Archives for Agoraphobia
"Just...just do it," she said, looking me straight in the eye. She wasn't a Nike spokesperson: She was my therapist, circa 2004, warning me against the dangers of agoraphobia. "Even if you feel panicky," she said, "Just go. Go out with that friend or this one. Go to the store. No matter how your body feels, just keep going. Don't cancel plans. It'll get worse in the long run if you do." Wise words. Did I always heed them? No.
Years ago, before panic attacks became one of my defining characteristics, I decided I wanted to be one of those crunchy mothers-to-be who avoids all medication at all cost. I'd be growing a tiny human inside of me, after all. I vowed, early in my twenties, that even Tylenol wouldn't even be allowed. Oh, the naivete of my youth. It's been a long time since I've posted a med update, and that's sort of been an intentional choice. Months ago, I started a short series about withdrawing from Celexa, an SSRI drug used to treat depression -- but I'd been taking it off-label for panic disorder for about 2 years. I'm no stranger to SSRI withdrawal, so I was careful to perform a very slow taper. SLOWLY BUT NOT SURELY Things were looking sort of bright on about half my original dosage until I tried to go and pick up a crate a vegetables a mere 2 miles away from my home: It was Tuesday, and I was driving my car to pick up my CSA share — a box full of veggies from a local farmer — just across the bridge from where I live. Easy. Close. A simple task. Agoraphobically, I’ve never really had a problem with bridges before. (And, architecturally, I’m fascinated by them!) But on that day, in the middle of this unremarkable concrete bridge, I felt a small twinge of fear brewing in the basement of my stomach. Something felt wrong — indescribably and uncomfortably wrong."
Think back to first grade, if you can. Alphabet posters on the wall, Dr. Seuss books, and simple math. You were probably pretty comfortable with counting to ten, twenty, thirty, and beyond. In first grade, you probably began doing some easy addition and subtraction problems, too. Maybe you used flashcards. Maybe you remember your teacher using beans or pasta or coins to illustrate the concept of adding something more or taking something away. And then, you feel like a genius when you master 7 + 2. And then, you move right into long division. Right? No. Come on. Of course not. You can't jump right to long division right after learning how to add. It just doesn't make sense. ONE STEP AT A TIME And likewise, it doesn't make sense to dive right into treating your worst fears when you've got some minor and mid-level fears that you need to work on first.
I went camping this past weekend -- a feat in itself, essentially. Thanks to our awesomely large tent and my penchant for over-packing, I felt safe. I had my anxiety meds. I had enough clothing. I had food and I had water and I had plenty of blankets. And, thankfully, I also had my "nausea bag". Because nausea is one of my most difficult-to-handle anxiety symptoms, I lug around a big black bag of Every Nausea Remedy Known To Man whenever I travel. I don't get carsick, exactly -- I've never actually puked on the side of the road or anything. But no matter: my stomach does flips, I start to sweat, I feel the impulse to dry heave, my mouth gets all spitty, and I sit whining in the passenger seat with my head between my knees. THE CHICKEN, THE EGG, OR BOTH? Does the nausea cause the anxiety, or does the anxiety (of traveling) cause the nausea? Framing such a question in an either/or fashion answers nothing. I'm certain it's a little bit of both. I'm emetophobic, so I'm afraid to puke (and afraid of feeling nausiated in general). And, I'm agoraphobic -- so I'm afraid to go out and travel by car. When nausea and anxiety combine, they form a powerful boss. And, as we were leaving the campsite on Sunday, my anxiety began to kick in. We collapsed the tent and, immediately, my symbolic safe space had been rolled up into a bag.
(Note: We spend so much time dwelling on the debilitating effects of our anxiety disorders, don't we? Why not devote an entire day to focusing on our accomplishments [instead of our bumps in the road]? Enter "Win Wednesday": a day to reflect upon the past week and share our successes -- no matter what their shape or size.) Patience is a virtue, they say. And I lack it. Even when I'm feeling relatively calm, I have trouble waiting. (Lines, waiting rooms, and restaurants are the worst. How long do I have to stand in line? When will the nurse call my name? Will they bring my appetizers before my blood sugar drops to zilch and I begin to panic?) But this week, I had a small waiting-related win. I had woken up early to meet my husband and our realtor to sign some paperwork. (We're in the process of buying a house! More on that soon.) I'm more of a night owl these days, so morning energy doesn't come easily. We finished up our paperwork and I decided, on a whim, to take a drive to the mall. I had some coupons to use at CVS for some dirt-cheap makeup and a free candy bar, and I also wanted to browse through the bookstore. (Even though gas is expensive, and the mall is a good 15 miles away, I can always rationalize spending money on gas. If it helps to keep agoraphobia at bay, it's worth it.) I drove right from the realtor's office to the mall. I parked in a strangely-empty parking lot, got out of my car, walked to the mall entrance, and tried to open the door. Locked.
