shaking my legs, twirling my hair with my fingers and not being able to sleep. These physical manifestations were not as debilitating as were the mental/emotional symptoms.

For example, there is a term I learned during this time called, “depersonalization.”  Before I learned this term, I described it as a feeling of watching the world from above myself. It was like walking through my day on autopilot: I was fully aware of my surroundings, in touch with my own five senses, thoughts and emotions but I also felt disconnected. It was as though being aware of myself and feeling connected to myself were two different things. As you may be able to anticipate simply by reading that description, I thought I was going crazy. I was happy to learn that this sense of “depersonalization” is a symptom of anxiety and it CAN be cured and it WILL go away with proper treatment of the anxiety itself. Remember, knowledge is power: once I realized that what I was experiencing was a recognized medical occurrence, I was able to let it go and not fixate on the way it made me feel. I have not experienced the feelings of depersonalization since February of 2013.

The physical effects I experienced as a result of taking Zoloft in the beginning included the following: fatigue, a vague sense of dizziness every now and then, I had a hard time coming up with words in the midst of conversations, I felt some unwarranted irritation and agitation with myself and others, and my appetite became substantially bigger. To combat these physical effects I worked out. And worked out. And worked out. I quickly found that if I could push through the fatigue to exercise, the discomfort I felt in exerting energy through the fatigue was far outweighed by the sense of overall calm I experienced at the end of my work outs.

So, there were days I can specifically remember when I would walk for 3 ½ miles and then begin running until I felt all of my “jitters” dissipate. Some days I would end up covering 8-10 miles.  Trust me when I say, I am not a runner. Running is to me what bath time is to cats. Even so, this level of physical activity truly released enough endorphins to balance my mind and bring a sense of stillness to my body so I ran like Forest Gump and managed to avoid any weight gain in spite of the ravenous hunger I experienced.

Some of the best advice I got in the beginning stages of my experience with Zoloft came from both my mom and my counselor, Ben. They both told me, at different times, to stop fighting the discomfort of anxiety and, instead, to lean into it. That sounds counter-intuitive, I know. Especially when you are used to steeling yourself against anxiety. However, what they taught me was that it was okay to feel anxious, it was okay when the medication made me feel “weird” or dizzy or tired . . . instead of fighting against it, which caused more tension and anxiety, I should simply listen to my body and respond to it’s signals.

Even 10 or 11 or 12 weeks into taking the medication there were days when I felt anxious. Normally, I would berate myself for being unable to control the feelings, feel disappointed that “this medication is not working,” and wonder, “is this what the rest of my life is going to be like?” This succession of thoughts and feelings would rapidly spiral into a dirty laundry pile on the floor of my brain and then I would douse the laundry in the anti-detergents of fear and a sense of hopelessness. However, once I really began to listen to mom and Ben’s advice—“lean into it, don’t fight it”—my approach to dealing with difficult moments or days took a different shape. Instead of falling down and rolling around in the dirty laundry of my mind I would recognize the initial discomfort. Stop. Acknowledge the discomfort and then make a CHOICE about how to face the discomfort.

Here is an example of how I handled these moments of discomfort BEFORE I learned to simply lean into them:

One afternoon, after I had been taking Zoloft for about three weeks, I was sitting at a Panera Bread restaurant in St. Louis with my husband and my mom. We were enjoying one another’s company and having a perfectly relaxed meal together when I began to feel a little dizzy. I also felt a little nauseous, which was a sensation I recognized as a side effect of the medication. My thought process was as follows:

I don’t feel well.

I bet this will get worse.

What if I faint?

What if I throw up right here at the table?

Act normal.

Why can’t I breathe normally?

Oh no, this medicine isn’t working.

I am going to be like this for the rest of my life.

I think I am going crazy.

Act normal.

I am becoming a burden to my family.

They have been patient with me for this long but their patience will run out.

Act normal.

I hope I don’t die.

I might die.

I will probably die.

Act normal.

