You Can’t Always See Anxiety

I want to give you all a glimpse behind the curtain of anxiety for a brief minute. Maybe this is stupid and you all already know it, but I feel as if the outside face that I present to people makes me look way more together than I am.

 

So you all know that I’m getting married, and you all know that I’m a pretty hyper organized person. Basically everyone I have spoken to about my wedding has been nothing but compliments on how far ahead I am in terms of planning and organization. People have told me over and over that they are impressed with the way I’m working ahead and doing so much DIY far in advance, how good I’m being at keeping everyone up to date and making lovely spreadsheets and lists and staying right on schedule in terms of what needs to get done.

 

And I smile and say thank you and “Oh I really hope so”. Because what I can’t say in the moment is “this is all just a coping mechanism.” Underneath the very competent exterior, I am regularly feeling so anxious and overwhelmed that I’m giving myself headaches and nausea. I am having trouble being social because I’m so nervous that I’m behind. I regularly will just start crying at Jacob that everything is wrong and I don’t know how to fix it because there’s no way I’m going to finish everything on time and the wedding will be a disaster.

 

If you knew me in college you knew I was typically a week ahead on any work. Everyone always acted as if this must mean I didn’t feel any stress over deadlines. This could not be further from the truth. I was SO terrified of deadlines that i had to work that far in advance. I felt all the stress of pulling all nighters and working straight up to the deadline, but weeks in advance, because if I wasn’t ahead I was behind. That is how I feel about my wedding. Every day I wake up and feel short of breath and tight in my chest, and I look over my to do lists again and again and see that I’m doing perfectly fine and wonder what am I missing? What haven’t I done? What is slipping through the cracks? And then I find something that needs to get done and I panic and wonder how it’s ever going to get finished on time and do it all right this instant, but the feeling of “this is too much I will never finish it” lingers and lingers, and every time I find another to do it builds on every other lingering certainty that I will never finish in time.

 

No amount of rationality dispels the continued anxiety from every project that has to be done and even the ones that are already finished (am I sure they’re complete? Are they ALL THE WAY complete or do they still have things to be done? What if they need to be changed?). In my mind I am carrying every single task that it takes to put on a wedding ALL THE TIME.

 

THAT is why I’m so far ahead on everything. If I let a single ball drop, the panic comes crashing in. Maybe, just maybe, if I’m weeks ahead on my to do list, I can put it all down for a minute and relax. I can accept that it will all get done on time. Maybe if I finish it all a week or two weeks before the actual wedding I’ll have time to calm the fuck down and actually enjoy my time.

 

But when you look at me and think that I’m really competent and have everything under control, what you miss is that the reason I hold so tightly to everything is because it feels like a mass of chaos that I’m barely grasping at all. THAT is what anxiety is.

Note: this was cross posted from my Facebook because it seemed like it needed to be a blog post.

Real Tips for Really Decreasing Your Anxiety

Anxiety sucks. Clinical grade anxiety is basically sweaty monkey balls.

Over the course of my time in therapy and various kinds of treatment, one of the things that I have wanted more than anything is to not feel anxious all the time. Unfortunately it isn’t as easy as walking in to therapy and having a therapist tell you what will make your anxiety easier. Typically you have to do some work on the roots issues before you can even get to the real, concrete strategies that you can use to make anxiety less intense or less disruptive.

I want to share some of the strategies that I have learned with you. If you’ve been diagnosed with anxiety, you may already know some of them, but there’s also a possibility that depending on the type of therapist you have, or whether or not you’re seeing a therapist, you may not have heard them before. Some of them might work for you, some might not. That’s ok.

It’s also important to remember that all of these strategies are for dealing with anxiety as it’s happening and for trying to decrease the immediate intensity of the anxiety. If you’re finding that you have intrusive anxiety on a regular basis, you may need to talk to someone or get on medication or do something else to help stabilize your basic emotional state so that these strategies are more effective and so that you don’t need them as often, but these strategies can help as part of a larger treatment plan aimed at decreasing instances of anxiety.

This one will be a little long, but hopefully that’s because there’s a lot of good information in it.

Mindfulness Techniques

The first series of techniques I’m going to talk about all circulate around mindfulness. Don’t get scared off by the name: it’s not spiritual or woo woo, it’s not doing nothing, but it is also not easy. Mindfulness is essentially paying close attention to what is actually happening in this moment. It will take time and practice to get good at, and I strongly recommend practicing it when you’re not anxious so that when you are anxious you can do it without getting frustrated or feeling like it’s pointless.

There are essentially two ways you can do this: you can pay attention to something internal or you can pay attention to something external.

Internal techniques:

1. Breathing

This is a nice one because you can do it anywhere. You always have your breath, and you can always take a minute to stop and pay attention to it. There are a few different things you can do to help yourself focus. One of the easiest is counting. Some people suggest breathing in to a count of four, then out to a count of four. DBT recommends counting your breath, and always breathing out one count longer than you breathe in. You can choose the number that feels good to you. Whatever you choose, pay close attention to the numbers and what it feels like to breathe. If you notice other thoughts, that’s fine. Just let them happen and then refocus on your breath.

Another way to use your breath is to pay very close attention to the actual physical sensations of breathing. What does the air feel like coming in through your nostrils? What part of your body expands as you breath in? Especially focus on trying to breathe from your diaphragm. You should notice your stomach moving rather than your shoulders or chest.

