Category Archives: cyclothymia

a little down

I’ve been feeling a bit low the past few days. I really miss Kansas City and my family. Talking on the phone with them just isn’t the same.

I’ve been running a lot. I signed up for the San Francisco Marathon. Running has become something to live for. I love it. I can’t explain it. I’ve never felt like I had any true hobbies or anything I’ve really loved in this world, but I do think I’ve found something–and it’s actually healthy.

I’m still waiting to hear back about the eight jobs I applied for at the public library. I’m already starting to lose hope. I applied for some teaching English jobs abroad for after I graduate in August.

Nothing much is happening right now, really.

I am thinking about ending therapy and just seeing my hypnotherapist and continue doing CBT with her. CBT has made such a tremendous difference in my life. It’s great! I know my hypnotherapist isn’t formally qualified to be working on CBT with me, but she’s recovering from social anxiety herself and has used CBT extensively–so I feel like she’s more qualified than my therapist.

I’m also thinking of getting off the Lamictal. I do not think I have Cyclothymia. I think my deep depressions happen within the context of social anxiety.

I am starting to accept myself more. I am who I am inside–and I am starting to be okay with that. I do have limitations, but I do have many positives as well–like all people. Most days I am happy and feel good about the future. I am excited (well, most of the time) about starting my internship in a few weeks, and I am just overall liking the direction I am going.

Finally, I want to give a shout out to Nick over at The Social Phobic. He’s been away for a while but now he’s back. He inspired me to start my blog and writing about my day-to-day experiences with social anxiety.

Thanks Nick. I hope all is well.

in a safe place

For longer posts, dealing more with theory, I usually start writing them three or four days, sometimes weeks, before I post them. I have an idea in mind, and I like to watch it grow, like a piece of art. As of late, though, my moods have been fluctuating so much that I often times abandon my original idea altogether or change it so much that it barely resembles its original form–which is the case for this post (the latter issue, that is).

***

Put simply, I had to give two class presentations this past week. One on Thursday, and the other on Sunday. I haven’t had to do any sort of public speaking in over a year, so I clearly was very nervous/anxious going into it. I decided to try to get some of my thoughts out to help not only understand the anxiety (and where it’s coming from), but alleviate it as well. What you’ll soon find out is that the presentations went well. Sure, I was nervous, but I did fine, probably better than most people, in fact.

Anyway, here are some highlights–

Anticipatory anxiety hit me on Wednesday: I feel like shit. My stomach is tense and wound up in a knot. I’m having trouble swallowing. I’m sweating. I feel like I should take an Ativan or something, but I sort of feel like I’m becoming dependent on them. But none of my relaxation strategies are working. I’m sick (with a cold), so I can’t go running. I don’t know what to do.

Honestly, I’m mostly worried about the questions after the presentation. What if I won’t be able to answer them because I’m flooded with anxiety? What if I sound nervous? What if I fail?

I eventually calmed down, but anticipatory anxiety returned before my presentation (no surprise there): My presentation is in less than 3 hours. I’m in denial (sort of). I just ate, took an Ativan (1mg) and a Propranolol (10mg), and went over my presentation again. My stomach is tense. I’m sweating pretty bad, especially under my arms, and I feel an impending doom. I know the negative thoughts are hidden under this doom, but I’m scared to see what’s under there. I wish I had therapy tonight–and I wish even more that I hadn’t skipped therapy on Tuesday (because I was/am sick).

Again, the presentation went fine: It’s over. It didn’t go bad at all. I got hung up on one question, but overall, it went really well. I feel stupid for making a big deal out of nothing. About five minutes before the presentation started, I chatted with the professor and the other students. I then stood up, shook my body all over, and then went to the mirror and smiled (to make sure I still could). This helped to calm me down. I can now strip off my sweat-stained undershirt and move on.

Anticipatory anxiety started again on Sunday, about seven hours before my next presentation. I’m starting to feel a bit nervous. I feel that impending doom again. It’s scary because I don’t know what lies beneath. It’s unknown. Thoughts, on the other hand, are tangible, while this feeling is not. I can hold thoughts. I can touch them. They are real. But I’m too scared to find those thoughts.

Then two hours before the presentation depression hit: I’m depressed, and I DON’T GIVE A SHIT ABOUT THE PRESENTATION. I don’t know where these feelings came from or why I’m having them. Maybe they’re connecting with this doom feeling?

The depression wore off for the presentation, leaving me with anxiety, but it came back immediately after: Well, the anxiety  pushed the depression into the background. I took an Ativan (1mg) before the presentation. Again, the presentation went well, and, again, the anticipatory anxiety was much worse than the actual presentation. I feel good about the week, but depression is hitting me again. I’m scared.

