A New Job

I’m starting a new job. I won’t go into the details of the position now, but will say that there is lots of training required before I get going. I mean lots!

  • 3 5-hour sessions of basic training in the skills the job entails.
  • 10 hours of video examples of the different procedures.
  • 10 hours of direct observation.
  • Training manuals to read.
  • Procedures to practice.

My brain hasn’t worked this hard in more than 10 years, probably since the last time I had a new job. But even that was just some training, and the rest learned on-the-job.

It feels good to work my brain like this. To stretch and absorb, to listen and assimilate. I admit it’s exhausting too – so much to take in. Not just the individual procedures, but coding too. I’ve never needed that for a job before. It’s a long list of abbreviations!

One of the trainers encouraged us to “marinate” in all the materials they were presenting. Such a good description, as I feel like I’m floating in procedures and words and codes and processes and scenarios. It’s hard not to think about it constantly, as it runs around my brain and I try to put structure to it.

Thank goodness there was a holiday over the weekend so that I had time to start putting the pieces together in my mind. One more evening of training on a new program, and then I start observing in person to see the flow, watch it come together and start to make practical sense.

I admit that there have been many times over these past few days that I tell myself I can’t do this. I won’t remember everything, I’ll work too slowly. I’ll screw up. The negative talk in my head is loud and clear. My inadequacies are glaring up at me from the marinade.

And that is all probably true. But I’m not being asked to be perfect. I have help, as others are watching and guiding once I get started. And I will make mistakes and nothing will be earth-shattering. It will be correctable. I need to be well-informed and practiced, and I’ll get better as I go. So now I need to ignore those voices of doubt and replace them with louder voices of confidence and encouragement. I am not alone – Christ is with me and will help me! I can do all this through him who gives me strength (Philippians 4:13, NIV).

 

 

My First Panic Attack

The morning sun was shining out from behind an occasional cloud. The air was cool – it was a typical Wisconsin Springtime day. The indirect sunlight meant I wore sunglasses, but the sun wasn’t glaring, just a little hazy.

The men were meeting at the north side Perkins to carpool to the airport, which was closer than all those days I drove him there. He’d been traveling a lot lately, but I was used to it. No big deal.

After he got into their car, I pulled out of the parking lot. I turned right instead of left and headed toward the water. My heart was beating a bit fast, and my stomach felt a little funny. “What if something happens?” I drove in a circle and back around into the parking lot. Now my hands were shaking, so I clutched the steering wheel a little more tightly. “What if something happens to the plane?” “Nothing will happen!” “But what will you do if something does?  What will you do? Who will you call first? What if..? What about..?”

The thoughts came suddenly, not even distinctly. They were more like a flash across my brain – in and out, here and gone. But they were enough to start the panic process.

I suddenly needed to walk, somewhere, anywhere, and fast. Walk fast. I pulled back out of the parking lot, and my hands shook harder. I drove down to Riverside Park and looked for a parking spot at the end of the walkway. Now my chest felt like it was shaking, like my whole body was going to convulse from the center.

I got out of the car, dropped the keys in my pocket, and grabbed my phone. The sun came out from behind the clouds, and I could feel it heating my skin. It shone down on my face, and reflected off the water and back up into my eyes. I squinted, even with my sunglasses on. The water was beautiful with the sparkle of the sun shining, with pinpricks of very bright light as it hit the river’s ripples. I hardly noticed.

My head was pounding, my hands were shaking, my heart was thumping hard and my breathing was getting shallow, as if there was a weight on my chest. I tried to dial my therapist’s office, but my fingers were too fat for the correct numbers. I tried again, and got his voice mail. I was desperate to hear his voice, to talk to him and have him talk me down off the ledge I was clinging to. His voice mail message helped – I could at least hear him. I stumbled over words. “I’m not sure what’s wrong. Please call me. I can’t think. I can’t breathe.” I hung up, dialed again, and hung up again.

