Friday, October 29, 2010

Overcoming Anxiety

The problem with anxiety, as with most mental disorders, is you most likely don't realize when you're suffering from one. And even if you do, you're probably uncertain of how to change the behaviors that make up that disorder. Worse still, it's likely your family and friends don't understand what you're experiencing, offer very poor advice, or blame you for the way you behave and believe it's within your immediate control to change those aspects of your behavior which make them uncomfortable. This is a tragically flawed and very challenging situation to find yourself in.

The thing about mental "disorders," is that they are just that, "disordering." You find yourself suddenly different than you were previously, whether it seemed like it happened over night or over the course of a few years. The way you perceive and experience the world changed, and everyone else around you stayed the same. And they can't understand why you've "chosen" the path you're currently wandering down. This is truly one of the worst aspects of mental problems. The very people you love and hoped would help you, turn out to be totally confused by what's going on in your head, and often reject it and become the complete opposite of helpful in your recovery.

The first step to take in mental illness recovery is realizing you have a legitimate problem that you CAN work on. I won't say you can ever "cure" something that happens in your mind the way you can with a bacterial infection, but I will stand by the premise that you CAN reshape your mind and build up defenses to remedy your woes. The second step is realizing you can't change people easily, and taking the energy you waste on convincing your friends and family how to understand your circumstances, and putting it toward something more beneficial in the short term; your recovery.

The truth is, family and friends are actually fundamental and very important in practically all therapies for mental health concerns. The sad reality is that unless you've experienced one of these concerns for yourself, most people are unfortunately unable to understand them on a level that would allow them to support you appropriately in your recovery. So if you're struggling with a family or group of friends who simply can't understand why you've changed, or perhaps are even blaming you for the way you act, do yourself a favor and put that situation aside for the time being. The old adage of "loving yourself before you can love another" holds true for mental health as well. You cannot practice good mental health habits with family and friends if you do not possess such faculties. Sometimes you have to step outside the comfort zone and fix yourself, before you can rejoin with those you hold dear.

My past paragraph makes me quite sad, because I believe if you have even just one person to help you through your struggles, you will be that much more successful in overcoming them and maintaining your progress. If you have that one person, embrace them and thank them for their understanding and patience. If you don't, get used to it and get excited about healing yourself. There is very little in life that feels better than dragging your own ass out of a debilitating mental disorder and you'll be even stronger than you imagined for it in the end.

So... there are a lot of things that trouble people out there, I'm well aware. Today we're focusing on anxiety, since many of us seem to have trouble with it at some point in our lives. Even people who will never be diagnosed with a mental disorder have most likely experienced semi-debilitating anxiety at some point in their lives. The way we deal with it is the KEY in whether we get better from that point, or sink further into the potential neurosis that anxiety can bring. The important point here is starting as soon as possible, and working as hard as you can without damaging yourself.

The main problem with anxiety is that most of it is completely irrational, yet even the realization of this doesn't fix it and make it go away. When it IS based on a rational concern, it's even worse because you have to change the situation causing the anxiety to rid yourself of it. Either way, you MUST immerse yourself in it if you want it to change. Your brain will repeat its patterns if you don't make a conscious effort to retrain it. This is the key to improving anxiety, retraining and immersion to a point that forces the brain to change the way it responds. This holds true with any type of anxiety.

There is a famous quote by someone I can't remember...but the quote read that "if you are afraid, you must." That is the beginning, middle and end of anxiety therapy. In the clinical world, we tend to try to group things into types of anxiety. But this is a waste of time.....the bottom line is simply if you are afraid, then you MUST. For some types of anxiety that are very debilitating, you may find a therapist is needed to accompany you on this journey of "doing." If that is the case, please seek that help. The bottom line is the doing, however you are able to "do" is the way you must travel.

The more able you are to "do" these anxiety-provoking things on your own, the closer you are to recovery. I myself went to anxiety therapy for years before realizing I needed to engage frequently in the very activities that made me anxious before I would feel comfortable in them. This is not something you should expect to happen in a matter of weeks or even months. It is literally a course of doing things that make you uncomfortable and even "freak out" for years, until you realize one day that you're no longer sure why you were so uncomfortable in those situations. That's when you know you're "cured." When something that used to make you sweat, tense up and feel compelled to flee to the scene, becomes a daily, normal, routine activity.