2. Visualization or other sensory imaginings

You can tailor this one to your own preferences: if you’re a visual person, then use imagery. If you rely more strongly on a different sense, you might imagine a song or smell. But the idea is to think of a place or sensation that is very calming to you, and to imagine it as vividly as possible. Put yourself in a place or setting that feels safe. Describe it in great detail in your mind. For me, I imagine a huge library. It smells like old books, and has thick, imposing marble architecture with nooks and crannies everywhere. There’s a huge, overstuffed armchair that looks out a large window onto an empty field. I can read whatever I like for as long as I like, with no impositions or tasks to do. It’s quiet, the special quiet that comes from marble soaking up sound, with the occasional tip tap of a librarian’s shoes across the floor. Take yourself to your safe place, wherever it is and stay there until your body has relaxed.

3. Body scan

I like to use this one at bedtime. It’s fairly simple, but takes some time and patience. Start at the top of your head and spend time focusing on each part of your body in turn. Notice what your scalp feels like, if there’s anything touching it, if it itches, if you’re tense there. Again, your mind might wander, and that’s ok, but simply notice then refocus on what you’re doing. Move down your body and do this with every body part. You can go as small or as big as you want, but the smaller you go the more likely you are to notice where you’re tense and find ways to relax.

4. Progressive relaxation

This is something like a variation on the body scan, with a little more umph to help you relax your muscles and body. This time, as you move down your body, at each muscle you reach, tense as hard as possible for a count of three, then release. That’s it! This is a slightly easier one to start with since it gives you something to do instead of just something to pay attention to.

External techniques

1. Descriptions

I find this one works very well if someone else is with me and they are trying to help. Anxiety is anticipation of a fearful event or situation, so one of the ways to combat it is to remind yourself that you’re safe. This technique works by asking you to describe in as great of detail as possible, the room or space around you. I like it because if another person is with you, they can prompt, or you can talk to them and it doesn’t feel as weird. It doesn’t seem as if it would do much, but if you pay close attention to what you’re describing, it can take your focus off whatever is making you anxious.

2. I Spy

This is a variation on the description game that gets your brain a little more involved so that it’s harder for the mind to drift. Pick a color and find every instance of it you can. If you’re in a small room, find somewhere with more things in it and take a few minutes to play. I was surprised at how into it I got and how quickly the anxiety receded because I wanted to get every green thing.

 

Physical Techniques

Many times when you feel anxious it seems as if it’s your brain that’s making it happen. Your thoughts are spinning or you’re saying nasty things to yourself. In reality, anxiety is an incredibly physical experience, and even if your thoughts are what’s causing the anxiety, your body will react. Helpfully, this means that altering your body can also alter the anxiety in your mind. Here are a few ways to bypass the mental and go straight to calming down your body.

1. Deep pressure

Deep pressure is something that tends to work for people on the autism spectrum, but if you find it comforting, then GO for it. Deep pressure is basically what it sounds like: providing a lot of pressure on your body to help it calm down. This could be a weighted blanket, a strong hug, a weighted vest, or even just burritoing up in your blankets nice and tight and snuggly. Try experimenting and see what works for you!

2. Exercise

No, exercise will not cure your anxiety. Don’t worry, I will not tell you that. What exercise CAN do is a. work as a a helpful preventative measure, and b. help you to regulate yourself when you are feeling anxious. If it’s safe and healthy for you to do so, one method is to exercise as vigorously as possible for 5-10 minutes (full on sprint, or something equivalent), and then calm down to a walk or cooldown. Normal exercise can also help let out some anxiety, but at least according to my therapist, the intense exercise followed by a more relaxed pace does some tricky shit to your body that gets it to calm down quickly (I do not understand this science, nor am I a scientist, so take this with a grain of salt and see what works for you). Sometimes all it takes is a walk to shake up the anxiety.

3. Ice water

Be careful with this one if you have any heart conditions or similar issues. However if you don’t, and you have some time and space, this is one that can REALLY affect you and have immediate results. Fill a bowl with ice water. Now stick your face in it. Yup, that’s the whole thing. The important part is to get the ice water on the place just below your eyes. Again, some physiological magic happens that helps your body calm down. If that’s too involved you can hold ice against your face, or an ice pack, but focus on that area where you get bags under your eyes. I’ve never personally been a fan of this one, but it might work for you!

4. Intense sensations

One good way to distract from anxiety is to do something that you HAVE to pay attention to. Physical sensations are a great example. Hold ice cubes, punch a pillow, take a hot shower or bath, or listen to music that really speaks to you. Pay close attention to what you’re doing instead of on the anxiety.

5. Notice your body

Anxiety often comes with physical manifestations: tensed muscles, an uneasy stomach, or a clenched jaw. Take stock of what your body is doing, and if possible, adjust it. You can unclench any muscles or body parts that are tense. You might use breathing to calm your stomach. You might stretch if some of your body parts are feeling tight.

 

6. Notice your physical needs.

It’s really really easy to forget about your basic needs if you’re very anxious, but sometimes the most basic levels of self care are the most effective. Take stock of your physical needs. Are you hungry? Thirsty? Do you have a headache or other pain? Do you need sleep? Have you moved your body at all today? If any of these needs are not fulfilled, or if you’re dealing with pain, try to manage that first. You’ll often find that your anxiety decreases once you take care of your body.

CBT Techniques

These techniques are more about challenging the thoughts that are leading to anxiety. I don’t tend to find them as useful, but for some people they are the most helpful of all, as they head on address the anxiety. Test them out and see what works for you.

1.Check the facts

Of all the exercises for thinking your way out of jerkbrain territory, check the facts is my favorite. Essentially you sit down and see if your emotions are based in facts or not. Sometimes you might want to check in with other people to see if you’re perceiving a situation correctly. So for example if you feel incredibly anxious about a test, you might ask whether you’re prepared for the test, whether you have a history of doing poorly on tests, or whether the test is likely to have a huge impact on your future. If you have clinical grade anxiety, in many cases your anxiety will not be commensurate with the things that are actually happening.