Now my hands were shaking almost too much to hold the phone, my eyes were filling with tears, and I couldn’t catch my breath. My thoughts were coming too quickly to stop them, all negative. All ridiculous. Of course nothing was going to happen. No reason to plan for it. Stop that. Actually, it was more like, “Nothing…plan for it..stop.” all in one thought. No individual words or coherent ideas.

I remember praying, but the prayers were like my thoughts – arrows shot towards heaven with no clear-cut thought other than “Father God, please help me!” Later, I remembered how the Holy Spirit intercedes for us when we don’t know what to pray (Romans 8:26), and I was thankful for that.

There were other people in the park and walking on the path. I couldn’t really hear them, though, and hardly saw them. It’s as if they were muffled and fuzzy, and their words were unintelligible over the sound of my heartbeat in my ears.

And then all of a sudden, it was gone. The panic, the racing heart, the sweating – stopped. I was better. Exhausted, but better.

I went back to my car and sat in the driver’s seat, trying to figure out what had just happened.  How had I lost the abililty to reason? Why did my body and thoughts go spiraling? I had been trying to breathe, to focus, but there was no way – I was out of control.

I sat in the car, trying to sort out my first panic attack, but not realizing that’s what it was. The sun continued to warm the dark seats, and I got hot from sitting there, so I drove to work, a little shaky yet. I was very tired and my legs were heavy, like I had just run a great distance. I slowly entered the elevator – there was no way I could walk the stairs to my office. Once I sat at the desk, I typed “Panic Attack” in the Google Search Bar, and read all about what had just happened. Sure enough.

 

Where Does It Hurt?

I can feel my emotions in my body. This is true most of the time now, but especially if I’m in a depressive episode.

My shoulders are pulled up toward my ears, as if to hide my neck. I feel pressure and tension in my lower head, on the sides around my ears. So I push my shoulders down and back, and there’s a crunching sound, like my muscles are rolling logs down my bones, and they pop loudly. I turn my head to the side, feel another “pop” and the muscles in my neck stretch down down down along my spine, almost all the way to my waist. I slowly turn my head in the other direction and feel the stretch. There’s brief relief as I try to relax my shoulders, but putting them into a resting position brings them back up and forward.

My jaws ache. My teeth feel loose, and my bottom lip is tight. I’m frowning. I’m not gripping with the back teeth; instead my lower jaw is pulling forward until my bottom teeth hit the inside of my upper teeth, and they stay that way – straining up and tight. I feel them suddenly – I didn’t know I was clenching, and I relax my bite. I open my mouth as if to yawn, trying to relieve the pressure in my ears that has built up from gritting my teeth for who knows how long.  That hurts, too.

There’s pressure. Something is sitting on top of my stomach. Yet it’s inside, too, and my stomach churns and rolls over and feels like it’s being chewed on. And there’s fire burning in the pit of my stomach, with the flames licking upward into my rib cage and making it hard to breathe. I say, “My stomach hurts.” I feel like I want to retch. The back of my mouth tastes terrible, like I’m going to be sick. That steely taste that tells me my insides are coming up to my throat. Yet there’s nothing there. And I clench my jaw to hold nothing in.

My chest hurts. It’s like there’s a hole in the center of my body where I think my heart should be. Which is strange, since if my heart is missing, then how can I feel this pain? And at the same time that there’s a hole, there’s also this incredible pressure, like a boulder resting on my chest. It’s so hard to take a deep breath, and it hurts when I try. I can’t get air all the way in. The insides around the center of my chest are jiggling like Jello; they won’t stay still. The fluttering moves down toward my lungs – my ribs are full of this writhing.

At a massage a few weeks ago, the therapist pushed on my calf muscle and my thoughts were flooded with anger and sadness and grief. Caught me completely by surprise. The therapist felt it, too. “Did something just change? Was that you or me?” I told her about my emotional response to her touch, and she told me that many people carry emotion in their legs. It just had never happened to me before.

