Some kind of a Noma

"Bill this is a pleasant surprise. I have not seen you for a while."  Rose, my therapist, said while sucking on a straw sticking out of the top of a McDonanld's cup. "What what brings you in?"

"I think I need a tune up." I said. "I have been doing really well. Really well. Very happy. Life is good. But a few weeks ago my uncle committed suicide. He shot himself. It was kind of jarring to me so I wanted to just come in and get a tune up."

"Wow." She looked over her glasses at me as if to get a better sense of my mood. "Were you close to your uncle?"

"Not really. I mean I grew up with him being one of my younger, cooler uncles. I saw him at family functions where we would always laugh and joke around. He was always fun to be around but I would not say I was close."

Rose asked me a few more questions about family history and what I knew of my uncle. I answered all questions to the best of my knowledge.

"What concerns me Rose," I said.  "Is that I don't think anyone saw it coming. And if people did see it I am shocked no one talked about it."

"What do you mean?"

"My dad died from Melanoma. For a few years everybody talked about going to a dermatologist to get checked out. Melanoma not only has genetic risk factors but also environmental risk factors. So family history is important indicator because families share genetics and most times they share environments."

Rose nodded.

I added,  "One of my uncles, my dad's brother, found out he had Melanoma. They caught it early enough so he is ahead of it as far as treatment."

Rose nodded again.

"So if my uncle, one of my dad's other brothers, was suffering from some type of mental illness, I want to know if there is a genetic link and/or an environmental link. But no one in the family talks about getting checked for that. I don't get it."

Rose started talking about the stigma of mental illness. She said a few words about the difficulties people have with admitting they have a disease they cannot understand.

"But that is not right, it is not fair. If I am predisposed to an illness I should know about it. Even if it is just so I know that my kids may be predisposed I should know about it."

We discussed other diseases that people feel okay talking about like Cancer, Heart Disease, Diabetes, and Hypertension. All of these have some genetic links.

She asked if I was suicidal.

"No. But I also do not have Melanoma right now. I go to the dermatologist once a year. That  is why I am here right now. I need a tune up and a check up."


We talked for another 40 minutes. It was one of my best appointments.

Stupid Genetics

Like most diseases, mental illness does have a genetic link. Family history is questioned at every appointment. However a lot of the mental illness is not reported or discussed due to the bad stigma that was associated with the various mental diseases.


For a while I was having a good run.

I was on a roll.

The medicine, the therapy, the follow up doctor appointments all seemed to be working.

I felt good.

I felt physically and mentally healthy.

My life seemed to be in a really good spot.

 I had a nice house.

 I had a great family.

I did not feel like anxiety or depression were affecting me at all.

No panic attacks in a long time.

Slowly but surely I cut back on the meds.

I stopped going to therapy.

I stopped following up with my doctor.

I was on a roll.

I had this thing under control.





Then my uncle shot himself.

Sex and Excercise

Some of the symptoms of Anxiety are, excessive worry, irrational fears, self doubt and muscle tension. I would worry about a lot of issues, money, job security, health. I had all kinds of irrational fears. I was constantly doubting my abilities, always worried about being liked,  as well second guessing decisions I would make.

It is my understanding that there certain activities that are actually good for people that suffer from anxiety and depression. The activities release and increase serotonin levels in a person. Serotonin is a a chemical the body releases which affects mood, appetite and sleep. Endorphins, Dopamine and Serotonin are all chemicals that can make a person feel happy.  The body releasing one of these chemicals boosts the release of the others. Two of these activities that increase these "happy" chemicals are exercise and sex.

When I was first diagnosed with Anxiety I noticed an increase in my desire to pursue both activities on a regular basis. Not that someone told me that I should, I just learned from experience and how I felt after doing these two activities I tended to feel better. I also felt better longer.

When I first started running, my exercise of choice, I could not get enough of it. I ran almost everyday. Running was a great way to spend time by myself and sort out thoughts. I found running helped with the excessive worry and the irrational fears. At first I just ran a few miles. Then I started working on my time and focusing on races. I wanted to be competitive and establish endurance. I wanted to run races and compare myself to my peers. There was a certain mental high from competing.