***

By the end of the night I was really low. I binged on food, drank a big beer, and had a cigarette (the first one since the wedding)–nothing helped. I woke up feeling even lower. What’s going on? I asked myself. I had a fairly good week. I mean, I not only got through the presentations, I did really well. I should be feeling good. I should be feeling great. As always, though, there’s much more going on than what meets the eye.

Actually, depressions usually hit me after successful social situations because that part of me that wants to be messed up–that part that likes having social anxiety, that part that I know, that part of me I think is me–flexes his muscle and brings me down. He, my anxiety, wants to maintain control. Does that makes sense? However, I still think there’s more there.

I’ve been triggered by quite a few things this week, namely this post and this post and this post and the movie Black Swan.

For the sake of length, I’ll try to not go into too much detail.

As some of you know, I’ve been dealing with this question as of late–Without social anxiety, who am I? The answer is a resounding I DON’T KNOW!, which is exactly why I’m so scared to find out, which is exactly why I sometimes like my anxiety–and even fuel it. My illness is warm and fuzzy; it’s familiar; in some ways, it’s all I know about myself.

There’s also my perfectionism, my need to always be perfect. I can’t make mistakes. I can’t have any flaws. I have to anticipate every move. I have to always be on the guard. And yet, perfectionism, is about mistakes, because a perfect human is flawed. Thus, by not allowing myself to make mistakes, I prevent myself from not only being perfect, but knowing what it means to be truly human. There is a part of me that does want to let go, but I’m still wrestling with the question of what exactly that means–and how to go about doing it when all I know is rigidity and repetition and compulsion.

But maybe I got a glimpse of what it was like to not be hindered so much by anxiety or my perfectionism this week? I engaged with people and was able to give two presentations without feeling too much anxiety. I also let go (somewhat) during them. I allowed myself to fail a bit on the question and answer section afterward. I could of been more thorough. I could have answered them better. But, frankly, I didn’t give a shit. I also have a huge, 15-page paper–30% of my grade–due on Thursday that I haven’t even started–and, again, I don’t give a shit.

I’m wondering, am I feeling depressed because I’ve seen a glimpse of myself in a new light–without so much anxiety and perfection–and not liked what I saw? Or is my ego (my anxiety) just flexing it’s muscle, wanting to maintain control?

***

Finally, without my anxiety, I’ll have to deal with deeper issues–

I really hate this system I’m living in. As reminded here, we’re just living a joke (capitalism) and our lives are the punch lines.

Here, I’m left with the difficult question of how do I fill this void inside of me? I’m continually looking to the future for happiness. That is, my next goal, my next achievement, my next cure, etc. What happens when there is nothing left to cure? What happens when I actually have to start living, and what if I really don’t believe there is any point to living besides not dying?

Finally, here I’m reminded that these feelings I’m having are temporary. In fact, I’m feeling much better now–but even that is temporary.

How did I know that someday–at college, in Europe, somewhere, anywhere–the bell jar, with its stifling distortions, wouldn’t descend again?  ~Sylvia Plath, The Bell Jar

is social anxiety real?

Please note: I wrote this post for the first ever Blog Carnival of Mental Health. The topic is diagnosis.

***

So, as many of you know, WordPress allows me to see what people search for to find this blog. As of late, I’ve had some alarming searches, namely–“is social anxiety real” and “is cyclothymia real.”

I guess it’s good that people are questioning their inner experiences, but I’d like to know to what end? Labels are dangerous. It’s very dangerous to define yourself by a set of labels (or diagnoses) because you limit yourself. For example, if you say, “I have social anxiety, so I should be acting a certain way,” you can literally limit yourself to those courses of action. I also believe that the pharmaceutical companies profit greatly on these labels. If they can make us believe we have something wrong with us (i.e., a particular diagnosis), when in fact there’s not, then they can profit at our expense.

I think it’s easy to forget that there is a big difference between experiencing some anxiety during social experiences and having Social Anxiety Disorder (more on this here).

However, diagnoses can also be good, namely because they allow you to get the treatment you need. If you don’t understand your inner experiences, it’s hard to get treatment. When I finally sought out professional help, I felt greatly empowered. I took back some control from my anxiety, but I also had to take responsibility for my well-being. In other words, I had to do the work inside of therapy and out, to learn strategies on how to manage my social anxiety.

In a sense, the people who conducted those searchers are right–labels aren’t real. They’re only the tip of the iceberg. When we label things (without looking deeper), we ignore the essence. We ignore what’s really going on. I think it’s good to question your labels and diagnoses, as long as you are still addressing your inner experiences–because those are real, without a doubt.

If you deny the way you feel, you only strengthen the negative emotions, in my opinion. You must learn to accept.