2. Gratefulness

I personally despise these types of exercises because the good things in my life don’t seem relevant to whatever is making me upset, but for some people they work really well. Essentially you want to make a list of the things you’re grateful for in your life, as a way to combat anxiety about the bad things that are happening. If you’re feeling particularly down on yourself, you might also make a list of qualities about yourself that you like.

3. Work!

As mentioned before, distraction is often a good way to decrease anxiety in the moment. If you know of something that requires your full attention, that can be a great distraction. Maybe it’s working, reading a book, doing a tricky puzzle, or some other form of work that is high concentration. Some people find that the anxiety distracts them too much, but if you can get focused, it’s a great way to distance yourself from the anxiety until you feel more calm.

4. Challenge your thoughts

It’s easy to think that anxiety comes directly from a situation. In reality, anxiety typically comes from thoughts about a situation. For example you might think that you are anxious because you are supposed to go to a party. But in all likelihood you’re having thoughts about the party, for example “I will be awkward,” “No one will like me,” “I won’t know how to behave.” Those thoughts are what leads to the anxiety. If you can identify which thoughts and beliefs are leading to the anxiety, you can ask yourself whether those thoughts are realistic or true. This can be another place to ask for help from someone who might have a less biased opinion about whether no one will like you. If you can start to believe thoughts like “I can find one or two people to talk to at this party” instead, your anxiety will decrease.

5. Probability estimates

If you like facts, this is a great technique for you. Many times we feel anxious about things that are not very likely to actually happen. It can be good to spend some time estimating how likely it is that the event will actually happen. If you’re very anxious about getting on a plane, you might read up on the statistics of how often crashes actually happen (it’s really, really rare). Focusing on those statistics can help remind you that you are most likely going to be completely ok.

Now that this post is over 2000 words long, I think it’s probably time to stop. If you have more ideas or suggestions, feel free to add in the comments. Remember that none of these ideas are a treatment plan that will help you address clinical and chronic anxiety. They’re just things that can help. Good luck!

 

Asking for Accommodations Doesn’t Mean I’m Delicate

There’s this thing that I’ve noticed from people who are generally very nice and reasonable people when I tell them about the ways that my neurodivergent brain affects my life. I might say something simple like “I really can’t handle socializing for extended periods of time,” and ask for an accommodation.

Then comes the special tone of voice, one of mixed surprise and condescension. Especially when my accommodations are for something that seems small to me, like asking that people text instead of call, or when I say that I prefer to be in a small group to a large group, I often get the sense that people are astounded that I’m so broken.

Some people have even gone so far as to say things like “Well YOUR life sounds so much more stressful than mine. I can call people on the phone just fine.” There’s an assumption that because my brain prevents me from doing certain things, I live in some kind of hellscape or that I’m severely limited in what I’m capable of doing, sitting alone in my house wishing I could pick up the phone or go out and party.

It’s weird, because when I say things like “I have lots of anxiety about talking on the phone. I really hate it and would prefer not to do it,” I am not looking for sympathy, nor am I trying to tell people that I’m unhappy with my life. I’m not trying to make myself out to be fragile or delicate or in need of protection. I am asking for accommodations. I’m letting people know that I’d like to do things slightly differently from other people. Often I’ll include the full extent of why I’m asking for the accommodation because otherwise people think I’m being a diva or won’t respect my request.

There’s a really challenging kind of circle that you get stuck in when you’re disabled or mentally ill or asking for accommodations: explaining to people how hard things are means they start to discount your competence, but not explaining means that they will assume you don’t need the accommodations.

More often than not I’m likely to let people in on just how hard things can be because we need more honesty in that discussion, and because often people don’t really get what it means to be chronically mentally ill. But I’m getting incredibly sick of people thinking that this means I’m fragile, or acting as if they’re better than I am in some way because they can do “basic” tasks. Bully for you. Sometimes I can’t eat food without breaking down. But you know what I can do? I can write a mean blog post, take over a social media page without blinking, and alphabetize the shit out of anything. I can see patterns in things, I can make connections between things, and I can hold down some awesome conversations about everything from living forever to the intricacies of disability activism.

But you know what? Even if I COULDN’T do all those things, I still wouldn’t deserve your pity or your condescension. Because there’s nothing about talking on the phone or hanging out in crowded places that makes me less or more human. I am not a worse person because I am uncomfortable with times when I can’t quite catch the social cues for when to start and end sentences. My life isn’t WORSE because I can’t do or feel uncomfortable doing certain things. It is made worse by people who won’t accommodate my need to not do those things and by people who accommodate with a side helping of judgment, but there’s nothing about talking on the phone that would leave me fulfilled in a way that I’m not right now (in fact I maintain that my life is way better now than it was when I was trying to do a lot of things that set off my anxiety).

Asking for help doesn’t make me weak. It is not an invitation to comment on the value or fulfillment of my life. It isn’t something that puts you above me. In fact it’s probably a lot harder than most things most people do. It is self advocacy. But more than that, it isn’t an admission of limitations. When I say that I have trouble with something I’m not saying that I’m giving up on my life or giving up on interacting with people. I’m asking for help to find another way. It’s just like someone who can’t reach a shelf asking for a stool: it’s not a judgment about their abilities. It’s a recognition that they need to do it differently than someone taller.

I see too many people acting as if a statement like “I can’t talk on the phone without getting anxious” is the end of the conversation. It’s not. It’s the beginning. It’s the point at which you say “can I text you instead?” or I ask for another accommodation. It’s a statement of fact but not a recognition of failure. There are things in this world that I will never do. Run a marathon, quantum physics, and also feel comfortable in group settings. No one gets all uppity if I say I’m never going to understand the intricacies of the theory of relativity, so why do they make faces like they’re sucking lemons when I say I’m never going to feel comfortable in certain social situations? None of those things diminish my ability to live a good life that I enjoy and that contributes something to the world around me.