As you can see, one physical sensation had the power to trigger all of these negative thoughts, which triggered negative emotions, which triggered extra tension in my body, which trapped oxygen in the tension I was creating, which caused a quick succession of anxiety and depression coupled with rolling around in dirty laundry right there in Panera Bread. Incidentally, my mom and husband walked me out to the car and that is when my mom first said, “Honey, how do you feel right now?”   To which I answered, “I feel like I need to lay down. I feel like I might pass out.” (I had never passed out in my life).  She replied simply, “Then lay down. I think you just need to listen to your body right now. If you feel like you need to lay down, lay down. Instead of fighting it, just lean into it.” And suddenly, with her words, I felt like I had permission to respond to my own body, instead of trying to control its every action and reaction.

Here is an example of how I handled these moments of discomfort AFTER I learned to simply lean into them:

I was teaching Public Speaking again during the spring semester, 2013. As I mentioned in a previous post, I felt compelled to quit my job teaching at the university in the city but I learned by reading Dr. David Carbonell’s book, Panic Attack Workbook: A Guided Program For Beating The Panic Trick, if I had quit my job anxiety would not only have won the battle but it could have won the war. So, there I was teaching again but this time I was working through the fog of Zoloft and Xanax. I kept reminding myself that “help is on the way” and that one day I would stop feeling the side effects and I would begin to simply feel better. One day that I remember particularly well, I was watching student speeches. I was sitting in the back of the room grading their presentations when I began to feel a physical trigger to having a panic attack: I felt a little dizzy and a little nauseous.  My thoughts were as follows:

Uh-oh.

Act normal.

What if I have a panic attack?

Will I be able to hide it?

Stop.

What am I feeling?

I feel nervous.

I feel my breath quickening.

I feel fear.

Well, okay.

I acknowledge all of these feelings.

I am just going to keep watching the rest of the speeches WITH these feelings.

And then, something wonderful happened. While I was leaning into the feelings, they began to dissipate. I learned in this moment, and in many moments similar to this one, that the negative sensations of anxiety would continue to surface. I learned that these feelings that used to trigger a quickly spiraling tornado of horrible thoughts, feelings and physical reactions were invitations to brace myself. I learned that I no longer needed to brace myself. Instead, I could sit down in the midst of the storm, be aware of the wind and the rain, the thunder and the lightning, and just keep listening to my students’ speeches. Sometimes I even felt the storm begin right in the middle of a lecture. Even then, I acknowledged the discomfort, focused on the lesson instead of my own present state and leaned into the wind.

There was a real sense of freedom I incurred during the most tumultuous time of side effects of taking Zoloft. It was the freedom of not feeling okay and realizing that it is okay not to feel okay. Really, it’s okay not to feel okay.  The world will not end if YOU don’t feel strong.  YOUR world will not even end if YOU don’t feel strong or “normal” or well or so illustrious that everyone wants to be you.  There is a reason you don’t feel well.  Use that discomfort to initiate a process of discovering why.

Taking medication to allay the effects of anxiety and depression, along with the use of cognitive behavioral skills (such as breathing properly and deciding to lean into the discomfort) absolutely helped me regain my life. In fact, going through the tumult of falling from grace in my own eyes and having to take medication to regain my sense of balance is an experience I would not trade now. This particular struggle taught me to see my own pride, it helped me tear down some of the protective walls I had built over so many years of trying to erect a perfect image, and it created a space for me to face some of the demons from which I had been running for years.

This struggle also gave me a deep compassion for anyone else who struggles with this two-headed beast. If you are currently involved in this struggle, please receive these words: anxiety and depression are not your identity. They are symptoms of something else that is buried within the laundry basket of your own mind. You absolutely CAN regain your own life back, one day at a time, if you face the anxiety and depression itself and seek help from a professional who can help you assess your current condition and set you on a better path.

God has a plan for you. And He IS in the midst of the storm with you. In fact, the Bible says in Psalms 34:18, “The LORD is close to the brokenhearted and saves those who are crushed in spirit.” It also says in Jeremiah 29:11, “ ‘For I know the plans I have for you,’ declares the Lord, ‘plans to prosper you and not to harm you, plans to give you hope and a future.’” Sometimes God uses difficult seasons such as I have described here to get you to the next level in your life: sometimes God uses difficulty and pain to shape you for the purpose He has for your future.

