The Brink

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This is a bit early, but Bell Let’s Talk Day is this week, on Wednesday, January 27. I’m a Bell employee and I’m very proud of this initiative. It’s not perfect, and there are plenty of well thought out criticisms of its shortcomings. That said, mental health is something we continue to learn more about, and with our knowledge, comes a deeper understanding of just how far these conditions reach and how many lives they touch. I think anything that helps us understand, and talk about improving access to mental health services is vital to our evolution as a compassionate, productive society. If you’re on the Twitter, use the hashtag #BellLetsTalk on Wednesday and help drive money to programs that can make some great things happen for people who need them.

 

The Brink

There’s a dog that lives in the apartment across the hall and two doors down from mine. I remember when he was a little puppy and super cute. He’s still a puppy and cute, but now he’s huge. Whenever my neighbours are out, this dog loses it. He howls and barks and whines and claws at the door for hours. It gets annoying, especially if I’m trying to sleep in or read or do anything that requires concentration. I get fed up sometimes, but I know it’s not the dog’s fault. It’s not the owners’ fault either. It’s the furthest thing from rational that even the dog wouldn’t recognize the pattern. No matter how many times the dog’s owners leave, only to return safely, the dog is terrified once the door closes, leaving him alone. Sometimes I want to talk through the door in words he’ll never understand, tell him “Hey man, it’s okay, they’ll be back soon enough.” Even if the dog could understand me, it probably wouldn’t work. That’s the thing about anxiety: it’s irrational by definition and once I sink past the point of reason, all I want to do is scream and yell and try to claw my way out.

It usually starts with something innocuous, a little discomfort or a minor, albeit sudden pain in my chest or midsection. It’s never debilitating, and usually doesn’t persist for more than a minute or two. That’s all the time my mind needs though, to warm up my imagination. I’ve become pretty good at managing this kind of stuff, reminding myself how unlikely it is for this moment to be catastrophic, how nothing points to this being an emergency. A lot of times it just takes a few minutes of those reminders to shake those feelings of dread before they really get nasty. Other times, they really get fucking nasty.

No matter how many times it’s happened before, no matter how many times I went to the ER and was shown a perfectly normal ECG and left feeling foolish for wasting time and money, no matter how few actual, persistent physical symptoms I show, I begin to connect dots that my mind conjures from very limited information, to make pictures of worst case scenarios.

I tell myself that knowledge is power and I’ve Googled signs of heart attacks, strokes, kidney failure, esophageal cancer, and so many others. I’ve cross-referenced those with panic symptoms to try to differentiate. Sometimes knowledge isn’t power, it’s just another weapon your brain can use against you. Panic has a way of doing that, turning your most reliable mental resources (in my case, pragmatism and rational thinking) against you, or completely neutralizing them as you drown in thoughts of despair.

Some people have described anxiety like the feeling you get just after you trip, but before you catch your feet, or the feeling when you lean just a little too far back in your chair and you feel yourself losing control before all four legs touch the ground…except they don’t touch the ground, and you don’t catch your feet, and that feeling doesn’t stop. I think that’s pretty accurate. I’m constantly bracing for an impact that never comes. I’m constantly feeling like I’m on the brink of disaster, falling into a void in super slow motion.

Panic is incredibly distracting and exhausting. Everyone has those conversations with their significant other or parents or other people close that aren’t really fights but they’re important, emotionally charged interactions carried out with a sense of urgency. That’s my internal dialogue for a significant part of a given day if I experience a trigger. It’s really hard to do everything I want with the kind of mental and emotional investment intended if I’m having an internal argument about whether something horrible is about to happen every moment (how about now? How about now? now?), or convincing myself that I’m not going to die in the next minute, hour, or day. It affects relationships, work, enthusiasm for doing things I love, and interactions with people important in my life. It’s a hard thing to explain to someone unaware, that I’m not seeming completely engaged because I’m just having an intense back and forth in my head about how incredibly afraid I am right now, especially when I don’t look like there’s anything wrong, because there most certainly isn’t (physically, anyway). It’s not like I want to be dishonest about anything, and I have no problem explaining things to people. That said, I’m not one to publicize things that are going wrong, especially in the moment, unless I’m confident in my audience having a certain level of understanding.

