Tuesday, November 30, 2010

Back on We Go ....

Well, what can I say? You’ll remember that last May and early June I experienced a few uncomfortable weeks withdrawing from Cymbalta. It was an experiment; I’d originally been put on the medication for anxiety and mood swings, which my physician’s assistant attributed to perimenopause (because I had bad morning sweats at the time). When I quit drinking, the sweats went away (duh) and I felt tremendously better, coming out of the alcoholic fog. So I was thinking that perhaps I didn’t need the Cymbalta at all. I wanted to see if I could get through life totally drug free.

That didn’t happen. I do have a diagnosis of social anxiety disorder, which, luckily, is fairly mild for me. It’s tough to explain how the symptoms present themselves; the easiest way I can think of to describe it is “having perpetual stage fright.” What’s heinous about it is that the anxiety attacks come of out nowhere: I can be fine one moment and two seconds later, my throat is getting dry, my knees start shaking, I start to feel light-headed, and my heart starts racing. It’s extreme anxiety bordering on panic. And for absolutely no reason. They come out of nowhere.

Over the years, I’ve come to recognize the symptoms when I start experiencing them, so usually I’m able to talk myself down. I take deep breaths; I remind myself it’s all in my head; I force myself to slow down at whatever I’m doing; I tell myself it will pass in a moment. It always does. When it happens in the classroom, I doubt my students even notice.

But those few terrified moments are hell.

Other people with a more extreme degree of this disorder suffer unbearably. Some stay confined to their homes (in which case agoraphobia is usually the diagnosis); some can’t take jobs that require dealing with the public; any job in which public performance is required gets taken off their lists of possible careers. Two famous performers who’ve admitted to their struggle with SAD are Cher and Donny Osmond. Medications and cognitive behavioral therapy have proven effective.

The thing that differentiates SAD from simple stage fright or panic disorder is that the anxiety is centered around the specific fear of being judged. Actually, it’s not so much being judged as it is being judged unfairly. I’m pretty sure this is just the way my brain got used to thinking when I was a kid, growing up with a stepmother that therapists have dubbed “an irregular person,” someone who was impossible to please and who withheld affection when I was found failing. And since I couldn’t be perfect, I was always found to not measure up.

I think it was the unpredictability of how she would respond to me that knocked me off any equilibrium I ever had as a child. Once I brought home a “D” in Geometry, and I was prepared for a whipping and to be grounded; she just said, “I don’t know why you have to take that nonsense,” and that was the end of it. Another time I brought home a “B” and I was punished for not getting an “A”—I guess it was a subject she thought I should do better in. I never knew her agendas (and nowadays, I think maybe she wasn’t even aware).

The human mind is full of mysteries that we’re only just now starting to unlock. Like brain chemistry: do our brains get screwed up on their own and we’re born with a chemical imbalance; or do patterns of behavior get the brain used to operating a certain way, and we get locked into that? Psychotropic drugs supposedly correct imbalances.

Think about someone with OCD: they have to have things a certain way or complete particular rituals or they become so upset and uncomfortable that they fly into a panic and can’t function. What about hoarders? If you try to remove something of theirs, even a magazine that’s years old, they panic. Your trash is their treasure. They need that magazine. What impulse in their brain makes them think that? That their life will unravel if that magazine is no longer in their possession?

The brain makes no sense.

In any case, my social anxiety has been creeping back over the semester, and I suppose it should be no surprise that as more stress enters my life, my body’s way of coping returns to the way it once was. I’ve had a few bad moments in class (still, they never notice); my back is a solid rock of tension; I’ve felt unsettled, unfocused, out of control. The one thing I don’t want to do is return to booze. There’s the old-fashioned propranolol (beta blocker) and Ativan (anti-anxiety med) that got me through so many years, but they make me tired and listless. No, I actually felt pretty good when I was on Cymbalta, after I stopped drinking. I was losing weight, I was exercising, I felt calm but all there, too. I don’t like feeling out of it.

Isn’t that just what wacky people do: they start feeling better, so they go off their meds?

So the experiment didn’t give me the result I wanted. I don’t thrive when I’m not on my medication. But that’s okay. I’ve learned to accept the fact that I’m not a perfect human specimen.

There are some Old Timers in AA who insist that any kind of drug (beyond aspirin, cigarettes, or caffeine) are not to be taken or else you're not sober. I'm glad my sponsor doesn't think that way. [It's not like Cymbalta gives you a buzz or lifts your spirits (even though it is mostly known as an anti-depressant). It just evens me out.] But you know, I feel like if this is going to be a recovery blog, I need to be honest and put this out there.

I'm hoping it won't make one whit of difference to any of you.

8 comments:

Lindalouise said...

Oh my, having a mother that doesn't accept you, give you love, support & encouragement for who you are & no matter what you do isn't right is a challenge.

Have you ever thought through if you had been in an environment where you were treated as you should have been where would you be now? What would you have become & done with your life?

You mentioned at one point you were exercising & watching your diet & you felt good except for the side effects. Do you exercise now?

Lindalouise said...

Oh my, having a mother that doesn't accept you, give you love, support & encouragement for who you are & no matter what you do isn't right is a challenge.

Have you ever thought through if you had been in an environment where you were treated as you should have been where would you be now? What would you have become & done with your life?

You mentioned at one point you were exercising & watching your diet & you felt good except for the side effects. Do you exercise now?

Joyce said...

Actually, I've thought about that often ... who would I be today had my home environment been better than what it was. Who knows? Actually I feel lucky that I got out and got into foster care when I did, because my stepmother told me I'd never go to college...she was determined for me to join the military. (Go figure.) I was lucky to have a foster mom who encouraged me to apply to college.

I do feel better when I'm exercising, but lately I've been doing a lot of nothing. That's actually another reason I chose to go back on the Cymbalta instead of relying on the beta blocker and Ativan.... those make me sleepy and sluggish, whereas Cymbalta doesn't.I'm hoping to start running soon... just doing light weights this week.

Lindalouise said...

That is good you are moving & finding the correct meds for you.

I have thought if we didn't have a specific experience where would we be against we are meant to have the experiences we have to make us who we are.

Joyce said...

Yeah, there's also that, I totally agree. Our experiences make us who we are, so if we like our present selves, then you know ... it's hard to be too angry about the past.

I'm not angry (anymore, anyway), but I do speculate that my brain chemistry was affected by early childhood experiences. It's just one of the theories. My stepmother was constantly judging me unfairly, so in later life that's developed into an irrational fear of being judged. Maybe that's oversimplifying it, but it kinda makes sense to me.

Lindalouise said...

I understand exactly what you mean Joyce. Being treated like that does leave you with the task of seeing the truth of a situation & realizing your inner feelings are not the truth.

Lucia Olson said...

Thanks for writing this, Joyce. I'm sure it took courage. From everything I've heard, unpredictability is really the worse thing for the developing brain. Kids would rather have someone who is consistently mean (at least they know what to expect and the stay out of his/her way) than someone who is nice one minute, raging the next.

I can see how this would create a lot of anxiety, and there is probably a genetic component to anxiety disorders,too. In a way, it is good you got away from her, although I'm sure things were tough.

Joyce said...

Hey, Lucia. Well, when I consider all the schizophrenia in my family (biological mother, aunt, cousin, and two brothers), I'm lucky mine is just an anxiety disorder. ;-)