Next time I will explain how anxiety and fear almost stopped me from traveling to Auschwitz with Eva Kor in the summer of 2013.  Can you imagine?

Jill Szoo Wilson

Photo Credit: Treasury Today website

Depression and Anxiety: The Why Behind The What

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According to American Psychologist Lawrence J. Crabb, Jr. in his book, Understanding People: Deep Longings for Relationship, every human being has three God-given inner needs: for love, significance and security. Apparently, if we as children incur some deficit in any of these three areas, we can feel compelled to fill the deficit in varying ways, as we grow older. For example, if you as a child were made to feel as though you were never good enough by your parents and siblings, you would likely seek to fill your need for significance by engaging in relationships and/or activities later in life that make you feel significant.

There were many aspects of my childhood that were wonderful. I had a single mother who loved me, took care of me, taught me how to love and laugh and always encouraged the gifts and talents she saw in me. We moved to California when I was 7-years-old, which was a decision I truly hated, but even there I knew my mom had my back. And then later, my little sister, Jennie was born just months before her dad—my step-father of three years—would leave our family (it’s a confusing story, I know). Close behind my mom and sister in terms of important relationships in my childhood were my St. Louis family: a collection of grandparents, aunts, uncles, cousins and even family neighbors that remained constant throughout my childhood and adolescence. I also had a few key friendships in California that grounded me and gave me a “home base” outside of my own home. The older I get, the more I realize the importance of these childhood friendships, all of which were extremely positive and affirming.

Even with the support system God so graciously wove into my life, there were other influences that began to drain my accounts, specifically the Significance account. I will not go too deeply into this idea but I think it is important to create some context as to the overall idea of significance and how it relates to depression and anxiety in my life.

As a small child, I was adorable. As an older child, I was still cute. As an adolescent, I began to gain weight and during these years my mom struggled financially so I often wore shoes and clothing that were not “cool” by the standards of almost anyone. (For example, my mom had a sweatshirt that had her name embroidered into the front of it. It was really cute, actually . . . for her. Because it donned HER name . . . and I wore it to school). I always had everything I needed but beginning around sixth grade, “need” is replaced with the identities of teenaged super stars whose images are shone into the sky like bat signals over middle school playgrounds. In other words, I was not cool. And there were other young men and women who were able to attain the bat signal Debbie Gibson status that reminded me how far short I fell of their worthiness.

During these trying middle school years I had enough wherewithal to discover that there were ways to overcome mediocrity even in spite of uncool clothes and chubbiness: academic glory or athletic prowess. I tried to reach both heights. In fact, I remember a moment in my 7th grade science class when the teacher, Mrs. Jurris, was instructing our class on the Earth’s atmosphere. Embarrassingly, I do not now remember the exact lesson but I do remember understanding it at the time. So, when Mrs. Jurris asked for us to raise our hands for comments and questions I proudly raised my hand and explained the lesson back to her. What I understand now is that this is how I process information: I have to restate it to myself. I have to use the information in some real-life example to make sure I comprehend what I am learning. But, to my fellow 7th grade classmates, I sounded like I was showing-off (I guess). I began to hear giggles behind me. Then, the girl sitting next to me said, “Stop talking, Jill.” I felt a collective disregard for my moment of academic pride and I stopped talking. I would not speak up again in class for several years. Not only because of this one moment but I remember this one moment serving as a culmination of other snide, bullying remarks and attitudes pointed at me like a bat signal of rejection and dismissal.

When being the smart kid didn’t work out for me, I went the other way. I decided I was not smart. I believed the lie that others were telling me about myself: I believed that I was not significant and that I was not smart enough to be successful in school. So, my grades began to slip and I tried to become athletic.