And I suppose that’s the point isn’t it? When I say there are certain things I can’t do, some people think that those things are a prerequisite for being a functional, happy human. They think that I’m diminishing myself by recognizing there are some things I can’t do. They seem to think that I’m fragile, or I need protection, or I can’t be independent because I can’t or won’t do certain tasks that they see as basic or necessary.

There are certain activities that enough people do that they have become synonymous with “human.” Of course these standards of “basic human tasks” have changed greatly over time and in different places, so no, there’s nothing inherently human about eating three meals a day, or being able to strike up a conversation at a coffee shop, or making small talk. When people hear that I can’t do some things they take for granted, they don’t understand that there’s nothing all that great about the things they take for granted.

The more I can question the idea that I need to do certain things in a certain way in order to be ok, the better I feel. I can’t do some things. So what I need from the people around me is just a little bit of adjustment. There are some things all of you can’t do that I can do. It doesn’t make you less than me. I make adjustments for people around me all the time without giving them any side eye. Can we make it mutual?

Curb Cut Effects and Mental Health

This weekend I was at a work conference about autism for my new job (which is as a side note the best job ever), and I was once again struck by something that other people have noticed before: curb cut effect. The basic concept is that many things that disability advocates push for actually help more people than just those who are disabled. People in wheelchairs pushed for those areas on curbs that have a little ramp instead of the sharp curb so that they could make it from street to sidewalk easily. It ended up helping people from parents pushing strollers to the elderly, even though no one imagined that it would help anyone but people in wheelchairs.

I have an anxiety disorder, which is a big part of why I’m a fidgeter and a finger picker. When I don’t have something to fidget with I often end up ripping at the skin around my nails until I bleed, sometimes without realizing it. As part of the merchandise at the conference there were tons of little fidget toys, things like tangles, silly putty, and other small things you can play with to keep your hands busy. They’re incredibly popular and helpful for people with autism who need sensory input or have trouble focusing. And although I am nowhere near the autism spectrum (I’m more on the overly emotional end of things) I jumped at them and got a couple that didn’t leave my hands the whole weekend. They helped with my anxiety and left my fingers fully intact after a long weekend of difficult socializing.

Over the weekend I spent a lot of time around people who had learned to communicate in a very straightforward manner, and found that I could better understand social cues. There were also a lot of precautions to keep things relatively quiet and calm on the sensory spectrum so that those who were sensitive could stay around and be comfortable. And let me tell you it was absolutely fantastic.

The curb cut effect doesn’t just apply to physical disabilities. It applies to mental illness and mental disabilities as well. This is something that is widely ignored, but could be incredibly helpful for mental health advocates to keep in the forefront of their mind as a way of reducing stigma. One great example is therapy. Most people assume that making therapy widely available, covered by insurance, and easy to access is good for people with depression or mental illness. It turns out it’s probably actually great for just about everyone, since almost every human being needs some support for their mental health at some time in their life, and no person comes fully equipped with emotional skills. These are things we all need to learn, and therapy can help with that.

The more we keep in mind that therapy is something that helps everyone, but that some people might get more out of it than others, the more we can lessen stigma. It changes therapy from something exclusively for “crazy” people and into something that all healthy people do. (Disclaimer: not everyone has to go to therapy and therapy doesn’t work for everyone, but it can be helpful for people in all kinds of situations.)

Even things that seem far more specialized, like social skills training or fidgets or even just asking the people you’re with about their sensory preferences, can help tons of people who might have a little anxiety or body issues or social anxiety. But for some reason those things are only available if there’s a complete breakdown.

I think the curb cut effect can teach us a lot about preventing problems, and if we apply it to mental health it might go a long way towards giving people the tools to take care of their own mental health before something snowballs into a bad place. Mental health tools should be available to everyone.

 

What Do I Mean When I Say Anxiety?

Yesterday, I made a Facebook post that included the word anxiety. When I made it, I was dealing with a fairly strong anxiety attack, and I mentioned my frustration at coping skills that weren’t working. A few people commented and joked or just treated it like I was talking about having too much energy. It wasn’t a big deal, but it did rub me the wrong way as I was trying to be open about something that was a fairly crappy experience for me and a lot of people completely misunderstood what I was saying.

A lot of the time, people don’t understand why mental illness advocates suggest that they don’t use words like “OCD”, “anorexia” or “depression” to mean things other than the actual diagnosable illnesses. This seems to me to be a good example. We have lots of words for things that aren’t clinical level anxiety: worry, fear, nervousness, a sense of impending doom. But we don’t really have any other words for the feeling of anxiety that comes with an anxiety disorder. So when I try to express that feeling, I have no way to say it except with a word that will inevitably be misunderstood by at least some of the people I’m speaking to.

That’s actually incredibly frustrating and can feel quite invalidating. If you had a broken leg and tried to tell someone, and their response was more along the lines of what you’d say to a stubbed toe, you’d be a little miffed. That’s what it feels like to try to talk about mental illness and get advice that applies to neurotypical brains. There’s fairly good evidence that invalidation is really bad for a person’s mental health, as it makes it hard for them to trust their own emotions. So while no one was intending to fuck with me last night, it certainly felt as though I was trying to ask for help or comfort or recognition, and instead got people completely ignoring what I was saying.

These are the kinds of small experiences that add up. If you have a mental illness you get them all the time, which means that you have to spend extra time and energy deciding how you want to explain yourself and your feelings to other people. It also means always feeling as if you have to convince other people of the seriousness of a given emotion or problem. When I say anxiety, I don’t mean I’m worried about something. I mean that my whole body feels like it’s going to rip apart, that I have so much energy I can’t keep still, that I alternately cry and do pushups, that my brain will not and cannot turn off, that I am desperate to escape whatever situation is bothering me. These differences are important. We need a word to talk about the intense anxiety. It’s hard enough to talk about it without having the language itself obscure your meaning.

