What Happens When Things Fall Apart

Pin Down That Mummy Hand

In my outpatient crazy classes we talked about self-care–a lot, actually. The first thing I did that helped to lift me out of my wretched little hole was to clean and organize my space. I know very well that my external surroundings are a projection of my inner state. Peaceful and zen like? Every thing is in its place. The bed is made. The laundry is put away. As I sink further and further into the chaos my space gets less and less organized. It’s one of my warning signs that things are out of whack. When I stop meditating, that is a definite flashing red light.

Somehow I managed to make it to work today, unraveled and with flashing red lights, my insides all squishy, my cognitive function deteriorating. Let’s not mention the crying fits. I work in a place that is inhabited almost exclusively by men. I need to sneak out of my office, into the bathroom and push the tears out. Like a tiny birth. Today I accidentally double dosed on Wellbutrin. It didn’t really take effect until halfway through my work day when I was on the phone and all of the sudden things became unreal like they do with LSD. My jaw started grinding, my heart started pounding and I started pacing. I think I managed to pull the phone call off without obvious signs of insanity. But did I pull the day off? I don’t know.

I’m at a familiar crossroads here. Many times in the past I have reached this point in a job and have just dissolved into depression, anxiety or mania. I make too many mistakes thanks to my holey brain and my inability to focus. At first the boss is somewhat understanding, then a little testy then pissed. So I apply the over-compensation–working extra hours that I don’t clock on for. The ensuing anxiety and down right terror wakes me up at night because I have all of this work-related anxiety.

Now that this has happened so many times I’m starting to think that maybe it is a choose your own adventure. Or better yet, maybe it’s like the Buffy the Vampire Slayer mummy hand episode where our saintly heroine was magicked into reliving the same torturous hour of retail service over and over again until she succeeded in satisfying her customer.

This was tricky because the Mummy hand was a devious trickster and the customer was a bitch. Bewitching aside, I think it’s an apt metaphor. Buffy realized that using the same tactics yet again would land her in the basement wrastling a mummy hand to the ground. She tried a new approach. It’s time for my new approach but I haven’t quite pinned it down. Much like Buffy did the mummy hand with a knife.

So I’m going to be sans husband for the next ten days. His band is touring and I can’t go with because of work and money, yadda yadda. I think that taking this time for some spring cleaning would be a good move. Maybe I’ll actually get some stuff done.

Deep Panic Breaths

Don't Panic

I have been in panic mode since childhood. Violent household. Hiding in the closet with my fingers in my ears and holding my breath until my face was red. That’s how I learned to play possum. If I couldn’t cope with my surroundings, I would just make myself numb, still, silent until it passed (or I passed out). There would be some dissociation. Sometimes I could see my body, balled up and trying to disappear. When it was over I would cry so hard I’d choke on my own tears, my sinuses would puff up and I would still not be able to breathe.

Now all of the stress I have shoved down into various parts of my body forms a well-worn path. If something stressful comes up, I go into full panic mode. I automatically assume crash position. A type-o becomes a worst case scenario and I become neurotic and hypervigilant. I can’t relax until I have made it right. And sometimes I can’t make it right. I know that’s the shallow end of my PTSD but it is enough to really get in the way of my happiness and productivity.

I think I might find my way out of this feedback loop by going into my body. By getting deep body work and motion therapy. Currently all of my past injuries, still very much alive but usually dormant, are acting up. My neck is frozen, my lower lumbar is in spasm, I have pain shooting down my leg into my foot and across my hip, latching on like an itchy sweater. I just can’t get comfortable. But maybe that’s the point. I should no longer ignore this pattern and go about my day until the next cataclysm takes hold.

Any thoughts? Any volunteers to be my panic buddy?

The Mind and the Muscle

Image

I feel the connection between mind and body deeply when my mental pathologies are in high gear. When I am depressed, my bones hurt, I feel burnt from the inside, my metabolism slows down. When I am in the throes of a mixed episode with heightened anxiety I have a flight or flight reflex that is catlike. My adrenals dump into my bloodstream and my nervous system zaps away. I have horrible agitation and all of the wonderful self-care tools like meditation, Reiki, breathing and even exercise are futile. It’s obvious to me that these illnesses aren’t just in my head, they’re in my body too.