I actually just laughed out loud when I wrote that last sentence, “I tried to become athletic.” It is not easy for an over-weight adolescent with little confidence to simply “become athletic.” There are gym shorts and tank tops involved in such endeavors and I felt much more comfortable in long t-shirts and baggy sweatshirts with my mom’s name embroidered on the front.

Alas, I began to do something I had never before done in gym class: I tried. And I kept trying. I was actually good at tennis. I was good at soccer. I began to learn that I actually had some skill in many of the sports our teachers taught us. So, I worked up the courage to try out for varying sports teams. Long story short . . .I ended up in a baton twirling class that I eventually quit right before we were scheduled to march in the Rose Bowl parade. I quit because baton twirling is stupid. (No offense to anyone who enjoys a good baton twirling but for me it was a last ditch effort to be a part of someone, ANYONE’S, club and I was thoroughly unimpressed with the whole thing). The sports world wasn’t interested in what I had to offer.

When athletics turned me away I had a short stint in the political world, which began when I gave a rousing speech in the cafeteria of Foothill’s Junior High School in 7th grade. I was running for the office of secretary in my school’s student government. Perhaps I don’t have to even tell you the results of the election because I assume you can see where this is going. I did not win the race for school secretary. Thus ended my 10 minute political career. To make matters worse, I was the only candidate in that particular race. I thought I was a shoe-in for Secretary given I was the only name on the ballot. Nope. The seat went, instead, to a very popular young woman named Laura who ran for Treasurer . . . and still beat me in my race for Secretary. [cue the song Send In The Clowns]

Eventually, in 8th grade, I did find one thing in which I excelled: theatre. I was just as surprised as anyone to learn that I was funny, talented and that all my years of standing outside and looking in helped me build a skill that is quite marketable in the arts: I am a good listener and an excellent observer of human beings. And so, after finding nominal success in drama class I tried out for the school play and landed one of the lead roles. That, ladies and gentlemen, was the beginning of a beautiful friendship between me and the muse of Theatre.

So, how do these snapshots of my childhood relate to the struggle I faced with depression and anxiety as I stood before my Public Speaking classes in 2012? I still felt I had something to prove. I felt, by then, that I had attained some significance in life and I knew I wanted to keep it.

When I was hired at the university in Kansas City, I felt proud of myself. The university has a urban, cool vibe to it and the students are savvy. Among them walk future doctors, lawyers, chemists, businessmen and women, Broadway stars, pharmacists and other important people. I do not mentioned the importance of their studies to communicate a sense of being less than them but, instead, I wish to communicate that I felt proud to be in their midst. To think that I had something to teach these students made me feel good about myself. I am a darn good teacher and I felt a true sense of purpose fulfilling this role that semester. But then . . . something else crept in: perfectionism.

Right from the first day of class almost all of my students recognized that I was “The Price Chopper Girl.” For those of you reading who are not aware of this, I am an on-air spokesperson for a regional grocery store chain. This means that my visage appears in the weekly newspaper, on the sides of semi-trucks, on billboards, in grocery stores and on commercials. This particular job has been both wonderful and nerve-wracking for me. I would not change it for anything and yet there is a side effect to the job that no one could have guessed: during that particular season I felt that I always had to be “on.” When I was teaching, when I was sitting in the teacher’s lounge, when I was shopping, when I was walking my dog, when I was working my extra part-time job at Old Navy, when I was at the gym . . . I was recognized. Everywhere. Excited passers-by would shout, “You are the woman on TV!” Or, people would stop and ask, “Can I take a photo with you? My brother loves you!” This recognition was fun at first! Then, I started to internalize this awareness: you cannot leave the house without looking like the spokesperson, you cannot ignore anyone who recognizes you and you cannot say anything that would be considered unsavory for “The Price Chopper Girl.”

With this added pressure, I began to become perfectionistic in all ways: the way I taught, the way I looked, the way I shopped for groceries at my local grocery store as I heard recordings of my voice exuberantly talking about vegetables and gas cards over the loud speakers. When I failed at any of these self-imposed perfections, I was really hard on myself. I was not outwardly self-deprecating: I did not yell at myself or say mean things to myself in the mirror: it wasn’t that dramatic. Instead, I internalized this deep-rooted feeling that I was not really significant and that the things that made me appear significant (my professional acting career and my role as a teacher) better not slip, at all. If I slipped, I would end up in Mrs. Jurris’ 7th grade science class hearing cooler people than I giggling behind me. Or, worse yet, I would end up disappointing those who believed in my as an adult, my students, the grocery store chain, my family and myself.

