Category Archives: panic attacks

Keeping a Routine – Essential but Oh So Hard!

Staying on a routine is incredibly hard for me, but it is one of the most important things to keeping me mentally healthy!!!

I am on disability and so I literally have almost nothing to do all day.  I try so hard to keep a routine.  I try to plan things to do – get up, brush my teeth, take a shower, ummm what else? What else is there to do?  I can’t spend money, I have no money.  I have no where to go.  I really don’t know anyone.  The people I do know are from my support group and they live like an hour away.  That’s a no go.  Hmm, what else is there.  Sit around, read, write, draw paint.  Walk.  Ok, but I can do those whenever I want.  Sleep.  Ruminate on the past.  Have a flashback, a panic attack.  Cry.  Ruminate some more.  Oooh hi anxiety, you are back for a visit! 

The most stable I ever was, was when I was in the state hospital for 6 months.  I had a set schedule, wake up, get ready, breakfast, community meeting, go to groups all day long (all of which I really enjoyed and learned from), made lots of friends, had lunch in between it all, came back for dinner, had option groups (fun stuff like cooking class, movie club, etc), and then we could stay up as late as we wanted to watch tv, read, etc as long as we woke up the next morning on time.  It was perfect for me.  I was held accountable to a schedule. I was expected to be somewhere at a certain time and I had consequences for not being there.  There was really no stress related to it though, if it didn’t happen, there was a consequence, (loss of off unit privileges etc) but I could talk through what happened with the therapists. 

My problem here is the stress of getting a job completely overwhelms me.  I will self sabotage because of the anxiety.  I have attempted suicide on multiple occasions before a job interview.  If I even get a job I end up getting so stressed out I just quit the job or call in sick all the time.  And now, I cannot even get an interview to a job because I have no work history for the last 2 years.  So I cannot even try to see how I would do. 

I have worked with my psychiatrist and therapist to discuss getting on a routine at home on me own – wake up, daily hygiene, daily walk, spend time working on my art, call someone each day (socialization of some time since I isolate), no electronics for more than 4 hours a day (not working so much since I started this blog!), and then a bedtime routine.  As much as I tried to do that, I just cant stick to it.  I am not accountable to anyone but myself and there are no consequences if I don’t do it.  If I had to be somewhere at a certain time to meet someone, I can follow through with that – therapy, NAMI group, those I can do.  But spend 2 hours on art, sure I will do that when I feel like it.  Call someone, I freak out calling people, so that will happen when I decide it happens – unless someone says I owe them a lot of money and I know that my bank account depends on it cause I cant afford it and I know it is a mistake.  Routines just don’t work for me!

I know they are essential to my mental health though.  I have talked to a lot of other people from my support groups and have heard it from many other therapists over my years in counseling and they all agree, routines make things better.  They help you stay focused and busy so you have less time to think about the negatives.  They keep you from ruminating on the past or what is going on. 

Do you have a routine? How do you keep your routine?  Do you feel like it helps with your mental health?

Anxiety Wins Again

Since my therapy session on Friday morning my anxiety has been absolutely ridiculous.  Normally I have somewhat of an on and off low grade general anxiety and a very high social anxiety.  Then there is the panic attacks associated with my PTSD when I have a flashback or nightmare or something of that sort.  Since Thursday night/Friday morning though, I have had intense anxiety. My heart has stayed at a high rate, I cannot seem to sit still, I actually feel incredibly exhausted from it all, and I am feeling somewhat depressed and have cried off and on.

My therapist told me to go walking as I used to do this quite a bit for my anxiety to get the energy out.  I tried to do this on Friday and Saturday.  Friday I just broke out into tears about 30 minutes into it.  I wasn’t just slowly walking either, I was going in intervals of walking/jogging.  But the energy and anxiety just wasn’t leaving me.

I recently changed anxiety medications.  But my previous one wasn’t doing anything at all.  I am not sure if this new one is making things worse or therapy is just bring up new emotions.  I also just came back from the family reunion which was quite difficult for me and I think brought up a lot of memories too.

Getting through this weekend has been incredibly hard.  I cannot wait until tomorrow morning when I can call my psychiatrist and beg him to raise this dosage or give me something to get through until the next appointment, or make the appointment earlier.  This anxiety is really getting to me!  It doesn’t even seem like my coping skills are helping me anymore.

