Today is a bad day

Today is a bad day... a really bad day.  I keep trying to function normally, but all the time this huge fucking weight of depression is pressing me down, down, down.  I keep having suicidal thoughts.  And not just thoughts, impulses.  I keep wondering how hard it would be  to cut my neck deeply enough so that I would bleed out quickly and relatively painlessly.  I have pain pills and muscle relaxants from when I hurt my leg, and I wonder if those are strong enough that if I swallowed both bottles with a bottle of vodka, if that would put me out of my misery permanently.

The impulses ebb and flow.  Sometimes they are easier to resist.  Sometimes, I have to really struggle not to act out the thoughts in my head. 

I wonder if my husband and my very, very few friends would be better off without me.

I wonder when I'll stop wondering and take the steps to actually find out.

Maybe not today...

But maybe...

Clockwork Dream

Last night I had a dream where my body was no longer human.  Instead it was made up up of clockwork mechanisms.  But these clockwork mechanisms were broken.  I could function, barely, but I couldn't function properly.  This being approached me and said that if I fulfilled certain quests, then my body would be magically repaired.

I tried and tried to fulfill the quests the being set me, but always, I failed.  I failed because my broken clockwork body simply couldn't do what needed to be done.  I kept telling the being that because my body was broken, I couldn't do the quests properly, but the being just kept insisting that the only way to get my body repaired was to complete the quests.

I kept trying and kept trying, but eventually my body broke down so badly that I couldn't even try anymore, and I lay there broken and crying.

I woke up as the powers that be were lowering my broken body into a burning cauldron to reduce my parts back to molten metal.

Despite the rather cool steampunk imagery, this was not a pleasant dream.  My "real" body is broken and has been for some time.  I've been almost continually sick or injured for almost five years now.  Most recently, I tripped and fell while trying to fence off a part of my pasture where the septic system had imploded.  I fell on one welded wire fence panel while carrying another panel.  I landed on the panel I tripped over, and the panel I was carrying fell on top of me.

I ended up covered in deep bruises, with two sprained ankles and a broken kneecap.  Just a hairline fracture of the patella, but still...  I also re-damaged and/or damaged more severely the muscles in my right hip and leg which were still not completely healed from being thrown from my horse two years ago.  The broken tailbone that I received then, has also still not completely healed.  (And may never completely heal, from what I've read online.) 

Over the past five years, I've gained 20 pounds of weight, and I've lost the physical fitness that I had worked to maintain all my life.  Every time, I get well enough to start exercising again and begin to trim down and tone up, something else happens.  I get whiplash, I have to have abdominal surgery, I get thrown from my horse, I come down with pleurisy, I trip and break my knee.  It seems as if I will never be allowed to get healthy again.

I'm tired.

I'm tired of being sick and injured and overweight and out of shape.

This dream is quite easy to understand in light of what's been going on in my life.  I just wish that it had had a happier ending.

Clockwork World by Vladimir Vitkovsky

Weird Dreams

The dream started when I was in a space suit aboard my friend Richard's space ship. I don't remember exactly how I ended up there, but it was as if they had simply come and gotten me one morning, threw me in a space suit and launched me into space. In the dream, I hadn't had a chance to take a shower before getting into the space suit and I felt all dirty and grimy. And weirdly, Richard's space ship was not aired up inside, so everybody had to stay inside their suits. Of course, you can't take a shower inside a space suit, so I knew I just had to stay dirty and grimy for as long as we were in space.

There were lots of people on board, about thirty or so. In my dream, I knew them all, but other than Richard, I don't actually know any of them in real life. But strangely, even with all these “friends” around, I still felt very isolated. The space suits effectively kept me from making contact with anyone else. I could talk to them, but I couldn't touch them. The suits were built in such a way that you couldn't even feel pressure through them.

Everyone else was very excited about being in space. I was sort of excited, but I also just felt grimy, out of place and alone, even in the midst of all these other people. And for some reason, one of the girls was trying to convince me to let her highlight my hair.

It was a very weird dream and I felt very grimy, unprepared and isolated.

Then it morphed into a sort of jousting tournament, renaissance festival sort of thing. I was supposed to be camping with my husband, but I couldn't find him. I kept wandering around trying to find him, but no one knew where he was. Someone finally told me where my tent was, and this insanely good looking young man led me and a woman and her child to our tents. The woman was falling all over herself because of how good looking the guy was, so I teased him about being treated differently because of his looks. He grinned and didn't seem to be bothered by her attention.