These are ways that my body holds emotions. Anger. Anxiety. Fear. Grief. Sadness. It hurts! I can feel it, not just in my head, or in my thoughts, but in my body itself. Depression has often been very physical.

On all these occasions, where I can actually physically feel my emotions, the best approach for me has been to breathe. I tell myself:

Focus on taking a breath. Just stop thinking about anything for a second. Put my thoughts on breathing in. Feel the air come in through my nose. See my chest and stomach and shoulders and arms move, feel my head tilt slightly. Don’t think, just watch my body. Hold my breath, just for a few seconds, then loudly exhale. Make all the air leave my lungs. Do it again. Deep breath – feel it, watch it. Hold it – count to four. Don’t think. Just count to four. Now as I breathe out, with my lips making the shape of an “O” and loudly through my mouth, count to six. Make all the air come out. Push it with my diaphragm, with my stomach muscles. Do it again. Breathe in for four – count to four as I take a deep breath through my nose. Hold it – count to four. Breathe out, counting to six. Listen to the sound of the air leaving my lungs, coming out of my mouth.

Breathe in through my nose for a count of four. Hold my breath for four. Making an “O” shape with my mouth, breathe out loudly for a count of six. Repeat as needed until calm enough to think.

There. Better.

(footnote)

Better living through pharmacology…?

I’ve often said the above phrase, especially when talking about how I’ll probably be on meds for the rest of my life. I don’t mind, really. I’ve accepted it, like others with illnesses who will have to take life-long medication (insulin, high blood pressure meds, blood thinners, etc.). Honestly, I don’t think about the long-term effects. They don’t really matter, I guess. I need the meds to allow me to function as a mostly normal, mostly healthy person. It is what it is.

I’ve been on a particular combination of antidepressants and anti-anxiety meds that have worked for at least a couple of years. Yes, my previous psych doc and I tweaked them a few times, and increased one up and down depending on my emotional situation and ability to handle immediate issues. But it’s been awhile since I had to think about what I was taking. I just take them and live my life.

And it’s all good until one of the meds “poops out.”

The first time that happened was in 2009. The short version of the story is that I had been on the wrong med since I was first diagnosed with depression (1 year) and every time its effectiveness tapered off and we increased the dosage, the improvement time was shorter and shorter. My doc and I added another med which put me into a serotonin toxicity, but the on-call psych doc diagnosed it immediately, and changed my meds. I was hospitalized for a few days – my choice – because I wanted to find the right meds quickly. Even then, it took several months for my body to heal and adjust. But I liked this psych doc tremendously – he helped me with my meds for the next five years, until I moved across the country. I miss him, his knowledge of my brain chemistry sensitivities, his caring and calm demeanor and his gentle approach to changing my meds!

Anyway, back to medications. For anyone unfamiliar with medications taken for mental illness, it is far from a precise science. I’ve read that there exists a simple blood test that could be used to help psych docs quickly determine the type of antidepressant or anti-anxiety med, or the best type of med to treat bi-polar or other mental illnesses, but it is currently not available for use in the U.S. (Different types of meds: not going into details here, but there are Antidepressants – SSRIs, SNRIs, NDRIs, atypicals, NaSSAs, MAOIs, tricyclics;  Anti-anxiety meds; Antipsychotics – including Mood StabilizersStimulants (often used for ADD); and Depressants, just to mention a few classifications. The ones highlighted in blue are all types I have been on at one time or another.)

Since there is no simple way to tell what kind of medicine might work best, doctors prescribe the lowest dose of one that is regarded as potentially successful to the patient’s needs, and then the patient and doctor wait – usually four to six weeks – to see if the med works. Seriously, 4-6 weeks! It’s like finding the right brain medicine with a sledgehammer instead of a scalpel. “Let’s hope this works…Slam!” And if it doesn’t work, then the patient tries another one, for 4-6 weeks. It can be a long difficult process.