For those who don’t have to learn how to express their emotions in a language separate from the one everyone else does, it might seem like no big deal. But if you’re trying to be honest and open with others and not seem overly dramatic, it’s really important to be able to use the accurate terms without them being misunderstood.

You Can’t Turn Off An Eating Disordered Brain

Massive trigger warning for eating disorders

For about the past nine months I’ve been feeling pretty good when it comes to my body and my food intake. I still have a few hangups, mostly surrounding times when I should eat, but overall I was getting a decent number of calories and feeling fairly energized. I had stopped thinking about what my body looked like every day, and I had even stopped adding up the totals of what I had eaten each day to try to decide if I was allowed another item (or if I needed to go work out).

It was a massive relief to not have those scripts playing in my head anymore. But recently, somewhat out of nowhere, they’ve started to play again.

I have a lot more tools available to me now. I have more friends to ask for help, a better idea of what I want out of my life and why an eating disorder isn’t compatible with that, a fuzzy kitten to distract me, and a variety of strategies about what makes me feel good in the moment, but none of these things have managed to turn off the voices or the accompanying anxiety. They are enormously helpful when I need to choose a better behavior than restriction, purging, or overexercise, but no matter how often I try to ignore the bad suggestions my brain keeps giving me, it comes back louder.

This is what a lot of people refer to when they say that you never really recover from an eating disorder. The disordered brain will linger on and on and on. And while outsiders might suggest distracting yourself or challenging the thoughts, what they don’t understand is how incessant it is. When you wake up in the morning you wonder about what you’ll eat that day and think about whether yesterday was a “good” day (ran a calorie deficit). You go to put on clothes and are left with the quandary of what fits and what doesn’t, what you can convince your brain is acceptable. You go outside and now it’s the comparison game, who’s smaller than you are, who will see you as acceptable, does everyone see how big you are or do they care?

It goes on endlessly. You cannot turn it off (or at least no one has figured out the magic switch yet except constantly choosing a different behavior and working to focus on something else).

What no one tells you about jerkbrains, whether they’re eating disordered or OCD or depressed or anxious is that they will exhaust you. They don’t tell you that the worst part isn’t the full on meltdowns, but the normal days where you thought you were ok but instead have to spend half of your energy fighting with yourself.

It’s discouraging. While it is realistic to know that someone with a disorder that is highly linked to genetics will probably always have to be on the lookout against a recurrence of symptoms, it makes life feel like a neverending Sisyphean endeavor, even moreso than it might for someone who just has to get out of bed and drag themselves to the office each morning.

Even writing this feels like a repeat of things that I’ve said far too many times. It certainly puts more importance into the question of whether genetics are destiny. But pushing against all of the woe and angst and “determinism means it just doesn’t matter!” is the fact that I know I have changed. The eating disordered brain remains, but there is something in there or in me that can adjust. I make different choices, and the lows come further and further apart. I hate inspiration porn, especially when it comes to mental health, so I have to admit that I have no idea if there’s a relapse in my future or what it means for the quality of my life that self hatred is an essential ingredient of every day. But I am also done with wallowing in the unhappiness, so I also have to say that I have hope. There is the possibility of joy.

Bad Things Will Always Happen

One of the things that many people who struggle with depression or mental illness find extremely difficult is understanding what it means when people say that life can be better. It’s very easy to look at the bad things that happen to basically everyone at some points in life and wonder how things will feel or be better. It’s especially difficult to imagine how other people can go through life without being overwhelmed or sad about the state of the world as a whole. When you’re a naturally fairly reactive person, it can seem as if the only way to not be hurting is if nothing goes wrong.

I have good news and bad news for people who are really struggling with the idea of imagining recovery.

The bad news is that bad things will always happen. Sure, getting some of your emotions under control and learning better ways to interact with people will probably improve your external circumstances to some extent. If you’re doing relatively well at your job and not getting into fights with your spouse, things will feel calmer overall. But there will always be random, nasty things that happen. In the last two weeks I’ve lost my key card for work (which was also holding my bus card and gym membership card), popped a tire on my car, had another tire on my car repeatedly go flat, and had an unexpected fee added to my rent bill.

All of these things are stressful. This kind of stuff isn’t ever going to stop happening. It’s the nature of life that unexpected things happen. Sometimes good things, sometimes bad things.

This is where the good news comes in: bad stuff doesn’t always feel that bad.

All of these things were things that I could deal with. None of them put me in a financial situation that was untenable, I’m fully capable of fixing all of them with a few phone calls or a trip to the lost and found of the bus service. Of course it’s a nuisance and things I have to add to figuring out in my day to day life, but none of them is the kind of irreversible issue that can’t be solved.

The total revelation for me came when I realized that I can both be upset and frustrated, and still be functional and capable at getting stuff done. Maybe I need to run off to the bathroom for 15 minutes and cry in frustration, but then I’ll pick myself up and fix the problem. This might not seem like a revelation for some people, but when a stressful event can trigger a complete meltdown, it’s amazing to realize that the stress and anxiety isn’t a bad thing and it doesn’t stop you from being competent.

There is often an assumption, especially in the more competitive and high test areas of society, that if you have an emotional reaction to something, then you aren’t handling it. That can snowball quite quickly, as feeling the emotion will trigger feelings of inadequacy or a sense that you’re out of control. The emphasis on logic over emotion tells us that if you’re feeling an emotion you’re not in a state to deal with problems. That’s straight out not true: one of the most important skills of being an adult is the ability to feel an emotion and act in a way that isn’t dictated by that emotion. In fact feeling stress, anxiety, unhappiness, or anger at situations like these is entirely healthy and can help you set up ways to keep them from happening again (in cases where you might be able to be more proactive).