***

As for me, I’ve been suffering with social anxiety since high school. It took me a long time to figure out though what was going on. I just thought I wasn’t trying hard enough and needed a stronger will to get through social situations. I’ve since found out that only makes the anxiety worse. Anyway, I was officially diagnosed with Social Anxiety Disorder in the Fall of 2008, and I was just diagnosed with Cyclothymia this past August. In both instances, I felt relieved, because I could finally explain what was going on inside of me–and start getting the treatment I needed.

EDIT: All the posts on the Blog Carnival can be found here

high to low and back again

I started writing this post yesterday afternoon, and it was originally called, stable .. for now, but nothing I wrote felt right, and by the evening I had abandoned it altogether. Some highlights–

I’ve been fairly stable since the wedding. That is, not depressed. I’m caught up with schoolwork again, and I’m starting to enjoy activities again, like reading, writing, running, and cooking. (I even went to a yoga class on Friday!) I’m looking forward to seeing my student on Wednesday and tutoring in general (I volunteer at an adult literacy center), as well as Thanksgiving. (I’m not delighted about being around fourteen people, but I do want to see if my mood holds up and how, or if, that will affect the outcome of the social situation. Plus, I want to test out some of my new cognitive techniques. So, it’s not so much about the social situation itself; it’s more about seeing whether I can get through it without being flooded with anxiety [an experiment, really]. And I’m actually feeling more confident that I will be able to do just that, and if I don’t–NO BIG DEAL!)

I’ve been doing lots of CBT lately. I still don’t know whether it’s working or not–whether it’s affecting deeper change–but I do know that it’s changing the way I think. I’m more positive and upbeat. I haven’t been engaging in my normal destructive behaviors of finding faults in the past and using those to ruin the present, etc. It’s a strange feeling, really. I’m not comfortable with feeling good–or, more precisely: not feeling bad. I guess I’ve just been feeling neutral lately. I look to the future and I don’t get the hopelessness that I got a week ago; it’s more like a staleness.

Finally, I’m also excited about trying a new drug. I’m not comfortable with taking Klonopin daily, so I’m going to talk to the pdoc on Tuesday about trying an MAOI–Nardil. A friend of mine who also has social anxiety is on it and I have noticed a huge difference in her behavior. Yes, MAOIs have some pretty bad side effects and you have to be on a strict diet to avoid hypertension, but maybe the ends will justify the means (for once)? I just have to talk my pdoc into it, because he had a patient die while on Nardil because s/he ate the wrong kind of cheese (aged) and didn’t seek medical attention.

Anyway, somewhere between writing and watching a football game and reading and taking a bath, my mood changed. By the end of the night, I was pretty low. Actually, I could feel my mood turning pretty much throughout the evening. My energy level dropped, and I couldn’t do the things I wanted to do. I’ve been pretty hyper (or hypomanic) this past week. I’ve bounced from activity to activity to activity. I haven’t given myself much leisure time or given myself time to think about things, which is good and bad. Sure, I didn’t think about the bad things, but I also didn’t get to process and own my negative feelings. I pretty much suppressed everything throughout the week, and maybe some of the those feelings were coming up while I was writing.

It’s a strange feeling knowing that your mood is going to turn. I started to panic a little, actually. I wanted to do everything I could to stop it from happening. I stopped writing altogether, and I tried to just sink into the feelings a little with the hopes of crying. I always feel better after I cry. I think it allows some of the feelings to release. It’s healthy. But it’s very hard for me, especially now that I’m on medication. I need to find more triggers. Last week I found a good song that brought me into tears almost immediately but I played it like ten times over the week, so when I listened to it last night, nothing happened. I need to find more triggers. What works for you?

I’m also very stressed about school and the holidays in general. I have three papers and two presentations to do in less than a month. The papers are no big deal. Sure, they’ll be a lot of work, but I’m more worried about the presentations. For those who don’t know, I’m in an online graduate program studying Library and Information Science. I’m becoming a librarian. Anyway, the presentations are done over a conference call, and even though they aren’t in person, I’m still a little upset about them. CBT is helping, though–I may have had lots of anxiety in the past, but I’m doing better. And it may not go exactly how I want it too, but I will get through it–and it will be okay. Again, I don’t know how much of that’s suppressing my feelings and how much of that is subtly dealing with the feelings but not letting them take control. I don’t know.

The holidays are another big thing. Thanksgiving is coming up. As I said before, I’m going over to my girlfriend’s brothers, where fourteen people from her family will be there. I am still hopeful that I’ll be able to get through it without getting flooded–with the help of Ativan and Propranolol, of course. I’m counting on there being a little anxiety there, just not the debilitating kind like I had at the wedding. I want to be able to converse with people and smile and not have to worry about sweating through three sets of shirts and looking like a complete idiot all the time.

I’ll address Christmas at a later date.