When this happens, it probably takes awhile to even realize it. You've become so used to feeling upset and nervous about whatever the situation is, that you never expected to become comfortable in it. Perhaps you got to the point where you were able to tolerate it, either on your own or with the help of some benzodiazepine medication. While I highly disregard much of our modern medicine, and also do not condone heavy reliance on benzos, I DO recommend starting your therapy with the help of a mild, short acting tranquilizer like Ativan.

The key with anxiety therapy is to immerse yourself in situations as much as you feel comfortable, without going overboard. The medication helps you start that process. The great thing about something like Ativan, is that it helps you initiate the situation without the panic process, and gradually wears off a few hours later after you're hopefully already semi-comfortable with the situation. Repeated experience like this is crucial for helping rebuild your neural structures and the neurons that fire to tell you whether or not something is scary or mundane.

The problem with benzos is their highly addictive nature. You don't realize you're addicted to it, but your body has already altered the way it produces GABA, a substance responsible for regulating your fight or flight/anxious response. If you take long-acting benzos for an extended period of time, your natural production of GABA will down-regulate naturally. Too much science.....basically the drug is a helpful crutch and if you take it too long your body assumes it to be a regular thing and changes its own production of very vital chemicals accordingly. That is the scary aspect of anxiety medications. The "valium addict" who fulfills all the duties of normal life is a total myth. Anxiety medication should be just that; medication to help you DEAL with your anxiety, not a permanent coping mechanism for it.

As I said earlier, anxiety, depending on the nature and severity, may take you years to overcome. In the meantime, whatever helps you experience the situations that make you feel anxious is beneficial, even if it includes a drug in the benzo classification. The important thing to keep in mind is that the more you experience without the drug, the more you take into your brain and thus help to rewire your anxious circuitry. The stronger the anxiety drug, the less aware you are of what you're going through, and thus the less you take away from the situation in terms of helping you maintain something in the long run.

People who are completely unable to deal with life, take strong, long lasting benzos like Valium. They get through the day, the half life of the drug is longer than most people stay awake, and thus the amount of time they spend dealing with anxiety-provoking situations "uncomfortably" is minimal if not non-existent. This may seem like heaven to someone who is wrapped deeply in the throws of anxiety. But I promise you, this is short term and not the answer. The way to solve the problem is to take the least amount of medication possible, to immerse yourself in the situations that make you anxious, and keep doing that over and over and over and over.....until it starts to feel OK.

I apologize if after reading this far you feel left out in the cold. But the one thing I CAN tell you, is that developing a strong addiction to benzos will only set you back even further than you were when you started. The portion of your brain that wants to deal with anxiety, relies on GABA. Suppressing its production by drugs only delays your progress. If you can experience that which makes you anxious without the aid of any drugs, do so regularly. Eventually you'll find it doesn't bother you nearly as much as it used to. And the more you experience THAT feeling, the closer you come to ridding yourself of it completely.

As for the things you find you simply CANNOT tolerate without the aid of drugs, do those things too, as often as possible. Take the drugs you've been prescribed, again, hopefully the lesser of the benzo class.....short acting and not so sedating. The most useful part of these drugs is to allow oneself to begin the anxiety-provoking situation and endure past it....without numbing oneself to it entirely. You simply cannot learn anything in that setting. You MUST feel to understand, and to change.

Therapy should not be comfortable; it should not be unbearable, but if it's comfortable then you're probably not really trying that hard. I most respect Fritz Perls, for his inspirational and challenging therapeutic interventions. He took what people expressed and threw it right back at them in a way that forced them to realize their shortcomings and either alter them, or run away. If you're not willing to face that situation, you're not ready for change. If you're not ready for change, no one can help you, not even yourself.