When he finally pointed out my tent, I went and checked and sure enough, Hubby's and my name were listed on it, but two girl's names were also listed. When I tried to get inside our tent, I ended up having to through two guy's tent where they were already asleep in a pair of hammocks. Then once I got to “my” tent, I had to get on my hands and knees and crawl into it. There was this heavy blanket like thing pressing down on my back as I crawled. It also hung down around me in such a way that I couldn't see where I was going.

I could hear the voices of the two girls that I supposed were the other two names on the tag in front of the tent, but I couldn't see anyone. I just had to keep crawling underneath that heavy blanket.

And then I woke up.

In both dreams, I felt lost, unprepared and isolated for the most part. I have to wonder what exactly is going on in my subconscious.

What exactly do anxiety, depression and non-24 CRSD do to me?

It has come to my attention that most people really don't know that much about clinical depression and have even less understanding of what an anxiety disorder is. So I'm going to try and explain a little about what these psychological illnesses do to me not just emotionally, but physically. I did earn a bachelor's degree in psychology when I was in college, but that was over twenty years ago. And frankly, the very basic knowledge that you get from a BS in psychology isn't that useful. So everything I am going to talk about in this post is based on my own personal experience and many, many years of therapy. However, I did use google and wikipedia occasionally to make sure that I was using terminology correctly, and in doing so discovered some new and useful terms to use to describe and define my problems.

My main problem is anxiety. The depression seems to be more of a side effect of the anxiety, though that may be an incorrect assumption on my part. So what exactly is an anxiety disorder? There are actually several different kinds of anxiety disorders that may occur separately or in combination. I not only suffer from Generalized Anxiety Disorder (GAD) which is basically just chronic worry and stress (and which seems to me to be the foundation for most of my other anxiety disorders), but also from Panic Disorder, Enochlophobia, Agoraphobia and some type of Social Anxiety Disorder(anthropophobia or possibly Post Traumatic Stress Disorder). I also suffer from a sleeping disorder that may or may not be related to my anxiety and/or depression.

Panic Disorder seems to be just a more extreme form of GAD. Basically, it means having continuing or recurring physiological fear responses(fight or flight responses) when there is no reason to be afraid. Or when there is reason, having an extreme response when only a mild response is called for. In my case, among other things, it means that I have panic attacks even when there is nothing to be afraid of, and when something stressful actually does happen, these panic attacks can become so severe as to be completely incapacitating. So what exactly happens to me during a panic attack?

When most people think of panic attacks, they imagine the movie version where the person screams and flails about and/or hides in a closet curled up in the fetal position. Well, some panic attacks are like that. And I have experienced that kind, but not very often. In reality, like most things psychological, panic attacks can vary in extremity from mild to full blown. Most of my attacks vary from mild to somewhat intense. A very mild panic attack can simply involve an elevated heart rate and quick shallow breathing. I may not even be consciously aware of one of these mild attacks until Foxfire asks me what's wrong. Somewhat intense panic attacks might include a pounding heart, difficulty breathing, headache, the feeling that your skin is jumping/twitching(possibly caused by spiking blood pressure and/or hyper-firing nerve endings), involuntary muscle twitches, nausea, cold or hot sweats, racing thoughts, difficulty thinking, blurred vision and/or diminishment of physical co-ordination. A full blown panic attack means complete loss of emotional and physical control, and in one case, loss of memory for the event.

One of the stranger symptoms I occasionally suffer is a sort of aphasia. Having trouble speaking during a panic attack is not that unusual. But more frequently, I have trouble understanding speech. In other words, even though I can hear the words perfectly, my brain simply doesn't comprehend them. Sort of like listening to a foreign language, except that the language is English. The more anxious I am, the harder it is for me to understand what is being said. This type of problem is almost always a constant condition associated with a brain injury of some sort, either a trauma or an illness. As far as I know, it is not generally associated with psychological problems. Nevertheless, I sometimes experience it.

So how often do I have one of these panic attacks? Well... almost every morning when I first wake up, I have a panic attack. I refer to it as my Usual Morning Panic Attack (UMPA). (Since my sleep schedule is very erratic due to my sleep disorder, "morning" refers to whatever time I happen to wake up, whether it's 6AM or 6PM.) Sometimes my UMPA is fairly mild and lasts as little as 30 seconds. Other mornings, it can last 30 minutes or more. Very rarely, I don't have an UMPA at all. Those are very good days. Most times, I can still get out of bed even while I am having a panic attack and have done so fairly often. If I hug Foxfire during this time, he can feel my heart racing/pounding. It worried him the first few times it happened, but now he seems to be used to it. Occasionally, my UMPA is bad enough that I can't get out of bed for hours. And even when I make it out of bed, all I can do is lay on the couch and read or watch TV. Reading is usually the most effective way for me to deal with panic attacks, but occasionally, the attack is such that I can't concentrate well enough to read or my vision is too blurry.