Significance is vital. However, like any good thing that you make an idol in and of itself, significance also has a dark side: pride. I was being extremely prideful. I made my own image an idol and I did it out of fear that I was secretly not good enough.

The chasm between my public self and my private self began to widen and this is when my struggle began. Think about it: when you are striving to maintain an image you are constantly busy trying to guess what other people want from you. So, maintaining your own image is a series of small guesses and gesticulations: it is walking on a tight rope over New York City. You put yourself on a high pedestal and make adjustments according to the way the wind blows. You make adjustments according to all the external elements that could affect your balance. THAT IS EXHAUSTING!

This is why the panic attacks began. This is why I felt depressed and anxious. I was isolated from the people around me and myself.

While I do believe I began dealing with depression and anxiety at some point longer ago than 2012, it was my search for significance during this time period that brought my struggle directly to the surface. I was not only dealing with 2012, I was also dealing with a culmination of unhealed moments that occurred in the 1980’s and “90’s.

In conclusion for today, I would like to mention three things that helped me break through the monotony and pain of the back and forth between private and public self: Jesus, medication and counseling.

  1. I learned to find my identity in Christ instead of the fallacies of personal success, intellect and others’ opinions of me (sometimes I am successful in this endeavor, sometimes I am not).
  2. I utilized medication for a time (it was absolutely, 100% helpful for me).
  3. I met with my counselor about once a week for several months. I still meet with him from time to time as issues arise.

Next time I will discuss my experience with medication: the good, the bad and the ugly.

Jill Szoo Wilson

Photo Credit: Treasury Today website

Depression and Anxiety: Panic Attacks

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I used to fear panic attacks. More accurately, I used to fear the fear of panic attacks. When you live in a state of fear that something might happen, it is like providing a place setting at the table of your life, filling the empty plate with delicious morsel after delicious morsel and then just waiting. Sitting across the table, staring at the feast you’ve prepared for your enemy and . . . waiting. Wondering if there is a way to poison his food before he comes in but knowing that he moves through walls like a ghost and getting caught poisoning his food would lead to a fate worse than that which you originally feared. So you tolerate his impending visit.  Fear is like a ghost.

I no longer have panic attacks. I have learned that the feeling I used to get moments prior to an attack is actually an invitation to panic, not an entrance into an attack itself. It is the difference between standing outside the door of a party and deciding to step over the threshold. Life is a series of choices and I was able to regain my sense of freedom when I learned that even as I could feel by pulse quickening, my breath becoming irregular and my hands getting cold, I could still choose to walk away from the door, instead of going through it. My last panic attack was the day after Christmas in 2012.

For me, anxiety looks like a furrowed brow, constantly grasping and squeezing my hands, breath that gets stuck in the tension I’ve allowed in any given part of my body that causes my chest to fill and empty with breath that is too shallow, or too quick. Sometimes, I stop my breath for seconds at a time without realizing I’ve stopped its flow. Anxiety for me feels like foreboding, impending doom and sometimes even a precursor close to death itself. All within the comfort of my own home. Or a movie theatre. Or a restaurant. Or my car.

Between depression and anxiety, anxiety is the end of the spectrum that I have learned to manage the best. I promised I would not get too teachy in these blogs for fear of hiding my true experience behind a veil of pedagogy.  However, I would like to teach you how to avoid panic attacks altogether. I will do so by sharing two things:

  1. How to get control of your breath.
  2. The most helpful resource I have ever found on the topic of anxiety and panic attacks.

