Contentment With a Side of Panic Attacks

Life is fairly good these days.  I’m attributing it to plenty of sunshine and DBT and working hard in therapy and having more structure to my days.  There are some big changes on the horizon, like moving, and QoB *finally* retiring (maybe), but those are good changes.  While my mood has been fairly neutral, I have been having some physical symptoms that have been giving me trouble.

Physical symptoms that I decided were lithium poisoning, because that is where the problem  usually is, but when that wasn’t the answer (after a blood test) and the urgent care provider sent me to the Emergency Room, I was stunned that I hadn’t thought of this:

from http://www.slideshare.net/mwalley/panic-attacksatnight

I was having every single one of these issues, a minimum of three separate episodes each day.  So, apparently, my anxiety (that I *knew* was high, but, um, it always is!) is manifesting into more physical problems.  Also known as, multiple panic attacks a day with very high anxiety between attacks.

So while I thought that I was mentally very healthy, because I was not feeling extremely depressed or extremely elevated, and because I was not having more than my usual amount of generalized anxiety, I misdiagnosed myself as having lithium poisoning or something wrong with my heart because it has been so long since I have had full-blown panic attacks.  I should note that these attacks almost always additionally come with gasping, sobbing, and cursing on the side.

I beat myself up that I didn’t realize my anxiety was so out of control before having this little Emergency Room epiphany, but I think that I was just so grateful to not feel extremely depressed, that I decided everything else was “fine” and that I was just “physically ill.”

I still “don’t feel good” physically and am going to need to get in to see my psychiatrist this week, but I am really not looking forward to that.  I reported increased anxiety at my last appointment, and I do have a PRN for anxiety that generally works.  It is only when the anxiety gets really blown up and into a full-on attack that seemingly nothing makes me feel any better.

I am curious.  Have any of my readers ever had something like this blow up out of nowhere?  I mean, it probably isn’t really “nowhere” and I just can’t pinpoint where it started.  Thoughts, feelings of commiseration, home cures (hahahah!!!)?

 

Because I Don’t Feel Like it, Ok?

As I have mentioned before, if I don’t get a good night’s sleep and quickly into my morning routine, ugly things happen.  Last night was one of those nights where I couldn’t fall asleep, and then I couldn’t stay asleep.  I had nightmares, which used to occur frequently, but not so much anymore, so I was doubly sucker-punched when I had probably one of the worst nightmares I have had in over a year.

It was one for the record books.  And I was not prepared for it.  How do you really prepare for something that terrifying, anyway?  Well, first of all, you don’t let your guard down.

You don’t fall asleep with your entire collection of “The Wallflowers” playing, because you just wanted to listen to that one song.  You know, the one you played on repeat for years when you were sad and that made you cry uncontrollably, the one you wanted to hear just to “test” to see what would happen?  You stupid fuck.

You don’t drink a Pepsi at 6pm and you don’t start a new, very graphic memoir about a borderline woman and her steps towards recovery (although it is a very good book) at bedtime.  You don’t skip taking that Klonopin PRN when you really needed it after being set off, yet again, about why you will never let yourself have children.

There are all these things you DON’T do in the course of the day to prevent these nightmares from happening, and I DID DO many of them.  I didn’t go through my bedtime routine, I didn’t allow myself enough hugs and kisses from DSB before turning in, and I didn’t deal with the day’s mess like I should have.  That and the aforementioned are why the super-bad nightmare snuck up on me.

And really, I know better.  I know better than to do x, y, and z and I know better than to make sure I do a, b, and c.  This has been a recurring problem (sleep, nightmares, etc) and I am just pissed at myself because I DO know better.

And the lack of sleep created an issue this morning, because DSB told me to go back to bed at 6:00 a.m. because it was clear to him (although not as much to me) that I wouldn’t make it through my day without doing so.  But knowing that DSB sometimes knows me better than I do myself, I went back to bed without a fight and woke up at 10:30 a.m., feeling much more awake, somewhat more positive, and very much more pissed at myself that I had squandered away productive time.

I could have done a lot of things today, and there were a lot of things that needed doing.  Instead, I took a mental health day.  I did a few errands with DSB, did a lot of reading, went through and caught up on all the blogs I follow, and am now blogging.  I didn’t get anything major accomplished, although it’s possible I will throw together dinner and maybe do some dishes.

But really, I just didn’t feel like it, ok?

Uncertainty (and Gratitude) by the Bucket-full

I went months without needing to use more than two or three PRN’s a month, but here lately, it has become almost a daily thing.  I cannot shake this overwhelming anxiety I am feeling.  I know there has been a lot of stress in my life lately, and ongoing, but I just don’t feel like I can get it together in this department.

I saw my only, dearest, baby sister yesterday for a brief time.  We met for coffee and I talked with her about how I am not sleeping and about the horrible anxiety.  I told her how I was afraid that a continued lack of sleep would send me into an episode.  She just sat calmly and oh-so-collected (like only she can) and asked if I had told my psychiatrist about this.  Well, no, I haven’t.  She  then urged me to call the mental health center right then and there and ask what the earliest appointment with my pdoc I could get would be.

She is so right, about so many things.  I was able to get an appointment 25 minutes later, and though it cut our visit short, I was just so damn grateful for her listening and caring and making the suggestion.  I don’t think she knows how incredibly supportive she is, just by making sure that I know she cares and that she loves me very much.  We haven’t always been close, but it feels like we are getting closer by the minute and I just love her so much and am so thankful for the love that she gives me.  I couldn’t ask for a better sister and I would go through hell and back to keep her love.

