26 December 2015

Sometimes when I write about me, it's really for others::Anxiety

I can really empathize with my friends and family who experience heightened anxiety.  Perhaps my own experiences will help others, in some way.  Sometimes, folks just need something they can relate to.

While I was listening to a friend the other day talk about the paralyzing anxiety she feels at times when she is least expecting it, I was reminded of the horrible anxiety and panic attacks that I suffered from throughout most of my life.  I've not felt it quite so much nor quite so often within these past few years, to that degree.  But starting in my midTeen years and lasting to my early forties, anxiety and panic lurked, loomed, seized me, and basically made my life pretty unpredictable.

Anxiety, fear, panic; those can be good preservation skills, protecting you from danger.  But when that anxiety begins to escalate and spin out of control, when it affects your ability to function; then it is passed the "pay attention" stage and can be debilitating.

My first experience with unbidden, unstoppable, out of my control panic that seemed to come completely out of the blue happened on my first day of tenth grade at a new school.  I was fairly sensitive as a child, but as an adolescent, I would become volatile at times and by the time I in neared sixteen, explosive rage would consume me.  I generally had pretty good control of it, that I wouldn't lash out and hit or scream others was remarkable because I certainly felt like it an amazing amount of time.  I think that not investigating those feelings in a safe place or way led to some other problems like overwhelming panic that implodes with little to no warning.

I totally freaked and lost my shit, on the school bus, at the end of the day.  It was alarming to me, to all the other students on the bus, and to my bus driver.  The level of the noise that triggered it was so bad that my bus driver pulled the bus over and parked on the side of the road.  Since the driver decided to assert and establish her domain on the bus by telling us that she would not move the bus until we all quieted down, the students' noise escalated, and I could feel myself getting dizzy, short of breath, sweating, and so I tried to get off the bus.  The bus driver blocked the way and I lost my shit.  Was it handled well?  No.  But the thing is, it was only a matter of time before the anxiety got the best of me.  If it wasn't that day, that incident, that bus driver, then it would have been some day, some incident, some body.

The next day, I could not make myself get back on the bus.  It felt horrible that I was having this reaction and I was miserable.  I went home, crying, and woke my father with my panicked sobs.  His reaction was to ask me if I wanted to be like my crazy aunt, who everybody knew was a hypochondriac, and that I best get control of myself right.NOW.

Over the next few years, I became hypersensitive to everything.  Sensory overload made me feel like I was aware of every.single.thing.  Every detail of every nanosecond bombarded me.  That's when I became aware that time is taffy, stretching and shrinking, but mostly streeeeetching.

In my twenties, shopping became a nightmare.  Too many options and choices would overwhelm me to the point I would flee and return to my apartment, shaken and feeling cowardly and bewildered.  In my thirties, I would awake in the grips of a physical panic attack, blood racing, mind revving, nerves jangling, unable to catch my breath.

That was an especially horrifying and frustrating time.  It was frustrating for me because I couldn't figure it out.  It was also frustrating because counselors would say that I must be worried about something and it was my mental state that brought about the physical state.  In actuality, I tried to explain but was often dismissed, it was my physical state that brought about the mental anxiety to match the physical anxiety.  Regardless of the chicken or the egg, I wanted it to end, or at least to understand it so that I could somehow figure out what to do to get thru it.

The secret?  Sometimes the only way out is thru.  I am not the first to have said that, but it certainly seems to be the case for panic attacks.  I had begun to fear the fear itself.  I would panic because I was panicking and that never seems to end well.  So instead of trying to stop it, get off the train barreling down the track; I'd reassure myself that this is not going to kill me and most everything that can happen during this moment is fixable.  I also learned not to care quite so much about not embarrassing others who were with me when it happened, because it's not about them, and they are the ones choosing to be embarrassed by something they have no control or ownership of.

For a time, thru my thirties, I took medication that was specifically aimed at reducing anxiety and panic.  I still do, tho the medication that I take now is not quite as strongly sedating.  I don't like that drugged feeling and that would actually cause me to be more anxious rather than less so.  I also stay away from highly addicted medications that are for acute panic attacks, like Xanax.  The thing with that is that the effect escalates quickly, peaks, and then drops just as suddenly.  Which then means that folks are more likely to feel they need it more often and that can be not only habit forming, but ineffective, and not the best way to cope with shit.

I also was receiving counseling.  Still do, most for maintenance and reality checks.  I've a complex set of disorders that require lots of self monitoring, which I manage pretty well.  But sometimes I need to make sure that something was an appropriate reaction or just to check in and have a more objective observation than my own.  I'm in my own head, so I can't exactly get out of it in quite the same way that someone who is outside of me can, ya know?