During the worse season I have ever endured under the influence of anxiety, I was having panic attacks in front of my classes, while teaching, and no one ever knew it. It was the fall of 2012.  I had over 120 students that semester and I was teaching at two different universities. Ironically, I was teaching Public Speaking. To most, speaking in public is a fate worse than death but I do not have any fear of speaking in public. What I was experiencing during this season were internal fears that had nothing to do with the topics on which I was teaching each day, or even the environment in which I was working. Here is a slice-of-life example of how anxiety began ruining my life, one day at a time:

I would walk into class and I was genuinely happy to see my students. I loved teaching (I still do) and I loved my students. I would begin class by taking role and as I did, I would feel the tightening of my breath and begin to breath from my chest, instead of from the center of myself. Then, I would begin to feel the need to breath more quickly (not more deeply, more quickly). The presence of too much oxygen would begin to make me feel dizzy. Dizziness, for me, was a trigger to panic: the physical sensation of light-headedness and the thought that I could pass out at any moment (which I never actually did though by the amount of fear I had assigned to passing out you might think it was a daily occurrence in my life). This dizziness caused me to brace myself, physically, mentally and emotionally. Perhaps “steel” myself is a more accurate word. My thoughts were as follows, “I don’t feel normal, I wonder if I needed to eat something before I came to class. Can they tell I don’t feel normal? Just keep talking. Focus on the words, focus on the topic. Why can’t I breathe? I would be horrified if I passed out in class. They would lose respect for me. I am losing respect for myself. Keep talking. Oh man, I feel dizzy. I wish I had some water.” Thoughts like that. Thoughts that pulled me in two different directions.

As a side note, I will add that the very first time I ever felt this feeling of dizziness was the first time I had a panic attack in 1997. During that time I was trying to decide what I should do concerning the high school teacher who made seduction an art and made grooming young women for future sexual favors part of his daily curriculum. This first panic attack caused me to call 911 because I thought I was dying. Alas, since the doctors could not find any medical condition that might have lead to the symptoms I described, they diagnosed me as Hypoglycemic.  I lived with this diagnosis until 2013 when I realized that the symptoms I attributed to a need for protein—chief among them was dizziness— were actually the symptoms of anxiety. This would become extremely helpful information as I learned to understand the sensations that triggered my panic attacks.

In truth, that semester I was having heart palpitations every hour, I began drinking at night to help ease the stress of the day, I began eating more to combat the “dizziness,” I stopped spending time with anyone outside my home because I was afraid I would have a panic attack in front of them, and I made a decision that I could never teach again. That decision did not end up holding because I later learned that if I gave into the anxiety by making such a choice I would have been letting it win. Instead, I ended up winning.

Incidentally, I was later diagnosed as being “high functioning with Generalized Anxiety Disorder.”  I agree with the high functioning part, as evidenced by the fact that I got the highest teaching evaluations in my department that semester.  (As I have said before, I am stubborn and I refuse to let others in public see this struggle).  I still take issue, however, with the “disorder” label because, psychologically speaking, a disorder usually indicates an inability to function in your daily life.  While this particular season I am currently telling you about was certainly marked with extreme difficulty in functioning, I could still function.  Even more so now.  But, perhaps that is simply a semantical issue.  Also, I do not like the label.  I digress . . .

So, as I promised above, #1: I will share a resource with you that explains how to control your own breath as I learned it from Dr. David Carbonell whose wisdom saved my life and career. To anyone who does not struggle with anxiety this might seem like an odd tutorial. It might even sound amusing. However, to anyone who has actually uttered the words, “I can’t catch my breath,” this will be helpful.

When you feel like you can’t catch your breath, it’s because you forgot to do something: you forgot to exhale.