If anyone has any insights into how they deal with anxiety when their meds aren’t working or if they don’t use meds at all, please let me know because I could really use the help.

Therapy – It came and went

Therapy – It came and it went.

I was terrified about going today.  After dealing with a family reunion that made me face relationships and past issues that had hurt me I was not looking forward to even thinking about therapy, and yet I was also looking forward to it because I wanted to talk about it.

My problem is simple though — I want to talk about things, and then I get to therapy, and no words come out.  I have all these words in my head, but I can’t form them into sentences.  I don’t know how to say them, I don’t want to say them, I don’t want to hear them out loud.  Occasionally I have been able to say certain things here and there though.  So I was hoping that perhaps some of it would just come out today.  Opening up to people is incredibly hard.  Even once I have built up trust with my therapist I find it hard.  I completely trust her, but for some reason, talking just seems almost impossible even though I want to do it so bad.  Does anyone else have this problem?

The session actually did not go horribly.  I did go into a bit of a flashback though and ended up completely breaking down crying.  We were talking about something, I don’t even remember now, and I simply just went out of the moment, the next thing I knew I was just crying cause I was having so much pain and emotion about what had happened.  But thankfully I was with my therapist and she could walk me through it.  I wish I had a professional therapist on my shoulder 24/hrs a day for when that type of thing happens!  It calms me down so much quicker than I can do on my own!

I cannot wait until I work through all of these past traumas.  I can tell I am stronger than I was from when I started though.  And while things might get harder, I will only grow from this in the end.

Alarm set for Friday next week to begin again!

Things that I am not…

Therapy Tomorrow

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Tomorrow I see my therapist.  My bipolar and borderline personality disorder have been fairly stable over the last year.  Since August 2013 though I began working with a therapist who specializes in trauma therapy.  I never talked about my past history of abuse/sexual assault.  It wasn’t even until these past few months that I truly began opening up to my therapist though, which has made things incredibly hard for me.  Nightmares, flashbacks, and panic attacks have been almost a daily part of my life.

In one way, I am looking forward to seeing her tomorrow because I feel like I really need talk about things.  I was able to talk to my brother prior to our family reunion about some of our childhood growing up and it really brought up even more memories that hurt me.

It is amazing how the brain works with post traumatic stress disorder.  For so long I thought I could just block all of it out of my mind.  But the more I did it, the harder it hit me when it came back up.

Once I get past this though, hopefully I can get rid of the numbness, guilt, shame, nightmares, flashbacks, anger, hopelessness, self-destruction, insomnia, anxiety, panic attacks, and bad memories.

I am getting closer and closer to coming to terms with my past though.  It is hard now, but my future is going to be so much better for it.

Post Traumatic Stress Disorder

Having PTSD has made my life extremely hard. Waking up from nightmares, going into panic attacks in the middle of the day, suddenly having a flashback, having horrible social anxiety as if people can just tell about my past and are judging me, guilt about things that happened, and even the awful thoughts about suicide.

While many tend to relate PTSD to veterans that have come back from war, often PTSD is related to other traumas that civilians have experienced – such as childhood abuse, sexual abuse, domestic violence, rape, natural disasters, or violent crime (anything that might have caused physical harm or the threat of physical harm).

There are three stages of PTSD. You can experience one stage at a time or multiple stages at a time:

1: Re-experiencing
-Nightmares
-Flashbacks

2. Avoidance
-Staying away from places, events, things that are reminders
-Numbing your emotions
-Having trouble remembering the event

3. Hyperarousal
-Being easily startled
-Being on edge

I did not understand how I easily got through life from 8th grade – 12th grade without having any problems despite being sexually abused and then suddenly fell apart after my rape and other issues in college. Upon talking to my therapist I realized I had been in the avoidance stage at those times and so I had numbed myself and avoided things that reminded me of the situation so I wouldn’t have to face it.

Children will deal with PTSD in similar stages, but they will also have slightly different symptoms as well. Bedwetting, acting out, and being clingy might also occur.

There are different treatments for PTSD:

Eye Movement Desensitization and Reprocessing (EMDR)

Accelerated Resolution Therapy (ART)

Cognitive Behavioral Therapy (CBT)

Talk Therapy

Group Therapy

Family Therapy

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I currently am working with a therapist at a crisis center that specialized in trauma therapy. We are doing talk therapy at the moment, but focusing on different techniques to help me process through the trauma – rewind techniques, collages, etc. I couldn’t talk at first, but slowly as I have begun to trust her more, I have opened up more. It has been extremely hard, but I know that it is for the best.