Now the sex part, well that activity involved someone else. That someone else was my wife. My wife was one of the best things that ever happened to me. I loved her. I loved being with her. I could not get enough of her. Her happiness was so important to me. All of this is what I think all married or committed couples should feel. I also loved having sex with her. Why? She was hot, sexy, intelligent and fun. I wanted to be with her everyday. I found that having sex helped ease the muscle tension and the self doubt. There was a certain mental high from sex.

I was about 2 years into my anxiety diagnosis when my wife decided she wanted to go back to school. The plan was she would go to school at night and I would do my best to work and take care of the kids and house. Once she earned her degree she would get a job and we would be able to have a double income.

Having a second income would ease the excessive worry I always had as being the sole income earner for the family.

Sacrifices had to be made. It would be worth it. She started school and was out of the house almost every night.

I found myself running more but having less sex. I was becoming more stressed by the responsibilities of taking care of the kids, taking care of the house and being the sole provider.

I found the inner monologue in my head during my runs had changed dramatically. I was no longer organizing my thoughts I was overwhelmed by them.

"Okay I need to switch the laundry over when I get back. I need to make lunches. I need to make sure I stop at the store to get something for dinner. Who has practice tonight? I need to get them to school. I need to call my client when I get to the office. I cannot afford to lose this client. Oh wow. What would happen if I lost this client? That would be awful. My commission would be seriously cut. I would need to get a part time job. My wife would kill me. Actually my wife is never home. She is probably going out with some young dude from her class. I need to run harder. I need to burn more calories. Maybe the young college student is going to kill me. That would be horrible if the kids found me dead. How would a college kid kill someone? Probably a gun. I should get a gun. No I shouldn't. If I had a gun one of the kids could find it and end up shooting themselves. Oh my god now I picturing my kids shooting themselves. Oh the blood. Oh my god I think I am going to cry. My wife is cheating on me and my kids are dead. Okay, Calm down. Calm the fuck down. She is not cheating on you. Not with a student anyway. Most likely the professors. How would a professor kill someone. Most likely a gun. Great now I am thinking about my kids being dead again. I can't breath. I can't breath. Am I having a heart attack? I am running. maybe I pushed myself too much. Calm down. Calm down. Start over.  I need to change the laundry over, I need to make lunches...."

This is what I would think on almost every run.

I started to run less.

Wishing for a Heart Attack

In my experience a panic attack happens when I am alone. There is no one around to distract me from my own brain and my own thoughts. It is also my experience that a panic attack feels just like a heart attack but without the sympathy from friends and family that usually accompanies a heart attack.

During the early stages of a heart attack there is chest tightness, shortness of breath, there is sweating and radiating pain. Then either a friend or family member gets called so they can let everyone know you are in the hospital.  Once diagnosed as a heart attack you are admitted to the hospital, have a procedure and your friends and family come visit you. You get flowers and Get Well Soon cards. Friends tell you how you have to make some changes so you can be around a long long time. Friends and family say: "I will exercise with you everyday, I could stand to lose a few pounds." Or "For now on there will be nothing but healthy food in my house so come visit me."

During some panic attacks there is chest tightness, there is shortness of breath, there is sweating and radiating pain. A friend or family member gets called so they can let everyone know you are in the hospital.  Once it is diagnosed as panic, you are NOT admitted to the hospital, there are NO procedures, and only a few friends and family call you to make sure it was not them that caused the panic. NO one wants to exercise with you, or invite you over for a healthy meal. Actually some people may avoid you all together because they think you are crazy.  Some of your friends, some of them, will tell you to just shake it off and tell you "Thank God it was not a REAL issue."

I have had about a half dozen of full fledged panic attacks. None of them were NOT a real issue. My chest hurt. I could not breath. I was sweating and my vision narrowed. If I were to have a full blown panic attack while I was driving in my car, you would think it WAS a REAL issue if you were in the car in front of me.

The problem with a panic attack is that inside your head you know you are only having a panic attack. But also in your head, right next to the part that is acknowledging it is a panic attack, is the part of the brain that doubts it all. It is the part of the brain where anxiety hangs out.  That part of the brain is telling the reasonable part of your brain it is full of shit and that you are actually going to die of a heart attack or stroke or something. Which then makes the reasonable part of the brain start to doubt whether it is reasonable or not. Then that reasonable part of your brain starts to have it's own mini panic attack. Once the reasonable part of your brain has the mini panic attack your whole body goes into a fight or flight mode.  The body responds by increasing blood pressure and adrenaline which adds to the feeling of panic.

