Worrying

I’m a worrier.

For those of you who know me, this is no surprise. I worry about my friends, my family, the people I care about. High on my list right now is Calla, because I know there’s a lot going on with her, and I wish I could help; I know I still have feelings for her, even though I’ve come to terms with the idea that we won’t have a romantic relationship; there’s a gap between the rational side of my mind – the part that know’s we are just friends – and the emotional side, which spent months building up feelings for her, and is extremely slow to let them go. I’m stubborn like that. I worry about my friend who is switching medications, because she seems to be taking it pretty hard, and it’s not like things have been terribly easy on her. I worry about my other friend here, who’s a single guy and an awesome friend who just seems to have a hard time catching a break. I know it’s coming, but I still worry about him.

I know I worry, and I know it can be intense and annoying. It can cause me to try to intrude more than I should, and just be more of an ass than I normally am.I also know that for a lot of people, this would be a cause of a lot of stress. But I worry because I choose to, not because I have to. I want my friends to be happy, and I worry about them when things aren’t going so well. I’ve had one friend come very close to killing herself – not one of the above friends, a separate one, in Canada – and another actually go through with it – my friend Alice, my took her life in June. I know that I can’t change the past, and that ‘what if…’ scenarios will just mess with my head. But I wonder if having someone to reach out to, or who reached out to her, might have made a difference. So I worry about my friends because I never want to see one of them get to that point again, or if they do, to know that I am here for whatever help or support I can give.

In other news, things are proceeding as planned, and I know that two blog entries in two days is pretty unusual for these times – more reminiscent of my early blogging. But I had this on my mind, and I spent the day at work thinking about it – well, the part of my work day when I wasn’t going through the process of reporting a workplace injury, because I slipped on a loose piece of cardboard and twisted my knee. It’s nothing serious, but I’m going to be limping around for a day or so. Thankfully, I’ve got the next two days off, so I’ll be able to keep things easy on my knee. So, whoever is reading this, don’t worry; it isn’t serious, just an annoyance, and I’ll be fine in a day or two.

The Feeling of Feelings

Acknowledging one’s emotions is an important part of the process of recovery from mental illness. A lot of people never really develop very well emotionally, and I was no different; from an early age I put a lot of energy into distancing myself from what I was feeling, and in later life that came back to bite me, and hard.

One of the interesting things I have found, though, is that each emotion for me seems to have an associated physical sensation. It’s taken a a fair amount of time to really pinpoint them all, which is odd, considering that we are feeling some degree of emotion virtually all the time. But I think some of them don’t really register until we feel an emotion strongly, and I would think that these particular feelings could vary from person to person.

For me, one of the ones I have felt to a fair degree recently has been a feeling of fear or panic. This isn’t something I have mentioned before, but my neighbors, over the past several weeks, have been prone to loud, seemingly violent, fights. I hear them through my ceiling; yelling and screaming and slamming of things into the floor, and at first I found it annoying, but as it grew more frequent, I began to wonder if it was something like domestic abuse. I eventually had to call the police on them, and now every time I hear them I fear that it will be something bad, or that somehow I will get involved. This fear manifests itself as a tightness in my chest, my heart beating really strongly, and a little out of sync; it makes it feel like blood is rushing through my head.

Anxiety is much easier to express; anxiety can be set off by a lot of things, but hearing from anything involving a new job is almost certain to set it off. I have it sometimes when talking with friends who are having rough times; I don’t want to say the wrong thing, but I also want to be a helpful and supportive friend, and that can be a tough road to navigate. It feels like butterflies in my stomach; the easiest way I can describe it is that feeling you get on a rollercoaster when climbing up the first big incline, that feeling of apprehension – is this really a good idea?

Guilt is one I am familiar with, largely because while Is pent so long worrying about the lies I was telling to everyone around me during the worst periods of my depression. Guilt just made me feel sick to my stomach, like I needed to throw up, even when there was nothing in my stomach. Oddly, it didn’t ever make me any less hungry, and it only ever actually made me throw up once, but it really spent a lot of time working its unpleasant magic on me.