  1. Place one hand just above your belt line, and the other on your chest, right over the breastbone. You can use your hands as a simple biofeedback device. Your hands will tell you what part of your body, and what muscles, you are using to breathe.
  1. Open your mouth and gently sigh, as if someone had just told you something really annoying. As you do, let your shoulders and the muscles of your upper body relax, down, with the exhale. The point of the sigh is not to completely empty your lungs. It’s just to relax the muscles of your upper body.
  1. Close your mouth and pause for a few seconds.
  1. Keep your mouth closed and inhale slowly through your nose by pushing your stomach out. The movement of your stomach precedes the inhalation by just the tiniest fraction of a second, because it’s this motion which is pulling the air in. When you’ve inhaled as much air as you can comfortably (without throwing your upper body into it), just stop. You’re finished with that inhale.
  1. Pause. How long? You decide. I’m not going to give you a specific count, because everybody counts at a different rate, and everybody has different size lungs. Pause briefly for whatever time feels comfortable. However, be aware that when you breathe this way, you are taking larger breaths than you’re used to. For this reason, it’s necessary to breathe more slowly than you’re used to. If you breathe at the same rate you use with your small, shallow breaths, you will probably feel a little lightheaded from over breathing, and it might make you yawn. Neither is harmful. They’re just signals to slow down. Follow them!
  1. Open your mouth. Exhale through your mouth by pulling your belly in.
  1. Pause.
  2. Continue with Steps 4-7.

If you would like to read further, please visit Dr. Carbonell’s website. I have logged hours on this site and I cannot tell you how often it has made me think the words, “Oh! I am not crazy, after all!”

http://www.anxietycoach.com/breathingexercise.html

Moving on, #2: the most helpful resource I have ever found concerning how to stop panic attacks is also from Dr. Carbonell. He wrote a book called, Panic Attacks Workbook: A Guided Program for Beating the Panic Trick. Incidentally, this man has no idea who I am. I have never met him in person and I in no way get any reimbursement for this recommendation.

There is a chapter from this book printed in a PDF format online: http://www.anxietycoach.com/support-files/panicattacksworkbookchapter7.pdf

The name of the chapter is “The Panic Cycle.” This chapter was a lifeline to me the first time I read it. In fact, the first time I read it was the day of my last panic attack. I went for a drive in my car that day and I was crying out to God, “Lord, I have no idea what is wrong with me but you do. I NEED your help. I NEED you to send me a person or a resource that can HELP me. I NEED your HELP. If I don’t get your help I do not think I can survive this torture for even one more week.”   I guess I would not say I was suicidal because I did not want to die.  I was, however, desperate for the pain to end.  This prayer–this fervent request for help–was answered that same night when I read this chapter. After I read it, there was a long journey of medications, doctors, psychologists and learning that had to take place BUT this chapter was like a crack of light in an otherwise dark room.

I would like to make a specific invitation to anyone who would either like to share their story of anxiety and depression with me or has questions about their struggle.  According to the Anxiety and Depression Association of America, it is not uncommon for someone with an anxiety disorder to also suffer from depression or vice versa. Nearly one-half of those diagnosed with depression are also diagnosed with an anxiety disorder.  Over 40 million Americans, or 18% of our population, in involved with this struggle.  So, the odds are that at least a few of you who are reading my blog can relate to this topic.  There is hope for you.

Tomorrow I will share with you the reason anxiety took hold of me at this particular time in my life.  The deeper why behind the what.

Depression and Anxiety: The Two-Headed Beast

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I would like to write about depression. And anxiety. As it turns out, these two words go hand in hand, kind of like peanut butter and jelly or the uneaten vegetables left in your vegetable crisper and the brown, slimy sludge that they leave behind. More like that latter.

When people do not struggle with this two-headed beast I think they make assumptions about what it looks like. Depression, for many, conjures images of tufts of hair carelessly peeking out from beneath a comforter, in a dark bedroom, at noon. It looks like drawn shades and heavy black make-up and a mastery of the fetal position. It smells like stale coffee or ashtrays heavy laden with smudgy memories of lost love, forgotten goals or broken dreams. It sounds like a song played on repeat, over and over again: songs like “Everybody Hurts,” by R.E.M. or anything sung by Adele.