All of the panic symptoms happen and you know you may end up wasting your afternoon at the ER because you just want to make sure you are not having a heart attack, Then while you are in the ER you start to worry about what if it is not a heart attack and it is just panic. Then you worry you will  have to explain to friends and family why you were in the hospital. While the nurse checks your enzymes you secretly hope that you actually did have a heart attack so you do not have to feel embarrassed about suffering a mental disorder.

 And if you really had a heart attack your friends will invite you to exercise and have healthy meals.

And if you have your friends around exercising and eating food you would not be alone with your own thoughts and then you would not have a panic attack.

Sixty Bucks

When I first started going to talk therapy for anxiety and depression I went every two weeks. My co-pay was $30.00 a visit.

I paid $30.00 out of pocket and the Health Care Plan company would reimburse the therapist what was considered a fair amount between the two parties.

I paid $60.00 a month to talk to someone about my anxiety.

I know $60.00 is not a lot of money to some people. I also know there are a ton of people in the world that $60.00 could probably feed them for an entire year. But in my world and in my head the $60.00 became and issue to me. It seemed like too much. 

I knew I was lucky enough with my income and benefits to be able to provide for my family and have my wife stay at home raising the kids. As all families do, we made sacrifices in order to be able to provide for the kids. I thought it was important for the kids to have a parent home during their younger years. We were kind of living week to week during this time. 

Sixty bucks a month is $720.00 a year. That money can buy a lot of diapers. It can buy birthday presents. It can buy Co-Pays for ER visits. It can pay to have an older car inspected and repaired on an annual basis. 

Talk therapy was good for me but I also knew  or at least I thought,  I could spend $15.00 a week at the bar with a buddy for an hour and accomplish the same thing I was doing with the therapist. My therapy sessions became more like complain session than anything else.  I could get twice the amount of the sessions and be able to drink beer at the same time for the same cost.  That was like a win-win. But it was still sixty bucks. 

The anxiety that surrounded the money I was spending on trying to fix my anxiety became somewhat of an issue for me. My wife would remind me at least once a week about our finances, what our budget was, what we were spending and of course what we were NOT saving. This became a sponge in the sink for me.

Every time I went to therapy I would break down the co-pay into where the money I was spending could actually go. I felt like I had to justify the payments, not only to myself but also to my wife. 

No matter what good was coming out of the therapist I could only focus on the cost. I kept asking myself what was I getting out of the sessions. I started finding excuses to not go. I would compare therapy to Chinese food; it was good for a little while but then a few hours later I was feeling like I needed more. 

So I stopped going to therapy.

I started to hang out at the bar more. 

I started drinking more. 

I started feeling like things were okay. 

I started spending more.

I think bars should offer a Co-pay program. 

The Queen

To me feeling depressed and depression are two different states of mind.

 If I was feeling depressed I wanted to spend time with my wife, or my kids, or other people that could distract me from sadness.

 In my head and my body depression feel like a total lack of any emotion. It is not sadness. It is not doom and gloom. Depression is a feeling of nothingness, a black hole with a gravitational pull that sucks away all emotions. I would take sadness any day over the void.

It is during depression I want the Queen.

The Queen knows me. She knows all my weak spots. She knows all my strong points. She is who I want when the depression hits.

She blankets me with protection from the outside world. She uses her coils to offer me support where I need it most. Her hand has one of the greatest touches.

When Depression strikes I spend a lot of time with the Queen. Sometimes a few hours, sometimes a few days.

I have spent way too much time with the Queen. I know all her sounds, all her flaws, all her quirks that make her a perfect fit for me. Because when you do not feel anything the only thing you can do is try to feel something.

I can feel the pills on the Queens corners just to try to feel something.

I listen intently to see if I can decipher the meaning of the slight little squeaks the Queen makes as I move.

The Queen's 300 thread count spread usually gets soaked with sweat as I try to just feel something.

