Wednesday, August 28, 2013

The anxiety

I'm slowly getting back to work on a regular basis.  This has been the greatest hurdle for me.  As I mentioned in yesterday's post, "High Functioning", I believe this recent period of depression, something I have experienced before, has really paved the way for my anxiety, something entirely new.  I have a tornado for a son, a clinger for a daughter and a law practice that's really only necessary because people are unhappy.  I'm no stranger to difficult situations.  I'm familiar with stress.  I've been juggling lots of responsibility for a pretty long time.

I can trace the very start of my descent into madness to last July.  Yes, I believe I've been here in this place, sometimes worse than others, for more than a year.  I took on two of the most difficult clients I've ever had the pleasure of working with.  I can't, nor do I want to go into detail about those clients or those cases, but I can give you a glimpse of what had become my normal work environment over the last year.  Last Labor Day weekend, I worked nearly fifty hours preparing for one trial.  In the month of September, I had a ten day stretch where I had three trials scheduled.  In January, I had three scheduled in two and a half weeks.  I began spending my nights crashing to a fitful sleep for three hours, waking in the middle of the night, working in my "office" (it was really a walk-in closet, and formerly my youngest's nursery, because we had long since run out of space at our condo) for three or four hours, sleeping for another hour or two and waking up trying to keep it together for my two small children.  I worked weekends often.  I worked evenings frequently.  I stressed and fretted and worried constantly.  If I was at home, I was worried about my work, if I was at work, I worried about how I was failing at home.

It wasn't until December that I started to really fall apart.  I was meeting deadlines, keeping up with clients and prepared at court, but the effort was crushing.  In January, I received a pretty disconcerting threat via email.  I'd begun racking up irritated voice messages.  I was feeling too sick to come to work too often.  I tried to work from home, but I became a zombie and sat wishing I could work, knowing I had to work, but feeling completely incapable of working.  I came to the office as often as I could, but that was less and less frequent.  I would have panic attacks just walking into the building.  I used to feel home and confident here.  This is a place I used to bring my children to play on weekends while I worked.  I have toys in the office collecting dust because I don't want to expose them to what has become such a toxic place for me.  When the phone rang, as it did this morning which inspired a panic attack and this post, my heart would race, my face would flush and my neck would get hot.  I'd get the chills, my breathing would become shallow and I would fade a little, like trying to focus on a conversation from underwater.

Just as I had a moment of clarity that alerted me to how bad my depression had really gotten, I had a moment with the anxiety too, although I didn't learn to call what I was experiencing "anxiety" until I started talking about it with therapists.  I have admitted this to very few people.  I received so much support for being "brave" and telling my story via this blog recently.  And while I can't adequately express my overwhelming appreciation for that, this next revelation is far more terrifying for me to admit than anything I have shared so far....  One day, I was working in my office (with the doors locked, both inner office and main, and the lights left off) and someone came to the door.  I had been on the phone and so I was sure the knocker knew I was in here.  He or she knocked again, then knocked on my neighbor's office door.  I heard talking, but couldn't make out the conversation or determine who was out there.

Even now, although it's not reasonable, I imagine it like a horror movie.  Some evil somebody or something is stalking outside the door, knowing I'm trapped inside without any place to go.  While I have no idea what this person wanted because I've never determined who it was, I was sure the intention was something sinister.  I can't really articulate what I thought might happen.  My logical mind, which has persisted through this all, frankly befuddling me because I KNOW better, is aware that this person wasn't here to hurt me.  The worst case scenario was a confrontation and, as an attorney, that's something I've never really feared.  Yet, I was absolutely terrified.  I have two windows that face a back parking lot and a building next door.  I was truly so afraid that someone was out to get me that I crawled under my desk that day, in case someone stalked around the building, peering into my windows.  And that's when I knew this had all gone too far.

