"Now is the age of anxiety.” *

Three years before I was diagnosed with bipolar disorder, I was diagnosed with a panic and anxiety disorder. I was working at the newspaper in Berne, had started having these weird attacks where I would get super hot starting in my stomach, have an electric taste in my mouth, then get cold and shaky. My blood pressure would rocket up; I'd get very dizzy and disoriented; and I was convinced I was dying. I'd never felt anything like that before. It took several trips to the ER and a trip to the doctor mid-attack ("Come in when you have one of these so we can see what's going on") before I was finally diagnosed with the panic attacks. The anxiety disorder was diagnosed at the same time.

That I'd had an issue with anxiety should have been no surprise to me. I'd had horrible fears about people dying, getting sick, being hurt, disappearing, etc. since I was a very small child. All with no reason. A weird pain in my head would trigger a sense of impending doom and I'd think something was horribly wrong with me.

When I was 8-years-old, everyone was taking a nap one day while Dad was at work. I was supposed to be napping, too, but I couldn't sleep (not an unusual thing for me). Instead, I was in the living room watching "Island of the Blue Dolphins" on TV. When that was over, I was bored and trying to think of something to do. A few months before, I'd made a craft in Girl Scouts - a blue block with my picture on it, coated in varnish to seal it. It was a Mother's Day gift, I believe. I picked it up and kissed it for some reason, being only 8-years-old and somewhat goofy. And then I had what I think was my first panic attack.

When we'd made the picture blocks, the Girl Scout leader had told us, "Don't get any of this in your mouth, it's poisonous." I was very careful and of course, did not get any in my mouth. But she didn't tell us that it was going to be safe once it dried. And when I kissed myself in the picture, I freaked out because I knew I'd poisoned myself and I was going to die. I didn't know what to do, and I didn't know how long it would take, but I was under the impression that death was imminent.

Instead of waking up my mom and telling her what I'd done, I went to the room where she and my middle brother were napping. I quietly said goodbye to them and asked God to take care of them. Then I went to my infant brother's room, said goodbye to him, and prayed for him to grow up big and strong. Finally, I went into my bedroom, laid down on the bed, and waited to die.

I heard a voice that told me I wasn't going to die, that I was going to be okay, but I should take a nap. I did...and was more than surprised to wake up. I'm not sure when I told my mother about what happened, but it was years later.

During junior high and high school, I had severe issues with anxiety and depression (and the bipolar mania), but I didn't know things weren't "normal". It's just how it was. My paternal grandmother was a "worrier" and I supposed a lot of us were. (And a lot of us ARE...but not all of us get to a point where our mind goes to worst case scenario at the drop of a hat.) I can't tell you how many times I planned my parents' funerals in case they died suddenly, leaving us children as orphans. Or the times I tried to figure out how the three of us kids were going to go to school and grow up alone.

As an adult, I have called Emergency Rooms when people have been 30 minutes late home from work. I have called Sheriff's departments asking about accidents involving my loved ones' vehicles. Never has anyone I've been looking for been in the hospital or involved in a wreck. Probably 99% of the things I worried about and fretted over never happened. Which, oddly enough, was kind of a relief and at the same time, fuel for my anxiety-treadmill. I had it in my head that if I worried about it, it wouldn't happen. And yet, if I worried about it, it was also possible. Which made me worry more.

It is no wonder, with the series of life changes I was going through (a divorce, raising a teenager alone, working at a high-stress job many hours a week, and being on a bipolar mania that I was unaware of) that I got to the point that I was having panic attacks several times a week, sometimes several times a day. Not all were bad enough to send me to the hospital, but some were. Blood pressure levels over 240/160 were not uncommon and I had a whole cadre of doctors trying to get that down and keep it down. Once I was diagnosed and started getting counseling and pharmaceutical treatment, things starting calming down for me.

In the 10 years since my diagnosis with the anxiety/panic disorder, I have learned a lot about it. I've learned how to recognize when it is ramping up, when to breathe deeply and center myself, when to take a pill to short-circuit a full blown attack (which isn't nearly as often as it used to be), and when (and how) to reach out to fellow sufferers on different support websites I've been a member of. I am by no means a doctor, nurse, or other medical professional. I am, as some would say, a "mental health consumer" - meaning I participate actively in the mental health world as a patient and client. However, I have learned a few things over the past decade that might be beneficial to others. If the following is helpful to you, I am glad. But always, always, always check with your doctor before pursuing a course of treatment if you are having panic and anxiety attacks. Don't be afraid to get the help you need - often and early.