Sponge

"So, after all of that, my doctor decided to prescribe me some cholesterol medicine. My cholesterol was little high and I have a a family history AND she thought it would help counter act the side effect of the Sertraline."

Rose, my therapist, smiled. "That is good. So you no longer are experiencing...uhm...you no longer have your...issue."

"Nope. It is back to normal. My doctor is pretty smart."

"That's good. What brings you in today?" She flipped through my chart. "You have not been here for a few months."

My chart, which was a brown folder with about 8 pages of hand written notes jotted down by Rose after every session. She never wrote anything down during the sessions unless it was a drug dosage or some other medical changes I was having. I always compared the amount of pages in my folder against the other folders that were placed on Rose's desk. My folder was by far the one with the fewest pages. That made me happy.

I always started each session with what I would call my disclaimer. I know other people have it far worse than me. I know there are many bigger problems in the world. I know my issues are small in comparison. I know I should not worry about the little things. I have it good. 

Rose would always tell me that she understood but it was okay to talk to someone.

"I know I have not been coming in but I was having a good run for a bit." I said.

"That is good. I am glad to hear it. What has made it a good run?"

"Since I started on the meds and got some of the side effects under control I have been less worried."

Rose peered over her glasses."Less? Or No worries at all."

"Less."

"Are the worries you are experiencing real? I mean are they normal worries?"

I smiled. "Yes. At least I think they are normal. It is not the Sharks."

"Are they interfering with your life?"

" No. I have not had any kind of panic attack in a while. I just made this appointment because I thought I should get a mental health check up."

"Okay. Great." She smiled.

We talked for the rest of the session about what I would consider little things. A few issues I had with other parents, or some disagreements with my wife. We talked about the dish sponge. Every night I would do the dishes but I would not put the sponge in the sponge holder. Every night my wife would get mad at me for leaving the sponge in the sink. The sponge was a bone of contention between us.  I thought my wife should be happy with the fact that I did the dishes but she only focused on the sponge in the sink. Some days I would cook, do the dishes and then run the kids to basketball or something else. But if the sponge was in the sink nothing else mattered. The sponge took away any of her appreciation of all the other things.

 I left the session feeling great. My medicine seemed to be working. Life was good.

That's the funny thing about Anxiety and Depression, just as things are feeling good, Anxiety and Depression will leave sponge in your sink.

Frank and Beans

I was sitting in another waiting room at the hospital. An attractive women in her late thirties, wearing some kind of Disney Character scrubs called my name directly to me. I was the only person in the waiting room holding a purple folder. Red meant CT scans. Green was X-Rays.

Purple was Ultrasounds.

I followed her back to the ultrasound room. She looked at my paper work and looked at me. Looked at my paper work and looked at me. I was sweating so bad I felt like I was in a sauna.

"I will need you to remove your pants and underwear." She handed me a paper gown. "I understand that we are doing an Ultrasound of the left side. What are we looking for? What are the symptoms?"

I was silent. I did not think she needed to know my predicament.

"I need to know what I am looking for." She said.

"I know. I just don't think you really need to know. My doctor, she just wants to make sure I do not have any physical issues."

"Well are you in pain? Is there a noticeable lump? Why did you see your doctor in the first place?" she asked in rapid succession.

Anxiety and embarrassment sometimes, physically,  feel very similar. I could not tell which I was experiencing.

"I would rather not say, if that is okay with you." I responded.

I removed my pants. She started instructing me on how I was supposed to positioned.I was laying on my back.  She was going to move the frank upward towards my belly and wrap a towel over it to keep it in place. The towel was slightly tucked under my back.  I was to place the beans on top of a rolled cloth to keep them easily accessible.

"This may be cold she said." She squirted lubricating jelly on the beans.

I was looking at the drop ceiling trying to count the holes in the tiles to keep myself distracted.  Now the whole reason I was at the hospital in the first place was that I was having issue keeping the frank in check. Now I was laying down while a woman is rubbing the beans with lubricant. In my head I knew it was not going to end well. I was doing my best to concentrate on anything else. I started to do some breathing exercises my therapist had taught me. I thought I was about to have a panic attack.  After a minute or two I found my mental zone and finally felt okay.

"Everything okay?" She asked. " I need to check the other side to make a comparison."