So for those who feel mired, imagine this: something stupid and shitty happens. You get a parking ticket. You feel annoyed and frustrated, but you get in your car, you drive home, you pay the ticket, and you cut out something fun in the next week to make up the cost. And then it’s over. It can be that easy. That’s what recovery looks like.

 

What It’s Like: Generalized Anxiety Disorder

This is the fourth post in a series. See posts 1, 2, and 3.

To reiterate: none of these posts are meant to be a conclusive picture of everyone who has the diagnosis. All of these are simply my experiences of a given diagnosis. GAD is a wide ranging diagnosis that takes lots of forms. If your experience of it is different from mine, I’d love to hear from you!

Generalized Anxiety Disorder is like having a broken alarm system. This is probably an overused metaphor, but whatever. Imagine you have a home alarm system that’s supposed to let you know whenever you’re in danger. It’s a magical alarm system that doesn’t just alert you to intruders, but also tells you if there’s a natural disaster or some sort of accident in your house waiting to happen. It’s suuuuper helpful. This is what normal anxiety is like. Normal people get afraid or worried or anxious when they have reason to believe that something is going to harm them. Sometimes this is in a very obvious way like if your car goes out of control, sometimes it’s in a more long term sense, like when you’re anxious about a test or a job interview (which has the potential to affect your future in positive or negative ways).

For most people, the strength of the alarm corresponds to the severity of the potential harm. If a bomb is about to fall on your house, your alarm system will be FREAKING OUT. If there’s about to be a thunderstorm, your house might beep at you a little and get you to look out the window. Same with emotions: we get very anxious about big things (like the bar exam or being very close to a large and dangerous animal) and kinda anxious about smaller things (a small quiz or slack rope walking a few feet about the ground). This isn’t across the board true, and certainly some people have one or two irrational fears, but for the most part anxiety follows a pretty predictable set of patterns.

Now imagine you have a house that has an alarm system that goes off whenever something is going to hurt you, but also will randomly go off at things like the neighbor’s cat or a kid on a bike, and when you try to turn it off it just keeps starting right back up again. Sometimes when it should give you a little nudge, like for a thunderstorm, it gives you the blaring DANGER DANGER of a bomb above your house.

Some of you might say “well just start ignoring the alarm.” But the alarm does still go off at all the right times too. You’re left with a near constant confusion about whether you’re in danger or not, trying to figure out how you can differentiate what’s a real threat and what’s not. It starts to wear on you, the noise and the uncertainty. You think you’re going crazy because you can’t tell what’s real and what’s not, when it’s reasonable to jump out of bed and pull out a baseball bat or when it’s reasonable to just wait it out.

This is a lot like what GAD is for me. It isn’t that I’m afraid of everything, or that I’m timid, or that I can’t talk to people. It’s that anxiety and uncertainty will hit me at the most unexpected times, sometimes for no discernible reason. A very big part of it is my anxiety just happens BIGGER than almost anyone else I’ve ever met. Catastrophizing is basically my middle name. Once in fifth grade I got a B on a test. I started freaking out and crying, leaving my teacher and my parents somewhat uncertain about how to reassure me that it was totally fine. In my mind I could see exactly how my future would go: the B would mean I wasn’t put in the honors classes in junior high, which meant that when I went to apply for high schools (because I went to a private school, high school required entrance exams and applications) I would be laughed out, and I would end up in the worst school ever which meant I wouldn’t get into a college, which meant that I would never have a good job and be miserable forever.

My brain is very, very good at consequences. As I’ve mentioned elsewhere, I’m a rule follower, and part of this is being acutely aware of the long term consequences of my actions. The problem comes when I start drawing out long, ridiculous chains of events that COULD happen and would probably ruin my life. It’s often paralyzing. If I think something’s gone wrong I generally have one of two reactions: I either have a huge adrenaline rush and start accomplishing absolutely everything I possibly can as a kind of ritual to prevent badness, or I freeze up and can’t do anything.

But I also get anxious over the stupidest things. I’m fine with heights and needles and blood, spiders, snakes, death, disease, germs…most of the things a normal person might be a little worried by. But having a day at work with nothing to do? Cue a panic attack because I will get fired and it will be the end of my life as I know it. It’s a very physical kind of a disorder for me. I have some seriously impressive knots in my shoulders and neck (I got a massage last week and the masseuse told me everything felt fine, except my shoulders and neck which felt like “you’ve been hit by a bus”), I get the pounding heart fluttery breath feeling, the tight throat, my whole posture curls into itself. It actually just happened about 20 seconds ago because someone wanted to put off hanging out until after dinner instead of ASAP after work and my brain just started chasing itself in circles chanting “they don’t like you, they never want to see you again” and then laughing like some sort of evil torture expert. It will likely take a few hours before I can work my way back into a basic state of normal heart rate, normal breathing, and relatively calm muscles.

Possibly the worst part is that if I’m bored and my brain has nothing else to do, it tends to just manufacture anxieties. This has led to the additional anxiety I have about getting bored, because getting bored leads to being anxious. I have a lot of recursive anxieties about being anxious.

Any other experiences of anxiety out there?

Leaving the House in the Winter

It is winter, the time of low spirits, comfort eating, shitty body image, and “NOT THE HOLIDAYS” anxiety. For lots of people who deal with mental illnesses of any variety, winter is a time when it is incredibly difficult to leave the house. Isolation is the name of the game when it’s cold, dark, and you feel like crap that doesn’t deserve to see the outside world.

There are a few different brands of this kind of isolation, and each comes with a unique set of challenges. So here is Olivia’s Handy Guide to Leaving The House in Winter. These are my tactics for getting my ass out of my pajamas and into the great wide world when all I want is to sleep for another 12 hours.