As easy as it might be to try and forget that it never happened, eventually the trauma might come up and haunt you eventually. Some people can work through it on their own, but many cannot. It is always good to work with a trained professional and talk through it with them. Let them help you process through your thoughts and feelings about what happened and how you are dealing with it. Having a good support system will also help you out a lot. I did not have therapy as a child and I avoided talking about my traumas with anyone until I completely broke down. Twelve years after my first trauma and 8 years after my second trauma, I am finally facing them. Even though it has been incredibly hard, I know it is the best decision I have ever made because it is going to pay off in the long run for my mental health.

Stop Telling Me to Get Off My Meds if I Need Them

A lot of people tell me I don’t need medicine.  This especially happened when I was first diagnosed with depression.  “Oh I have been depressed, it will pass.  Just don’t worry about things.  You have such a good life.  You are doing so well in school.  I don’t even know why you are depressed.” – they would say.  Even today, I get the whole “mind over matter” given to me or “God will heal you, just pray.”

My problem with this is, none of these people have been in my situation.  Sure, everyone gets “depressed,” BUT depression is such an overused word now that it has lost its real meaning.  In reality, everyone gets “sad.”

According to Merriam-Webster dictionary, depression is defined as:  a serious medical condition in which a person feels very sad, hopeless, and unimportant and often is unable to live in a normal way.

According to Merriam-Webster dictionary, sad is defined as:  affected with or expressive of grief or unhappiness

So when people say they are depressed, they are not, they are sad.  Unless they have been to a doctor and have been diagnosed with a disorder that encompasses depression, they do not understand.

I am not saying that everyone who has a psychiatric diagnosis of something that encompasses depression will need to take medication, because there are a select group of people that can function and learn to function without it.  However, many people do need to take medication. For others to put stigma on mental illness and basically encourage them to not take their medication by saying they do need it is dangerous.

I personally have gone on and off medication.  I was noncompliant with my medication when I was first diagnosed.  I didn’t think I needed it and I didn’t want to take medication the rest of my life.  What ensued after every time I stopped taking them was a trip to the ER and then psych hospital for a suicide attempt, a trip to the psych hospital for suicidal ideation, the cops coming to my apartment for welfare checks and then usually bringing me to a psych hospital…and that continued until I was eventually committed to a state hospital where I was forced to take medication.  The light bulb went off in my head there, my Aha! moment occurred there though.  I was actually doing better! I was feeling better!  The medications actually helped me!

It took years and years to find the right combination of meds for me.  And for most people it does take that long.  It is easy to give up, especially when people are telling you that you don’t need it.  If you know that you need them because you are not functioning well though, don’t give up.  Continue to use your coping skills and continue to fight to gain your life back.  Mental illness is not easy, but you can learn to live with it.  And not only live with it, but live a good life with it.

Most importantly, if you ever feel like you want to get off or change medications, for any reason at all, make sure you talk to your doctor about it.

Grounding Techniques for Anxiety, Panic Attacks, PTSD

I have struggled with anxiety for forever!  I have PTSD and so panic attacks have come and gone in my life for a long time.  Since I began therapy to deal with the trauma specifically they have become much more frequent though.  Luckily I have an amazing therapist that has taught me some wonderful grounding techniques.

1) When you begin to feel anxious and panic, take deep breaths in and out.  Blow out longer than you breathed in.  Pick a specific color that you see in the room around you, then begin to focus on all the things you can see in the room that have that same color.  For example, if you see something that is green, look for all the other items in the room that are also the color green.  This particular technique is my favorite.  I am a very color oriented person and so this distracts my mind.  It took some practice at first, but it has become an excellent tool for me to use.

2) Again, begin to take deep breaths in and out, with the blowing out being longer than breathing in.  Begin to name the objects in the room.  Describe them, such as where you got them or who gave them to you.  Think about why it is important to you.  This one is still a bit hard for me, mainly because many times I do not have much attachment to the things in my apartment.  They were simply bought at a store that I do not remember and not many things that people gave me.  But many people have antiques or special gifts from family members, and this could possibly be very good for them to use.

