A Few Charms (Banner)

A Few Charms (Banner)

Friday, 4 November 2016

When your brain and body scream 911

The strangest thing happened a few weeks ago. I had this very unfamiliar feeling. My daughter had just left for her 3-day camping trip in a provincial park 3 hours from home. And my son was 3 hours away in the other direction at a cross country meet, and not due back until the evening. My kids were 100% someone else’s responsibility that day. I thought, “What is this strange feeling?” (Actually I asked the question on Facebook.) In hindsight, if I had to hazard a guess, I would say I felt calm. Huh. How unusual. I was not feeling anxious, vigilant, waiting for the other shoe to drop. I looked around me and felt happy!

The teal "Flowers for You" muranos.

I have to say this recent development is quite hard to believe, especially if I look back just a few years. And I want to share with you how I got here. If you or anyone you know battles anxiety or depression please read on – and share this post – because there is hope and there is help.

In April of 2014 I went to my family doctor and asked for help. He asked me lots of questions about my history: I had an eating disorder in high school and beyond, I’d had a number of major depressive episodes, and despite being in recovery from my eating disorder for a few years, I was having panic attacks. He felt that my case was quite complex and so he referred me to the Shared Care Mental Health Team, a group of mental health professionals that provide consultation to family practitioners in the Family Medicine Centres associated with the hospitals in the city.

My daughter Taylor, home from her canoe camping trip

My son Mitchell at the end of his run in a local cross country meet
I first met with the mental health nurse and then in July of 2014 I met with Dr. Mercer, the psychiatrist with the Shared Care Mental Health Team. After reviewing the notes from the mental health nurse and asking me lots of questions she diagnosed me with Panic Disorder (PD), Generalized Anxiety Disorder (GAD), and Social Anxiety Disorder (SAD). We discussed the possibility that I have PTSD and ADD but she did not have time to formally assess for that. Of course I was already in recovery from my eating disorder. You can read my post about how I started my recovery - and my journey with Pandora - in December 2011.

The teal muranos on my Lucerne Recovery bracelet.
The two teal "Flowers for You" muranos are on the top right.

Dr. Mercer then explained to me WHY I had depression and anxiety. I think my jaw must have hit the table, because I was so shocked that she could describe me so accurately, especially since we’d just met. In fact I was so gobsmacked that I didn’t write down a single note – very unusual for me! Later, when I got home, I realized I couldn’t remember all that she had said and I desperately needed to know! I called her office and begged the receptionist to let me speak to her – not usually part of the normal course of events – and here’s what she explained to me.

“You’ve been living in the 911 system. We have two different emotion systems (psychologists actually identify three, but for simplicity we use just two). One is called the “Affiliative System” (which we call “Wise Mind”) where you feel emotions like joy, happiness, or disappointment. The other is the “Threat System” (often referred to as fight or flight, or 911) and there are only three emotions when you are in 911: anger, fear, and shame.

Some people are wired to 1. have more intense responses of anger, fear or shame and 2. have a stronger “preference” for the “safety system.”

When you grow up in a stressful home it puts a lot of stress on a child, which increases the levels of the stress hormone cortisol and strengthens the 911 system.

Your mom was busy and not available – and not effective at dealing with emotions. And your dad was expecting you to take care of him. This led to high anxiety and perfectionism to try to prevent your parents from fighting.

The eating disorder was a way to damp down the anxiety and find a way out of the conundrum of feeling responsible to get control of your life and regulate your emotions.

Getting depressed in university when you were injured (and couldn’t play volleyball), as well as getting depressed after your wedding, was linked to a sense of not knowing how to make everything work – so the 911 system kicked in.”

There you have it. That’s me in a nutshell. That’s the explanation of why I am the way I am. Or was.

Dr. Mercer reassured me that the “Wise Mind” system is always there, even if we’re not using it at the moment. And she reassured me that it was starting to engage: I was making improvements in our home (see my post about tackling the mess in our kitchen) and I was doing behaviour activation – making changes in my behaviour – and earning my Pandora rewards.

