Get your meds checked.

I am not sure how many diabetics have a conversation with a significant other or loved one where they are told to get their meds checked.

I am not sure how many times a person with Hypertension is told by their spouse in an argument over something stupid that they need to check with their doctor.

I would like to know if there are any people out there with a genetic predisposition to high cholesterol or IBS or some other type of disease are told by their spouse they need to "get over it".

Depression, anxiety and other mental illness are illnesses and should not be dealt with any different than any other type of illness.

For better or worse. For Richer or poorer. In sickness and in health (unless the sickness is not really considered a sickness in the other persons eye and then they can mock or make fun of the other person until death do you part).

Yes I am being harsh.

Santa

I recently had a conversation with an old friend of mine. I do not mean to say that she is old, I mean more that our friendship is old. We have not seen each other in many years and through various social media we recently became reacquainted.

During our conversation I mentioned that I go to a therapist. She scoffed at the idea and said that she does not believe in therapy.

I countered her statement with "Therapy is not like Santa or the Easter Bunny. It does exist."

My friend did not want to offend me and backed off her original statement.

I told her in a somewhat joking way.  "It is people like you that make it difficult for people like me to seek a professionals help."

She asked what I meant.

I told her there is a stigma around certain mental conditions. That stigma makes it difficult to feel like it is okay to seek medical help.

She was not sure how to respond.

I did my best to explain it. I said something like this:

I go to a therapist to make sure that the decisions I make in my life are not clouded by my anxiety or depression. If I ask a friend, their advice is clouded by the friendship. If I ask family, their advice is clouded by the fact that they want whats best and usually easiest for me. If I was suffering from Hypertension I could have a friend or family member take my blood pressure and they would know whether it was high or not. I could adjust my medicine accordingly.  With Anxiety there is no simple tool to use. I need to check in with a person who is not biased in any way about my behavior and who can tell me if I am acting in a socially normal way. 

People go to their medical professionals all the time. A dermatologist wants to see you once a year unless there is a need for more. A Cardiologist wants to see you every 2 to 3 years depending on your situation. A therapist wants to see you every few weeks. Now a dermatologist looks at your skin with a black light. A Cardiologist will hook you up to monitors. The only real tool a therapist has is to talk with you. 

I don't think my friend completely got it.

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.