I think that if I had remained untreated, I would likely be a hermit now - afraid to go out and interact anymore. For a while, I didn't leave home unless I had to, wouldn't go anywhere without my safe person, etc. There is nothing wrong with that - a person does what they have to do to protect themselves. But when I got treatment and support, I was able to get out of that coccoon and learn to function in spite of my attacks or underlying anxiety issues. It is now to the point that sometimes, a panic attack will happen - for no reason - and no one around me will know it. Which is a vast improvement over my former freak outs.

Anyway, below, I've provided some of the information about medications that I've learned about in the past decade that help treat anxiety and panic disorders. I hope you will find it helpful.

For anxiety, doctors will sometimes prescribe an anti-depressant. I found this list that outlines which ones those would be and what they are prescribed for other than depression:

Citalopram (Celexa) –off label for panic disorder, social phobia and trichotillomania

Duloxetine (Cymbalta) – approved for generalized anxiety disorder (GAD)

Escitalopram (Lexapro) – approved for GAD

Fluoxetine (Prozac) – approved for OCD and panic disorder

Fluvoxamine (Luvox) - approved for OCD in children (8-17 y) and adults

Paroxetine (Paxil) – approved for obsessive-compulsive disorder (OCD), panic disorder, social phobia, GAD and post-traumatic stress disorder (PTSD)

Sertraline (Zoloft) – approved for panic disorder, PTSD, social phobia and OCD

Trazodone (Desyrel) – off label for panic disorders

Venlafaxine (Effexor XR) - approved for GAD, panic disorder and social anxiety disorder in adults

There are also some hypertension medications that work against anxiety. If you have high blood pressure, you can talk to your doctor about which ones might be more helpful to you. This link has some information about those: http://www.livestrong.com/article/206559-blood-pressure-medications-for-anxiety/


Finally, doctors can also prescribe anxiolytics (fancy word for “anxiety breaking”) like clonazepam (Klonopin) or alprazolam (Xanax). They can be very addictive, though, and they aren’t always a first line of defense for many doctors. It depends on your symptoms, how frequent and how intense your anxiety or panic attacks are, and how inclined your doctor may be to prescribe them overall. At one point, I was taking three Klonopin a day (every 8 hours), but that was before I was diagnosed with bipolar and got on meds more suited for a bipolar rather than just for someone with depression. (Antidepressants alone can trigger mania in bipolar.) Now, I’m on 0.5 mg, either half a tablet or a whole one, that I only take when I feel an anxiety/panic attack coming on.

For the underlying pervasive anxiety, I do have the hypertension med that works, the Klono back-up, and then the things I learned in the hospital and in therapy (as well as what I learned through an online support group called tAPir – The ANXIETY/PANIC Internet Resource; it’s at www.algy.com/anxiety ). I have a book (I think it’s called Anxiety Disorder for Dummies) that was helpful, too. But there are also other print resources (online, at the bookstore, or at the library) that are available, as well.

There are many other resources available online, and very often, there are face-to-face support groups available through your local community health programs or churches. Take part in as many as you feel comfortable participating in, because I don't know that there is ever such a thing as too much support. If you don't know where to look, you can contact your doctor and ask him or her about resources in your area.


* W.H. Auden

"... I'm not crazy, I'm just a little unwell..." *

I like Rob Thomas and Matchbox Twenty, and have for some time. When the song "Unwell" first came out, it was before I was diagnosed with bipolar, yet it resonated with me somehow. Probably because my whole life, especially in school, people would always talk about how "crazy" I was. Generally, they meant it in a funny, teasing, laughing-with-me-not-at-me kind of way, because let's face it, folks: I have an AMAZING sense of humor, if not sometimes just a little wicked and warped.


Still, I also knew what my friends and peers did not know: that sometimes, there were things going on inside of me that I had absolutely no control over. While part of me considered that these odd thoughts, random visions, and creepy sensations possibly normal, I also had some sense that maybe they weren't. Maybe it wouldn't be a good idea to tell anyone some of the stuff that happened inside my head.


