How Can I Help?

     I've discovered something recently. I've discovered that most people (myself included sometimes) don't really know how to deal with someone with an anxiety disorder (or any mental health condition)when that condition seems to be getting the best of us for a moment, or in my case when I experience a significant amount of anxiety or when I have a panic attack. It seems to be humanity's default setting to go into helper-teacher-cheerleader mode (myself included) when we see someone we care about struggling with the symptoms of a mental health condition, which means we try to fix the problem, solve the puzzle, and pep talk people into feeling better. It's a nice gesture, and we're all so glad that someone cares enough to want to help, really.
     The problem is that in the middle of a bout of really high anxiety or a panic attack, or a particularly rough day with depression, this helper-teacher-cheerleader mode might not actually help. I know when I'm trying not to panic because of my anxiety, a pep talk filled with reassurance and suggestions about what I should be doing to fix it don't exactly help because I'm so stuck in the unpleasant way that I'm feeling. It actually just makes me feel more frazzled, and when I'm frazzled I tend to get irritable. (I'm really sorry about being irritable, too.) Then, I just feel guilty for being irritable when someone I care about was just trying to help.
     A better way to handle these rough moments is to ask one simple question. Ask me, "How can I help?" Odds are, that if you're close enough to me to actually be present when I'm having a rough day because of my anxiety or panic attacks, I'll tell you what I need. It might be something simple like letting me crank up Bob Marley's "Three Little Birds", watching one of my favorite funny movies with me, or just letting me cry for a little bit while you just sit there. Or, it could be more complicated like going for a walk or taking a drive. Or, I might not need anything. It depends on just how bad the day has been.
     How can I help? I might not know how to answer this question at first, especially if I'm in the middle of a meltdown, but I'll think about it. I'd also be glad that someone cared enough to ask because that means that whoever asked doesn't want me to struggle, or at least the asker might not want me to struggle alone. Kindness goes a long way, especially if I already feel like an irrational, out of control, crazy person.
     Asking someone how you can help someone you care about is also a good idea because that means you care about that THEY (the struggling person) needs most. This question also means that you aren't assuming that you (the asker) understand whatever is going on because, if we (the strugglers) are being completely honest, we may not completely understand what is going on in our mind either at that moment. Even when you ask, though, keep in mind that sometimes, the best thing you can do is just sit with us because we have no idea what you could do to help, but just being there is often helpful.
     I'll end with this: It's really hard to see someone you care about struggling, and it's so great that you want to help. I know I'm always simply grateful when someone sticks around to help, even after my anxious brain has gotten the best of me for a few moments. Just keep in mind that giving suggestions, or a pep talk, or treating us like a problem you can fix isn't the most helpful thing to do. The most helpful thing is to ask how you can help, or ask what we need from you, and then just be there.

Thinking in Extremes

     My therapist brought something to my attention this week in our session, and I'm still struggling with it. It's called thinking in extremes, and it's the reason that my anxiety gets the best of me. Apparently it's a pretty common thing when you live with OCD (or other anxiety disorders) along with the doubt and the need for certainty, but according to my therapist, it's a thing that can happen whether or not a person has a diagnosable mental health condition.
     What I mean when I say thinking in extremes is seeing the world (or whatever issue you're dealing with at the moment) in only black and white with no gray area. In my case it's seeing something only as good or bad, and by something I mean myself. I would label certain thoughts I would have as bad, and since I had those thoughts, I was also bad. I also classified emotion in this way. Anger and sadness were bad, so I must never feel those. In regard to my OCD thoughts and my anxiety I would often go to the extreme in thinking that I was never going to get well again, and that I was always going to feel as awful as I felt in that moment. (I still struggle with the last example in particular.) Basically, thinking in extremes is an unhealthy thinking pattern.
     Most of the time, I only tend to go into thinking in extremes when I'm already experiencing an elevated level of anxiety, and when I go into the extreme thinking pattern, my extreme thoughts always revolve around the OCD worry that I have that I'm really a terrible, possibly intrinsically evil person. Do you know what happens when I think in extremes? I get even more anxious, and then I cry...a lot. This happened yesterday. I had a thought (a completely normal thought that I've had before), and I wasn't proud of the thought, even though it was a completely human thought. I went to the extreme, and I felt like I was a terrible person.
     My therapist and I are working on separating my thoughts so that I can develop healthier thinking styles. At the moment, I just have to label my thoughts as extreme and/or OCD thoughts. My therapist is also working with me so that I can be okay with a gray area instead of insisting on certainty or thinking that to be good I can only live life strictly in the "white" area of things. I shouldn't feel guilty if I can't be all good, 100% of the time. It's impossible to live that way. We all have a shadow self. Life is full of uncertainty and the "gray area". Nothing is ever just black and white, and no person is only good or only bad, like my OCD and extreme thinking patterns would have me believe when my anxious brain chimes in.
     I'll end with this: Thinking in extremes is a harmful thinking pattern that has definitely added to my anxiety, and changing that thought pattern takes more time and effort than I thought it would. A gray area of uncertainty does exist in life, and it's impossible to live an all black or an all white life in a world full of all kinds of different shades of gray. Life is on a spectrum of good or bad, and it's okay to slip into the middle sometimes because we are human, and we don't all always make the best choices. They gray area isn't the end of the world, or at least I don't think it would be if I could find a gray area to categorize my thoughts into. (I'm working on that...")