Depression Isolation:

This tends to be the isolation that comes from having no energy. It’s dark, it’s cold, and I want to stay where it’s fucking warm thank you very much. I don’t care anyway, nobody likes me.

Ways To Fight It:

Bribe yourself. What sounds remotely good right now, other than being in bed? Make that thing happen outside of your house.

Make plans with people that you’d feel bad about canceling.

Keep your goals reasonable, and don’t get down on yourself for what “reasonable” means right now. Sure, in the summer you might be a machine of productivity, working from 8AM to 10PM nonstop. That is not reasonable right now. Is there one task that absolutely needs to get done today? Leave your house for that, and don’t expect more. Think you can make it to two? Awesome. Get to the bank and the grocery store. Set clear time limits of how long you have to be gone so that it doesn’t feel like a gigantic pile of “oh god not out there” weighing down on you.

Reward yourself! Yes this is hard. Yes it is easy to just be annoyed at yourself that leaving the house is a challenge. Yes it is easy to berate yourself for struggling so much with “basic adult tasks”. Secret: many, many adults struggle to complete “basic adult tasks” because they are annoying and emotionally draining and actually really hard in a lot of ways. If you manage to drag your unhappy self out of bed, put on adult clothes, and sit your butt in your adult chair at work for eight hours AND THEN still go out and be social like an adult is supposed to, or run your errands like an adult is supposed to, or whatever else it is that is calling you away from your bed, THROW A PARTY. If you like chocolate, eat that chocolate. If you like bubble baths, take that bubble bath. If you like not thinking, flip your brain into the “off” position for the remainder of the evening. You earned it friends.

Prepare before you venture out into that frozen tundra. This is actually just generally helpful, at least for me. Look up the location and hours of the places you need to visit. Have documents filled out and signed. You want to work out? Great, get in your workout clothes ahead of time so that the moment you hit the gym it’s sweatpants off and sweat on. This means less time stressing while you’re out and about and more while you feel mildly safe, comfortable, and warm.

And finally, a tip that is very personality dependent, so think carefully about it and how it might work for you before you do it. Do all of the things you possibly can in one go. This tends to work well for me because I feed off of accomplishment. Some people get tired. For those of us who get one burst of energy a week, when you have that energy and you’ve made it out, be the efficiency monster you know you can be.

Anxiety Isolation:

Everything is scary! I don’t know what I’m worried about, but it’s something, and so I should probably not speak to or see any human beings indefinitely in case there’s work I need to be getting done or I’m doing something wrong or I look stupid. People are scary, the world is scary, the cold is scary, the ice is scary, and there are so many things that need to get done I will avoid them all right here.

Ways to Fight It:

Start with a little bit of mindfulness, breathing, or other calming activity. You probably know what works best for you. If it’s at all possible to get your body and mind functioning in a way that’s more even-keeled, this will help you with getting out there.

Focus on activities that are not anxiety provoking. Is socializing sounding really hard right now? I’m sure that there is an errand or two that you have to run that requires minimal human interaction. Try that for now. Is there someone that makes you feel more comfortable no matter where you are? Meet up with them for coffee. Leaving the house and seeing or hearing other people goes a long way towards keeping you out of the depression/anxiety spiral, so any way you can do it is a good thing.

See above: break things up into manageable tasks.

Give yourself an out, and try to remind yourself leaving early is nothing to be ashamed of. Let’s say you made it to that awful holiday party your parents throw every year, you’ve been there for an hour and the panic spiral is starting. First of all, you made it! Good job! You built up your social relationships, got into a new setting for a while, probably moved around more than you would lollygagging in bed, and got a bit of fresh air. Success! Now is there a friend who can say they desperately need you to come help them with something? Do you have important other plans that will interfere? Are you feeling unwell? Because you can skedaddle with any of those easy outs. If you have to talk to someone close ahead of time to set something like this up and develop a secret hand gesture that says “dear sweet Jesus, please let me go somewhere quiet and have a book for a while”, make that happen.

Despite its many downfalls, winter is a season of delightfully comforting things. Hot chocolate while watching snow fall outside. Soft, fuzzy blankets. Cuddling under said soft, fuzzy blankets. Good food, steaming hot. Candy canes and other Christmas goodies. Excuses to spend time with family/friends/people you like. Revel in these things and incorporate them into your “going out” routine as often as possible. This might be one of those seasons where you have to decide that spending money on your favorite coffee drink once or twice a week is what will get you through, and that means it’s worth it.

Body Image Isolation:

Ugh, I am a hideous beast of disgustingness and I should never, ever, ever leave my house. I can’t believe I ate so much at Thanksgiving/Christmas/that utterly arbitrary meal last night that I binged on because I was cold and lonely. Flee from my hideous mug, poor mortals!

Ways To Fight It:

Cover or dispose of your mirrors. And your scale. You better not have a scale. *glaring eyes until you properly dispose of the evil scale creature that tells you your worth is a number*

Pick one: choose clothes that feel comfortable. This is my personal preference. Oversized shirts and warm sweats are my uniform once I get home from work. I give a big ol’ finger to anyone or thing that implies I should have put more effort into my appearance because these pants are soft and I don’t like wearing bras. Option two: choose clothes that make you feel confident. Even on our worst body image days, most of us have one outfit that still fits just right. Maybe it’s a pair of boots. Maybe it’s a dress. Maybe it’s fancy earrings. Doesn’t matter. If it makes you feel confident, get it on.

Have you eaten yet today? I don’t care if you feel oversized, put some food in your body. Your emotions will feel more stable afterwards. It’s hard and it feels counterintuitive, but most of the time it helps.

Check out some body positive blogs, like Dances With Fat. Not everyone feels better about themselves after body positivity, but sometimes it helps to get a role model or some optimistic thoughts.