Of course, I don't just have panic attacks in the morning. I also have them during the day. Sometimes, they are brought on by a stressful situation, but other times they seem to occur for no reason whatsoever. Like my UMPA, these attacks can vary greatly in duration and intensity. Sometimes, it feels like an attack will wax and wane over several days without ever completely fading away. Those are the days when I just don't leave the house, and frequently, I won't even pick up the phone. These extended panic attacks usually coincide with a depressive episode of at least moderate intensity. Strangely enough, I can still chat online even when I'm beyond the point of being able to talk on the phone. Possibly because you can take longer to respond to people online, or possibly because reading text and typing uses different parts of the brain than talking and listening. I don't know. But sometimes even chatting online is more than I can manage, and all I can do is lay on the couch and wait for it to end. Even when I am asleep, I am not safe from having a panic attack. Sometimes I'll wake up with my heart racing and the sheets will be soaked with sweat.

The most severe panic attack I ever had occurred when I tried to go watch a friend's band perform at a night club. It was very, very crowded. People were literally pressed up against one another. I don't do well in even moderate crowds, so I just kept getting more and more nervous. I should have left, but I didn't. I wanted to stay and watch my friend perform. But eventually, I broke and had a full blown panic attack. I don't remember what I did. There is a completely blank space in my memory. I remember getting more and more stressed out and the next thing I knew, I was standing with about five feet of space all around me and people were staring at me. The friend that had brought me with her to the club came over and led me outside. She didn't ask what the problem was and I didn't ask what I had done, but we never went out together again.

Even though I had suffered from the fear of crowds before that panic attack, that experience has made me even more worried about being in public situations. I had thought that my fear of crowds was agoraphobia, but when I googled agoraphobia, every medical definition that I found described it as being a fear of having a panic attack in a public situation where help was unavailable or from which you couldn't easily escape. But I had been afraid of crowds long before I had that panic attack, and although I did worry about being able to escape, I wasn't afraid of having a panic attack, I was afraid of the crowd itself, of being hurt by the people surrounding me. So I googled “fear of crowds”, and the best term that I could find to describe my fear of crowds was enochlophobia. It's not exactly the most reputable reference, but I couldn't find anything better. The Wikipedia definition of agoraphobia did include a description that seemed more closely related to my fear of the crowd itself rather than just fear of having a panic attack in public. It described ”a condition where the sufferer becomes anxious in environments that are unfamiliar or where he or she perceives that they have little control.” My fear of crowds could well be caused by my inability to predict or control what the people around me are doing. Strangely enough, it seems that there may also be a link between my enochlophobia and my inability to determine spatial orientation once my feet leave the ground. Those with weak vestibular function rely more on visual or tactile signals for spatial orientation and may become disoriented when visual cues are overwhelming, such as in crowds.

Anyway, now, whenever I start feeling stressed in public, I'll try to leave whatever situation I'm in before it gets too bad. Therefore, I have to be careful about getting into situations where I can't just leave whenever I want to, and that rather limits my social life. I recently went on an overnight camping trip, and even though it was just for one night with just my husband and one close friend, I was seriously worried that I might have an intense panic attack during the trip and wouldn't have anywhere to go where I could panic in private. So apparently, I do suffer from agoraphobia as well as enochlophobia.

Fortunately, I do not constantly have panic attacks during most days. And as long as I can avoid anything that stresses me, the attacks I do have are generally mild and short. Unfortunately, it's not just crowds that stress me. All sorts of things can and do cause me stress, but one of the most common stressors I have to face is simply interacting with individual people. Some people cause me more stress than others, and there are the few that very rarely cause me any stress. (I am very lucky to have Foxfire who generally makes me feel less anxious when I am around him. Though even he will occasionally cause me stress.) But being around most people for any length of time almost invariably brings on a panic attack of some sort.