So, with my mood rapidly changing, and without being able to release some of the pent-up emotions through crying, I went to bed feeling like I’d wake up feeling even worse. But here I am. I feel a little down, a little stressed and depressed, but a little happy and hopeful too. Maybe I avoided a depression? I don’t know, only time will tell. But for now I am going to continue with what I’m doing: schoolwork, running, keeping myself busy.

Oh and I probably won’t be updating much until the end of the semester (12/9). I hope you are all doing well, by the way.

Finally, I’m curious how you deal with things when you know your mood is getting ready to turn. Do you just accept it, knowing you can’t change it, and try to do your best to weather the storm? Or are you more proactive about it–are there ways for you to avoid the depression altogether, or at least lesson the severity of it?

Thanks for reading, and I look forward to hearing from you. 🙂

I Don’t Know

I don’t know what to say, but I feel like I should say something because I’m feeling so low. I’ve been trying to track my mood this week–and it’s been all over the place, as usual. But it’s been quite a bit worst this past day or so. I cannot deal with so many fluctuations in one day. In a span of three hours earlier, I went from low to high to low–and I don’t know why.

I don’t know what to say to my therapist tonight. I don’t know whether I should tell him about some of the thoughts I’ve had in my head these past few days. I don’t know how to distinguish between non-harmful suicidal thoughts and harmful one’s–and I don’t think he does either.

I don’t know what to say to my girlfriend when she leaves me tonight to go visit her family. I’m scared that I’m going to binge. I’m scared of the negative thoughts I’ll have. I’m scared of her being disappointed with me, again.

I don’t know what I’m going to say to people at the wedding. I don’t know who I’ll talk to. I don’t know how I’ll act.

I don’t know what to say to you. I’m sorry I’ve been so low as of late. I hope I start feeling better after the wedding. I hope you still like me, even though I’ve been so low. I’m not trying to grab attention or anything, I’m just being honest .. for once. I hope I can do the same in therapy tonight.

life means suffering

Suffering is equally divided among all men; each has the same amount to undergo…. (Paul Bowles, The Sheltering sky)

***

Depression hit me on Wednesday–killing my positive, albeit hyper, mood–when I started analyzing the interview in my mind, over and over and over again, finding all the negatives .. I found a bunch, of course. I also had a difficult tutoring session (see previous post). This depression stuck with me until Thursday evening when anxiety took over while I was in the car with my girlfriend and her father, on our way to my girlfriend’s hometown to visit her family. I actually started panicking a little.

I know I need to connect more with people, especially with my girlfriend’s family, but it’s too hard. I can’t do it, and I really don’t want to, either.

On Thursday night I went with my girlfriend and her sister-in-law to a bar to watch a baseball game. I had two beers which really calmed me down. I felt calm the rest of the night, but I woke up depressed again on Friday and felt down throughout the day until my girlfriend’s brother arrived.

Her brother’s a lot like me–he suffers from anxiety and depression, he doesn’t really like people etc–but I actually think we’re too similar: neither one of us knows how to talk to the other, and a third-party needs to be present in order to facilitate conversation. Actually, I pretty much always need a third party. One-on-one conversation is the hardest for me, and, consequently, that’s when anxiety hits me the most.

Surprisingly, the anxiety wore off quickly, and I was able to relax for a bit after her brother arrived. We all talked for a while, and then I went to bed. My girlfriend joined me after some time.

Like clockwork, I felt depressed again in the morning. I went for a run, reflecting on my week, focusing on a letter I sent to my parents on Thursday. In it, I briefly described what I’ve been going through as of late, as well as my frustration with my family’s lack of emotional connection.

Some highlights–

I haven’t connected with either of you in a long time; and I’m angry and frustrated because of this. There’s so much distance between us—not just geographic distance but emotional distance. Our family has always been a very private family. We just don’t talk about things. I think that worked for us when we were all together, when we were seeing one another every day. But now that Jeff and I are both gone, that lack of emotional connection is catching up to us.

..

I have Social Anxiety Disorder. I’ve suffered with it for over ten years. I know that everybody experiences anxiety in social situations to some extent, but it’s much more intense for me, even debilitating. Often times the anticipatory anxiety is much worse than the actual anxiety I get in the event. Just last week, my anticipatory anxiety kept me from going to a job interview, for example. Also, after social situations, I continually brood on the negatives from the social event. This is self-defeating—it reinforces the anxiety, in other words. Recently, I’ve also been diagnosed with Cyclothymia. It’s a form of Bipolar Disorder—albeit a very mild form. I’m also a Perfectionist, an Introvert, extremely Shy, Highly Sensitive, and so forth …

..

You weren’t/aren’t perfect parents—and that’s okay. I’m getting to the point where I can accept that you weren’t the type of parents I wanted you to be. I’m not there yet, but I think I’m close.

As of writing, I still haven’t heard from my parents. I’m a little worried.