If you're troubled by anxiety, realize this one key point: discomfort will be necessary in helping you grow and change and eventually develop the tools and mindset to not feel that discomfort. If you're comfortable and happy along the way, find a new therapist. You're clearly reading this because you WANT something in your life to change. Whatever your mental concern may be, trust me, it isn't something that can be fixed by a passive interest in helping yourself. You must be seriously invested and willing to feel discomfort before you will feel true comfort. If therapy didn't hurt, it wouldn't be therapeutic.....and if you didn't experience anxiety, you'd have no basis on which to understand true placidity and lack of anxiety. Like I said earlier.....if it hurts...you must. No questions asked.

Sunday, October 17, 2010

Wanting What We Don't Need

This seems as appropriate a time as any to post about a conclusion I made a few years back. With the economy as it is and unemployment shaky at best, a closer look at the things we spend (i.e. waste) money on is certainly in order. This is one of those topics where some will argue "money can buy you happiness," or "I absolutely DO need that," but I will firmly support my argument based on the sole consideration of what really signifies a "need" in the first place.

There is an entire sub-field of psychology devoted to understanding our need to own, consume, purchase and possess various items. That same field deals specifically with the inner processes that lead us to believe these things we buy will make us better off, or "happy." There is a whole other sect of religious philosophy that deals with owning as little as possible, and how the very lack of possessions is the true path to happiness. As with most of my beliefs, I will espouse that neither extreme is the best solution for the majority of people. Any scientific bell curve will show you that the middle portion of the curve (accounting for 95% of the population) accounts for the greatest amount of people in any situation. To put it simply, what works for most, lies in the middle. The outer extremes on either end fall upon a mere 5% of individuals, indicating extremism is usually not in your favor.

Now that we have the science part out of the way, I will return to my main point. The majority of us own so much more than we could ever truly need, that we lose sight of reality before we graduate from high school. I'm not talking about the wealthy kids who already had cars purchased for them before they got a drivers license or the fashionistas who spend their free time perusing the malls for the latest fads. I'm referring to practically everyone who lives above the line of abject poverty. Once you have shelter, food and the bare minimum of clothing and some extra change for incidentals, you've peaked...in terms of meeting our basic needs.

Many of us are unfortunately not taught the value of money. We grow up expecting that basic things like toothpaste, shampoo and food will just be present in the house we live in with our parents. These are not financial considerations for a lot of kids. This fantasy extends into college, where our tuition, dorms, food and everything else we ask for is paid in full. Even if one takes out loans or piles up credit card debt to fund such an excursion, most fail to grasp the financial reality until they're out in the real world.

I came from a world of "stuff." I had all the clothing and crap I wanted, and despite having a legitimate job since I was 14, I still failed to learn the valuable lesson about money. When someone else is covering your rent, food, gas and toiletries, it's very easy to be fooled into thinking your $6 an hour wage will be more than capable of supporting your lifestyle. Then come the credit cards. Oh, the lure of frivolous purchasing you will "attempt" to pay for at a later point without realizing that $5,000 with interest takes a freaking lifetime to pay back.

I got my first full time job (where I still work), straight out of college. To someone who has worked only part time gigs for hourly wages their whole life, whatever crappy salary they offer you seems like the most money you've ever heard of in your life. I had insurance, close to 3 months of paid leave every year, a 401K, and around 30K. For 2004, this seemed like a good situation for me. In that interim I racked up credit card, medical, and eventually graduate school debt that I will be paying off for the next 9 years unless I win the lottery.

The reason I bring this up, is because it took me all of that time going through those situations, crying over whether or not I'd be able to afford rent that month, to realize how much wasteful spending I did. I had no conception of spending frugally in the grocery store; I simply purchased the brand name items my mom had always served our family growing up. I went to the mall to buy bags of clothes I couldn't even fit into my already overflowing closet. I bought brand name cosmetics and toiletries because I didn't give it a second thought. And the scariest part of all of this, is that I'm not a vain or unintelligent person, as much as these recounts may make me seem. I was simply doing what I'd been brought up with my entire life; I was doing what one does when they are completely lost and searching for a grasp on life. Unfortunately it took me 3 years of living in abject poverty on graduate student wages to understand my errors.