She squirted more jelly on the beans.

She totally took me out of my mental zone when she talked.  Then I felt the towel move. Then it moved some more. Then it moved a lot. The towel fell off.

She was very professional. She did not say anything. She finished the scan and told me that everything looked okay but was going to have to get a doctor to double check. She covered the frank and beans with the paper gown and she left.

Two minutes later a man in a white lab coat in his forties walked in followed by the ultrasound tech,

"Hi. I am the doctor. What seems to be the problem?"

"My doctor recommended I get the ultrasound to rule out a few things. She also said there was a slight bump on the left side." I said.

"But why would your doctor send you here.  Everything I can see on the pictures is that everything is normal. There is a slight varicocele but nothing to worry about. What were the symptoms to lead up to this?"  He crossed his arms and gave me a stern look.

"I...I... seem to, seem to have..." I stuttered and could not get the words out.

"It's okay. Let me take a look."

He removed the paper gown and the frank was staring right back at him not wanting to go camping but making sure the tent was ready. The doctor took a step back. The technician turned around.

I started crying. I was crying out of relief that I did not have cancer. I was crying because of how embarrassed I was. I was crying because at that time I felt crazy.

"I can't control this." I said through tears. "This happens all the time and I can't get rid of it."

"It's okay." the doctor said as he sat in the chair next to the exam table. "Let's talk about this from the beginning."

For the next ten minutes I poured my guts about about everything, the sharks, the meds, the side effects. When I was done talking I finally calmed down (frank did not).

The doctor stood up and said, "You are probably right, this is probably due to the medication. As far as I can see there is nothing physically wrong with you." He turned and left.

I did not like they way he stressed the word "physically".

What is the Code

"Do you have your I.D. and insurance card?" The elderly volunteer asked from behind a large, white Formica covered, desk.

I handed her my cards.

"Okay let's see what brings you in today."she said as she clicked on the computer keyboard. "Oh I see. OK, ultrasounds get the purple folder. " The last sentence was more to herself than to me.

She handed me a purple folder with some papers and my cards attached by a paperclip to the cover. She asked that I wait in a chair until some one could process me. A few minutes later a woman in the office marked with a number two called my name.

I handed her my papers and took a seat across from her. She was silent for a few minutes.  I stared at the various pictures of her dogs that plastered the wall next to her. "Ok" she finally spoke. "The paper says you need an ultrasound but it does not say where you need it."

"At the hospital." I joked, knowing that I was going to have to give some uncomfortable answers to questions.

She smirked. "I need to know so I can send you to the right area. There is no code on this paper to indicate the part of your body that needs an ultrasound."

I could feel my heart start to race. My palms became damp. I already had to have this conversation when I called for an appointment. This would be the fifth person I had to tell. I am used to saying inappropriate things to make people laugh. I have no problem sharing parts of my life in writing or telling stories around a fire or being the butt of jokes at parties. I really don't. But in the moments when these stories are  actually happening the Anxiety builds up. I start to worry. I start to think of the possible outcomes. I entered the hospital already thinking I had a potentially serious problem. I spent the past 4 days worried. My mind was racing in all kinds of directions.

This was all because of my last appointment with my Physician. Dr. Christina did a physical check of my problem area and she felt something that needed to be checked. She wanted to rule out any physical issues before changing my meds.

I took a deep breath and I let the air out slowly.

"My left testicle."

"Oh. Okay. Let me look up the code for that." She clicked on the keyboard. "Why are you getting that checked?"

"Because my doctor told me too."

"But why? I need to find the right code."

I was thinking of the tent issue I was still experiencing. My mind was thinking I had a serious health issue.  I was trying to control my mind and my body.

 "Believe me, I do not think there is a code for what I have."

Checking Myself

Due to the side effects of my anxiety medication I found myself getting more anxious. I started to become more withdrawn. I was still able to do normal day to day stuff like going to work and coaching kids sports but I was not able to enjoy anything. I was always looking forward to getting home so I could be away from the possibility of embarrassing myself.

 My bed became my favorite spot. I was becoming depressed. I was not sad. I was not down. I was suffering medical depression. Actually I was diagnosed with Dysthymia or PPD.