Anger is pretty easy; I sometimes find myself going straight to anger in traffic when something crazy happens – which is not unusual in Houston traffic, sadly. It only happens when I drive alone, too, which is strange. Anger is just a burning needs to do something immediate, often violent; I tend to satisfy this by saying or yelling quite an interesting array of things at my fellow drivers, warranted or not. I try not to make rude gestures where they can see me, or hit anything, because I don’t want to engender similar anger, but the yelling kind of feels good to get out.

Sadness is probably the one I have the most intense experience with, considering my depression. I haven’t felt a whole lot of it lately – at least, not to the extent of my worst depressions, or anywhere near that – but I have had moments of disappointment, like being turned down for a job or reprimanded by a manager, that remind me. It’s oppressive; it makes me feel tired, so tired I don’t want to move, or work, or do anything but maybe eat or sleep. It makes me lose interest in things, to just want to sit, sleep, withdraw from the world. It’s dangerous, and can be very insidious, and so I have to watch out for it often.

Joy is the emotion I haven’t had a lot of experience with – well, not until October or so. It was when I first realized I had feelings for Calla, and found out she had feelings for me, as well. My heart almost popped out of my chest, and when I was around her it still felt like that. When I was trying to describe how I felt to her, I used something similar to the rollercoaster description I used above – except for with her, it wasn’t the anxiety of the climb, but the feeling you get right at the apex of the climb – the flash of terror, but then the realization that you’re about to do something awesome.

That covers the five biggies – fear, guilt, anger, sadness, and joy, with anxiety as a bonus. So, how do emotions feel physically when they manifest for you? What kinds of sensations do they create? Think about it, then think about how often you’re feeling each; it can be a sobering conclusion.

Describing Depression

Depression is more complicated than a lot of people think. Well, in my experience, anyway. To a lot of people, depression is just sadness, albeit extreme sadness. It lasts for an unknown period; with some people, it’s situational, with a distinct cause, and once that cause has been overcome, the depression goes away. For others – like me, for example – it is chemical, something wrong with basic brain chemistry, and as far as I know, there’s no cure, just regulation and management. 

Depression can be so much more – and by more, I mean worse – than just sadness, though. Among common symptoms of depression are:

  • Persistent sad, anxious, or “empty” feelings
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, or helplessness
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable, including sex
  • Fatigue and decreased energy
  • Difficulty concentrating, remembering details, and making decisions
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Overeating, or appetite loss
  • Thoughts of suicide, suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment. (Source: http://www.nimh.nih.gov/health/topics/depression/index.shtml)

Even then, that probably isn’t the whole picture. One of the things that was frequently mentioned at Menninger was that depression was anger directed inwards. Instead of taking your anger out on things around you, in healthy or unhealthy ways, you internalize it all and direct it at yourself. You make yourself believe that nothing you do is ever good enough, or ever will be good enough. You hate yourself for the way you feel, or don’t feel. It can manifest in extreme sadness, or, because you hate yourself so much, you don’t want others to know how pathetic you are and so you try to just show nothing at all.

Anxiety is also a frequent component of depression – if not as a part of the depression, then as a complementary issue. Up until I got to the step-down, I never considered that I might have anxiety issues; I knew I was uncomfortable in most social situations, but I figured it was just because I was an introvert. I felt strange, irregular heartbeats, and I would get dizzy or start sweating, but I just thought I was eating too much junk food, or over-exerting myself. Eventually, though, I figured that those were all components of anxiety attacks – not major ones, but enough to worry me seriously. Some people have extreme social anxiety – they don’t want to be around too many people, or they don’t trust others; some are scared just to go outside. Anxiety manifests in a lot of ways, and it’s brutal.

One of the more insidious problems that affects people with depression is one with a variety of different manners – for lack of a better term, we call them cognitive distortions. According to this article, “Cognitive distortions are simply ways that our mind convinces us of something that isn’t really true. These inaccurate thoughts are usually used to reinforce negative thinking or emotions — telling ourselves things that sound rational and accurate, but really only serve to keep us feeling bad about ourselves.” These are things like black and white thinking – things are either good or bad, up or down, black or white, with no middle ground; catastrophizing – assuming things will always go the worst possible way; or filtering – seeing only the negative aspects of a situation, and ignoring the positive so that only bad things are seen. The article linked above has many more. 