After being immersed (ironically) in a situation where everyone wore the best clothes and dressed the part of the proper therapist for 3 years, I had learned quite the opposite. It's not the clothes, its not the hair, its not even about daily showering or wearing makeup every day. It was about me; what made me happy and what made me spend more money and become that much more miserable. The day I realized all of this was the day I cut up the credit cards, starting living within my means, and from that point I grew more and more as a non-neurotic individual each day.

There was a point where I wouldn't leave the house without a proper manicure and pedicure, hair at least dealt with in some way, and wearing something I felt proper in. When grad school set in I realized time was my biggest asset, and to waste a second of it on grooming and getting dressed was absolutely ridiculous. That was followed by learning to find clothing for cheap, learning to update your last seasons wardrobe with a few scarves or hats, and learning to avoid even entering a mall. In the mall everything is so flashy and "gotta have it" its no wonder so many of us have issues with our spending. The truth is, going into debt from loans and having to live off half my usual salary while in graduate school was the best thing that ever could have happened to me.

This was, perhaps coincidentally but in my opinion not at all, the same time I stopped attending my doctoral program of clinical psychology. I realized for all their efforts to be the "helpers" the world so desperately needs, these people engulfed in my program of study were so far away from helping themselves that there was no shot in hell they would ever realistically be able to help anyone else. I realized something about myself that made me feel completely aberrent and foreign, something that made me understand I had chosen the wrong path in my search to help others. I had mistakenly entered a world of becoming rich off the woes of others, at the expense of becoming, for yourself, a real person actually capable of offering sound advice that came from something other than a manual.

They teach you that therapy is a process of change, but the majority of therapists in training refuse to reconcile what that means. Change, in my opinion, isn't simply about curtailing your drug habit or behaviorally managing your anxiety. Change; true therapy, is about forcing yourself into an uncomfortable situation in a way that allows you to eventually feel comfortable and almost natural doing so. It's not enough to treat symptoms; finding happiness entails dealing with the very aspects of life that have brought you to a point where you feel unhappy in the first place.

If this seems tangential or irrelevant to my starting point, let me explain my intent. I believe very strongly that the most influential source of unhappiness in our lives is what we bring upon ourselves. How does this relate to spending habits and over-consumption? Without quoting a bunch of research on the topic, the only reason you should be purchasing something is true necessity or for the purpose of entertainment. If you're able to rationally review your spending habits and categorize them accordingly, you'll likely find that much of what you spent your money on doesn't fall into either of those two scenarios. The more insecure you are with yourself and your life, the more money you will spend trying to remedy this, subconsciously or otherwise.

Many people dislike their jobs, and they rationalize this by stating the money they make allows them to live the lifestyle they enjoy. But I ask, how enjoyable is yachting and designer clothing if you've had to sacrifice so many other aspects of your life to afford the luxury? I will state a personal opinion here, that love and family is the most important thing to attend to. Everything beyond providing for that is a secondary need. I could continue to call it a "personal opinion," except every body of research in the fields of biology, psychology and anthropology would say its not an opinion, its a fact. We're primates; we're programmed to mate, nurture, and provide. Everything we eagerly grasp at beyond that point is simply greed, or misplaced understanding of the self and what it needs to be happy.

Clearly there is so much more to delve into here that would take more than anyone would care to read in a blog. Blogs are for the attention-deficient, emotionally stunted people who want to listen to how someone else says you should live your life. So, if you've read this far I'll just leave you with a few words of consideration. Think of the one or two things in your life you would be most unhappy to give up. If they are other people, passions you have about life, or a personal dream, pat yourself on the back and go have a beer. If they're anything material in nature, please take some time away from your work to think about your priorities. In either case, look over your bank account, the way you live your life, and realistically ask yourself if its maintainable, reasonable, and true to who you are.

Tuesday, October 12, 2010

Crosswalks: The magical paint that protects you from being hit by a car.....

Before I begin another semi-relevant rant, let me ask a simple question. Crosswalk on a road, shrouded by trees, blinded from view by both sunrise and sunset glare and highly trafficked: should one attempt to create such a death-trap? Given my biased explanation, I hope most people would reply, "No." Yet this is the first and last part of my commute to and from work every day. A recent tragedy where two individuals were struck and killed by a possibly drunk driver at night on just such a crosswalk brought this long-standing pet peeve to mind and inspired this entry.