Replacement Anxiety

     A week has passed since I decided to jump in and give exposure therapy a try. Everything was going well. Then, this week, I noticed that I had a whole new set of concerns to add to my list. I had become very concerned with developing another obsession.
     I've done quite a bit of research on Primarily Obsessional OCD as well as the more recognizable types of OCD. I know that it is common for OCD obsessions to change over time. I also know that it is pretty common for new obsessions to develop. I had never really worried about that, though. I'd had the same religious obsession for nearly a decade, and my second obsession reared its ugly head as a result of some medication I tried before to treat my anxiety. I had been lucky in regard to obsessions so far, in that I wasn't constantly developing new ones.
     Then I remembered something about my mind. I'm working through my religious obsession in therapy, so that means one less thing to kick my brain into anxious overdrive. That sounded like a good thing, but then I remembered that my brain doesn't really know how to chill out our go into neutral, at least. I had dealt with replacement anxiety before, when I first started therapy over the summer. I could feel the same thing happening again.
     This time, the replacement anxiety wasn't taking trips down memory lane or making me hyper-aware of my behavior so that I constantly analyzed how I behaved to see if it was normal. (Which were things I knew how to pull myself out of.) This time the replacement anxiety attached itself to the idea that I could develop a new obsession at any moment. Any new thought could trigger an anxious brain meltdown, and there I would be, with a new obsession to terrify me. I was suddenly even more aware of my thought patterns than I had been before. I was aware of every strange, nonsense thought generated by my brain, even though I was trying not to get caught up in any of them. (How could I manage something that hadn't happened yet, even if I thought I knew it was going to happen?!) I was having replacement anxiety about replacement anxiety.
     How did I handle this new fear? Not very well. (Until after I talked to my therapist, anyway.) I tried to avoid anything that might trigger a weird thought that could turn into an obsession. That really is impossible. So, after I realized how irrational I was being, I went back to  the beginning. I pulled out my old workbook, and I went back to making my charts. I feel like I narrowly avoided a setback, but at least I didn't beat myself up about it this time.
     I'll end with this: It's impossible to avoid everything that might send you into a setback. It's also impossible to change an anxious brain overnight. Replacement anxiety can happen, but it can be managed using the techniques that I've mentioned in previous posts or that you might have learned from your own therapeutic journey. Don't beat yourself up if it happens because that'll just make it harder to get back on your feet.