Cognitive distortions aren’t unique to people with depression, or even other mental disorders; if you look through the list, you might see a few that you fall prey to. They are worse on people with mental disorders, though, because our minds are already somewhat compromised. We are already prone to thinking about the negative over the positive. 

So yeah, depression is more complex than just feeling sad all the time. And it’s rough, because depression is one of the easier mood disorders to describe. I know friends with bipolar, with borderline personality disorder, with extreme anxiety disorders, with schizophrenia. I don’t know that I could describe them. I can only describe depression because I’ve been living with it for over a decade. It’s not something we can just think our way out of. Without the right combination of therapy, treatment, and medication, there’s not much we can do against an enemy inside our heads. 

Panic (Not at the Disco)

I can occasionally be a pretty nervous person. If a friend sits me down and says he or she wants to have a serious talk with me, then I get nervous; same thing with going out on job interviews. But one of the things that scares me the most is the possibility of dating, which is problematic for me, since I would like, at some point, to have a girlfriend – if not something more serious.

My ability to even really consider a romantic relationship has been messed up for a long time, and I’m not sure you could say I have ever had a girlfriend. And yes, I’m 33, which makes me worryingly close to a Steve Carrell movie. My problem is that I want to get to know someone before I ask them out, and that can be awkward, because by the time I feel comfortable enough with someone to ask them out, I am likely to have been ruled out by the woman as a romantic interest. While I can always use more friends, when I am trying to be more than friends this can be frustrating, and terrifying.

I recently told someone, a close friend, that I have feelings for her. I basically expected her to say that she didn’t feel the same, and my guess was correct, though she was very compassionate about it. The build-up to my saying anything, and the realization that I had those feeling, was one of the most terrifying experiences of my life. I was, apparently, having a pretty heavy-duty panic attack (I had to look up the symptoms), which subsided after getting what I had to say off my chest, even with the expected disappointment.

Because I have mentioned my lack of experience, and my concern about it, the program director here at the step-down has decided to try and find some things for me to do about it. Unfortunately for me, the first thing on her list is speed dating, which, to be frank, scares the crap out of me. Even as I write this, I’m having a low-grade panic attack at the thought; having to meet so many new people, all of them women, and then trying to make a good impression so many times in just a couple hours is a huge obstacle for me. It hits me in a number of weak spots at once, and I would really prefer to start more slowly.

Now, I know that my body is just reacting to my mind; if I can get my mind off of the idea of speed dating, or the idea that I am committed to it, these feelings of dizziness and heart palpitations will go away. But that, right now, seems like being told not to think of a pink elephant. I’m watching TV, talking to a friend, and writing this, and none of them seem to be doing anything to mitigate the symptoms.

So right now, I am not having a very good time. I don’t really know what to do about it, though, so I guess I am stuck with it until either my mind or body decides to move on to something else. If anyone has any suggestions for dealing with panic attacks, I’d be mighty obliged.

Introspection

There are a lot of things about ourselves we take for granted. Most of us don’t spend a lot of time thinking about the reasons why we do certain things, because if we did, it might be uncomfortable – or we might learn some things about ourselves that might help us out.

This was part of what happened with me at Menninger. My team (my psychiatrist, social worker, and my contact nurse for the day) would get together every week for rounds, and I would come in and talk to them about concerns I had, directions I wanted to go with my treatments, or how I was feeling. If I didn’t have an abundance of material, they would start to ask questions or pointing out things they had noticed about my behavior, whether over just that week or my entire stay. For the most part, rounds were relatively tame; while they asked challenging questions and tried to push me harder, I knew that was what they were supposed to be doing and I accepted it – at least, until one week.