3) Pick a particular object.  Use all 5 of your senses to describe it.  For example, make a cup of coffee, tea, or hot chocolate.  (This way you can enjoy it also!)  Look at it intently.  How does it look?  What is its color?  Are there swirls in it from stirring?  Is the cup warm to touch or too hot to touch?  What does it smell like? How does it taste?  Is it flavored coffee with a hint of French vanilla, or regular strong coffee?  Is it a dark chocolate or milk chocolate flavor? Do you hear anything?  Are you stirring your cup? Does the spoon clink against the glass?  Or is it simply quiet where you can only here the birds outside or the fan spinning in the room?  This is an activity the I enjoy as well.  It allows me to focus strictly on what is going on in front of me.  Although it is a bit harder to do exactly during a panic attack, I can practice it at other times to help me be more mindful and reduce anxiety on a daily basis.

4) To bring myself out of a nightmare of panic attack and back into the present moment, it has been recommend that I just simply grab a piece of ice.  Simple right?  Doesn’t sound like it will help?  I didn’t think it would do much at first.  Supposedly the change in temperature shocks your body into recognizing there is a difference and therefore coming back to the present.  So, if you go into a panicked mode, a flashback, or wake up from a nightmare and do not really know what exactly is going on – are scared and frightened and need a way to refocus… simply grabbing a piece of ice or running your hand under cold or warm (not scalding hot) water, this might help to bring you to the present moment.  Then once in this place, you can begin to practice one of the other grounding techniques.

Those are a few techniques that have helped me.  Everyone is different though and not everything that helps one person will help another.  It is important to try things out though.   If it doesn’t work the first time, don’t give up, because most times things do not work on the first time and take practice.  Talk with your therapist or doctor though to see if they have any ideas as well, as there are a multitude of grounding and mindfulness exercises out there.

Importance of Support Groups

Today I “graduated” from the NAMI Connection Facilitator Training!  I officially can be a facilitator at my local NAMI meetings.  Why am I so excited about this?

Well, first off, NAMI has been an integral part of my recovery through mental illness.  I first found a NAMI Connection Group when I was in college and began having severe symptoms.  I was in nursing school and had heard of it during my psychiatric clinicals.  I was nervous to go as the meeting was held in the local hospital where I did my clinical and thought some of the nurses might recognize me.  I went anyway, and continued to go.  Meeting others that had similar diagnosis and faced similar problems in their day to day lives with me helped me tremendously.  I was able to relate to them and learn new coping skills.  I still struggled a lot and was in and out of hospitals, but they were there for me.  I had no family in Indiana and they really became like family to me – they were my support system as I did not really have one before joining NAMI.  After moving to Florida, I immediately began attending a NAMI group here.  The closest one to me was about 45 minutes away at first, but I went anyway.  I made such amazing friends.  Another one started closer, about 30 minutes away, so I went to that one too – but I could leave my friends from the other one, so I went to both.  And now a 3rd one is even closer, only 15-20 minutes away.  And I have trained to become a facilitator for that group, as I want to step up and grow within the organization which has helped me so much.

So, what exactly is NAMI?  NAMI is the National Alliance for the Mentally Ill.  It is the largest mental health grassroots organization.  It has local affiliates all over the US and Puerto Rico.  There is most likely one in your area – and you can go to http://www.nami.org to find out if there is one.  They run all types of educational programs.  They have support groups for people with mental illness (NAMI Connection), support groups for family members of people with mental illness (Family to Family), educational classes for people with mental illness (Peer to Peer), educational classes for family members (also called Family to Family), educational class for parents of children with mental illness (NAMI Basics), and many other services depending on what your local chapter might also offer.

Support groups are important to our success when we are trying to recover with mental illness, whether it be through NAMI or another organization.  Whether we feel great or bad, attending them helps us.  It helps us focus on how to continue to focus on the positives, how to socialize and not isolate, how to help others which in turn makes us feel good, how to learn new coping skills, how to examine our own needs, and how to express ourselves in healthy ways.  Someone once told me, when you feel like you want to go to a meeting you should go, and when you feel like you don’t want to go to a meeting, you need to go.  They said this because generally, if you don’t want to go, that is when you really need to go – you are isolating or feeling depressed, and being around people and hearing the support they can give is what you most likely need.

I hope that if you are not already involved in a local support group, you find one and check it out.  There are many out there.  A few that I know of are DBSA (Depression, Bipolar Support Alliance), NAMI (National Alliance for Mental Illness) and MHA (Mental Health America.  Depending on your area, these organizations might or might not run groups or another organization might have groups too.