I’ve recently developed an ongoing left lower lumbar spasm. It just won’t heal. It causes radiating pain and weakness and is in general a pain my ass. I’ve had unpleasant dealings with doctors who don’t want to treat patients who are in pain. They prescribed a short course of a muscle relaxer and recommended ice and heat. It wasn’t cutting it. They had no further answers for me and no concept of how all of my symptoms connected.

So I went to the chiropractor who I visited when my lumbar went into spasm last year before the ACA kicked in and before I had insurance. I needed to talk to someone who would listen to me, someone who actually understands the body. Doctors are good for the prevention and curing of diseases but when it comes to anatomy, many seem to have skipped that class. My chiropractor, after doing a series of strength and range of motion tests directed my attention to the psoas, the muscle at the root of a lot of lower back and hip pain (some people think it’s the root to almost all chronic pain).

When I first learned about the psoas muscle in massage therapy school, something about it stood out to me. It is the deepest muscle in both the back and the abdomen, it holds you up, it creates a shelf for all of your organs as well as massaging them and the spinal fluid. It is the core that supports health and longevity–not the abs or obliques but the psoas. But it seems nobody really talks about it that way. People talk about core strengthening in terms of abs but nobody mentions the humble psoas that takes the biggest beating from not only physical activities but mental and emotional stressors.

Since it is also deeply linked to the sympathetic nervous system holding up and massaging the body’s organs its job, among other things, is to protect them from the hailstorm of stress. When trapped in a state of flight or fright–when a person is pathologically scared, filled with anxiety, panic, terror and is hypervigalent–the psoas constricts to protect the precious organs and spinal fluid but it can cause crippling conditions wearing away joints and harming spinal disks. This wearing away doesn’t kill us but it can make us a lot weaker.

So, according to the philosophy of the body set forth in Yoga, as well as the understanding of human anatomy and psychology, it turns out this relationship works both ways. The releasing of my psoas, encouraging it to work correctly will theoretically help reduce my nervous symptoms as well as the physical ones. My new favorite body blogger Brook over at Fascia Freedom Fighters shared this. It’s called constructive rest. I love the idea of intentionally incorporating rest into the day. Apparently some people fight it wanting to multi-task but I say no way, my body needs a break from the perpetuality of doing.

We’ll see how that works. Anybody have any experience working with the psoas? This is a part of the body that I am definitely going to explore further because as I mentioned, when I am in a state of flight/fright and my adrenals are pumping for no good reason, the mind-oriented self-care techniques I’ve accumulated do not work.

Bipolar Mixed States and PTSD – Finding Doctors Who Can Deal

FreudIn the last city I lived in I had a Freudian psychiatrist. Don’t ask me how it happened because like many things in my life I didn’t really plan it. He looked very much like a short version of my father and that just made the whole Freudian thing a lot weirder. In his narrative regarding my bouts of anxiety and workaholism, I was always trying to save a man who couldn’t be saved. It was true that I tore through a number of jobs in establishments owned by dysfunctional men but when I tried to tell my doc that my interest in improving the business was selfishly motivated he would shake that conviction.

It’s weird for a psychiatrist to be Freudian. Usually they have more interest in cocktailing drugs than rehashing the past to fit an analytic narrative. But I he listened to my stories and responded with meaningful questions and suggestions (most of the time_. We had a good rapport and for the most part we had the meds on track. Until I went hypomanic. I don’t think he was quite ready for that.

Bipolar disorder is extremely hard to diagnose accurately in a timespan less than a year or even two. In my experience, the psychiatrist or psychologist has to witness the mood disruption first hand to really believe in the diagnoses. Most bipolar people don’t go to the doctors when the hypomania takes hold because it feels good. But I did, finally. I have found that psychiatrists, used to seeing me in a depressed state, when confronted with my crazy, they balk. My psychiatrist in the new city pretty much dumped me as a client when I fell into the K hole of a mixed state and wound up in the hospital. It did not make the whole thing any better

I could tell the difference in Dr. F’s assessment of me. I was experiencing a mixed state which is usually what drives me over the edge. I am miserable but with energy that is turned against me in the form of panic, restlessness and agitation. Unfortunately he upped my dose of Lithium at the same time he reduced my Wellbutrin. This did bad things for me including amping up the tremors. As a Reiki practitioner and artist this was a problem–my hands would shake on my clients which was distracting to say the least. That mixed state unraveled my life. All of my traumas that been coiled tightly in the realm of my subconscious broke free.