I used to be one of those people that when someone said they were depressed I would say "Suck it up." Or "Oh come one, you have so many reasons to be happy. You are just having a bad day."

I hate those people.

 I know they mean well. I used to mean well. But now that I understand the thick dull cloudy murkiness of a depressed mind.  I know that the person experiencing the depression cannot really out-think the situation. It is like asking someone with Hypertension to "just relax".

Most people do not want to talk about mental issues. It is too judgey. I do not mean that people without the mental sickness are judging those with it. It is actually the other way around. People that have mental illness judge other people as "They won't get it. They won't understand."

Every person experiences anxiety and depression in different ways. A lot of people say they "suffer" from anxiety/depression. I never really felt the suffering. I felt the lack of suffering. I felt the lack of almost all emotion except worry. Worry was always there.

I started keeping a journal during these early stages of diagnosis. Journal is just a masculine way of saying diary. I would also keep emails and read them the next day and the next day after just to make sure I was not missing anything or making anything up. Text messages became my main way of communication. I could always read the previous text thread and remember what was said to certain individuals. I kept checking myself because I started feeling like I did not know who I was.

I only knew WHAT I wasn't.

Dreaming

"How is the medicine working?" Rose asked as she peered over her reading glasses to get a better look at me.

 This over the glasses look made me feel like I could not lie. They probably teach this method in Therapist School. I bet those glasses are not even real.

"Good. Good. I feel much better." I said trying not to make eye contact.

I like Rose, She is a good therapist for me. I am not sure how she would be with other people but she worked for me. Rose would call "bullshit" when she needed too. But that was what was funny about me. In therapy I did not bullshit. I learned early in the process that I was paying her for her educated and experienced opinion. Me bullshitting was a waste of MY time and money.

"Are there any side effects?" she asked,

"Yes. A few. One of them we are looking into with my family doctor. But it could be something else." I said. "I have to take some tests. I am not ready to talk about that one just yet."

"Okay. What are the others?"

This is where it got tricky. I already kind of knew that I was an outlier with one of the side effects, the one I was not ready to discuss. But I was not sure where I was in the spectrum for the one I was ready to discuss with Rose.

"Rose, I do not know how to explain this except to say" I took a deep breath, "my dreams are real"

She crooked her neck in disbelief. "What do you mean?"

"Every night I have the most normal dreams. I dream about work, about coaching, about family, about anything. And when I wake up I cannot tell if it was a dream or if it really happened."

"So you are having very lucid dreams?"

"Yes. No. I thought a lucid dreaming meant you can kind of control your dreams. I do not control them. My dreams are so normal and vivid that I am not sure if the situations in the dreams are real or not."

I could tell from the look on her face I was confusing her. I was confusing myself.

"Rose," I said in a lower voice to convey the importance of what I was about to say, "I have dreams about me getting into arguments with friends. Then while I am awake and in real life I apologize to those friends and they look at me like I am a freak."

"What do you mean?" She asked.

"I apologized to a friend of mine about a disagreement we had only for my friend to tell me that we NEVER had that particular disagreement."

"Oh." Rose said looking down at her notes.

"I realized that the disagreement was in a dream. It never happened." I took another deep breath. "I also have good dreams that never really happened either. I had a dream where I found a bank mistake in my checking account in my favor for like 300 bucks. I was in the bank lobby ready to ask about it when I realized it was just part of a dream."

Rose sighed. "We may need to find a different medication for you."

"No." I said " This is working for me right now. I will figure it out."

I continued to take the medicine. They way I felt in real life out weighed the questions I had about what was true and not what was not. Some mornings during the early stages of me taking the meds, I would ask my wife if certain things happened. Did you and I fight last night? Did I call my mom and ask her to baby sit the kids? Did I go into the school and demand that my kids get A's.  These were all dreams but I needed clarification, just in case.

Due to this lapse of reality, I started to withdrawal from certain public situations. Volunteering at the kid's school, hanging at kids birthday parties, or even just attending certain functions. I did not want to feel embarrassed if I were to bring up something that never happened.

The social awkwardness is not listed as a side effect on the prescription bottle.

