Getting over a mental health relapse

I had my first major panic attack in several years.

YEARS. I had deep-breathed my way through those years. I had maintained medication, moved to the city, and started grad school. Then it hit me.

It hit me hard. It felt like a sign of complete and utter failure. A relapse. Square one. I felt stuck. It’s hard to get back to normal when the normalcy you enjoyed for so long is pulled from under your feet.

For years I built a wall of comfort to stave off anxiety. I gathered friends, animals, and photographs. I had my medication. I had my books. I lowered my stress level. Still, my insides feel no less vulnerable than years ago. At times, I still feel like a child afraid of the boogeyman.

I learned quickly comfort is not everything. This can be a disconcerting realization. It can make you feel hopeless.

When the calm no longer calms

What do you do when the tricks that worked for years don’t work anymore? When comfort no longer comforts?

I became used to the equation: Anxiety + Comfort= Anxiety goes away. Voila! No panic attack. It’s never that simple, though. Something subjective like comfort doesn’t work all the time. Heck, medication doesn’t always prevent relapse.

It can be especially difficult to swallow when there is no concrete reason for the relapse. Before this panic attack, nothing particularly stressful had happened. I hadn’t stopped medication or traveled to a new place.

With a mental health relapse, it is easy to feel like everything you worked for disappeared instantly, to feel like you are no better at overcoming this than you were before. Succumbing to this thought is dangerous. It can lead to giving up on what is working–medication, therapy, exercise.

Recovering from a relapse is all about re-framing it. It’s about changing the narrative in your head.

Here’s how I dug myself out of a mental health relapse:

 1. Celebrate

It’s important to go back to what you learned, to celebrate the progress you made. Think about the times you could have fallen back into your illness, but didn’t. Those are huge accomplishments, even if they seem moot now.

What did you learn that helped in the past? Write these things down and read them over and over. Even if this list didn’t work this time, it worked at one point. This means it could work again. Focus on the positive. Celebrate.

2. Strengthen

Strengthen your mental health strategy. Try a new therapy or form of exercise. Start hiking. Join a support group. Meet people who understand what it is like to live with a mental illness. 

Consider talking to your doctor about altering your medication. This isn’t essential, but may be helpful if the relapse was severe.

Doing something will not only help prevent a relapse in the future, it will help take your mind off your current slump.

3. Embrace

This one is the hardest for me.

Embrace the uncertainty. Realize you will likely have another relapse. This panic attack was not my last. I don’t exactly love this thought, but I accept it. As hard as it is, I realize panic is a part of me. It is something I fear, yes, but I don’t need to.

Don’t give up because the relapse happened. Take what you can from it and move forward. Don’t think about when it will happen next, just focus where you want to be.

Mental health is a journey. It’s not this one event. It’s a series of moments. It’s not where you are at this exact moment, it’s where you want to go.

Celebrate.
Strengthen.
Embrace.

Repeat this to remind yourself of what is important when you need it the most.

What do you do when a healthy mind suddenly becomes ill again? How do you bounce back?

Children’s games

Children play a game 
where someone lives 
& someone dies.

From inside it looks real.

I never understood 
blaming the coyote for eating the cat
or poisoning wasps 
		or setting traps for fear

Last night I caught a honeybee in a jar
& watched it die.
	            
Poison for pleasure 
or maybe
poison your pleasure. 

Something still tells me to close my umbrella inside, 
			  something says swat.                                         

I have scars from my last speculation, 
when cold water failed, 
when blood 
replaced lipstick.
	                Indomitable, you said. 
Abominable,
	         a bomb in a bowl 
under the bed.

truth and matter

I.

Tonight I’m convinced
anyone could hold me.

There is always some truth
in the matter.

What, then,
is the matter?

Let the hollow tree fall
onto the sassafras,
one leaf

for each child
we never had.

Go ahead—
smash it.

In fact,
get a baseball bat.

The trunk is already falling
There is no time to hold on.

The box screamed fragile
and even wind catching leaves
sounded loud.

Tonight,
weather wins.

II.

You packed saplings away
for a later day

Let’s be fair, you said.
You’re irrational, you said.

I heard
fair is safe.
I heard
an irritating rash.

The truth is—
who needs it?

My fingertips
burned to dust,

my branches used for
kindling

Turn the light on,
let us count the dead.

Tips for naturally anxious people (and everyone, really)

I’ll admit, somewhat begrudgingly, I’m a naturally anxious person. It’s funny because most people wouldn’t guess that about me. Us anxious people can be good at hiding.

I tend to attribute my anxious tendencies to my perfectionist nature. I tend to want to get everything right the first time. In my effort to achieve this, it sometimes feels like a constant to-do list runs through my head, spouting off this and that: pay bills, write a blog post, get groceries, and so on. 

It’s fairly easy to say “there’s no way I can stop worrying.” Unfortunately, no matter who or what I choose to blame, I have to live with the way my mind works. This mind is mine for the rest of my life. 

First, let’s clear up what anxiety means. Anxiety, by definition, is stress when there is no stressor (something that causes stress).