The scene: late summer, on a leave of absence from my cubicle-farm workplace. The culprit? Panic. Really bad panic that was keeping me, for the most part, stuck in my apartment. Most days, I was too scared to even drive down the street to Walgreens. I had been relying on Xanax to treat my panic attacks as they happened. I'd been diligently working through Dr. Edmund Bourne's Anxiety & Phobia Workbook (which I would honestly recommend to anyone who suffers from frequent panic attacks), but not seeing any immediate benefit. I'd been doing therapy and trying to eat normally again. At only 95 lbs, an all-time low for my adult life, I felt unhealthy and deflated. "Why don't you just try Celexa and see what happens?" my family doctor said at my next appointment. "If you don't like it, you don't have to continue taking it." Yeah. I've heard that story before. Cough cough PAXIL cough.
Earlier, I wrote about how I began to struggle with panic attacks again -- in a pretty severe way -- about three years after withdrawing myself from Paxil, an SSRI medication that treats anxiety disorders. I had a full-time "big girl" job in a customer service call center that, over time, began to painfully grate on my nerves. After successfully transferring to a new department (yay!) where my workday was less hectic, I found out that my entire department was being laid off -- except for me and about 8 other employees -- and we were all magically being transferred back to the nerve-grating department from whence I came. The anxiety was unbearable. Couldn't sleep; couldn't eat. I felt stuck. Even Xanax didn't help. And that's when I found myself on the Med-Go-Round again. I took a leave of absence from work and went to my doctor. In the exam room, I cried as he signed my LOA paperwork. "I think you'd feel much better if you tried some medication other than Xanax," he said. His concern was genuine. "Instead of treating your panic as it happens, we should try to prevent it." I refused. I said I just needed to rest and let my body and mind unwind for awhile. Next appointment: "I still think you'd feel much better if you tried some medication. Why don't we try an SSRI?"
(If you missed the first three parts of this story, click here, then here , and then here.) The scene: a small road off of a two-lane state highway in the woods. The cell phone coverage: first none, then a single bar. My panic state: full blown. I was laying down in my car, following the EMT-in-training's instructions to avoid sitting up or moving around, and I was scared nearly to death. I shook, I gasped for air, and I palpitated. I hated every single second that slowly and dreadfully crawled by. No matter how hard I tried, I couldn't even conjure up the energy or the clarity of mind to reach for my Ten Rules for Coping With Panic worksheet that lives in my wallet. I was in the middle of nowhere, I was stuck, and I couldn't escape without help. Not only was I about to receive medical help, but I'd had to call my husband and ask him to drive 40 miles to be with me. Ugh. Failure. The word kept repeating in my head: failure failure failure.
(If you missed the first two chunks of this story, click here first and here second.) This is the story of (one of) the worst panic attacks of my life. It happened in the middle of nowhere on a country road, geographically equidistant between my parents' house and my own apartment. Thirty-five miles both east and west of the closest "safe" place, and I felt both physically and mentally unable to complete the drive in either direction. I pulled back onto Schoolhouse Road after trying (and failing) to backtrack to the state park parking lot where I'd last had cell reception. I couldn't do it -- I felt lightheaded, the trees and the road and the sky felt cartoonish, and my body was uncontrollably shaking. I parked on the road between two houses, reclined my seat, and waited. And waited and waited and waited. I periodically checked my phone for service as I tried (unsuccessfully) to quell my symptoms. I managed to find a Xanax in my jacket pocket. I swallowed it with water and, for about a minute, felt a mild improvement thanks to the placebo effect. ARE YOU OKAY? Some young kid in a giant white pickup truck rolled up to my window and asked me if I was okay. "Yeah, I'm fine," I lied. "I'm just waiting for something. Thanks for checking." He drove off. Had I just missed my only opportunity to get help? My panic level increased.
(If you missed the first half of this story, click here first.) So, there I was: holding my cell phone and sitting in the driver's seat of my car on a small side road in the woods with no reception. Yeah. AM I GOING TO DIE? I was shaking like a leaf and I barely had any control over my limbs. What should I do next? I tried to think, but only one thought kept breaking through into my consciousness: you are going to die. You are going to die. You are going to die. First, because of how lightheaded I felt, I instinctively tugged at the lever that reclines the driver's seat. Wouldn't laying back -- and thus increasing bloodflow to the head -- prevent me from passing out? Yeah, that sounded good. It sounded like a good idea... ...for about three seconds, that is. It sounded like a good idea until the very fact that I was lying down in my car made me all the more aware that I was having a terrible panic attack. It's superstition, I guess: My panic resume boasts some real doozies, many of which involve either driving or being a passenger in a car -- and for the worst of those attacks, I laid back in the seat to keep that light-headed feeling at bay. The very fact that I was reclining reminded me of other panic attacks, which, in turn, made my panic worse.