For instance, before I was three years old, I remember waking up and feeling like monkeys - really evil monkeys - were sitting on my back, daring me to turn around and look them in the face. I could never breathe when that happened. I would lay really still and wait them out. Because I was afraid of what they would do to me if I ever told anyone about them, I never did. Not until I was an adult and they had been gone for decades.


When I was in grade school, I would get these odd ideas that if I did something in a certain way, or thought wrong thoughts, then something awful would happen. I can remember having obsessive thoughts (not knowing what they were at the time) that kept repeating themselves in my head, scaring me, and making me sure I was going to hell for having them. I also had a special litany of catastrophes I had to pray against every night, being very specific, so that God would protect us all. If I didn't remember to do it, I knew if anything happened, it would be my fault. That went on for several years, probably until I was 9 or 10, when I finally took the chance that maybe God could handle things and knew what He was doing better than I did. I quit praying that particular prayer...and nothing happened. Our house didn't burn down. We weren't robbed. No one died. I'd had no power or magic that was keeping it from happening; it just didn't happen.


In junior high was the first time I had actual "outside my head" hallucinations. It was always an image of the hooded figure of Death, complete with his sickle for reaping souls. It was bad enough when I saw it at home at night in my room, but when I started seeing it while playing softball, I remember being really freaked out. At the same time, I started having what I know now were episodes of "depersonalization" - when my own voice sounded like it was coming from someone else, when other people sounded like they were talking to me from across a great chasm, and when time (the fact that it kept passing and passing and passing) became a threatening and awful thing to contemplate. I detested looking at clocks and watches, the ringing of bells to change classes, watching the sun follow its course through the day. It overwhelmed me. Again, I don't remember saying anything about this, though once my mom and I were talking and she did ask if I felt I needed to see a psychologist. I said no...because I didn't want to think I was insane, and back in 1975 that's all I knew about psychiatrists - they saw people that were really, truly insane.


In high school and college, I was having wild mood swings. Mom (and I'm sure everyone else) knew when my period was due because I'd get snappy and crabby. But I didn't let anyone know, when I would become so horribly depressed that I was mapping out a will in my head, that anything more than just typical teenage angst was going on. Because honestly, I didn't know that it wasn't just that, anyway. I would also have these tremendous bursts of energy, days and days when I could just go and go and go! I've always been a talker (ask the people that freaked when the 9-month-old in the shopping cart at the store would greet them in complete sentences), but I felt compelled to talk and would...faster and faster. I know now that is called "pressured speech". I would have these amazing ideas, start all kinds of projects and never finish them, blow any money I had on buying gifts for my friends just because I felt expansive and in love with the world. In college, in 1981, I remember feeling it was a kind of "frenetic peace" - and I wrote once that it felt like God was tagging me on the shoulder and saying, "Come on...let's go play!" Creative? Intelligent? Very likely manic.


I never did the hypersexual activity, I was too much of a prude. Drugs? Nope...I was terrified of them. I couldn't even take an aspirin correctly, or prescriptions without worrying they would kill me (can anyone say, "comorbid anxiety disorder"?); besides, no one ever offered me any. That's probably a good thing. I also never drank. Oddly though, when I would go into what I was calling a funk (now what I realize were depressive episodes), the first thing I would think about to deal with things was "Maybe I should get drunk..." Yeah. Didn't make sense at all...but frequently nothing did.


I did well at work. I did well at school. I had always done well in school, especially in the "abstract classes" like English, composition, literature, art, etc. But wow, my head could give me fits at times.


One other thing, depressed or hyper, or even just on "even keel" - a condition that was never comfortable to me for some reason - I have almost always had voices in my head. I've explained it as like having a TV on or a radio talk show going all the time. The voices don't comment on me or talk to me, except for rare instances when my bipolar is not under control and twice on medication that caused auditory hallucinations as a side effect. Instead, it's like I'm eavesdropping on other people's conversations. Sometimes, I get a visual in my head of who the people are that are talking. It just lasts a second or two, then the "station" will change and it might be someone else talking, another show to listen to, or maybe nothing at all.