Anyway, I began to feel anxious on my run. I kept going over and over what my parents would say to me. Would they be mad? Or sad? Or concerned? Happy? Confused? .. These thoughts took me from the present moment. I really wanted to get away from my thoughts. I wanted to enjoy my run and connect with nature, but instead I got lost, and eventually trapped, in my own thoughts.

After my run my anxiety intensified, as everybody, aside for me, wanted to go visit my girlfriend’s sister (Ms. D) in Oakland and her baby and fiance–and we ended up going. I get really anxious around them because her fiance is really cocky and outgoing. I never know what to say around him. Whenever he even looks at me I just freeze. I can’t think, I can’t talk, I can’t do anything. I’m overcome with anxiety.

I also don’t really do well around children. I never know how to act or what to say. I feel like everyone is judging me: He doesn’t know what he’s doing. He probably has no experience with children. He’s an idiot.

I guess it didn’t go too bad. I felt stupid when Ms. D asked me how I was doing because I always say the same things: “I’m good. I’m just trying to get through school and find a job.” She gave me an awkward smile and nod, and thankfully the conversation moved on, the attention put on someone else.

A few minutes later everybody was lively and talking about babies and weddings while I just sat in the corner, keeping silent, trying to pretend I was playing with the baby (and enjoying it). Finally, when the conversation was over, I shouted out, “I don’t think I’ve ever been licked so much in my life,” referring to their dog. Everyone turned toward me, looking at me as if they were surprised I was still in the room. I’m not sure why I said it, I really don’t. Well, actually I do: I wanted to be included so bad, I just said the only thing I could think of. No one really knew what to say. Finally, Ms. D broke the silence–

“Mike, no one really likes it.”

“I’m not complaining,” I said.

A few people laughed, awkwardly, and then the conversation moved on. I probably appeared like I was complaining, because when I said what I said I know my face was stoic. When I’m anxious it’s very difficult for me to smile, and as a result I look serious or angry or mean. Ironically, inside I’m terrified. I just want people to like me. The response I got from Ms. D reinforced my anxiety, and it was appropriate given my comment and how I looked. I really shouldn’t take it personally, because she’s responding to my social anxiety not my true personality, but I still do. She gave me the reaction I’ve gotten most of my life–the same reaction that fuels my anxiety. If she could only understand that I’m feeling something entirely different altogether on the inside she would probably respond differently. I came across as unfriendly and uncaring and yet on the inside I just wanted to connect and be heard. I wish she could have seen this. I wish everybody could see this. Social anxiety changes my personality so much–making it impossible for me to be myself.

I didn’t say much the rest of the trip. Depression followed me home. I carried it with me on Sunday and on in to today. Right now I’m analyzing and interpreting every single word spoken, every gesture, every facial expression from the weekend. I’m also beginning to feel anxious again because I have another social event tonight: dinner with my girlfriend’s former roommate.

***

I suffered constantly in one form or another this past week. When I wasn’t anxious I felt depressed, and when I wasn’t depressed I felt anxious, and when I wasn’t anxious or depressed I felt hyper.

I’ve been thinking more about suffering recently. I’m starting to believe that everyone suffers in their own way. If you alleviate one form, like starvation, another appears, like anxiety–so what’s the point of even trying? I think the answer can be found in the Buddha’s four noble truths. Suffering is all around us, it’s part of life, but it only affects us if we attach ourselves to them.

To me, that means suffering is a choice. I suffer because I choose to believe my thoughts. I choose to let them control me. That said, I’m not sure how to go about releasing, or detaching, my self from my thoughts, but I do believe I’m on the right path. I need to keep doing what I’m doing.

P.S. I got a haircut and nobody noticed. My hair used to be long, and I cut it really short. I thought for sure someone would say something which would open up a conversation, but no one did. I’m invisible.

binge, lamictal, my story

Friday

I binged again last Friday on the usual: a super burrito and almost a quart of ice cream. It’s scary how the “usual” used to be a super burrito plus a pint of ice cream–and now it’s a quart! Anyway, I wanted to take a picture of the food because I want to keep visual records of my binges (because I think it will help make the binges seem more real after), but I didn’t because I had to eat the food immediately because I was feeling terrible. I didn’t have time to waste on finding the camera and arranging the food. I had to eat! I felt that bad.

After I jammed the food down my throat, I felt terrible. The depression seemed to increase and I felt shame, regret, and tension throughout my body. I wanted to eat more–a lot more–but there was no time because I had to go right to hypnotherapy after.

