Thursday 13 August 2009

This is Panic 10 - General Health

As I don't have much in the way of an order for how posts come along, I am heavily influenced by the insane amount of news that I take in via papers, tv and the internet. The talk in America about their health reform and all the insanity with swine flu at the moment, I got to thinking a lot this week about health in general.

They say that sometimes you don't see something till it smacks you in the face. A large chunk of my thinking about all this came when I got...well...smacked in the face. I was moving some stuff about at work and as I bent over to put something away, I managed to take an upturned chair leg just above my eye. Luckily there was no concussion, just a large bruise that hurts badly but it set off a familiar chain of events for me.

A lot of my triggers for panic attacks are health related and have been since they began. It was a blemish on my chest that sparked off the first ever panic attack that I had. Now obviously in hindsight there were a lot of other contributing factors but it was seeing that blemish that did it and off I went.

It's always little things like that or little twinges that set me off in some way. If I can rationalise out the issue then it makes it easier to calm myself down. Part of the process for me has become to try and sort out my health and be healthier. If, in the unlikely event that something ever was wrong with me, if I am healthy then I'd know about it right?

I realise now a bit further down the road that the above is not a great attitude to have. I see that now and I have modified my approach somewhat. Being healthy is a good thing full stop. Now I am not at the peak of physical condition but I am in decent condition. I walk 30 minutes a day (thanks to work), I cook with fresh veg and little oil and I try to keep stuff low fat. It doesn't sound like much I know but keeping myself in decent condition has helped somewhat with my anxiety.

From experience of casually meeting other sufferers of anxiety problems, certain lifestyle choices can exacerbate the issue rather than help it. Now I made a lot of changes after I went on to my tablets (see TIP part 5) so these are all since about December 2007 but they were useful to me:

1. Cutting down on alcohol: Admittedly this one was a direct result of my medication but I've kept this one up somewhat since I came off of medication. Those of us with a passing knowledge know that alcohol can be a depressant if you have loads and also (and this is definitely the case for my meds) you can't drink whilst taking them. If you're not on meds then a drink won't kill you but don't go overboard.

2. Cutting down on caffeine: This one was a personal choice. Now we've all had too much caffeine now and then and we know what it does to us; we get twitchy, we get jumpy and your brain rushes a mile a minute. Now personally I find none of these helpful for battling anxiety when I am having a moment. Whilst I know some people and books advise totally removing caffeine, I like the taste of tea and coffee too much. I limit myself to 4 caffeinated drinks a day in total which is normally 1 coffee and 3 teas a day. I spread them over the course of the day and I never have anything like that after about 7or 8pm. After that, hot milky decaff drinks like low fat hot choc or caffeine free herbal teas are your friend and will have a better effect and help

3. Cut down junk food: Sugar like caffeine has the twitchy high energy thing if you have too much of it. I like stuff like chocolate and the odd take away but I always feel slightly sluggish after one for some reason. I always try to use at least some veg in every meal I cook, even if it's tinned. Again, moderation and the world won't end if you have a kebab on a Friday night or a chocolate bar but eating loads of junk food will increase your weight, make you feel sluggish loads and I find it lowers my mood if I have too much of it in too short a space of time.

The other part to all of this as well is trying not to over react if you ever do feel unwell. Now this is the bit I struggle with. That twinge you worry about is an instant worry to me that I am about to drop dead but I am getting better at not going off the deep end.

When I took that whack to the head, I went and got seen by a nurse at work. I made a point of saying "I've done this to myself and also I suffer from an anxiety condition and I'd like some reassurance that I am ok please." The nurse did a good job of giving me a full examination needed for a head injury and took the time to clearly explain what was wrong, what wasn't and what to do when I went home.

Now we all get ill, we all get injured but we need to not instantly associate every injury with instant death. Now a shot to the head is different and do make sure to get yourself checked if you take a half way decent blow to the noggin but you will take a few knocks and they will do next to nothing to you in the long run. If you're worried, get them checked out but rest assured, unlike in the USA at the moment, the only bill you'll get is a clean bill of health.

Monday 3 August 2009

This is Panic 9 - relapsing

I am aware that the word relapse has certain connotations attached to it that are not pleasant. It speaks more of drug or alcohol addicts falling off the wagon rather than the context I mean it in here. I mean relapse as in having another attack after a period of relative stability. I wanted to use this post to have a look at how people deal with having a large attack out of the blue and how to get back on track.