Camping

I was sitting on the exam table waiting for my doctor to do the polite knock and enter that they must teach in the first year of medical school. The large white sheet of paper that they could use as a table cover at a Maryland crab house was crinkling under my butt. I was wearing shorts.  My legs were dangling over the edge of the table,  the skin on the back of my thighs was sticking to the red vinyl table covering.  I was sweating. I was nervous.

Knock- Knock. The door swung open. Dr. Christina smiled as she entered the room.

Dr. Christina was by far the best medical professional I have ever met. She was my doctor for the past few years. She did everything right. She did not talk down to me. She did not judge me. She took her time explaining everything to me. You could tell that Dr. Christina loved what she did. And what she did was treat the patient and not the symptoms or the disease. She treated people.

Still smiling Dr. Christina said hello and placed her laptop on the counter, and turned to shake my hand. I felt like a little kid with my legs dangling off the table so I scooched off the exam table to shake her hand. My bare legs rubbed against the vinyl.

BRRRREEEEERRRRRRRPPP!

"Uh, Hi. That wasn't me. I mean it was me, but it was my legs rubbing the...not a..uhmm. You know..what I mean." I stuttered as I shook her hand.

"I know." She said. "So what brings you in today? How is the Sertraline working for you?"

Sertraline is a selective serotonin reuptake inhibitor. Basically it balances the chemicals in the brain.

"It seems to be working. I feel a lot better, less anxious." I said. "But that is one of the reasons why I am here. You know how I am allergic to all kinds of drugs? Well I do not think I am allergic but I need to ask about some possible side effects."

"Ok, like what?"

"For someone who is experiencing panic attacks and anxiety and some social anxiety I think my, uhh, issue is causing more anxiety. The Sertraline is definitely making me feel better but if the side effects out weigh the benefits then I need something else."

"Why you think it is due to the drug." she asked.

"It has only been happening since I started on the meds."I replied.

"Ok. What are your symptoms?" She reached for her laptop.

"Ok. I can feel my heart racing right now. I feel, this is difficult. I wouldn't really call it a symptom."

Some of the medical terms and explanations in the following paragraph have been changed to protect the innocent, those easily embarrassed and various word searches. This is what I explained to my doctor.

My body is constantly ready to go camping. My tent is ready almost all the time. Even if I go camping, and I really like camping, my wife does not like to camp that much, but even when I am done camping, my tent is ready. I could be sitting at my desk at work and all of the sudden I have an urge to go camping. My tent is ready. My tent is ready for a few hours at a time. And it is not like I am thinking about camping. I am not looking at camping websites. It just happens. It happened in the grocery store the other day. I started freaking out. I almost went into a full panic attack. My body just thought I was ready to go camping.  It is really embarrassing me and causing me all kinds of anxiety. I know this is not a bad problem to have because I sure there are people out there that cannot even get a tent. I just need to figure out why. Is it my brain? Is it my body? Is it the meds?

People who have chemical imbalances sometimes question what is real and what is just in their head. This is the worst part about about anxiety or mental issues. This is why people do not discuss it. It is tricky.

When I finished explaining my face was flush, my palms sweaty.

Dr. Christina smiled, "It's okay. The usual side effect is the opposite of what you are experiencing. But there are rare cases of this. But we need to rule out other possibilities. I need to take a look"

She snapped on a blue rubber glove.

Thank god I did not feel the need to go camping right then.

Insulin

I came home from the shore (as we in the Philly area call the beach) knowing a few things about myself.

Number One-I needed help with my anxiety.

Number Two- People who do not have anxiety or depression do not "get" it at all. My wife and kids just thought I was crazy.

And number three -People who actually spell out numbers in writings instead of just using the actual number, are two thirds more likely to be an idiot than those who just use the numbers on the 1 keyboard they are typing on.

Oh and number IV--Things were not right in my world. I couldn't explain it. I couldn't figure it out. All I know is, at that time, I was feeling like I was water skiing in a leather Jacket.

I talked to Rose about the Sharks.

 Rose had been my part time therapist for the past year. I say "part time" because I only would go see her every so often to talk about the minor anxiety issues I was having. Rose, an attractive woman in her mid 50's, at the end of every appointment, would push her reading glasses down to the edge of her nose, read her chart look up at me and ask "Why are you not taking medication for anxiety?"

