Friday, December 9, 2011

this is me: part 1

this is a post i have been mulling over for a while. there are some things that are difficult to talk about at the best of times, but become even more difficult in the context of pregnancy and parenting. they are, however, part of who i am and what i bring to this story, so i want to address them.
this is me

i have three separately diagnosed health problems that each effect my life in different ways. these are: anxiety/panic disorder, chronic fatigue syndrome, and depression.
i think i need to split my discussion of these things up into a couple of posts rather than one giant one, so i'll begin with telling you about what these disorders are, and how they relate to each other. in future posts i'll talk about how i am treating them, and what i think they'll mean for me as a parent.

so. what do these diagnoses mean?

generalized anxiety disorder - this is the one i have had for longest. i don't want to go into details of why i developed it (at least not right now), suffice it to say that i believe it happened when i was quite a young child. you see, brains are malleable things. particularly in childhood. they are still going through quite dramatic growth and maturation all the way through adolescence into early adulthood. some brains, those with a genetic vulnerability, if exposed to particular adverse conditions learn to see the world as a risky, dangerous, place. the parts of the brain that are associated with using learned information to regulate interactions with, and responses to the world can become wired (both structurally and chemically) for fear and hypervigilance if they learn early that the world is a particularly dangerous or frightening place. 
having generalized anxiety disorder doesn't mean being dramatic, highly strung, or hysterical. it means that you have a brain that's wired in a particular way, which is not your fault. it took me a long time to learn this. and i still sometimes forget.
i go through periods when my anxiety is easier to manage than at other times. if i am experiencing a period of increased external stress (exams, travel, interpersonal conflict, illness), my threshold for anxiety decreases and my symptoms increase. that said, sometimes i feel anxious for no identifiable reason at all.
for me, anxiety mainly involves:
  • preoccupation with possible negative events or outcomes (often death of loved ones, failure, illness, etc.), even if these are highly unlikely.
  • difficulty with problem solving and other higher order cognition, due to aforementioned preoccupation.
  • hyper-awareness of risks in the environment
  • placing a disproportionate amount of importance on small worries and failures
  • nightmares
  • a hair-trigger startle reflex
  • nausea
  • certain physical behaviours, including picking/tearing at my nails, and poking and scratching at my chest. s is usually the one to notice these, as i am not generally aware of them (i've grown out of it now, but when i was in high school i used to pull my hair out. by the end of vce i had no eyebrows because i had compulsively pulled every last hair out without realising i was doing it.). 

in periods of heightened anxiety i'll often experience panic attacks. these are usually triggered by external events (being startled, feeling like i have made a mistake, etc.), but sometimes come from nowhere.
if i have been feeling extremely anxious for an extended period of time, i'll start displaying symptoms of agoraphobia - i won't want to leave the house without s, and i'll become overwhelmed and panicy in busy places like the supermarket or the cinema. luckily, this only happens when my anxiety gets very bad, and i try not to let that happen very often.

chronic fatigue syndrome - it's hard to say how long i have had this. i would venture to say about five years. either way, i was only formally diagnosed by a specialist at the end of last year. it was a big relief to have a name to put to what i had been feeling, but i must say i still haven't fully adjusted to what this diagnosis means. i still sometimes forget that i have it, then completely overdo things and have a bad attack. i still get very frustrated at the limits to my energy and abilities, especially as i am an ambitious and creative person and always have lots of things that i want to do. but more than anything, i still feel a lot of guilt about my limitations, and get very anxious about how other people see me - cfs is a disability, but it's not as visible, or as well understood as many other disabilities, and i'm very conscious and fearful of being judged as lazy, boring, useless, etc. by people who don't understand what's going on in my body.
for me, cfs mainly involves:
  • exhaustion that is wildly disproportionate to exertion
  • heaviness in limbs
  • aches and twitches in muscles
  • digestive/stomach problems (we thought this was coeliac's disease for a long time)
  • orthostatic hypotension
  • regular tenderness in the glands around my throat and neck
  • diminished cognitive abilities (i've noticed a marked decrease in my concentration and attention span, as well as in other higher order cognitive abilities - you'll note that this overlaps with the anxiety)
  • increased vulnerability to viruses like colds and flu.
  • difficulty regulating body temperature (i cope extremely badly with hot weather, and all my symptoms increase noticeably in the summer when my body has to work doubly hard just to try and keep me tolerably cool)

depression - i view my depression as secondary to those other two conditions. i experience periods of depression semi-regularly, and in retrospect i can usually find that it's linked to a particularly long/intense period of anxiety, or a particular cfs flare-up. nonetheless, it's more than just sadness, or feeling a bit 'down in the dumps'. it's serious, and i have to take it seriously, or it gets worse.
for me, depression mainly involves:
  • all the negative and sad thoughts and emotions that you would expect to characterise depression, and associated teariness etc.
  • hypersomnia - i literally cannot sleep enough, and just want to hibernate til it passes
  • loss of interest in the things i usually enjoy (s always knows there's something wrong if i stop wanting to sew)



while they are each diagnosed and treated as different disorders, i see these three conditions as very much interrelated. not only is there a degree of symptom overlap, but it doesn't take too much imagination to see how they interact with each other in daily life. for example:

i want to attend an aba meeting, but find that i am extremely anxious about the idea of being in a room full of people i have never met before. i decide not to go, then get depressed because i am ashamed of being such a chicken, and worried about being isolated with no social network of parents when fruiby is born.

i have a particularly bad week of generalized anxiety, with several panic attacks, and because my nervous system has been in 'flight or fight' mode for an extended period, i experience a cfs flare up.

i know that i've been having a cfs flare up, and that my energy reserves are low, but i have a family event that i have to attend. i feel increased anxiety about my ability to make it through this event, and about offending people if i have to leave early in order to preserve enough energy to drive home safely.

i reflect on my limited abilities, and what they mean for my career prospects, how they influence my daily life, s's life, and how they're likely to impact on fruiby, and i become both anxious and depressed about the future.


so for me, the overall picture ends up looking a lot like this, with a flare up in one node having follow through effects for the others:


so as you can see, i've been dealt an interesting hand in the mental/physical health stakes. i am definitely better off than some, but i have my own set of challenges that i need to manage as carefully and wisely as i can.
more on that in subsequent posts.



this post is part of a three part series: part two, part three.

2 comments:

  1. thanks for writing this post (series). 'enjoy' is probably not the right word, but it is definitely interesting to read a frank account of how different health problems interact. i know it can be difficult and take a lot of courage to write about these things, so thanks for doing it! x

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  2. Thanks from me too. I'm currently battling a severe bout of GAD and depression and trying to work out if it really truly is PTSD or not. And while it absolutely affects parenting and my relationship, they affect the disorders as well. Bunbun is an imperfect feedback loop so can quite easily trigger me into something close to a panic attack, but she is also extraordinarily helpful when I am having one.

    I worry abo up having passed the tendency for those things along to her. And I worry that my own experience of anxiety mak me not only see it in her but react disproportionately when she is triggered into a tantrum.

    But yes, thank you.

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