There were other bouts of ridiculous paranoia.  On a road trip, I once had a car "follow" me on the highway from Illinois all the way to my home in Lake Country.  I turned off into my neighborhood and that was the last I saw of the car, but I was absolutely certain, completely convinced that the driver was following me and undoubtedly with bad intentions.  Again, I had no logical explanation for this and I knew the thought wasn't rational, but I was scared nonetheless.  Other times, I would run down the hall to the bathroom because I was sure I'd run into someone "waiting for me."  And sometimes I was even scared to walk to my car at the end of the day because I thought someone might have slashed my tires or would be waiting on the far side of my car, where I couldn't see them.

This piece, my friends, has been an incredible struggle.  No part of me has ever been afraid of much other than heights, and even that I challenged on occasion.  I was an optimistic and sensitive person.  I believed in the good of the world and the strength in the unity of humanity.  I had become someone who was scared of the way her own shadow moved.  And while I'm not crawling under my desk anymore, thank goodness, I am sadly more reliant on my Lorazepam than my own capacity to get me through a day at the office.  We're tweaking my medications to allow me to sit still in court, answer my phone without feeling lightheaded and so that I can take pride in my work again.  Yet I fear I will never fully recover from this experience, this exposure to sheer terror driven by anxiety.  And I am sad for it.

Tuesday, August 27, 2013

"High Functioning"

One of the reasons my recent bout of depression went unrecognized, despite having managed through several other depressions in my life, is that I was "high functioning."  The term "high functioning" is usually used when speaking about someone with a disability, condition disease, such as autism or alcoholism, who can do many of the things that most people with the same condition cannot.

We're probably all familiar with the stereotypical signs of depression:  feelings of sadness or unhappiness, irritability, loss of interest in normal activities, insomnia or excessive sleeping, change in appetite, fatigue, feelings of worthlessness or guilt, trouble concentrating, and bouts of crying with no apparent cause, according to the Mayo Clinic.

I spent so much time being so busy with my family and my work that I noticed nothing.  Frankly, the difficulty of managing a three and four-year old and a solo legal practice could have easily caused the symptoms that I only noticed once I came apart and landed in the hospital.  Fortunately or unfortunately, they simply weren't the cause.

I didn't recognize the sadness or unhappiness, rather I would have described myself as "stressed," which I attributed to having a job where clients alternated from incessantly calling, to sobbing to threatening, and a workload that had me sometimes waking up from 1:00 a.m. - 4:00 a.m., just so I could work with no distractions and still get some sleep.  I also attributed some of the misery to navigating the terrible twos (My youngest didn't turn three until May and certainly didn't get any easier) and, as one wise friend called them, the "throat-slitting threes."  I also likely figured I was driven to "unhappiness" by managing the schedules and need of not only my two smallest, but also a teenager, who isn't mine and therefore deserved special effort so she knew how important she is.  For what it's worth, I never recognized "unhappiness or sadness."  It wasn't until the week before I entered the hospital that I noticed the recurring tears for no apparent reason.  

As for irritability, again, I'd call it stress.  Was I irritated with my difficult client(s), my full schedule and the demands of several trials in a few short months?  Of course.  Was I irritated with two small children who like to torture each other as much as I like to snuggle them?  I was, and understandably so. But I was irritated with everything then.  I believed I simply had grown to be an intolerant and irritable person.  I was devastated by that conclusion, but it was the one I came to nonetheless.

Having had two children in fourteen months, while trying to manage and build a successful law practice (in the trying area of "family law" no less), it had been a very long time since I had undertaken any activities to actually lose interest in.  My life was dictated by the schedules of my children, the courts, and the clients.  I hadn't taken any time for myself and by having failed to do so for so long, I didn't notice having lost interest in anything.

The sleep and appetite issues went hand-in-hand with everything else.  When you're busy and you have two kids that wake up before 6:00 a.m., there is no routine.  It's chaos and with chaos comes a lack of awareness of any changes.  There was no normal to have changed.

I was thoroughly tricked by my feelings of worthlessness and guilt.  The problem with depression is that it drives you to forget everything you've ever done that was good and to fixate on everything you've ever done, said, or thought as negative.  I downright loathed (loathe?) myself.  I described it as wanting to claw off my own skin.  It's perhaps the symptom I still struggle with most.  It's as if my own brain is fighting any recovery I could have and I can't even see it because I think I'm as terrible as I feel.