This fear of interacting with others would most likely be called a Social Anxiety Disorder. However, like the definition of agoraphobia, the description of Social Anxiety Disorder doesn't exactly fit my experiences. I do worry about what others think of me, possibly overly much, but mainly I worry about what others will do to me. Whenever I'm with most people, I have an underlying fear that they will attack me, either verbally or physically. I'm fairly sure that this fear developed because of actual events during my childhood. I was repeatedly attacked both verbally(by other students) and physically(by a family member) throughout elementary school and into junior high. (Those experiences could also be the source for my fear of crowds. Students on an elementary school playground could be considered a crowd.) The best term that I could find for this fear is anthropophobia, which literally means fear of people. But it's definitions focus on extreme shyness or fear of blushing, rather than fear of being attacked. I suppose, my problem could be a form of Post Traumatic Stress Disorder, but I hesitate to compare my experiences in elementary school to being in a war. Though Wikipedia does include being bullied during childhood as a source for PTSD. However, in my case, it wasn't the bullies who hurt me, it was all the normal kids who picked on me. The bad boys actually protected me from the others once or twice.

But whatever it's called, this inability to interact normally with others (combined with my other problems) has made it impossible for me to hold down a regular job. I spent most of my twenties and early thirties trying to find a career where I could fit in. Most of the time, I didn't last two weeks before the physiological symptoms of my anxiety and depression became so overwhelming that I simply couldn't go to work anymore. I did manage to last a bit longer at some jobs. (I think the longest was about two and a half months. I was editing training manuals and didn't have to interact with anyone but my supervisor and I didn't even interact with her that much.) But at almost every job, there eventually came a time when I was simply too physically ill to continue.

There were two jobs where I did not become too ill to show up, the first was a bookstore and the second a martial arts studio. However, I was fired from both places because of the disruptions caused by one or another of the symptoms of my anxiety or depression. I actually liked both of those jobs and it was devastating to be fired from them when I believed that I had finally found a place to belong. But apparently, my behavior was just too abnormal to be tolerated. Both managers cited financial reasons for "letting me go", but I know that it was really because of manifestations of my psychological problems. Those failures, especially the second one, left some pretty deep psychological scars. Now, I'm afraid to find a job that I actually like because I “know” that I will just end up hurt when they fire me because I don't really fit in. I don't want to suffer that kind of rejection again.

Perhaps there is some sort of work-at-home job that I could do, but now, even thinking about applying for a job makes me sick to my stomach. The more seriously I think about it or talk about it, the more severe the physiological symptoms become. Just recently, simply chatting online about the possibility of trying to get a job caused me to develop diarrhea and to have difficulty performing physical activities that I could previously do relatively easily.

In addition to the other physical manifestations of my anxiety and depression, I also have a continuing problem with insomnia. Or at least I thought I did. When I read through the insomnia page on wikipedia, I discovered that what I suffer from, though frequently mis-diagnosed as insomnia, is actually a Circadian Rhythm Sleep Disorder-free running type, more commonly referred to as non-24, short for non-24-hour sleep wake syndrome. I had no idea that there was a specific name and diagnosis for what I suffer with. Apparently neither did any of my doctors and therapists since none of them ever mentioned it even though the way that I've been describing it for years is almost the exact same way that it is described in Wikipedia, though with slightly less technical verbiage. Basically, my body's internal systems act as if a day is about 26 hours long. Thus my sleep/wake cycle does not sync up with the normal 24 hour day. It is apparently extremely rare, less than 0.05% of the population has it and most of those who do have it are blind. From what I can tell from skimming through a medical journal article about CRSD's, there are fewer than 100 documented cases of sighted people who suffer from non-24. Though I can't help but think that there are more people out there like me who simply haven't been accurately diagnosed with it. Unfortunately, although I now have a more accurate term for defining my sleep problems, I still don't have a way to fix them. (Though it does explain why the normal insomnia treatments have never really worked for me.) There have been so few cases of sighted non-24 patients that treatment is still very much in the experimental stages and nothing has proven truly effective. However the little data that exists does suggest that this sleep problem is strongly linked to psychiatric problems. Whether it causes them or is an effect of them is unclear. But regardless of it's cause, it's effect is that it is very difficult for me to function normally in society because of my dis-synchronization with the temporal norm.