I suppose to an extent I look at myself as a functioning anxiety sufferer. I have moments of high anxiety but they do not interrupt my sleep or my daily life so this past weekend was a real downer for me.

Looking back I’d probably indulged a bit too much on the Saturday evening. It was nice though, Chinese take away which I ate too much of, a couple of bottles of Perroni and watched Charlie Wilson’s War (good film) and repeats of Mock the Week before bed. Nothing new there, pretty average Saturday night for some I’d venture.

I woke up about 2:15am Sunday morning and I was burning up. The room felt like a furnace and it felt like the world was chattering in my head. I managed to get downstairs and into the dining room/kitchen and took a few good long deep breaths. I started having one of my moments where I thought a skin blemish was a sign of me getting septicaemia. I was awake for about an hour where I managed to talk myself off the ledge with a mixture of deep breathing, autogenic relaxation and a cup of chamomile and limeflower tea. I took a glass of water with me and headed back to bed. I am claiming a small victory as I managed to have all that and not wake anyone up.

I woke up feeling drained and a bit antsy still but felt ok after a bowl of Lidl own brand malt crunchies and a cup of tea. Having packed up all my stuff (I was on holiday last week), I hopped in the car. Now with 6 of us in there I was in a seat right at the back over the wheel arch in what in normal circumstances is the boot. Trust me, never a great place to be. I thought my stomach was ok but I felt nauseous very quickly which make me anxious and made me burp a lot. I tried to counter the panic by listening to an audiobook and taking deep breaths of air from the window. I got worse and worse as the journey went on, feeling more and more nauseous until I started properly hyperventilating. For some reason I was trying to fight the attack until I couldn’t get the words out, we stopped the car in a country lay by and I dived out onto the grass with my paper bag. Only when I got out did the pins and needles rush up my arms and face. I was breathing out of the bag with people gathered round me as I sat on the grass.

Now as ever, I am now feeling a lot better. Hyperventilation to end the whole attack lasted about 8 minutes if asked to hazard a guess. I got to my destination and sat down with a decent lunch and a cup of lemon and ginger tea which seemed to help. The annoying thing for me was that having done relatively well and not having had a full blown attack for about 3 months and if I am honest I feel a bit down about it.

Now those of us who suffer from an anxiety condition where attacks are (sadly) the norm, learn how to recover and move on from it. The issue here is how do we deal with the set back when we’ve come a long way? The idea is that we never want to have an attack again so what do we do now we’ve had one and feel like we have to start from square one all over again?

I personally try and have a loose attitude to timing when it comes to attacks. I obviously remember roughly when I have had one but I do not remember the exact date unless something else specific happened. I try not to have a mentality of an accident clock, “x days since last attack” and then resetting it when I have one. I can understand why people do that but personally I find the idea a bit restrictive. You end up in this cycle being obsessed with time and how many days and weeks and months you’ve not had an attack rather than just getting on with things.

The big thing for me is trying to reason out why I may have had an attack. Understanding the issue helps defeat it I feel. Allow a bit of hindsight (a day or so) and then think about the reasons why you had one. For me the attacks yesterday could be attributed to things like the argument I had with someone, the increased levels of alcohol in my system over the last week, the excess of food I ate Saturday night combining with being very over heated in bed. I don’t want to go too far into the ins and outs as to what was the primary cause because 1, there may not be one and 2, it’s possibly too complicated a process to try discussing inside 10,000 words here on TIP.

That said I feel it’s crucial to try and understand what may have caused the attack. Whilst on a superficial level “just because” may seem like an answer, it’s kind of glossing over the answer to me because there is a reason for most things. Now I admit that there’s no known reasons for many things (Why are the worst things for us those that taste the nicest? Which came first, the chicken or the egg? Why do people watch Strictly Come Dancing?) but when it comes to human behaviour, there is generally an answer for most things. Now I am not saying that people need to go into pain staking detail and peel back all the emotional scabs for every minor incident but self examination helps me so I generally suggest it to people.

The only real advice I can give is what I have heard from so many people, “don’t beat yourself up!” Attacks happen. They happen for a reason. The best way to counter them is to not agonise about the fact that you had one and balling yourself up to try not to have one again but to work at changing the factors that caused you to have one. It is all merely a stumble, nothing more.