A couple of months ago, when my depression started again, my psych doc and I increased one of my antidepressants. It had been working for a long time, and I’d had it at this increased level several years ago and it had been effective – so effective that we were able to reduce it back to my previous level once the depression started improving. But this time, the increase didn’t help. So last month when I met with my psych doc and told him that my mood had not improved, we agreed to increase my other antidepressant. I told him last week when we met that I hadn’t seen any improvement, nor had my husband. The doc felt like I should have noticed an improvement by now. After all, these meds are already in my system, so a boost should have occurred. Instead, nothing. In my opinion, I was maybe even slightly more depressed.

So last week, he reduced one of the antidepressants by 2/3, and I’m to take those until they run out. At the same time, I started on a new med – not an antidepressant but a mood stabilizer. It’s fast acting, so I could know within a week if it’s working. Or in 4-6 weeks.

I admit to being nervous. I was only on a mood stabilizer before and during my hospitalization, when I was being taken off the wrong antidepressant cold turkey. That was then. This is a different reason…because a previously very reliable med has stopped working.

Last week was really tough. Today I wondered if my depressed mood could be because of the reduction of one antidepressant by 2/3. Maybe my body is really missing that med, and the mood stabilizer hasn’t kicked in. I won’t know until the end of this week, at the earliest.

And this is what I wanted to share: finding the right combination of medications is not easy and does not come quickly. It can be a long drawn out process of trial and error and trial and error and trial and … Oh! Maybe this one will work! And the whole time I continue to fight depression, with fewer resources until the right ones can be found.

So I try new meds. And I wait. And I remind myself that I’ve gotten better before. But right now, it looks bleak and dark ahead. Might be awhile before the sun breaks through.

Thanks for reading.

The Boat Tour, part 2

I did it. I went on the tour, by myself, knowing nobody. Whew!

Edison Explorer
Edison Explorer

I arrived right on time, got my ticket, and walked out on the deck to join the others. Wait, let me back up – I came very close to turning around, and I had to take deep breaths as I was driving. My anxiety was high, and I kept thinking about coming back home. But I’d already posted part 1!

When I walked out back, there were maybe 13 people there, in groupings. One couple was clearly staying to themselves. Everyone was older than me, but that was what I expected. The first group I saw, straight out the door, was two couples. I approached, and they all turned towards me (I was so glad there was a table between us, so if they hadn’t noticed me, it wouldn’t have been embarrassing!) I said “Hi, I’m Peggy.” The first guy who had seen me said “Hi” and told me his name (I repeated it, “Hi, _____” so I would remember. (Notice the line is blank.) His wife was Diane – I know ’cause I asked her again later. The other couples’ names both started with the same letter – J, I think. I know I repeated each one. But all I remember is ______. (Depression often brings me trouble with my memory.)

I sat next to Diane as we left port, but once we were allowed to move around, I grabbed my iPhone to take pictures, and ended up sitting on the middle bench of the boat, kinda by myself. But I was ok with that. I listened to the two guides – one told some history of the Edison family, the other talked about the ecology of the Caloosahatchee River. Pretty interesting, took lots of pictures (not great, sorry). Don’t remember much that was said (memory!), but am still glad I went.

Edison Winter Estate when viewed from River
Edison Winter Estate when viewed from River

 

Bird Rookery on Caloosahatchee

 

 

 

 

 

 

 

Decided not to go to lunch with the group – too much to take on today. Ran an errand and came home to the couch corner, where I played on my iPad and watched repeat TV shows until my husband came home. Took a long nap. We went for a swamp walk (on the boardwalk, to see how all the rain has changed the topography since March), then home. And here I sit.

So, some good things: I pushed myself out of my isolation comfort zone. I took pictures. I said hello. I blogged about it – before and after.

And I prayed – oh, how I prayed! All the way to the dock (30 minutes) I prayed and reminded God (😉) that He was with me, and would comfort me, and enable me, and support me, and basically get me through. And of course He did!