As for my depression, it's manifestations are less physical and more emotional. It can and does cause headaches, body aches, fatigue and lethargy, but I feel it's effects most strongly in terms of my emotions/thought processes. Like my panic attacks, my depressive episodes can vary in degree and duration. Unlike my panic attacks, my depressive episodes are frequently severe, though they rarely reach the very worst level. My depressive episodes also tend to occur less frequently than my panic attacks, but to last longer. Though it is possible that I simply don't consciously notice mild depressive episodes if they don't last for very long. During a mild depressive episode, I feel tired and simply lack the initiative to actually get up and do anything, even things that I normally enjoy/want to do. During a moderate episode, I feel that nothing I can ever do will really affect anything so why bother doing any thing at all. Physically, it can feel like my body is weighted down by heavier than usual gravity. It is literally hard for me to move. I might also experience headaches and/or body aches. During a severe episode, not only are the headaches, body aches and lethargy even worse, I also feel utterly helpless and hopeless. I cannot believe that my life will ever be better than it is right then, and it seems that the best way to escape the emotional pain (the physical pain doesn't really matter at this point) is simply to end my helpless, hopeless, miserable existence. No matter how hard I try to think about more positive things, my mind keeps coming back to how difficult living is and how easy it would be to die. At it's very worst, I have to literally fight the compulsion to kill myself.

I don't know how to describe that compulsion adequately. It is very different from simply thinking about killing yourself. It is not abstract in the least, it is a very real struggle against an emotional imperative. The closest I can come is to compare it to the struggle not to breathe when you have been underwater a long time. You know you have to wait until you reach the surface, but your body just wants to take that breath in, no matter that you are still surrounded by water. If you stay under water long enough, you eventually give in to that desire to breathe and you drown. You can't help it, the physiological imperative overcomes your knowledge that you will drown. Fighting the compulsion to suicide is like fighting not to breathe under water. I have to continually convince myself that sooner or later I will reach the surface, and if I can just hold on till then, I can survive. And yes, I am afraid that someday that emotional imperative will overcome my knowledge that I will die.

I do not mean for this post to be a cry for help. I have plenty of help from my husband and my therapist. I just want my friends to understand a little better what exactly I go through day to day. I also find that writing things out helps me to organize my thoughts a little better for my own benefit. I certainly discovered several useful things while writing this post. Not only the stuff that I found online about agoraphobia and non-24, but also stuff that I worked out a better understanding of for myself through the process of trying to describe it to someone else. And maybe, just maybe, reading this post will help someone else understand either their self or a loved one just a little bit better than they did before.

Bleh...

I don't want to do anything. Not read, not watch tv, not even sleep. I'm tired, I should sleep, but it all just seems so worthless. I try to get interested in things that I know that I like to do, but the depression just makes it impossible for me to even think clearly about anything. There are so many things that I know that I enjoy doing from the times when I'm not too depressed to do anything, but it just seems that lately, I'm always too depressed. I'm just tired.

Right now, things may be exacerbated by a virus or something that I seem to have. My throat is sore, my head aches and I'm pretty sure I'm running a temperature. But I've been depressed since before I started to feel sick.

I'm still having the occasional suicidal thought, but they are less frequent today. I spent most of the night watching old episodes of SYTYCD. It was a good distraction. I love that show. But I couldn't even imagine taking a dance lesson or even designing a dance costume, all I could do was lay there and watch. It's better than having to fight off suicidal thoughts, but it would be better if I could actually engage my imagination in some sort of positive direction. Ah well... I survived another night. That's something.

What to do to die today

I'm sort of starting in the middle, but that is where I am, so that is where I'll start. I'll probably add posts from the other more public blog that I have and/or explain things more coherently as I feel like it. But for now, I'm just writing to say that I'm having suicidal thoughts that are tending towards impulses, but haven't actually gotten there yet. I'm fighting to keep the depression from getting worse, but even the usually effective distraction of reading isn't really helping much. I'm not sure why the depression is acting up so much now. I suppose it could be that it's taking me so long to recover from my surgery, but I'm just about recovered now. You would think that it would have hit when I was still in a lot of pain and unable to do much, not waited until I was almost finished healing. But who knows. It could also be the changing of the seasons. My depression doesn't seem to follow the seasons that closely, but it is fall and I suppose it could be SADD. I don't think so, though. I think it's just my brain chemistry deciding to act up randomly. It's annoying. I hate it. But even though I've spent years in therapy, gotten a degree in psych, tried just about every anti-depressant out there and even tried meditation and herbal treatments, when my depression kicks in, there really doesn't seem to be anything that I can do about it. It's frustrating as hell.

That's it. That's all I really have to say right now. I'll go back to trying to read and hopefully keep myself distracted until the depression goes away.