I didn't realize that I was struggling to concentrate.  When you have twenty clients, fifteen deadlines, three hundred emails to read and reply to, and the phone doesn't stop ringing, it doesn't seem as though there is any time to concentrate anyway.  Again, I labeled a reduction in my productivity, that was quite possibly as a result of lack of concentration, as "stress."

Last and perhaps most obvious are the bouts of crying.  I simply did not take note.  I knew, toward the end and before I entered treatment, that I was crashing hard and that's when I started noticing the crying, and somehow, I just wasn't alarmed by it.  I know my family saw it, but even for them I wore a carefully crafted facade. I can't honestly say how long it had been going on. If it was more than just at the end, it didn't register.

For me, it was when my therapist stopped gently suggesting and began urging me to consider taking psychotropic medication because I was getting no better, and perhaps getting much worse.  That night, I came home and talked to my stepdaughter, who is wise beyond her years and a rock I lean too frequently on.  Before I shared the therapist's opinion with her that night, I believe she'd seen my cry in pain or sadness one time, when I had a crutch dropped on my two-day old broken, set and pinned foot, post-surgery.  That night, I cried and she hugged me and it was comforting, but to hear how sad she was for me when I apologized for my behavior knocked something wide open in me.  And I went down hard.

There were other signs, probably dozens of them.  My anxiety was out of control and, while I recognized that I was stressed, it was the paranoia that really alerted me that it was something more than "stress.". I truly believe that the depression brought on the conditions for the anxiety, and while my depression is sort of under control and I have fewer and fewer days that I want to claw off my own skin, the anxiety lingers something fierce.  

I still struggle knowing that I woke up with my kids every day, I made them meals, I bathed them, I went to work, I appeared in court, I met deadlines, I laughed at parties, I read books, I shopped for groceries.  I did so many things beyond what "normal" depressed people could do that I just didn't see it...and what a shame for all the time I've lost.  

I am frustrated by my own lack of awareness, as I have always considered myself introspective and quite in tune with myself.  I don't know where along this path I left that behind, but I am working to regain the insight.  Perhaps most frustrating is that where I was once highly functioning in a depressive state, I'm getting help and support and now I feel as though I can barely move.  Recovery, fighting, and relearning how to function and feel is not an easy road.

Sunday, August 25, 2013

Ups and Downs

I'm a pretty black and white, right or wrong kind of girl.  I was absolutely drowning when I finally started my intensive treatment at Rogers Memorial.  I hadn't even realized how far gone I was.  I had such a poor awareness of anything that I sort of believed I would go through treatment and be done.  I somehow believed that by doing therapy six hours a day five days a week I would "kick" this depression.  Silly me. 

I was admitted to the hospital exactly two months ago.  While I have a much better awareness of what goes on with me, what I should and shouldn't listen to in my own mind, and what I need to do when I'm feeling overwhelmed, I'm still so depressed.  I have outbursts throughout the day where I declare that I'm going to be better.  I'm going to get up and do all the things I've been staring at for hours (or days).  I'm going to wake up early, look forward to the new day and be content.  And every day I seem to wake up exhausted, wishing I didn't have to face the morning, much less the whole day.  

It's definitely getting better.  My baseline is no longer hysterical crying, but instead I'm quite numb.  Numb is not a safe place for me.  Numb turns into hours lost, days lost.  Numb is what I'm fighting at the moment.  I hate the inner battle that is my instinct suggesting I go to bed and just be done with this day and my mind knowing that that's not the way to handle how I'm feeling.  I am exhausting.

Thursday, August 22, 2013

The Five Stages of Grief

When I was in the hospital, I spent some time learning about Dr. Elizabeth Kubler-Ross's five stages of grief:  isolation and denial, anger, bargaining, depression (ironically) and acceptance.  My therapy team brought this to my attention because I started there exhibiting serious signs of denial.  Despite having identified the depression to my own therapist and seeking help prior to my hospital admission, I struggled through doubts about my diagnosis.  I KNEW it was the right diagnosis, but I really struggled to accept it.