When people do not understand depression they say things—well-meaning things—like, “Cheer up! Life isn’t that bad!” Or, “You should just pray more.” Or, “Stop feeling so down.” But this is usually only when you tell them that you are feeling depressed. If you don’t tell them—if they are aware enough to sense it—they might say things like, “Snap out of it,” or, “What’s wrong?” The only problem with asking, “What’s wrong?” is that it is usually a question that gets repeated until the asker feels satisfied with your response. And, as the questionee, you can’t really say, “Well, I actually have no idea. I just feel down.” Because if you say that, a second wave of questions will rise up and douse you with the salty waters of overwhelming inadequacy and self-deprecating thoughts that have you join the questioner so that you too begin to question, “What is wrong with me?” Not being able to answer this question to others is one thing. Realizing that you’re not quite sure how to answer it for yourself can be downright scary as the mystery threatens to strip you of a sensible amount of control over your future.

For me, depression looks like a to-do list. When I am feeling depressed, I have to purpose to plan my day. When I am feeling depressed, I become more measured in the way I move, the expressions I allow to appear on my face and the things I allow to come out of my mouth. This is actually what I hate most about depression: I become more focused on myself than I wish to be.

The reason for all of this self-monitoring is that I refuse to allow anyone else to become aware of how I am feeling inside. I also refuse to give into the feelings of hopelessness and fatigue, the heaviness in my body and mind, or the irritation I can suddenly feel at any given moment. To this end, I wake up, workout, make my to-do list and then proceed through my day purposefully and with the sense that at any moment I can choose to think thoughts that will either lift me up or drag me down.

To clarify, I do not believe that “pretending” to be okay is the way to combat depression. Not even my own. When I tell you that I refuse to let anyone else see what I am feeling, I mean that I do not want my feelings of depression to be the mask that I wear.   Instead, I become aware of the feelings and I purpose to go about the business of my day with professionalism and a smile on my face; this practice is not hiding, it is coping.

Depression has taught me that we humans have an amazing ability to decide what we will focus on. We get to choose what we think about. Our thoughts guide our choices. Our choices direct our emotions.

So, mind (think) –> will (choice)–> emotions (feel)

This is why the days on which I am struggling with depression tend to be the days during which I am the most purposeful with how I use my time: I am aware that I need to direct the ship. If I don’t, this is how my mind, will and emotions conduct themselves:

Mind (think) –> emotions (feel) –> will (choose)

In other words, when I act based on my emotions, instead of acting based on my sensible and experienced mind, the cycle between these three parts of myself can begin to spiral into a sticky, emotional morass. I could end up with drawn blinds or, worse yet, listening to too much Adele.

I am going to attempt to share my journey with depression and anxiety over the next several posts. If you have been reading my blog already you know that I have shared several stories of a personal nature: chief among those stories having to do with being a victim of childhood sexual abuse. I mention this to give you some perspective on how uncomfortable it is for me to even think about sharing my journey with depression and anxiety: I feel more comfortable sharing my childhood victimhood than talking about depression. I think the reason is that the former happened to me and the latter threatens to become a part of my identity.

Even though I lived for many years with false guilt concerning the things that happened to me at the hands of perpetrators, there did come a time when my counselor helped me understand that I am not to blame for their actions. This truth shed light on the guilt and shame with which I lived and it brought freedom to my heart and thoughts concerning that part of my life. Though my inner self was affected by those traumatic events, it was easy for me to acknowledge the actions exacted against me as a part of my story but not my whole story.

When it comes to depression, however, I have to make myself vulnerable in the present. For some reason, it is easier to say, “I used to have this problem” than it is to say, “I have this problem.” The “used to” creates an air of competence, victory and mastery. The “I have” creates a feeling of heaviness, uncertainty and fear. To look on the bright side, the “I have” also creates a sense of brotherhood with anyone else who understands that through which I am currently walking. Perhaps we can walk together.

So, come along with me if you would like. There will be some good days and some bad days. There will be some days when I can be freely honest with you and some days when I will have to work hard not to tell half-truths or cover up the ugly parts to protect you from discomfort and me from even more discomfort. There will be days when I want to get too “teachy,” because it is easier to teach you what I am learning than it is to acknowledge how I am feeling. Even so, through it all, I will try my best to be open just in case my own journey helps even one other person.

Jill Szoo Wilson

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