I learned a ton of coping skills that work for ME, because just like my experience with any one drug is going to be mine and not necessarily everyone else's, some coping mechanisms work for me that won't work quite as well for others.  And I learned what my triggers were more likely to be, so that I could prevent a building of anxiety by avoiding those triggers or limiting my exposure to them.

Sleep became a hugely important issue and diet and exercise also factor in as well.  Do I still get anxious?  Yes, of course.  Some anxiety is normal and to be without it means that I would be dulled and affectless which is not desirable at all.

The thing about this sort of anxiety that becomes panic is that it can happen for NO discernible reason what so ever.  That's the thing that most people don't seem to understand.  Chances are that you aren't choosing to panic, you aren't choosing to be anxious.  And it becomes extremely frustrating for you and those around you.  Your spouse might be completely puzzled and not get that if you could control this, you would.  Oh you so would.

I understand their confusion, because I felt that way too.  As a child, I had been raised to value logic and reason above intuition or feelings.  I was constantly told in a myriad of ways that being sensitive was a bad thing and that I needed to toughen up.  So I often ignored those things about myself, until they became so explosively overwhelming that they demanded my attention.  So I would ridicule myself in an attempt to make myself listen to reason and stop all that nonsense, what am I crying about anyway?  It's just noise, it's just a crowd, it's just this and that, it's only ...

But the truth is, sometimes, enough is enough is enough and this is just too much.  So the next time you're handed a straw, it might be enough to break your back.  So if you feel this approaching, sure, do what you can do to head it off.  But you might also be to the point where there is no building up, there is no approaching to sense; because you go from calm to being panicked in a nanosecond, much like a vehicle that goes from a stand still to 120 in one minute.  You're not meant to move so fast, and that can wear you out and break you down.

Being balanced in many ways allows me to function and flourish.  Find your balance range, in your ways.  It took me a looooooooooooong time, with more than a few setbacks, and lots of assistance to get to where I am now.  Your journey does not need to be nearly so long.  Resources are available, you can do this.  I have the utmost confidence in you.

19 December 2015

Winter Solstice~~I wish you well.

Lena in the Snow
David Garrabrants
Earlier, when I was writing the close to sixty holiday cards or thank you cards or condolences cards, I was thinking a lot about how our autumn has been, how are Decembers have been, how the winter season is for me personally, and how the past few years have been in general.

I also thought about cards that I love, which are usually blank inside.  One of my favorites became one of my mom's favorites.  It reminded her of me, as a little girl.  I had a coat much like this, and I used to twirl about in the falling snow. Mom felt the card should be called, "Christmas in Shohola", because that was the name of the tiny town in PA we lived near when I was about nine or so.

Let me share my take on winter and why I don't usually experience the depressed side of bipolar at a time when most people are struggling with melancholy.  Traditionally, winter is a time when the earth is dormant, trees are bare, most plants wither and die off, the harvest of both animal and vegetation is past, and life slows down for humans too.  Animals slumber and hibernate, passing time in deep sleep, their systems slowed to a point that allows them to live on their reserves, fats stored in their bodies.

It really is only within the more contemporary times that human's in developed countries continue with the same hustle and bustle as the rest of the year; in the past, we slowed our activity too.  Winter was a time to repair or replace tools and implements that we used throughout the rest of the year; a time for us to stay indoors as much as possible, out of the elements, focusing on activities that we may have put off until we would be more dormant too.

I grew up in Pennsylvania, where winters are cold and snow is the norm.  January marked the midyear for academic schedules.  Holiday rush was over, Thanksgiving and Christmas travel was behind us, and snow days could be counted on.

So when winter comes now, those months of January, February, and March, I expect to slow down.  I look forward to the time to rest, the time to allow my brain to breathe and my body to repair from all the damage stress has worn.  I know that the days will grow longer, yes, but so slowly that the dark seems to settle early in the day, late afternoon or early evening.  Dark signals me that it is time to rest, to slow, to sleep.  Coldness creeps in, and you may find me layered in short sleeves, long sleeves, jackets, or thermals.

I expect to be quieter, more reflective, less likely to schedule myself with lots of commitments and obligations.  Perhaps because I do expect an ebb in the pace of my life, I am less likely to fight the shift into stillness.  I seek the deep slumber that my body craves, not because I am depressed, but because this to me is the natural cycle that fits.

Not everyone has these options, I know.  But, I do.  So I take advantage of the ability to breathe, to be calm and still, to rest, to surround myself with peace and pleasantness.  To be.

16 December 2015

Birthday's & Deathdays

Happy birthday to my father, the first man of my life.  Yesterday, he completed his 69th year, having been born in 1946.  Dad, I hope your 70th year is frabjous, you deserve to enjoy each moment.