I’ve been seeing a hypnotherapist for my social anxiety since April. I really like the idea of hypnotherapy (intellectually speaking), but I’m just not getting very much out of it. I probably would have quit a while ago if I didn’t connect so well with my hypnotherapist, Ms. L. She’s suffered with social anxiety most of her adult life and is currently recovering from it. She’s really easy to talk to, and it’s just nice because I know she actually understands what I’m going through. I think a lot of therapists and psychologists don’t really know all that much about the disorder, and if they do, they only understand it on an intellectual level–they don’t understand it first hand. Because of this, I think it’s hard for them to have empathy, and it makes treatment difficult.

With that said, my hypnotherapist is not trained in clinical psychology–she only has her hypnotherapist certification. Yet I treat her as if she was a psychologist. As of late, we’ve been spending a lot less time actually doing hypnotherapy and more time just talking. I feel comfortable telling her my secrets because I know she’s been through the exact same things.

Hypnotherapy is sort of like a guided meditation. She guides me away from my thoughts and the external world to my inner thoughts and feelings and emotions. It’s very hard for me to move away from my thoughts and into the present moment. I don’t think it’s possible to ever truly shut off your thoughts, but I do think it’s possible to not let them control you–letting them just be there without attaching onto them. I’m not there yet, and so I think it’s important for me to work on meditating on my own and on other forms of healing. Being lost in my thoughts prevents me from going deep into my intuition and, thus, getting positive benefits from the therapy.

On Friday we just talked. I told her about my depressions and how I was diagnosed with Cyclothymia. We both agreed that it would be best to hold off on any further sessions until I start getting relief from the depressions, as hypnotherapy can’t really help with something that’s biological in nature and the depressions are my main concern at this point. We scheduled our next session for the beginning of October. Hopefully I’ll be feeling a little better then.

During the session I also spoke about my frustrations with my mom: how whenever I talk to her she trivializes my issues by saying either, “Everybody gets anxious sometimes” or “You shouldn’t worry so much about what people think.” Which pisses me off, as you know. Anyway, Ms. L responded by saying, “Maybe your mom really wants to help, but she doesn’t know what to say. She’s trying to help in her own way. Maybe you should try telling her how she could help in the future.” This is something I hadn’t considered, and the more I think about it, the more I think she’s probably right. I engage in the same behavior sometimes: often when people are explaining their problems or issues I tend to respond by giving positive, practical feedback. I think sometimes people just need someone there to listen without judging–and that’s what I’m looking for from my mom. I just want her to listen. Maybe I should try explaining this to her?

After hypnotherapy I went for a run. I ended up running 3.5 miles with a belly full of ice cream left over from my binge . I gagged up stomach acid and chocolate ice cream every minute or so and just spit it out. I probably “threw up” thirty or forty times. So my binge turned into a purge. Wonderful.

Saturday

I started the Lamictal on Saturday. 12.5 mg. No side effects yet. But no positive benefits either. It’s too early to tell. I need to get up to the 50 to 100 mg levels before I’ll even begin to feel anything.

I hung out with a friend, Ms R., on Saturday. She suffers with social anxiety and depression and that’s how the friendship formed, but we have a lot more in common, as well: we’re both in graduate school studying information science, we’re both volunteering at a literacy center, we’re both interested in politics and literature, we’ve both lived in Bay Ridge, Brooklyn. I really enjoy hanging out with her. Again, it just feels good being able to actually talk to someone about my issues and know that they understand because they experience them.

Oh and I also showered for the first time in like five days! Yay!

Sunday

I spent most of Sunday holed up in the library, working through my history with social anxiety (My Story). It was incredibly difficult and evoked a lot of emotions. There were times when I couldn’t go on because I got too emotional, but I pushed through. It’s a work in progress and my hope is to continue expanding it. I also hope that you can relate.

On Sunday, someone came across my blog by searching “unhappy with graduate school and depress” from Google. I’m glad to see that people are finding their way here, and I can relate: I’m in graduate school, and I’m not really happy with it. I’m going to school online, which doesn’t help me to develop socially, and I’m going into a field (library science) that isn’t exactly growing. I have to constantly remind myself that (a) I am in graduate school (sometimes it’s hard to tell because the program is online) and (b) the economy will bounce back. It’s been hard.

Anyway, if you read this, hang in there. I think you’ll eventually find something that you enjoy doing with your life if you continue searching.