Say the stressor is a big exam. A student may be stressed when studying for the exam. Anxiety is what happens if the student leaves the test and continues to experience the same feelings they had when they were stressed. Of course, chronic anxiety is not as simple. Chronic anxiety tends to be deeper than this example. It can completely re-wire how a person functions. It can zap a person’s energy and affect your relationships. 

In the United States, anxiety has ballooned into an epidemic. According to the National Alliance on Mental Illness, 18% of American adults have some type of anxiety disorder. This is huge. If so many of us have problems with anxiety, is it just part of our American nature? I don’t have the answer to this question, but I know it doesn’t have to represent us.

Anxiety shouldn’t be viewed as a curse. If your tendency is to react with anxiety, you’re not inherently flawed. This thinking is just a different way of interacting with the world. This unique way of interacting can be managed. When you are easily anxious, small things seem to affect you more than other people. You wonder why this is. To deal with anxiety is to feel different.

People like to tell someone to “stop worrying” when they’re anxious. That’s like telling a train conductor to stop on a dime at full speed! Dealing with anxiety is a learning process. It takes time.

Here is what works for me. Please note I am telling you this as someone who has to work at this every day and has not been magically cured. There is no magical cure. There is learning to live a fulfilling life with it.

1.

Get out of your head

I find when I am constantly focused on my own thoughts, I can quickly spiral into a cloud of anxiety. I get stuck in my head and can feel incredibly bogged down for an entire day. 

Worrying about the future or whether I forgot something at home gets me nowhere. The sooner I can intercept my rapid fire thoughts, the sooner I can get back to the present where life is moving.

To get out of my head, I may have to literally tell myself “stop” and go do something, anything to get my body moving.

2.

Recognize unhealthy thoughts

This takes some practice. If you’re naturally anxious, anxious thoughts are so commonplace they are hard to discern. Practice picking out the anxious thoughts that aren’t helpful. Then, try to physically imagine the thoughts leaving your head.

3.

Be mindful

Mindfulness has become a buzzword. It’s one of those things you don’t really understand unless you experience it.

Be connected to the world around you and be aware of what’s going on in your head. Stop checking your email on your phone every ten minutes. Allow yourself to check in with how you feel instead.

4.

Cultivate joy

I don’t like the term happiness. For me, it seems to miss the mark. Happiness feels like a fake smile in a school photo. Joy feels like a belly laugh. I’d rather have a belly laugh. Cultivating joy goes hand in hand with being mindful.

Try to gather joy from the world around you. Recognize beauty in the small things. Even when you are worried about something in the back of your mind, force yourself to see the present. If you redirect your thoughts to something positive, that silly worry might just fade away.

5.

Simplify

This is imperative and probably the hardest for me to do. Don’t take on too many commitments. Learn to say “no.” Set rules for yourself as to what you will take on. If you’ve been working all day, don’t work all night as well. 

Give yourself mental breaks and the authority to determine your schedule. Don’t allow yourself to believe the simple life is an unproductive life. Try to resist feeling like there is always more to do. Insist to others that you need to simplify in order to be a better, less anxious person.

6.

Work at it

Responding to life with anxiety is like muscle memory. In order to change it, you must repeat, repeat, repeat.

Don’t be afraid of failure, just keep moving forward. If you feel like you’re stuck in a cycle of anxiety, try your hardest to swim away from the current.

Even if it’s hard to try, having it in your head that reducing your anxiety takes practice and isn’t instant can help you manage the ups and downs.

7.

Praise Yourself

Changing a behavior is hard. Make sure you acknowledge your successes, no matter how small they seem. Doing this will keep you focused on the positive.

Better yet, write down your small successes. This way you can go back and remind yourself at a time when you really need a reminder of how far you’ve come.

Why change what you already know?

I know, it’s hard to recognize an embedded behavior and set out to change it. I get it.

Here is a reason to kick start your journey. Understand that reducing anxiety is important for your health. When you are stressed or anxious, your body completely changes. It ramps up. Your mind signals the stress to your body and the body reacts like it was designed to.

Not only is anxiety bad for your mental health, it can contribute to physical problems like gastrointestinal and heart problems. Stress can make your body more prone to infection.

If your body is a home, imagine anxiety as an earthquake shaking its foundation. How can you function normally when the foundation is cracking? It’s difficult. In fact, it’s nearly impossible.

The key to dealing with anxiety is awareness. Awareness that being anxiety-riddled is not the only way to live. Awareness of your thoughts, strengths, and successes. It’s about taking steps, even tentative ones, away from your norm.

Note

National Alliance on Mental Illness is a great resource. Check out their online resources or enroll in one of their classes if you’ve been diagnosed with an anxiety disorder. 

And as always, if anxiety is negatively affecting your quality of life, please seek help from a licensed professional. It was life-changing for me.

Letter to a pre-panic disorder self

It’s understandable to avoid what scares you. It’s easy to shy away from an unsettling thought, to say you’d rather not talk about it.

For me, that sensitive topic is panic disorder. Thinking about the “P word” has a tendency to make my stomach curl and hold my breath hostage.