Meanwhile, I went and saw my pdoc.  He is an older gentelman, quiet, calm, reserved.  He listens more than any pdoc I have ever had and has the best approach to solving problems, big and small.  Even though he had only been notified of my appointment 25 minutes earlier, when I saw him he had read through the last several progress notes from my therapist, so he has some idea of what I am going through.

I talked with him about not sleeping and he basically said we have to nip that in the bud, now!  He had already looked back through my chart at medications that I have taken in the past and noticed that I have tried small doses of Seroquel before with the reason I stopped taking it being that it gave me too much of a hangover in the morning and I couldn’t function at work that way.

Since I no longer have to be up for work at 8:00am, he wants me to give the Seroquel a try again, and just to use it until I can get my sleep pattern straightened out again.  He also gave me some reassurance about using my PRN and basically said that’s what it’s there for and it didn’t sound to him like I am abusing it at all.  He said that, as the stress in my life lessens, I just won’t need it as much anymore.

It was nice not to have to see my therapist or go to group this week, but I really could have used some professional opinions on things going on in my life.  Not even an opinion is necessary, just someone to bounce things off of.  I can use DSB and QoB for that to a degree, but there are some things that I don’t/can’t/shouldn’t talk about with them.

I have a lot in my life to be thankful for.  I have very supportive parents, I have reconnected beautifully with both my dad and my sister, my previous therapist, Goddess of Mindfulness, has given me a beautiful gift in forgiving my debt to her, DSB and I are mending fences here and there, and I think things are truly going to start looking up.

There is still a lot of stress and tension and conflict, and I really must find a new therapist, but I get this sense deep down, as I type this, that everything really is going to be okay.  I haven’t felt that way for awhile now, and it’s such a good feeling to have.

 

Removing a Brick From the Wall of Rose

So, I have had kind of  hard week, especially toward the end.  My sleep has been totally off, which is always certain to create a bipolar glitch.  Or perhaps is always indicative, a mere symptom, of a bipolar glitch.  Really, it’s just a viscious cycle, wherein I sleep less, I start to get agitated, therin sleeping less, getting more agitated.  You get the point.

Dr. Love has been very patient and supportive this week.  Not that he isn’t in general, but he’s been helping me by packing my lunches for me, making sure I was up on time for some early morning meetings I had this week, and, as always, doing everything in his power to make me laugh and force me kicking and screaming help me to relax.  It’s amazing to have support and love like that in my life and I would gladly go through all the painful relationships I have had in the past over again if I knew I would end up with him.

DBT was somewhat difficult this week.  It is really frustrating to be so out-of-control with my emotions all week and then come in and look at that in the middle of my work day every Wednesday.  It’s like I don’t pay attention to how emotionally dysregulated I have been and then I go into DBT and it’s all thrown in my face.  And by thrown in my face, I mean that it is literally pushed right up in front of my nose by the exercises we do, by the skills we work on, by doing my diary card.

About six weeks ago, my pdoc suggested I start taking a PRN again.  Now, back in the day, a different pdoc had me so drugged up my hair was falling out (literally).  One of the things she had me doing was to take massive amounts of Klonopin.  Goddess of Mindfulness reminds me that, during that time, I really did need quite a bit of Klonopin to function (as I wasn’t able to do such simple things as leave the house or have a conversation with someone without totally freaking out).

At that time, I went to the intensive outpatient DBT program and learned skills that helped me so that I was not taking as much Klonopin.  Also, my pdoc really weaned me down off of it, which was something I truly wanted.  I never did give it up completely, feeling that the right time had never come about to give up the maintenance dose I take at night.

Within the past three months, probably since the start of November, my anxiety has been through the roof.  I am constantly ruminating (perseverating, if you will) about any and every possible thing there could be to worry about.  To the point where my bowels are out of whack, I’m getting headaches, finding it hard to leave the house for fear of what’s out there, unable to let go of the black-and-white rigidity in my thinking, and just generally feeling fucking insane.

So, the new pdoc that I started seeing this August recommended that I start using a PRN again.  I voiced concerns about becoming dependent upon it, feeling drugged out, and so forth.  She assured me that, taken as she was prescribing it, I should have no problems.

Of course, I have been totally resistant, willful even, to taking the PRN.  At DBT this week, I was really confronted about it after sharing on my diary card that I have one but don’t take it, something Goddess of Mindfulness has also been doing.  Something someone said really started to work on me and I began thinking that the anxiety I have been feeling really must stop.

I mean, it must, because I feel like I’m going crazy and it makes me want to unscrew the top of my head and throw my brain away.   I have found myself thinking over the past week that I would do anything, and I do mean anything, to quiet my head and make that tape stop playing.

So after DBT on Wednesday, I went home and took a Klonopin PRN.  It didn’t make me feel drugged and it allowed me to go to work and be productive, not ruminating on the huge failure I have turned out to be or the status of my sick leave account or if my dog is getting enough attention from me throughout the course of the day.

I have taken one or two since then and it has really helped.  I am thankful that the members of my DBT group were there to push me along a bit and, while this anxiety is not cured and is not quite manageable yet, I can have these periods of semi-calm from time to time, a break from the spinning top that is my mind.

Norah Jones, Not Too Late