She advised me to remember that anxiety is about trying to make something work. She said, “Stay with the anxiety and know that it can’t cause any harm.” Tall order, that!

Dr. Mercer was able to make some recommendations about where I should go from there. She recommended another anti-depressant, vitamin B12 supplements, and a sleep study, as well as referring me to the "Day Hospital" program.

I was followed by the mental health nurse from Shared Care until I entered the Day Hospital program in September of 2014. You can read my post from September 2014 to see how I was feeling right before I entered the intensive (full-day, six-week) Day Hospital program - when I felt that I didn’t deserve to be happy and healthy.

Day Hospital lived up to its description as “intensive” with a daily psychotherapy group with a psychiatrist and social worker. There were also workshops on goal-setting, identifying and expressing feelings, stress management and coping skills, and cognitive behavioural change (CBC). There was an introduction to anger, grief and loss, the drama triangle, mindfulness, and core beliefs. I had one-on-one appointments with the social worker and psychiatrist and worked on CBC one-on-one with the occupational therapist. On my discharge from that program the staff recommended that I find a therapist to work with, asking specifically for someone who could help me with emotion regulation and changing my core beliefs.

In January 2015 I started six months of schema-focused therapy at the Ottawa Institute of Cognitive Behavioural Therapy addressing my core beliefs. In those six months I learned how to identify my (many) triggers and change my feelings and responses. This made an enormous difference with respect to anger and anxiety. In the Fall of 2015 I participated in an eight-week group therapy program called “Working with Emotions,” based in part on Dialectical Behaviour Therapy (DBT). The goal of this group was to learn emotion regulation, interpersonal effectiveness, core mindfulness, and distress tolerance. And finally, in the winter of 2016, I participated in an eight-week course called “Mindfulness for Stress and Symptom Management” at the Ottawa Mindfulness Clinic and began a regular meditation practice.
An early version of my Lucerne Recovery bracelet,
 with only one "Flowers for You" murano.
I learned soooooo much in all of these programs that I feel like a completely different person than I was two years ago when I first asked for help. Two years ago I had no idea there were all these different therapies available. Back in my twenties and early thirties, I had years of psychotherapy for my depression, eventually going off the antidepressant when I was pregnant with my twins in 2001. I was in group therapy for years at The Eating Disorder Clinic. But in the last fifteen to twenty years there have been so many advances in the treatment of mental health, so many new approaches to recovery.

Two years ago I didn’t understand that I was suffering. I did not understand that I was in survival mode. I did not understand that I had no hope for the future, no dreams or ambitions. I did not understand that I was not living a life worth living. After all that work I can look around me now and feel happy. I now have desires. I now have hope. I now know where to get help if I need it. And most importantly I believe that I deserve to feel better.

For others who live with anxiety, depression, an eating disorder, or any other mental illness, please know that there is hope. If you are suffering, please know that there is help. Ask for it! You deserve to be at peace with yourself and the world, and to live a life worth living.
How I "stack" my teal Lucerne Recovery bracelet.
I’ve shared in a previous post that the teal “Flowers for You” murano was my reward for taking care of my health. I spin it and say “Flowers for Me!” every time I take a step towards improving my physical health. Well, now I have a second murano, my reward for asking for help with my mental health. Every time I take a step towards improving my mental health – to celebrate my efforts – I congratulate myself, give this murano a spin, and say, “Flowers for Me!”

I have been doing so much work on my mental health in the last two years that I haven’t really had time to write about it as often as I would have liked. But I’m trying to change that. So stay tuned for more stories, insights, strategies, and behavioural change.
So many charms, so many stories
Related Posts:

A post where I first mention this idea of "living a life worth living," and the power of intention. We worked on this in "Working with Emotions" using a book based on Acceptance and Commitment Therapy.

A post about managing intense emotions by learning to "ride the wave."

A post explaining that sometimes, when things get rough, you need to "just keep swimming" or "just float."

A post about the origins of schema-focused therapy. A rather long post but my explanation of panic attacks.

A post about my first Mii bracelet with the stone of strength for exhaustion, depression and panic attacks.