We live in a society where the law says pedestrians have the right of way, yet our cities are clearly designed for navigation by motor vehicle. Regardless of which is correct, or what type of infrastructure we should be aiming for, this is the state of things as they currently stand. You can paint whatever type of lines on the road you wish, but the fact remains that if you're walking across a road at the wrong time and a car intersects with your path, the outcome is likely to be negative.

This phenomenon of crosswalks has amazed me since I began my driving career. Coming from a small town, I wasn't used to random portions of the highway where one should expect pedestrians to be meandering about, in the middle of the road. I moved to the D.C. area at the age of 18 and realized these crosswalks were really more of a burden than an asset to anyone in our society.

Take the part of the pedestrian: you're walking in the city, you wish to cross the road. The diagonally painted lines on the asphalt tell you it's ok to do just that, creating perhaps a false sense of security. You see the crosswalk, you attempt to cross. It seems to me that this simple convention of modern cities has punched a hole in our otherwise rational brains. Whatever happened to mom's warning "look both ways before you cross the street?" That logic seems to have flown completely out the window when crosswalks are available. Be they on bike, on foot, on skateboard or pushing a baby stroller, the presence of the lines indicating it is safe to cross the road at a certain point makes the majority of those who use them, completely unable to take a second of precaution and check the road situation for themselves.

I won't disagree that in many of our modern cities the whole "crossing the road" situation is near impossible. It makes sense that someone would want something like a crosswalk to aid in that whole process. In more successful venues where people don't get plastered into the pavement by cars, I've seen such contraptions as pedestrian bridges that make an arc over the roadway. This prevents both drivers and walkers from having to deal with the situation. There is also the crosswalk sign attached to stop lights where an illuminated figure of a person mid-stride or a firm hand image indicates whether or not you should cross the road at a given time. But more often than not what I see most frequently are a few slabs of paint on the road, giving otherwise intelligent people the freedom to act in complete stupidity and cross an otherwise teeming highway without so much as glancing in either direction.

As with any modern convenience, we have to use these inventions to our benefit, not our detriment. If you haphazardly engage in any sort of activity you're likely to come out mangled and disappointed on the other side. I personally have never viewed the crosswalk as the "free for all," that most seem to take it for. Sure, there are some lines painted on the road and maybe even a sign that says "pedestrians have the right of way." Regardless, the car careening 45 miles per hour towards me tells my logical side that it doesn't really matter who has the technical right of way. I'd be best off avoiding a collision with such an instrument, even if it means I might have to actually pay attention to the road way or wait a few moments before barreling across it.

Unless you're suicidal, I believe you would agree with me that being plowed over by a car is an unpleasant consideration. Yet if you go for a morning walk or take your bike out for a spin before work each day, you're probably one of the people I call "idiots" who have barely avoided being trampled by my car in the crosswalk. Suppose you're going 45 miles per hour; the speed limit on the road where I most frequently encounter this very issue. As a driver of an automobile, you're accustomed to stop signs, stop lights, and traffic that makes you slow down. It is highly unlikely that you're instinctively trained to be wary of bikes and soccer moms with baby strollers popping into the roadway like an 80's arcade game. It just doesn't make sense. Yet more than a few times I've found myself screeching my brakes just short of that crosswalk to avoid hitting these very people. Typically they come out of the neighborhood bushes unexpectedly, and I naively assumed they would remain on the sidewalk until I had passed. They saw me approaching at regular speed and chose to endanger all of our livelihoods by stepping into the middle of a road without any regard as to whether or not it was clear to pass. Look both ways before crossing? If there is some magical paint on the road saying its a crosswalk, apparently there is no need to use common sense.

Tragically there are many aspects of modern life that fall victim to this same type of ironic stupidity. What I want to understand, is when we became so ineptly retarded that we stopped using our basic common sense and reasoning that had brought us this far as a society? Is the crosswalk a good consideration? Sure; it would make the roads nicer for pedestrians in a perfect world. Are condoms a good way to prevent STDs? Of course, but again in the heat of moment so many people make the conscious choice to not use them, in favor of our other urges. I don't think its necessary to go into the horrible outcomes that poor decision has lead so many people to encounter, nor should I have to reiterate the good reasons to disregard the lines painted on the road telling you its cool to just walk out in the middle of it without thinking. Look before you leap. Best advice in so many situations.