I have been through episodes of major depression - once after miscarrying twins, once when my husband at the time had a psychotic break and we found out he was schizophrenic. I was hospitalized for depression the first time after his diagnosis and after having been under extreme stress and major life changes for three years straight. Later, I was being treated for depression and had been doing well enough, but as the medication stopped working, I became depressed and started having visual hallucinations, thoughts of harming self, wanting to stop existing, etc. I wasn't sad, though, that was the thing. I just felt hopeless and worthless. I wanted to shake out of it, but I couldn't. I remember telling my family doctor, who I had worked for at one time, that "I should be stronger than this!" He just looked at me and asked me, "Why?" That's when we discussed depression as a condition and not just a reaction to something sad that has occurred.

We continued to treat the depression with different medications. I then took a job at a small newspaper, as the news reporter and photographer. I loved it! But there were long hours, lots of deadlines (of course!), and so many things to do at all times of the day or night that needed to be covered. For some reason, all those years of anxiety - reaching back into childhood - came to a head and I started having panic attacks.


I didn't realize at first that they were panic attacks. I was in the ER many times for outrageously high blood pressure, severe waves of heat spreading through my body, then massive cold waves, electrical tastes in my mouth, and a feeling that I was going to die at any second. It took a while to be diagnosed (finally!) with the panic and anxiety disorders, but after getting some counseling and medical intervention, as well as learning coping techniques over the course of several years, the panic attacks decreased and I rarely have them anymore.


After that diagnosis, and while still working at the paper and on anti-depressants, some really weird things began happening. I started acting less and less like myself. Dropped out of church. Stepped away from many of my acquaintances. Became involved in online friendships with men that were really pretty inappropriate (several guys were married, one was probably a stalker, and I married the one that had just gotten out of prison and had anger issues). I did wild things in the course of that long manic phase: slept in my husband's truck in the church parking lot because I was angry and didn't want to go home; covered my upstairs apartment patio so no one could see me, and slept naked under a full moon just to see what it felt like; mooned someone while I was merely a block away from the police station. Not at all the behavior of a professional woman. Not at all the behavior of anyone I'd ever been before. We won't even talk about the stupid, stupid things I did before I married my Internet boyfriend. How I did not see that I was behaving bizarrely, I don't know. My mom saw it. My daughter saw it. Friends saw it. But even when they pointed it out, I didn't get it.


Eventually, I ended up in the hospital as I crashed from the long manic episode. I was depressed. I was seeing horrible images in my head - very destructive ones. I was afraid I was going to hurt myself and I didn't want to. And we always treated the depression every time I went to the hospital - which, in the first year, was four times. It wasn't until the fourth time that my doctor realized I was bipolar, and looking back on all the symptoms from when I was a little kid, I probably always have been. Once we started treating the bipolar (adding mood stabilizers or anti-psychotics to the anti-depressants), things gradually got better. Gradually, though, because I ended up separating from and divorcing my new husband - which was probably one of the best things I could have done for my mental health at the time.


In the past six years, while I have had some depressive episodes that have interfered with being able to work and function sometimes, I at least have not had to be hospitalized again. I have learned to recognize my symptoms for episodes and try to work with my doctor to handle things. I know to pull back from things that I can when stress starts triggering the overt symptoms like bad mental imagery or more voices. I've managed to go back to school online, hold an A average, and take classes every term but one (because of financial aid problems that term) for the past three years.


In spite of how my head can be sometimes, I'm still amazingly funny (albeit wicked and warped); I still have friends and family to communicate with and can usually function at work, though I only work very, very part-time. I'm writing again, which I couldn't do for several years after I left the paper - either because I was too hyper to really do so or because I was too depressed.


What I'm trying to say here is what Matchbox Twenty says, "I'm not crazy, I'm just a little unwell." Some days are not great. But I'm still a functioning human being, capable of feeling deeply, dreaming big, and having fun with most other human beings, too. I have multiple interests and follow them as far as I can. I haven't "been off the deep end" in a very long time. And actually, even with all the weird stuff in my head all through childhood and my teenage years and adulthood, I still managed to graduate in the top 10% of my high school class, made friends along the way that I still cherish, and ended up with an amazing daughter who has a bright future in spite of what she went through with her parents.


If you are bipolar, have an anxiety disorder, know the depths of depression, regret some of your actions when you've been living larger than life - I can relate. But always know this: You're not crazy. You just may be a little unwell.


(The lyrics in this video are what resonate with me; the actual video just makes me bemused as I watch it. I know some people actually see things like this...I just never have...not in that way.)






"Unwell", lyrics by Rob Thomas