I always responded the same way.  "I am allergic to many different medicines. The side effects usually are too much to deal with versus the benefits of the drug."

This appointment, the appointment about the Sharks, was the first time I was able to explain in a way that Rose and I could understand what was going on in my head. She pushed her reading glasses to the end of her nose, looked at her chart, looked up at me and said, "You need to take medication for anxiety."

"Why?" I asked.

"Because the anxiety and depression are affecting your life. They are getting in the way of you being able to enjoy your life."

"Yeah, but..."

Rose cut me off. "Think of anxiety as a disease."  she said as she pushed her glasses back up her nose. "If you had diabetes would you take insulin?"

"Yes."

"Then think of the medicine as insulin for your brain."

I sighed. "Ok. Can you prescribe something for me?"

"No." Rose smiled. "You need to see your regular physician for that."

I had to call my doctor's office several times to make an appointments as well as getting referrals to make sure I would see the right kind of doctor. Each person I spoke to I had to explain the reason for my call. I had to tell them about the Sharks. I had to tell them about how I needed insulin for the brain. I had to tell them I was crazy.

HIPPA privacy laws are such bullshit.

Things were about to get hard.

The Sharks

I suffered through my first full blown panic attack in the summer of 2012. Although I have had minor panic attacks prior to this event (is "minor panic" an Oxymoron? ) they were more disguised as anxiety or trepidation, and not really an attack, but more of an incursion or encounter,  so I guess I previously had  "trepidation skirmishes".

 But that day in 2012, on the beach of Atlantic City, I had a full blown panic attack.  I could not move due to fear. I could not breath due to worry. I could not focus on what was in front of me due to the feelings that were inside of me.  I was being attacked by my own mind. In my mind there were sharks in the water right near where my kids were currently swimming. My kids, in reality, were swimming in the Atlantic Ocean, five feet in front of me, however there were NO sharks near them. Although sharks do live in the Atlantic Ocean they were no where near the beach that day.   MY brain put the sharks right near my kids. Sounds crazy I know, but that is what anxiety and depression can do.

I was unable to enjoy the afternoon and my family in the sun and surf because no matter what I tried I thought sharks. My wife at the time, told me I was acting crazy. That did not matter to me, because the sharks had already surrounded me and were closing in on me causing my chest to feel tight and my breath to shorten. The sharks were also making my eyes burn. Although there was a nice cool ocean breeze, the sweat was building in the creases of my forehead and along my hair line and slowly dripping into my eyes. The salt of the air combined with the salt of the perspiration made the whites of my eyes bloodshot with irritation. Wait, sharks can smell blood, can't they? Crap. I should get out of the water so I do not attract sharks. I backed out of the ocean.

Now, due to the burning irritation, my vision was blurry. I was further away from my kids.  How am I going to see the fins of the sharks that are about to attack my kids. My kids who are not paying attention to the dangers of the ocean because they are busy Karate chopping and  Kung Fu kicking waves. Maybe the kids will get lucky and actually land a kick on a shark's nose. But I would not be able to see if they made contact because of the sweat in my eyes.

I can't breathe, I am having chest tightness, I can't see. Why are my kids laughing? They are having a good time even though I am stressing out.  They must not love me.  Oh no, my kids do not love me. I am going to die alone. No. No.  I still have my wife. She will not let me die alone. Wait a minute she just said I was crazy. No, she said I was acting crazy. You know what, I will act brave. I will make sure that my kids and wife will see that I am a brave and a strong leader of the family.

"Everybody out of the water!" I yelled.

"But why dad?" the boys asked in unison.

"Because I need a break." was my response.

I needed a break from my own worries. I need a break from my own anxiety. I needed a break from the sharks that were in my head. I sat down on a flimsy low-to-the-ground beach chair trying to catch my breath. A frustrated expression was plastered on my wife's face. She did not understand.  My kids started playing in sand.

The panic slowly subsided as I inhaled deeply over and over again, counting every second of every exhale as I watched the foam of the waves retreat back into the ocean. I was looking for sharks. They were not out there.

The sharks were in my head. Like the Fonz in Happy Days I need to jump past these sharks. Wait a second, Jumping the Shark is a metaphor for the beginning of the end of the quality of something.

Crap.