I kept thinking I should just be able to do all of the things I was struggling to do.  I mean, seriously, how hard is it to stay awake past 8:30 p.m.?  And how hard is it to decide what to eat for dinner?  Why is it hard to get up and get dressed in the morning?  What kind of person can't step into their own office without having a panic attack?

The answer to all of those questions?  It's hard because you have a mental illness.  It's hard because you suffer from generalized panic disorder and severe depression.  It's hard because you are sick.  Those were very difficult answers for me to come to terms with.  I heard them over and over, although less often than I asked those questions in my head.

I had a tearful session with the staff psychiatrist about medication.  I was terrified to start them.  I was afraid of the side effects.  I was afraid I'd be a "different" me.  I was afraid my children would notice the change.  I was so far gone that I couldn't recognize the changes my sweet babies were already living with.  More than once Kaia had come to me, to tell me something she had done or wanted, and prefaced a simple discussion with her mother with, "Are you going to be mad, Mommy?"  Too often I watched my three and four year olds cover their ears when I got angry and began yelling.  I apologized frequently for losing my patience.  Thankfully, my doctor was not living inside my head and told me, point blank, that my children probably miss the me that had been hiding inside me during this depression.  The real me.  I didn't even know who the real me was anymore.  I had been slipping so slowly and then hopelessly into the depression that I believed that the ugliness that I embodied was just who I was now.

During my follow-up with the doc a few days later, we discussed my original diagnosis in an effort to rule out bipolar disorder, a diagnosis that I ironically feel would have been easier for me to accept because I am of the opinion that it is a "real" mental illness.  Then I got mad.  Which was it?  Was I depressed?  Was I bipolar?  Does anyone even know?  How can I get better if they don't even know what is wrong with me?

Bargaining came in the form of trying to regain control.  I'll just do better.  I'll get up two hours before I need to be up for therapy and I'll work through my emails.  I'll work through the night.  I'll just make a schedule and stick to it:  5:00 a.m. wake up, 5:15 shower, 5:35 coffee....it was almost a joke considering I couldn't do the simplest things.  I'll go back to school and do something different.  I'll set up the home office and be able to work there.  I would never have been capable of making so many changes without changing my mindset.

Depression.  It speaks for itself.  I was depressed that I was depressed.  I was grieving the life I wanted, that I felt like maybe, just maybe I was entitled to.  I was grieving the mother and person I wanted to be that I was failing so miserably to embody.  I was sad that I was like this.

I am still sad that I am like this.  I haven't quite mastered acceptance yet.  I take my medication now.  They were right about that - I needed it.  It has made unimaginable differences and while I hope that it will serve as a temporary solution until I'm back to who I believe I am, I will take it as long as I have to.  I say out loud that I have depression and anxiety.  I admit to people my shortcomings.  I cry in front of my husband.  When life feels too hard, I forgive myself if I can't seem to muster more than PB&J for my kids' dinner.  I accept that they'll survive if I don't bathe them every other night.

I have come a long way on my journey to acceptance.  My acceptance, however, will never go as far as complacency.  I will continue to learn and struggle and fight to be the person I ever so vaguely remember being before I found myself here.

Wednesday, August 21, 2013

I am still here

I have two blogs, one shares rueful but funny stories about my darling children.  The other has remained largely dormant as I have been largely dormant.  But I am still here.  I've said it before, but it is helpful to say it out loud as often as possible:  I have depression.  I have anxiety.  I have PTSD.

I wrote my first blogs about feeling disappointment in my life more than a year ago.  Back then, I didn't yet call it depression.  It wasn't until December 2012 that I recognized it for what it was.  It wasn't until January that I had completely succumbed to it.  It wasn't until June that I checked into a hospital for intensive treatment and it wasn't until July that I was discharged.  Now it is August and here I sit, still trying to sort out who I am, which of my thoughts are attempting to derail my recovery and which thoughts are rooted in truth.  Even when I can distinguish them, I struggle to believe.