Also yesterday morning, my mother~in~law, Carolyn, died.  We'd been expecting this, so most of us had the time to be somewhat prepared.  She'd been home with us since last Tuesday.  There was such a hurry up and wait, start and stop, quiet calm and chaotic fervor all through the week that all of us are now slightly stunned, sorta tired, and a lil absent brained.

So it was a great idea to have written the obituary beforehand.  She had prearranged her funeral just months after her husband had died in October 1991.  There were only a few details to see too.  Welch's Funeral Home has an online book of memories and they've used the obit as I've written it.  It's slightly unconventional in form, but lives start with birth and end with death; and it's not about whether the readers need to all the details of the services immediately, it's about Carolyn and her life.

Here it is:

Minnie “Carolyn” Wolf, nee Sanders

On Tuesday 5th March 1935, a baby girl was born to Grover and Jenny Sanders {nee Hunt} here in the Starkville area. She was named after Jenny's twin sister, Minnie; but everyone would call the little girl “Carolyn”. An only child, Carolyn grew up on her parent's small diary farm, just west of Longview. She attended school near what is now known as the Longview Opry. In the 1940s, area schools consolidated and Carolyn finished her high school years at what is now the Greensboro Center.

Carolyn married Fred Wolf and moved to Macon, Mississippi. Their son, Jerry, was born in 1955. Daughter Barbara was born in 1957, completing their family. In 1960, they moved to McKee Street in Starkville and Carolyn lived there for over thirty years.

Over the years, Carolyn greeted seven grandchilden, five are Jerry's children and two are Barbara's. Along with welcoming future generations, Carolyn had to bid goodbye to some of the most important people in her life. In October 1991, her husband Fred died due to lung cancer at the early age of 56. This changed her life in a myriad of ways that she did not fathom at the time.

In 1998, Carolyn moved back to the homestead where she grew up, so that she could take care of her aging parents. Her son had retired from the military and returned with his family to the Longview area as well. Soon, Carolyn's daughter moved back to the homestead and rejoined the rest of the family. So Carolyn was able to be present for her mother and father, as well as her adult children and their children.

In 2003, Carolyn's father, Grover “Big Daddy” Sanders, died. Just two years later, Carolyn's mother, Mama Jenny, died as well. Grover was 98 and Jenny was 97. These losses were devastating for the entire family, Carolyn most of all.

As Carolyn's own health worsened, she became focused on how much she missed Fred, and her loving parents who were pillars throughout seventy years of her life. She loves her family, as it has expanded over the years. Carolyn is now eighty, with two children, seven grandchildren, thirteen great grandchildren, and her first great great grandchild is on the way.

On Tuesday 15 December, Carolyn died at home, surrounded by the soothing, peaceful love of her family. Now, Carolyn has gone to rejoin her Fred, Big Daddy, and Mama Jenny. Visitation, followed by the services will be held at Welch's Funeral Home, beginning at 11a on Thursday 17 December. Carolyn will be interred at Pleasant Ridge Baptist Church's cemetery, next to Fred, near her parents. She will be missed.

13 December 2015

Dying, Death, and Respecting Final Wishes

It's been a few weeks, but they have not been unnoteworthy.  Mid~December is upon us and we're barreling to the end of the year rather quickly.  In many ways, it doesn't feel like December, certainly not as far as the weather is concerned anyway.  At seventy degrees outdoors and oh so much warmer indoors {we were using the oven as well as forgetting to turn off the heaters}, I felt as tho these past few days were a lil too unseasonable for my taste.  The ACs been on for the last several days.  I hope it's the hurrah for the year.

But in other ways, this December feels appropriately dreary and mournful.  Jerry's first wife had died ten years ago ten days ago; and that's when we learned that Jerry's mother failed her partial barium test {this measures and gauges the swallow reaction to the various thicknesses of fluids}.  At first, Jerry felt that this was bad timing in general {not that he was saying that his mother could have picked at better time, she couldn't have, because she didn't choose to stop swallowing, ya know?}.  But I felt a bit differently and when I explained to him my perspective, he thought that made some sense.

Last year, my mother died on December fifth; and lots of folks said about it being so hard for the holidays for those of us mourning her death.  I felt differently.  I felt like December is an entirely appropriate time for death to occur, because it is when the natural world in the northern hemisphere is lying dormant, having "died" for the year.  I felt like the dreary weather of damp, cool days and foggy nights was in keeping with my frame of mind.  I felt like it was suitable that the world around me was a reflection of my inner world.  It felt like it would have been wrong for June's warmth and sunniness and laughter and happiness to be when Mom died, so to me, it felt super appropriate that my mom died in December.