Baby Steps

     I finally get it. I finally understand the importance of progress in baby steps, in tiny puzzle pieces, when working on recovering from mental health conditions. It all just came together this week, and I actually got to see some of the baby steps pay off. Now, I understand why my therapist stressed over and over that I shouldn't push myself so hard to make leaps and bounds.
     I took one small step this week, and I discussed beginning exposure therapy with my therapist. I put it off, and I put it off for around a month. Every time I thought about it, I pictured this downward spiral that would set me back to the place when I couldn't function at my usual level. I was also terrified of the process. To me, exposure therapy felt like diving headlong into the deep end of the pool even though I can't swim and hoping I didn't drown.
     My therapist never pushed the idea of exposure therapy. She always told me that I would be in control of whenever and however we worked on that part of my treatment. She always also stressed one other thing about exposure therapy: it would happen in baby steps. She wouldn't start exposure therapy with me unless I agreed to go in baby steps, one piece of my OCD puzzle at a time.
     I agreed to go about exposure therapy in baby steps. After I agreed, though, I wondered if it was even possible for me to go at the baby steps pace. I'm sort of an all or nothing, just dive in and force myself to swim even though I might actually drown, sort of person. What if my idea of baby steps is different than my therapists idea of baby steps? (It is...thank goodness.)
     It took a couple of weeks of planning, but by this week, we were ready to try out an exposure exercise during my session. I was so anxious by the morning of my session that I was doing chores just to try to keep myself distracted before I left. By the time I got up to her office and sat on the couch, my palms were sweaty and my chest hurt a little. I dreaded the exposure. (I had been flooded by a previous therapist, so I knew an exposure might put me in the same place.)
     Then she explained how things were going to work. I was literally just looking at something triggering (a list I had made the night before that revolved around my religious obsessions) for 5 minutes at most. I was also only allowed to let my anxiety go up by 2 points from my baseline anxiety on a scale of 1 to 10, which was the limit I set for myself. I also had to tell her the relaxation methods I was going to use before we began. This was my therapist's idea of baby steps.
     I was relieved. My idea of baby steps was that I was actually going to do the thing that triggered my OCD (that I had brought the list for) for the whole hour session. I expected that I would be in sheer panic the whole time, and that I would have to just tough it out because that's what you did during exposure therapy is you toughed it out. I expected that I might have to take an Ativan when I got home. That was my idea of baby steps. (Maybe I really don't understand baby steps after all.)
     My first exposure went well. I had some trouble with intrusive thoughts for the rest of the day, but I knew how to cope with them. (A baby step from the talking part of therapy.) I had slightly elevated anxiety after I got home and realized that I actually had to be alone with my anxious brain, but I also knew how to cope with that, too, because we had worked on that in therapy as well. (Another baby step.) I realized that progress in baby steps might not be a bad thing after all. The baby steps had turned out to be just as important as the big leaps I had pushed myself toward.
     I'll end with this: Learning how to do things in baby steps may be more difficult for some of us (me...definitely me). Progress in baby steps when we're dealing with mental health conditions doesn't mean that we're lazy or not trying hard enough; it means we're trying to hang on to the little bit of progress we may have already made. Sometimes, even just the baby steps feel like we might lose it before we get one foot in front of the other, but as long as we're still going we're doing great. Baby steps are a good thing. The baby steps of progress will come together one day, and make a big picture of improvement that we've accomplished.

The Words I Needed to Read

     I read something last week, and it has sort of stuck with me since I read it. I read a Tumblr post by author Veronica Roth (author of the Divergent series), in which she detailed her struggle with anxiety. Her post about how hard she struggled for a while hit close to home for me, and I almost felt like I wanted to cry reading it. She also painted such a real, un-romanticized or sugar-coated picture of life with anxiety and the process of getting help that works for your brain. (Her post is titled "Anxiety, Meds, and Words from the Horizon. (So to Speak.)" if you want to look it up on Tumblr and read it. I recommend reading it. You can find the link for it on her Twitter account.)
     One thing in particular Ms. Roth said made me stop for a second. She said her therapist told her at one point, that she didn't have to fight so hard. Veronica Roth, according to her Tumblr post (like me for a time), didn't want to try medication because she thought she could handle her anxiety on her own. I just sat there for a moment after I read that, thinking, "Man, I wish someone would have said that to me this past summer when I was struggling and still too terrified to ask for help." The statement is simple, but to me, after I fought so hard for so long, it was profound.
     Ms. Roth basically detailed everything that had gone through my head at the idea of asking for help, especially if medication was involved. (I have since changed my way of thinking about medication.) Ms. Roth also pointed out in her post that she doesn't think therapy is fun either, but she went anyway to help get herself to a better place and not be so controlled by her anxiety. It was one of those moments, when you read someone else's story, and you think, "They get it. They really understand." For me, those moments are very rare.
     Ms. Roth also got real about the (sometimes) struggle to find the right medication. This is an area that I don't have a lot of experience with since I stopped trying medications after my first and terrifying experience with a certain medication I tried when I started experiencing the symptoms of Panic Disorder. I encourage you to read her post if you're on the fence about medication that could help you or if you're on the fence about getting any kind of help.
     I'll end with this: I'm so glad that Tumblr post from Veronica Roth popped up in my Twitter feed last week. I honestly wish I could have seen something like this sooner, especially from someone like Ms. Roth, since I look up to her as a writer. She basically said everything I needed to hear over the past summer when I felt like I was losing what little bit of sanity I had clung to over the years. I still need to be reminded of the things she said even today, as I work toward getting to a better place. 

Resources:

Roth, V. (2016, May 23.) Anxiety, meds, and words from the horizon. (so to speak.).

     (Web log post). Retrieved from http://theartofnotwriting.tumblr.com/post/144829690341/anxiety- meds-and-words-from-the-horizon-so-to