Saturday, October 9, 2010

That fairytale called LOVE......

When I sat down to update the blog tonight after many months of absence, I had an entirely different topic in mind. When I thought back to what inspires most of my writing- the lives of others around me- I was reminded once again of that huge aspect of life so many of us struggle with: love. For me love is that one thing I take the most pride in, the one portion of my life I never take for granted and align all the other aspects of my life to fit accordingly. For some it's the LIFE: the career, the obligations to self and others. For me love IS life; the only thing that really makes the rest of it worthwhile, the only thing worth fighting for, at all.

Love is something we all need to give unconditionally and accept in the same manner. It is the very thing so many of us struggle to achieve, nurture, and maintain. The very hardest thing for some of us to offer to others and welcome unto ourselves. It's hard to say for certain what the biggest problem is in that regard. Often it's the stress associated with the whole "marriage," permanency phenomenon. Apparently locking oneself in a binding religious and legal agreement with another person poses serious threat and inevitable detriment to the relationship itself.

I cannot speak personally on this matter; I can only mention that a number of my close friends were perfectly content prior to such an engagement; an engagement which has left many of them cold, discouraged and discontent. A self-proclaimed serial monogamist, I find this realization difficult to reconcile. I have lived with the same person, as if we were married, for the past 6 years. There is not a second of that life I regret; I feel immeasurably blessed and better off for having lived it. Instead I wonder, egotistically, if there is some trait I or he possess, which makes us better equipped to maintain such a relationship. My scientific side forces me to consider that perhaps there is a more humble realization..... something about the pairings of those I've watched was perhaps incompatible before they ever began--If there was another reason those two people did not, or could not, work together. And this is where I come back to feeling self-righteous and therefor most likely incorrect.

Like I said, I've had a series of long-term relationships throughout my dating life, each of which always felt more correct than the last, yet nonetheless had an end-point I was aware of, in the back of my head. Currently, in the back of my head (and sometimes more up front than I feel ready to be comfortable with), I see only a wedding, children, a happy life of aging with someone I feel no hesitation in saying I'll be "cool" with, forever. He lacks any of the traits that I'd feel confident saying will make me unhappy, in the end. The one thing I have learned in listening to people, is that the whole cliche of relationships being something you have to "work" at is total crap. As with anything else right in my life, relationships should follow the path of least resistance. That isn't to say you shouldn't try, only to say that it's not the spectacular feat of effort that most claim it to be. Nothing about my relationship has involved effort of any sort. If you love someone, you love someone unconditionally. There is nothing to work at. If you disagree, you might be with the wrong person.

I say this confidently because I can still remember all the things about life I've spent my time worrying over. Where to live, what to be, where to work, what type of life I want......and in the end none of it mattered. I realized I would be happy with everything else if I had a partner to share it with. If this seems submissive or insecure, consider this: even if you could say everything else in your life was perfect (job, home, location, yourself), what would you still ask for? A partner to share in your success. When recently talking with a friend about how he would transition his life to a new location and career, I discussed my slight distaste for my geographical location. We talked about other cities that might be more fun to live in, more appropriate for our tastes. He asked me "well, does Maryland feel like home for you?" My reply was instant and certain: "anywhere that Mike is, feels like home for me." Cheesy? Perhaps. Secure and unquestioning? Most certainly.

I realized after saying it so easily, that my daydreams of moving somewhere else, somewhere I might be more able to live the artistic lifestyle and enjoy my surroundings, were really nothing more than that.....daydreams. I realized once again that I was still here after all my doubts about this city, for the one person that made every struggle meaningful and not in vain. My beebs. And I realized that I shouldn't be worried that I wasn't "working" at a relationship as so many people had advised. I had something that required no work at all, and to run away from that for any job or change of scenery would be perhaps the first thing in my life I WOULD regret.