Mixed states are hard to treat. For me, the most effective method is heavy sedation in the form of Klonipin. It takes the anxiety down a notch or two and while it doesn’t allow me to function, it does allow me some reprieve from my adrenals. Now this has become almost a pattern–it happened again this year. I don’t know what the answer is because the BP and PTSD are tied up in knots, together.

Has anybody experienced this recurrence of mixed states that is triggered by PTSD? All of my self-care like meditation, Reiki, exercise and balanced meals may help prevent these episodes but once they are upon me, nothing seems to work. Any suggestions?

Body of Evidence

In many ways our bodies are physical records of our lives both inner and lived. Areas of knotted fascia (the webbed connective tissue that keeps everything in place) may be the result of the time I fell off my bike as a kid. You would have thought it would have healed by now but no. The body keeps a ledger of missteps.

We all know the commercial with the pathetic looking puppy and neglected family–depression hurts…everybody. It’s facile but not wrong. Depression amplifies pain and distorts it (and perhaps adds some reverb and a little delay). Depression lives in the body as much as the mind. Pain, the accumulation of extra pounds and lethargy are all the real deal for a depressed person.

For me, this is the baseline level of pain I feel (when I’m not hypomanic). Add PTSD and anxiety and it’s a wonder I function at all. Depression, anxiety and hypervigilence tax the body’s autonomic nervous system–the system that regulates the body’s functions (like blood pressure, digestion and heart rate) in order to bring it into homeostasis.

When that system is clogged up with constant triggers to its fight/flight response it remains engaged–meaning the body cannot rest and repair itself. Adrenaline is dumped straight into the bloodstream and when that runs out, it’s cortisol, a hormone that among other things makes us hold on to fat. Gross

It was this what brought me to the ER this summer. I had so much anxiety, I was constantly in a state of hypervigalence AND I was depressed. It was like being tied to a chair while being tickle-tortured but without the fun. Right now I’m feeling the restlessness again, along with the heft of depression. It’s not yet a mixed-state but it’s about one state over.

For anybody else who has or is experiencing this special brand of torture here are some things I have come across that can be helpful if I catch it in time.

1. Creative therapy. Automatic writing, fast drawing, sculpting clay or putty, beading, singing, playing a musical instrument and whatever else is kicking around in there can draw the attention away from self and onto something tactile or sense-oriented in other ways. It only works if you can manage to divorce yourself from the outcome. It isn’t about making art, it’s about the act of creating and it doesn’t matter if it’s good.

2. Tense/Relax Meditation. This is the kind of meditation I can do in the midst of a mixed state, when mindfulness meditation is a no-go because of pain or restlessness.  First, center yourself within your surroundings. Make note of sensory data–what do you see, hear, smell, feel and taste? If associations pop them up, notice them but don’t hop on the train of thought. Let them fall away. Keep your breath grounded in your senses. Then tense your muscle groups individually, hold for a few breaths and relax. Notice the difference?

3. Move It. Honestly it doesn’t matter if you’re prepping for a marathon or cleaning the attic. Moving uses the extra adrenaline as fuel. It can be fun too–I like Wii Fit Plus Rythm-Fu, or putting on a record and dancing like a fool. Other ideas: jumping jacks? Shooting hoops? Walking around town? Yoga? This is where I often fail. The pain and stuckness become so unbearable I feel I can’t move. I suffer for it. I get mad at my doctor for suggesting it. But I have found that it works.

The point of these activities is to get out of the brain and into the body, even if it’s just for a few minutes (though longer l, definitely better). It’s about reconnecting with the body and feeling it in the moment, trying to let negative associations go.

That’s enough proselytizing. I’d love to hear input from others.

Hitting the Hard Reset

Right in the middle of my outpatient treatment I had to fly back home for my brother’s wedding. I was tweaked, blinking extra in the harsh light, unsure of my footing and definitely not ready to deal. The whole thing was a mine field of emotional triggers between my family, friends and the city itself, the backdrop for some of the most traumatizing experiences of my life. I had been away from it all for a year and during that year I had every possible anxiety reaction my body.