Depression is an ugly and multi-faceted beast.  My depression attacks in several ways, eating away at my self-worth, my purpose, my desire to enjoy things, my ability to remain patient, the number of waking hours I can sustain...  Rather, it renders me foggy, angry, and completely exhausted at nearly all times.  In fact, the only time I'm not fighting sleep is in the middle of the night when the nightmares wake me and anxiety kicks in to keep me up.

Anxiety is another animal altogether, albeit related.  Anxiety rears at just the thought of stepping through the door to my office, a place I used to love, took pride and felt at home in.  It secretes paranoia and I begin worrying that the car following me is doing so for a dark purpose or that I'll leave a building to find my tires slashed.  I cower when someone knocks at the door and I jump each time the phone rings.  It takes a day of convincing to sort through my mail, much less open it.  I get the chills, I sweat, I shake uncontrollably, I have a difficult time hearing what people are trying to say to me.  Most recently, I've been throwing up at literally just the thought of doing something that causes anxiety.

And PTSD.  While I can't publicly share the details of the specific situations that brought this gem into my life, I can say that I suffer.  Combine the flashbacks, nightmares and sleeplessness and you've got true PTSD to go along with the anxiety.

The worst part for me is that, as an intelligent and left-brain dominant individual, I know the actions to take to fix the problems.  Unfortunately, the mental illnesses render me incapable of undertaking such actions.  I struggle to accept that I am sick, that this is an illness that requires treatment.  I was beaten over the head with the concept by my medical team in the hospital because I didn't accept it.  And so I spend hours and hours each week fighting an internal battle about what I should be doing and what I'm not doing and how I can justify that but that I know better and should be able to control it and why can't I just do normal things like a normal person...and on, and on.  This struggle, this battle of tides causes a whirlpool of thoughts in which I have been drowning.  But I am still here.

I write this blog for myself, although I will share it.  Sharing it makes the deep dark uglies (as I like to call it) not so scary.  I feel better when I'm not pretending.  I spent the better part of the last year pretending, and I think very successfully, that I was handling my shit, when really I was slowly slipping away into a very dark place that I can't seem to find my way out of now.  I am still here and I am still fighting.  Feel free to stick around and watch the freak show.

The original Beginning

Originally posted on December 30, 2012....

I started this blog so long ago that I can't remember how long ago (okay, I know it was sometime before July of 2012).  The point in that is, sadly, that I've felt this way for a very long time:  unsatisfied.  I wrote very seldom here, enjoying much more the funny stories that garnered likes, comments and shares of my other blog.  Yet, I find myself still needing this outlet in what feels today like my sad, sad life.

I had published a post or two here, but someone came across the blog, someone whom I felt might use the honesty about how I really feel against me, so I deleted it.  Immediately.  Without any hesitation, without saving my words, and with fear.  That should have been the tip off, right?  That I should be terrified that someone came across something honest about myself?  I either need to embrace who I actually am and not fear its disclosure, or I need to be someone other than I am and not hide behind a funny blog, or a life that I struggle to get up and live each day.

This is not all to say that I'm miserable day in and day out.  That would be unfair.  There are moments of extraordinary joy, usually at the hands of my amazing little loves.  It is to say, though, that there are many, many more moments of deep, deep darkness.  Aloneness.  Emptiness.  I sometimes spend hours wishing time would pass so that I could go to sleep, where one feels the ache of spending time aching less.

I am thoroughly lost in my own life.  I have contemplated so many ways to "fix" things, to feel better.  I have books that I don't read, memberships that I don't utilize, conversations in my head that never leave my lips, and far too many thoughts that float like snowflakes in a blizzard, so many that you can't really contemplate a single one from start to finish.

I know that this blog won't solve anything.  I also know that I won't be completely honest here, although I may make every effort to make the ugliness eloquent.  I know that I'll still feel like a fraud in my life, but I'm hoping that examining it will help me understand it, help me feel like I'm doing something to make it better and maybe, just maybe I'll be able to see better the beauty of the snowflakes in the storm.