I went to rounds with nothing in particular to talk to them about; I figured that my team would have something to say, and that we could easily occupy our time discussing that. I was right, but it wasn’t easy. What my team did was tell me that they felt I was doing very poorly at introspection – that is, looking inside myself to look for the reasons why I did certain things, rather than look for external answers or study other people.. The two examples they pointed out were two things I was employing, unconsciously, at that exact time – my tendency to fidget and to answer challenging questions and statements with vague or nonspecific answers. They felt that, unless I spent some time thinking about things like that, that much of my treatment would be fairly useless.

I left rounds feeling like I’d been hit by a Mack truck. I had spent a great deal of time during the worst periods of my depression being inwardly focused, but mostly that had been about how worthless and hopeless I was. This was different, and it was hard. I didn’t want to look at myself that closely, because I was afraid of the things I might find out.

My fidgeting is something that probably anyone who knows me and watches me for more than a few minutes notices. I tap my feet, bounce my legs, swing my knees, crack my knuckles, rub my hands together, roll my shoulders and my head (often with a serious of distressing cracks)… I do this all the time, and most of the time, it is unconscious. I don’t even notice I’m doing it. And, when I started to think about why I did it, it is because, on some level, I am constantly anxious. Often, it is kind of unspecific anxiety, and so it helps to release nervous energy. But when things in my life are making me more anxious, then I fidget more, whether faster, or more often, or more intensely. It’s a pretty good sign of my anxiety level, and yet it was something I had never even considered.

My answering of challenging questions with vague and nonspecific answers was the other example my team gave me, and I thought long and hard about that, as well. I don’t know that there was a specific reason that I did it, but it became clear to me that it was a defense mechanism to avoid answering things that made me feel uncomfortable or conversations that would take me places I didn’t want to go. Unfortunately for me, those were often places and things I needed to discuss in treatment if I wanted to try and change they way I was thinking and to let other people in. I’ve asked a number of people close to me to call me on this if they notice it. But it’s not even my primary defense mechanism socially.

My primary social defense mechanism is humor. When things start getting too serious, or too emotional, and I want to try and lighten things up so I don’t have to explore areas that may make me hurt or feel uncomfortable emotions (which, at the moment, is still most of them), I look for ways to tell jokes or make amusing comments. To cover for my insecurity and feelings of shame about being in mental treatment, and of needing treatment, I often tend to make jokes about ‘being shacked up in the wacko basket’ or the like. I put an amusing face on a serious topic, and keep myself from having to feel the associated emotions, while often also deflecting the conversation to something more pleasant for me.It is something I had noticed myself early on in my treatment, and pointed out to others so that it would be easier to notice, but there are times I still find myself sliding into that.

The one behavior that may be least obvious to other people, but the one which probably involves the people closest to me the most, is my overly vigilant behavior. When I am out in the company of people who I care about, in places where I don’t feel safe or secure, I tend to become extremely aware of what is going on in the area around me. I know I can’t control things, but I feel that I can at least protect my friends if something happens. There’s a reason for this, which I won’t go into now, but essentially, it means I am constantly scanning the area, assessing potentially threatening people. I tend to walk slightly behind and to the left of someone I care about, which lets me match their pace, see where they are at all times, and, if necessary, shove them aside in case of attack. If I’m in a group, I stay until I can make sure everyone I care about is accounted for; this led me, at Menninger, to stay behind at meals until the last people I was close to left even when I had a sufficient level of privilege to leave earlier. I know that this behavior isn’t realistic, and that in all likelihood my friends and loved ones don’t need a bodyguard, but it’s something I find myself doing regardless of necessity. Largely, it’s because I don’t feel any concern for my own safety, but I feel intense, painful anxiety at the thought of losing someone I care about, and so I do whatever I can to minimize the chance of that happening.

These are just a few of the more obvious things that I found out about myself while doing what my team had asked me to do, and there are more, though I figure these examples are enough to illustrate my point. While it can be uncomfortable to leave that part of our head that never looks inward, we can find out a lot of things about ourselves that we weren’t really aware of if we do. Some of those things will be uncomfortable, and some of them we’ll want to change, and there are others that we’ll look at and be happy for or proud of. But turning your investigative capacity inwards rather than outwards, I have found, is a rewarding experience. You might not find what you were looking for, but you will almost certainly find something of worth.