First my hormones went crazy. My skin broke out worse than it ever has since high school. My fight/flight response was so hyperactive I was practically electrocuting myself with my own nervous system and dumping adrenaline straight into my stomach like battery acid and kicking my spouse throughout the night. I had all my stress reactions at once–weight gain, getting sick every other week, stomach pains, breakouts, insomnia, panic attacks, asthma attacks and that frakking muscle in my lower left lumbar that spazzes out whenever I’m on the fritz. Which I was, hence my trip to the ER.

The tail end of hospitalization is not a recommended time to travel cross country to participate in a large family gathering. Out of all of the self-care tactics I had picked up in treatment, the only one I could hold onto was mindfulness. I was not meditating yet but I was watching my emotions bubble over me and fall to the ground, popping as they hit the pavement. I could see them but they weren’t  affecting me. I couldn’t tell if I had just turned it off or if CBT was actually working.

Now that I’m trying to actively participate in life, it’s not that easy. It isn’t as easy as pulling off a wedding and taking a vacation from losing my mind. Then, I knew that I would return to the safe pit of un-sane-ness, where it was OK for me to be a mess and work on my own safety. Last night my lumbar muscle started again which reminded me of the self-care I have been largely avoiding. Only three months out I already need to hit the hard reset before I find myself back where I started. I think I need to start where I started last time. Counting sheep.

My Excuse? Exercise Bulimia, CBT and Realistic Resolutions

Over at Harsh Reality, Opinionated Man says:

I keep seeing these fitness blogs with their 2014 resolution posts. Many of them have the title “What is your excuse?”

Opinionated Man has some rather hilarious and perfectly valid “excuses” for not becoming a carb-obsessed, fatty hating gym rat.

I thought I’d address this resolution trend myself because I am aware that it started with mommy blogger “Fit Mom’s” abrasive challenge to women to stop being lazy. It was obnoxious. It stirred up a shit-storm of feminist furor which in turn incurred the wrath of muscle bound meat heads who think bagels are the work of Satan and anyone who can’t bench press a school bus is a newbie. Comment threads on top of comment threads full of haters.

Fit Mom irritated me, I admit. I am not jealous of her. I don’t want to spend five hours a day in the gym and have the entire world take note if I gain a half a pound. I also think the inner drill sergeant tactic is ridiculous from the standpoint of CBT, which actually has a body of evidence to support it. So yeah.

What’s MY Excuse?

Exercise Bulimia

Fit Mom is a self-admitted bulimic who believes she has conquered her eating disorder yet works out for five hours a day. I don’t know her and won’t pass judgment but I know for me, that much time spent working on my body would not be a healthy thing.

Exercise bulimia can be just as damaging to your body and mind as the purging kind. Obviously your body and the comparison of it (implicitly or explicitly) to other women is an obsession. I mean, go ahead, be a fitness instructor but you don’t have to taunt “fatties” (not my word, or hers, to be fair but one used frequently on comment threads regarding this publicity stunt) with your four recent offspring and perfect abs.  

Some of us have invested serious time and work caging the beast of our eating disorders and are trying to learn kinder, gentler ways to keep our bodies in shape. It was the confrontational stance of “What’s YOUR Excuse?” that irritated me. In fact it triggered me. I’m sure it did the same for others.

All I frickin want to do is work out, knock it down a size or two. I quit smoking 15 months ago (go me) and swore a blood oath to my spouse to disengage from my 20-year-old eating disorder. So I can’t starve myself and I can’t purge. To be clear, purging includes working out for six hours a day. Sorry Fit Mom, you could still be a bulimic. Just because you aren’t tossing your cookies doesn’t mean that the mechanism of the eating disorder isn’t active.

Having gone through CBT, every week is like a new year with resolutions and such. Sometimes my resolution is to do a half an hour of Rythym Fu on the WII TWICE this week and traipse through the ‘hood (which is a hilly rain forest) once. That is not going to give me six pack abs but it is an attainable goal.

Taping a picture of my face Photoshopped onto Fit Mom’s body and writing “What’s Your Excuse???” in bright red lipstick on my mirror or obsessing over a size or a number on a scale or a measuring tape is all crazy-making behavior and not likely to produce the desired result. I mean, like I said, Fit Mom does have great abs.