Having people try to help with anxiety, especially during a panic attack, is a lot like my dad and I working together to fish a wire through a space. No one can see anything that’s going on and one person yells a bunch of instructions to the other in about 10 seconds in hopes they try them all at world record pace and one of them works and then they can say “See that wasn’t so hard.” People like instructing. It’s not a criticism. It makes all the sense to want to see a tangible connection between your action and the solution to a problem. It’s a lot easier when you can say “See, I said the thing and then the other thing happened and everything is good now and I did something good!” Anxiety is a lot more like doing a three-legged race in a black hallway with obstacles. The person dealing with it might be a bit more familiar, but they really don’t know what to do any more than you. So it takes a lot of coordination, and that takes a lot of listening to gather information. How are you supposed to tell if you’re listening the right way? If the person starts feeling better, how do you know when you were doing your best listening so you can replicate that for next time? It’s incredibly hard to see someone you care about in pain and distress and all you can think about is trying your hardest to fix it yesterday and you just want to try everything all at once so it can just stop and that person can be okay and everything can be okay.

I’m not ashamed to have anxiety. It’s an unfortunately common thing to deal with. The shame comes when I see effects on those around me when I have a panic attack or I can’t follow through on something. Plans being broken, having to quit or pull out of activities part way through, having to abruptly leave a movie theatre or a dinner, and seeing the disappointment, confusion and overt and vocal frustration from people I care for the most is far and away the worst feeling. It’s not that I could have prevented it. I know that’s not something I’m going to control per se. Seeing disappointment directly attributed to something I’ve done, no matter how irrational or perceivably uncontrollable is absolutely devastating.

****

It’s taken me a long time to write this. It’s been therapeutic at times when I was coming down from an attack and cathartic in other ways when I thought of the effects this had on many parts of my life. One of the reasons it’s taken me so long to write is that I’ve been doing a lot better as of late. I think it’s important to talk about getting help in case anyone who reads this is looking for relief themselves and might be unsure where to start.

Getting help can be pretty easy if you are financially equipped to find yourself a psychiatrist or other kind of therapist who operates privately. Anxiety’s onset with me started at a super inconvenient time, just at the end of my internship with graduation on the horizon, and with it, the end of school medical coverage. It might surprise you that in a city like Toronto, there is lots of demand for publicly covered mental health services (this shouldn’t surprise you). Resources are dreadfully sparse for the demand and it’s really a matter of luck if you get hooked up with a doctor. You ask your doctor for a referral and you’re put on a list. If you aren’t called within six months (or maybe less or more, this isn’t exactly clear) then you need to start the referral process again. There’s no way at any time to check where you stand on that list. It would be nice to know I’ve moved from 505th to 304th in four months so I can get a jump on re-submitting my referral.

This isn’t really a means of giving a positive message that sounds like an easy solution to anxiety or other mental health struggles. Those don’t exist. Getting help is a matter of buying in and committing to a process where just finding help that is covered through public healthcare feels inconvenient, frustrating and at times hopeless. Going back to the doctor, talking about the process, asking more questions, feeling shitty when he rolls his eyes at you because you booked an emergency appointment and missed work for something that isn’t really there. Eventually you’ll get a call, and you need to commit again, to the process of letting someone in to work with you on feeling kind of close to normal again, and then a little closer day by day. It can be scary in its own way, but I can’t think of anything that’s excited me more than working with someone to overcome the biggest challenge of the last two years of my life. Progress might be slow. There definitely will be obstacles and setbacks, but this is experimentation, finding how to fine tune a process to fit your needs! How awesome is that?

I make no illusions to how incredibly lucky I’ve been in fighting this, especially in the last year. From just having a family doctor with whom I can have a continued dialogue, to having a job with benefits to cover a few private counselling sessions for a couple months before finally hitting the referral lottery. I’m also fortunate to have a family who supports me, even if they don’t quite understand, but they try really hard to and that’s all I can ask. I also have a super understanding and inspiring boss who knows a thing or two about health anxiety. You should check out her writing HERE.

For me, medication, along with cognitive behaviour therapy and general talk therapy have worked out really well. I feel better than I have in months and it’s a great feeling to realize once in a while that I wasn’t paralyzed by fear today.

Solutions for everyone are different. The important thing is giving yourself every opportunity to succeed in finding yours, whatever it takes with whatever you have.

 

Good luck, you got this.

 

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