So this year, with the combination of two important women's deaths and another impending death of a woman who is loved by us both; what would be a better time for death to occur?  Dying is the process of death, and death is a necessary part of life.  Lots of folks tend to forget that death is inevitable and tend to prolong someone's misery well past the end of any meaningful quality of life for that person, so that that person is just existing for some one else's peace of mind or benefit.  That's pretty selfish, especially when that is NOT your own life but someone else's life you are messing about with.

Jerry's mother is dying.  We brought her home, to a calm loving environment where we can see to her comfort and focus on seeing that her wishes are respected and carried out.  We know that not everyone agrees with her do not resuscitate orders or her advanced directive that specifies her wishes.

We are also aware that many folks really are not very well educated on the process of dying and how smart the body is.  There is a reason that the body ceases swallowing when it does, and that is because the systems are shutting down so that stress is minimized.  Swallowing is associated with taking nutrition and processing that food and liquid is demanding, it puts a huge burden on the body and incorporates everything from the mouth to the anus.  All the stages of digestion, producing acids to breakdown food, and extracting the nutrients, and using them where they are needed and storing them, and eliminating the waste involves a huge expenditure of energy the body doesn't have the ability to produce because various systems are either malfunctioning, shutting down, or shifting into another stage due to the dying process.

If you feed someone who cannot swallow, you run the very high risk that they will aspirate that liquid or food into their lungs and that sets up infection, fever, and other demands the body is not capable of addressing at such a time.  You are putting that person thru great discomfort, pain, and anxiety in order for YOU to feel better about providing nourishment.  Feeding tubes are perhaps appropriate at certain times, but not so when a person is dying and in the end stages of life.  Again, the demands you are placing upon the body are enormous.

Carolyn is not capable of sustaining a feeding tube.  A few years ago, her aging body's inner tissues were slow to heal and infection would easily set in when she had an internal bleed such as a scratch on her esophageal sphincter during an endoscopy.  That scratch which was not a tear or leak, but a relatively minor scrape resulted in a two week hospital stay due to the slow healing time and the infection that developed.  A feeding tube that is inserted into her stomach via an incision in her trunk is more likely to be a greater danger, involving completely unnecessary stresses and demands on her body.

There are many other things that can be addressed, but the absolute bottom line is that Carolyn expressed her wishes to an attorney who drew up her advanced directive, and also discussed those wishes and concerns with several others, including my husband {her son} and myself {I was her caregiver for a few years}.  I urge YOU to discuss your own wishes with your loved ones, and be sure to clearly state your wishes in a living will or advanced directive.  Encourage your loved ones to do the same.  It eases the decision making process for you and your loved ones when that time comes, as it does for us all.

A few weeks ago, before this development with Carolyn, but after her health was already in swift decline, a distant family member had voiced to Jerry that he should make sure that I didn't arrange Carolyn's funeral, because "after all Debra didn't even have a funeral for her own mother".  I will do exactly the same thing for Carolyn as I did for my mom:  RESPECT THEIR WISHES.

My mother did not want the obituary, the viewing, the memorial service, the casket, the headstone, the burial, etc.  She opted for cremation, and counted on us to notify whom we wished, in whatever way we wanted to.  So that's what I did.

Carolyn prearranged most of her funeral details in 1992, months after her husband had died.  More recently, she discussed with me often what suit she wanted to wear, how she wanted to be arranged, that she wanted a viewing, memorial service in the funeral home, and a graveside service.  She discussed so many details that I have very little doubt that for her these things are of great importance.  So I will be sure that I do those things that she wants when the time comes.

In the meantime, we see that Carolyn is as comfortable as she can be.  She is bathed, lotioned, powdered, and her linens changed so that she has fresh sheets and night gowns next to her thin skin.  She is given appropriate medication via appropriate methods, so that her anxiety and pain are addressed.  She is soothed and comforted, with familiar music that she prefers, temperature that is not extreme, light that is not harsh, darkness that is restful, and a limit to any commotion that might be taxing and stressful for her.  Sometimes we talk to her, she doesn't respond verbally and sometimes doesn't do so at all~~but the auditory system is one of the very last things to shut down, because it is a receptive skill and not requiring a response.  Sometimes we give her quiet because that is what she seems to prefer at times, especially when deeply asleep.

So our main priority at this point is to see to her comfort.  Hospice is involved, so we can ask any questions, express any concerns, and seek assurances and advice.  We got this; we love her and feel that she deserves our love right through to the end.

AGAIN:  I urge YOU to discuss your own wishes with your loved ones, and be sure to clearly state your wishes in a living will or advanced directive.  Encourage your loved ones to do the same.  It eases the decision making process for you and your loved ones when that time comes, as it does for us all.