Today

I’m in a hypomanic state today. I got up early, came to the library, and have been working on schoolwork and blog posts ever since. I read seventy-five pages for school and finished a project. I wrote this post and am working on another. I’ve posted comments on other blogs and message forums. I’m caught up on email. And I’ve only been in the library for about four hours. I feel good, though. It’s nice being caught up with school and being so very, very productive. Earlier I was feeling extremely–extremely!–anxious. But not anymore. I’m not sure what that’s about. Actually I am still feeling somewhat anxious (and happy), but I feel sad as well. This is me right now: 🙂 + 😦 / happy and sad / I’m smiling and frowning / I’m laughing and crying …

cyclothymia

Depression is here. It found me sometime last night. It was a busy night: I had therapy, and then my girlfriend and I went to dinner, and then we went to a bar afterward to see a friend of hers perform. Through it all I could feel the depression coming. I felt sluggish, lethargic, and uncaring. I remember thinking, I could be here, or I could be somewhere else. It doesn’t matter–I’ll still feel the same, while watching the band perform. Finally, when my head hit the pillow, there was no more doubt: I was depressed. I felt better in the morning, though. My girlfriend and I watched an episode of Star Trek and made waffles. We talked. We laughed. We joked. But then I left, and went to the library, and it’s back again. It must have been hiding. It wanted me to leave. It wanted me to be alone. And yet, I don’t feel that bad right now. I feel sad but not too sad. I feel tired but not too tired. I feel empty, irritable, and anxious–but not too empty, irritable, or anxious. I can still function, and that’s good, because I’m still behind on school. There’s no time this week to take days off; I can’t binge; I have to push through.

***

Yesterday was a busy day for me, mentally speaking. I had a session with my therapist, as well as my psychiatrist who diagnosed me with cyclothymia after reading over and discussing my blog post with me from September 11th. (Yes, I gave it to him! It’s still hard for me to believe.) Put simply, cyclothymia, or cyclothymic disorder, is a mild form of bipolar disorder, characterized by mood swings ranging from mild or moderate depression to euphoria and hypomania. From the minds at the Mayo Clinic:

With cyclothymia, you experience periods when your mood noticeably fluctuates from your baseline. You may feel on top of the world for a time, followed by a low period when you feel somewhat blue. Between these cyclothymic highs and lows, you may feel stable and fine.

Compared with bipolar disorder, the highs and lows of cyclothymia are less extreme. Still, it’s critical to seek help managing these symptoms because they increase your risk of bipolar disorder. Treatment options for cyclothymia include psychotherapy, medications, and–most important–close, ongoing follow-up with your doctor.

Honestly, it felt good to get the diagnosis. It was a big relief to find out that what I’ve been going through is something tangible, something real, something that other people experience as well. I’m not alone, and I don’t have to continue experiencing it alone. It’s treatable. There’s other options besides the short-term relief from binging. Now, there is some disagreement in the psychological community about whether cyclothymia is a mood disorder or a personality disorder. It seems like most medical professionals treat it as a mood disorder, though. It’s biological in nature. It’s a chemical imbalance. And thus, I should respond to medication.

My psychiatrist prescribed me Lamotrigine (or Lamictal). According to Wikipedia:

Lamotrigine is an anticonvulsant drug used in the treatment of epilepsy and bipolar disorder. … Like many other anticonvulsant medications, Lamotrigine also seems to act as an effective mood stabilizer, and in fact has been the only FDA approved drug for this purpose since lithium, a drug approved almost 30 years earlier. It is approved for the maintenance treatment of bipolar type I. Chemically unrelated to other anticonvulsants, lamotrigine has relatively few side-effects and does not require blood monitoring in monotherapy. The exact way lamotrigine works is unknown.

Interesting, although a little scary they don’t know how it actually works. The side effect to worry about is a rash–a life threatening rash. Sounds absurd. But I’ll be on the look out. (If I see it, maybe I’ll let it grow! SUICIDE BY RASH!) If this medication is effective it should help with the social anxiety too, because If I’m not quite as depressed when I enter a social situation, I should be able to handle the situation better because I’m not as negative. I’m not going to start the medication until I’m fully caught up with school work. My last depression put me behind, and I’m still trying to catch up. I guess I’m a little worried that the medication’s side effects are going to put me into a zombie-like state, much like Zoloft. I’m so skeptical toward medication in general. I’ve read too many dystopian novels.

Must. Stay. Positive. Or try to.

Even though cyclothymia is treated as a mood disorder, I think it’s important for me to address this in my psychotherapy sessions too. I’m already fairly aware of the mood swings I go through, and I can feel the warning signs when I’m about to become depressed. But I think therapy can help me become even more aware of how this disorder affects me, as well as providing rational coping techniques to help with my depressions. I really need to find something besides food to cope with. I want something positive that I can do to ease myself back to my “normal” states. Further, I think there’s always much more to mood disorders than what meets the eye. Pills alone are not the answer, in other words. I have a feeling that my fragile psychological state coupled with social anxiety brought on these extreme mood swings. I still believe the social anxiety is my primary concern, and I know that some of my depressive states come directly from my anxiety. Continuing to address the anxiety while being mindful of the mood swings is my new goal in therapy–and in life.