Fear. Panic. The body responds the only way it knows how, by tensing, freezing, pumping full of chemicals that prepare us to fight. We wait for the blow, but it never comes. Our bodies stand ready.

With panic disorder, the fight isn’t what our body thinks it is. The fight is within us, in our brain where memories and emotions live.

The fight to overcome panic disorder can feel insurmountable. At times, it feels like the fear is hidden just below the surface, waiting for an opportune time to visit.

For this reason, it is hard to talk about panic attacks. It’s much easier to pretend they don’t exist. We need to open up the discussion, though. Maybe then, panic won’t seem so scary.

What is a panic attack?

In essence, a panic attack is fear distilled into its purest form.

I had my first panic attack in college.

The first time a person has a panic attack, they have no idea what is happening. It’s terrifying. Unfortunately, that fear never goes away, but you get used to it. You get used to understanding the fear is not real. You get used to having to convince yourself to step out of your head.

I learned to live with panic disorder. Here’s what I learned through the experience and what I wish I had known before my first panic attack.

Note: this article reflects personal experience, which is not the same for everyone.

What I didn’t know about panic attacks before I started having them:

1. The panic feels like a heart attack.

It feels like your body is on fire. During the first panic attack, you will think about calling an ambulance, shouting at the paramedics to fix you. Something is wrong and I don’t know what, you will think. I’m dying, you’ll say.

 The thought that you are having a heart attack makes you feel it more. The feeling builds. This is when it starts–the room moving in circles. Your heart pounding in the silent, dark room. You’ve never felt this alone, never felt this disconnected from your surroundings, from a bed you know, from people you love.

2. Breathe.

This is most important. This needs to become your first response to panic. If you can visualize your fear, visualize each breath as a strike against it.

Breathe through the panicky, scattered thoughts. Breathe into the tips of your toes and your fingers. Stretch your limbs and imagine your breath filling the narrowest spaces in your lungs. Breathing is the only way back. It is the constant reminder of your being. You can’t live unless you breathe.

Help build your defense by practicing your breathing. These are some good resources, too.

3. Every panic attack is a journey back to normalcy.

Tell yourself this and dig your heels in. Just get back.

Getting through a panic attack is like swimming toward the light against the current. You are pulled back deeper, deeper into the water. Everything within your body is pulling you back. Your mind has to push forward. That is the only way out of anything.

Pulling yourself out of a hole takes practice, like learning to recognize a dream is not reality when you’re in it. Learn what works for you. For me, it’s breath and petting my cat. Simple, maybe, but they help.

4. During a panic attack, the amount of life flowing through your body will make you want to scream.

You’ve never been so aware of being alive, of your beating heart, of the pattern of your breath.

On the outside, you may look completely normal. Others may have a hard time telling something’s wrong. Look in your eyes, though, and they’ll see fear and a person fighting to climb out of it.

5. In trying to climb out of the panic, you will feel like a child, writhing and grasping at whatever is closest to hold onto.

In these moments, familiarity helps. You feel like a child again. You want your mother.

Sometimes your arms reaching might hold onto the wrong person. This person brings short-term comfort. If this person is only a comfort in the panic, look for another source.

6. You will win over your body.

You will learn to live and continue to live day after day. You wonder if you’re going crazy. You aren’t.

In the midst of it, you might forget who you are, what you love, how you think, what is important. It’s okay. Try not to worry about this. Don’t convince yourself that the parts of your brain are changing beyond recognition. You will remain you.

You will wonder if this will ever get better. Will some invisible switch in your brain finally flip back to normal? Probably not. It will happen many more times, but you will live through each one. You will live.

7. People will tell you to “just relax.”

They will insist your condition is merely a product of stress, as though parting with a few obligations would magically cure you. Relax will forever be a complicated word. Sometimes you can even feel the panic in moments of joy.

Others will tell you to keep busy, that by filling your life with the outside world, you’ll be less likely to turn inward.

Both are really too simple. Find what fits you. Seek outside help (I did).

8. You will learn to appreciate the panic attacks, in a strange way.

They suck, yes, and you hate them. You often wish you didn’t experience them, but you understand that you learn from each one.

You will realize they have changed the way you interact with the world for good. You can no longer disregard the warmth of the sun on your skin.

It’s nearly impossible to understand this during, but what is happening is pretty amazing, right? The way your body is trying to protect you by working more than it needs to. Take out the fear and pain and you have your body, doing the same thing it would if a lion was chasing you, fighting for survival.

9. The world afterwards will be dark.

You will feel exhausted, nauseous. It will feel like the entire world is on your shoulders. You never believed that cliche, but you will understand it now.

The world needs you to come back. There is no giving up. Your only options is to keep writing, to try to understand this thing, to try to help others.

Final Thoughts

Nothing is ever entirely bad or good. It’s all messy. Panic disorder is the same way. For me, it’s one of those “what doesn’t kill you makes you stronger” things. Once you recognize you’re not dying, you can get back to living. That is the mentality I needed to get back.

If I could help just one person who is going through the same thing, I would. I know going through this, especially in the beginning, is scary. It’s easy to feel alone. You’re not. We can all learn to live with the fear.