There is very often a correlation between low mood and bad body image. If your body image is being incredibly stubborn and getting in the way of your daily functioning, it can be helpful to circumvent that particular fight by focusing on raising your mood. All of the suggestions for anxiety and depression apply, as do any other techniques that you’ve found helpful in the past.

 

So there we are friends. Winter is hard. During this time especially make sure you’re eating well, sleeping enough, getting vitamin D, exercising a little bit, and treating yourself kindly. We will survive together.

 

Identity and Anxiety: Struggles of Object Permanence

I had a realization this weekend. While I was prepping for a pub crawl with my boyfriend, I noticed that he kept wandering off to go grab things or do something else, and inevitably I would wander after him like a lost puppy. At some point he mentioned that I didn’t have to come with him everywhere, and jokingly I yelled “I don’t have any object permanence without you!”

Of course as is true with many of my jokes, there is a fair amount of truth hanging out in the middle of that statement. While it’s not true that I become worried about my own existence when I’m in a room alone, I do hang my sense of identity on other people’s validation and understanding of me far more often than is healthy. When I haven’t talked to anyone in too long, I start to wonder who I am and what I’m doing. Do I actually want to write all these things? Am I actually an empathetic person? Am I really intelligent or do I just fool people into thinking that?

My brain functions in comparisons. What does it mean to be smart? It means being able to understand more than other people, reach conclusions faster and better, speak more clearly or convincingly, or know more about more things than others. What if there are no others around? Then I would have no idea if I was smart or not. I assume that my experience of the world is the same as anyone else’s and the only times I know that there’s something good about me is when someone tells me that I’m different than others in some fashion: kinder, more compassionate, smarter. And so I crave those validations more than anything else. Without them I have no idea who or what I am.

One of the symptoms of Borderline Personality Disorder is a lack of self identity, an inability to solidly ground your sense of self without help from others. It can be one of the most difficult elements of the disorder to combat because it requires a fundamental reframing of who you are and how you exist in relation to others. When your identity is a comparison or a response to others, who you are is wholly dependent on them. In some ways, you cease to exist autonomously, because when the people around you stop talking to you or paying attention to you, you stop knowing who you are or what you should do.

In some ways, for me, this difficulty stems from a deep desire for objectivity. I am a perfectionist and I want deeply to be right about everything. That means that if I call myself intelligent, I want some sort of absolutely certain standard to which I can point. Comparisons are the only standard I’ve got. It’s my uneasy truce with the fact that in the grand scheme of the universe, “I am intelligent” is a meaningless statement. It may not be true that others with BPD crave this certainty the way I do, or that they use external validation because they’ve come to the conclusion that all meaning and knowledge is relative and self-made. But there are lots of parallels between my huge, existential temper tantrums and the concrete confusions of those who are struggling to define themselves independently.

So here are some of the conclusions I’ve come to about how to build a sense of self when all you want is for someone else to tell you who and what you are.

1. Stop asking. Seriously. It’s enabling. If you’re starting to feel uncomfortable about something (am I mean? am I stupid? am I annoying?) first try checking in with yourself and looking at some facts instead of getting someone else to give you the answer. Other people aren’t always around and other people can leave and sometimes you have to be ok on your own. So before you ask for reassurance, reassure yourself. Learn how to use facts and experiences to build up a sense of self. Am I annoying? Well, I have a lot of people who seek out my company, so probably not.*

2. Think about your values. Consciously. Constantly. Remind yourself what actually FEELS important to you. A great litmus test on this is to check in with yourself when you start feeling guilty or ashamed about something. Why are you feeling this way? Is it because someone else has told you that your behavior is horribly wrong, or do you think you’ve actually done a bad thing? If option 2, this is pointing towards one of your values that you have violated.

3. Practice uncertainty. Seek out circumstances in which you won’t have a concrete answer or label for something and just be with it. Get used to feeling like you don’t have a clear answer. It may never feel awesome, but you can start to desensitize yourself to it and get through the rough patches by knowing that there will be times that you feel confident and clear about who you are (protip: these are often times when you have just accomplished something, made a big decision, or spent time with people you’re comfortable around).

4. Labels can be really helpful. Sometimes it’s too hard to come up with a complicated self definition when you’re in a moment of uncertainty or fear or need. Having a list of go to’s can be helpful. “I’m a writer” is one that I rely on often, not only because it is so deeply true that I cannot imagine ever being anything else, but also because it gives me a path forward to start to figure out other elements of myself: writing them down. The label gives you something to rely on when you’re struggling. They don’t have to define you forever, but they can be a helpful stepping stone towards identity if you just want something simple.

5. Talk or write about it. It’s easy to get lost in your own head, but if you have to put words to who you think you are, it can clarify what’s actually important to you and how you think of yourself. You can also start to compare versions of yourself if you have a record (whether in writing or through a friend’s memory), and figure out either how those versions fit together or whether there’s one that doesn’t fit as well as the other. It can help you prioritize the elements of yourself and keep them in balance. That might sound super woo woo but all I really mean is “how much time and energy do I want to put into this interest/value, and how much weight do I want to give those concerns?”

6. Start building identities instead of identity. When there’s only one way you define yourself, it’s easy for it to be fragile. That identity has to hold all of you, be flexible enough to explain you in different contexts, and be 100% right all the time. Multiple identities lets you account for the fact that we’re different in different circumstances and no one identity is objectively you all the time. It gives you more flexibility and space to be and do different things.

These won’t solve any serious identity crises (for which I would suggest some therapy), but they are good ways to keep up a practice of strong self-identity if you struggle with your sense of self.

*of course sometimes it’s to the benefit of a relationship to check in and make sure the other person isn’t actually trying to send you signals that mean you’re horrible and they hate you, just for clarity’s sake