There’s also a part of me that thinks cyclothymia isn’t a real disorder. Everybody goes through ups and downs. Everybody gets depressed and goes through periods of excitement and euphoria every now and then. Why do I need medication for something that everybody goes through? It’s different in my case because the swings don’t seem to be triggered by anything–they just happen. For most people, their swings are the result of something that happens in their lives, like getting married or getting fired from a job, etc.. When the ups and downs come from nowhere, it causes anxiety and frustration because I don’t feel like I have control. It’s okay for someone to feel down because something negative or bad happens, but it’s not okay to feel down for no reason, especially when it happens over and over and over again. Severity and frequency are factors as well. When I’m depressed I sometimes get so low I can’t function. I can’t see anyone. I can’t talk, smile, or laugh. I can’t work on schoolwork. My life gets put on hold, and sometimes I feel suicidal. The lows are becoming more and more frequent too. It’s not okay for me to be knocked on my ass two days a week, every week. I’ve really only been aware of these cycles or swings for the past few months, but I know they’ve been going on longer. I remember telling my therapist like six months ago I binge at least twice a month to get out of depressions. The swings are happening more and more. Twice a month is something I can handle; five or six times, I can’t. I need help, and I’m finally getting it.

***

I gave a copy of the blog post to both my psychiatrist and therapist. I left the writing in its original format, so they know it comes from my blog and they know its name as well so they could find it pretty easily. They could also find my previous blog too where I went into great detail about what happens during some of my sessions with them. They may not like that I’ve been so candid about it. I’m not sure how I feel about this. I care, but then again, I don’t care. I probably should have removed the information about my blog, but I didn’t, and to be honest, I really didn’t event think about it. I guess I really don’t care. I am going to continue talking in great detail about my sessions because it’s important to me, and it helps me integrate and process everything–which helps me heal.

With that said, I do care about the journey I’ve been going through with both my psychiatrist and therapist. Therapy, especially, is a sacred, intimate experience. I don’t take it lightly. I respect my therapist and everything that’s happened between us. He’s letting me take him somewhere within me. I do not think writing about the process diminishes any of that. In fact, I think it strengthens it because writing has made it easier for me to go deeper in sessions. It’s brought understanding and clarity. Sharing my process with others is intimate, as well. The healing process shouldn’t, and isn’t, just about two people, my therapist and I. It’s about everyone. Keeping the process hidden doesn’t do any good. There are too many books out there that deal with social anxiety and depression after the fact–after the person has been through the healing process. This skips the journey altogether and shows us the destination, which doesn’t help, because the journey is the destination. By providing insight into my journey, I believe that I’m giving others the chance to see themselves in me and to pick out the parts of my process that may work for them. And that’s worth sharing.

On that note, last night when I told my therapist that my psychiatrist diagnosed me with cyclothymia, he didn’t have much of a response. We talked a bit about me attaching onto labels, but we moved on to something else afterward. I asked him about whether we need to specifically address cyclothymia in our sessions or if it’s unnecessary because it’s more biological in nature. He gave no response. I realize now that his none response was really a response. By not giving an answer, he was saying that it’s something we address by not addressing it. We just continue doing what we’ve been doing, and by doing that, it will be addressed.

***

Finally, I want to talk about labels. Yesterday I was given another label to add to the mix. What does that mean? Put simple, I have Social Anxiety Disorder and Cyclothymia. And I mean that subjectively. If I opened up the DSM right now and looked up both those disorders, I could probably read a little about myself–but in a detached, objective sense. I am much, much more than the words in the DSM, and I try my best not to limit myself to the judgments and feelings behind those words. My therapist is right: By constantly telling myself I have Social Anxiety Disorder, I’m also constantly saying that I’m a loser, I’m not good enough, and I’m a failure. Those labels are powerful, in other words. They’re weighed down by emotions and judgments. For me labels are still important, though, because they allow me to get the treatment I need and sometimes they are just easier to deal with.

We use labels or names everyday to define our world. When you go out for a walk you may see trees, birds, houses, people, stores, cars–all labels. How often do you go deeper and ask yourself what’s behind those labels? What really is a bird? What’s at its essence? Have you really looked at one before, seeing it for what it really is? How is it connected to you? How do the decisions you make affect that bird, and how does that bird affect you? I think it’s important to address those questions from time to time. It keeps me grounded. It keeps me connected. But I don’t think it’s necessary to see the world like that all the time. If I did, I wouldn’t have time for anything else. That’s why we create labels. When I see a bird, I think, That’s a bird, and then I move on with my day. The same can be applied to the labels I’ve put on myself. Sometimes it’s okay to just say, “Yes, I have Social Anxiety Disorder and Cyclothymia.” It’s okay to say it like that, as long as I understand there’s much more to it than that. (I alluded to this in my last post.) These disorders are subjective; they affect us differently. As long as I’m aware of that, I think it’s okay to just say sometimes that I have Social Anxiety Disorder and leave it at that. If I went into great detail all the time, I would never get anywhere.