Wednesday, 8 February 2012

My Life with Anxiety

I wrote this piece in support of the Let's Talk Campaign, which I consider a really important initiative. The stigma may be the greatest battle in people not being able to seek help.

One of the most surprising things about talking openly about mental health issues is you quickly find out it’s far more common than you think. I was having a beer with a group of guys from my hockey team where someone offered up a compliment on how well I deal with all the complexities or running a business and the travel it entails. I laughed and said that I can’t be that good because I have anxiety. The group was surprised. The group was far more surprised when two of the others talked about having similar issues which both had medicated for it at some point in their life. What fascinated me most afterwards was we would have likely been seen as the least likely among the group.

 Actually, just for clarity what I have is called Panic Disorder, a fancy title that means I can be prone to panic attacks. Now my panic attacks don’t occur completely randomly, although it seemed like it initially, I discovered over time that they need a series of important triggers put in place the likelihood of having one. In my case almost all are linked to driving. I can either get anxiety worrying about an upcoming drive or a full on panic attack during the drive.

What is a panic attack for me?

My panic attacks follow the same pattern: tightness in my chest, pain in my shoulders and arms, followed by light dizziness and occasional getting strong enough to cause a shortness of breath. I’m not incapacitated, but making it go away does become the focus. Most of the time I can “talk myself down” during lesser attacks, but in rare instances I need to pull over and get out of the car till I regain some sense of control (10-15 minutes at the most). It doesn’t mean I get in the car feeling great, and they do occasionally come right back, but most of the time that is enough to break the loop.

The toughest part of dealing with all of this was the beginning. The very first one came as a teenager when I honestly thought I was having a heart attack. I had a second one and went to see my doctor. He told me that I had some form of anxiety and that I should see somebody – the catch phrase when you don’t want to say psychiatrist. I spent about five sessions with the psychiatrist and while we never identified the issue that brought this one (at least that’s how I remember it so I could be wrong in this case), he certainly helped me find a great series of coping tools that worked for a half dozen years.

The attacks were initially rare and random enough that for a while I even thought I had a food allergy which has since been the source of laughter for our friends for years now since they cooked around it for a decade.

But eventually in my late 20’s I found that my attacks were becoming a lot more regular. But what was new was the impact it was having on my sleeping. I’ve never ever been a great sleeper even a s a child, but now I was often up all night worrying about the upcoming trip I was about to make.

I was also getting frustrated (not depressed and I avoided that word on purpose since anxiety and depression can often be related) because I couldn’t seem to solve the issue. I’m strong willed and take on problems head on rather than trying to avoid them. So not being able to “solve” this was a source of consternation for me.

I went to see my doctor (different one - just as good) explaining that my quality of life had become awful. We tried medicating, but after a single day with “no feelings” I had made the decision that I’d rather struggle with anxiety than numb things down. I understand the role of anti-depressants but that wasn’t for me.

I called her up and went back in and she recommended a book called Mind Ever Mood. She said that it was based upon using logic to overcome anxiety and depression. I could not possibly do this book justice by trying to explain these ideas. Instead I’ll explain how it worked for me.

Early on it states (again from what I remember since I did eventually pass the book along to someone else) that to beat your anxiety you have to face it head on each time. It was important in my case to never turn down a booking or trip just to avoid a drive.  

I read the book the first night and slowly began to unlock the basics. The trigger was two car accidents I had in my late teens. I had a nasty accident (purely my fault) on a side road where I demolished a car and was told by the officer that I was lucky to survive. His words have never left me. Then six months later I was hit from the side by a gentleman who turned to deal with a crying child and ran right through a red light.

I was mortal and I knew it. I now had a not so healthy fear of dying.

When the cycle got worse in my late 20’s I was very worried about my father’s health (we’re very close) and I was struggling with my fear of losing him. Secondary triggers are common and the workbooks seemed to point me to this fact. I don’t know whether this comes back to my own mortality or fear of death, but all of it seemed to swirl together during that period.

For some background from my late twenties through till my late 30’s I worked as a golf architect for a busy company. I spent an enormous amount of time on the road going to see clients and give presentations. Often the hours were long with early morning flights out and long drives out to remote courses. While I enjoyed the work, the travel had a major impact on my health. I spent many of the nights (particularly before long drives) anxious about the next day.

The one thing I never did is avoid driving. As I mentioned in the past I’m stubborn and felt that I had to face the fears and anxiety head every time to slowly solve this. Actually stubborn and na├»ve …

What I did learn from the book was to do is start writing about it and talking to my wife more. I used to carry the worksheets with me and begin to fill them out during anxious periods, attacks or occasionally at night before bed. By addressing the issues and identifying what was going on I was facing the fears and reducing the severity of the attack. Eventually I made notes in my workbook in the margins. I still have those books and read a passage recently looking for another piece of information on a course. Eventually I went through the process in my head and got to a point where only a few ever made it to a full attack. Even if they did I could dramatically shorten the span by going through the exercises from the book.

We had a few breakthroughs by following the patterns. My wife identified that the worst period always corresponded to the fall when I was most tired and most overscheduled. Throw in long drives on back to back days and it was almost predicable in the end. It took my wife a few years to pull it all together but she was keeping notes. She also found the link between exhaustion, anxiety and interrupted sleeping patterns.

I left my former employee for a lot of reasons, but quietly anxiety played a minor role too. I needed to be able to manage my own schedule and make my own appointments so I could have some influence on this. And that really helped. But an even bigger that was causing me regular anxiety was my inability to control my future. I was not confident about the direction and future of the company I was working for. Therefore not having any influence was a problem for me. Taking change of my own life and working for myself did not add additional stress, in fact it dramatically removed a major source of anxiety that I had not identified.

I was better, but not done trying to improve things. My wife and doctor (latest one also great) suggested we keep searching. We tried altering my eating habits and I even gave up coffee entirely looking to remove the single most common trigger (caffeine). There was no magic bullet, but I did continue to go to good restaurants for dinner while on the road because I noticed a regular diet of fish and vegetables improved my energy levels for work.

The real breakthrough for me was during the fall a few years back. My wife and I had decided that in our late forties that we needed to be healthier if we wanted to keep enjoying life into old age. It was harder to hold the weight in check, but I wanted to stay just as active as before if not more. I wanted to play hockey against the twenty years olds again one last time to see if I still had it. So we got in shape by walking for at least an hour every day. And I returned to open hockey.

About six months into this I realized I wasn’t feeling an anxiety any more. It was a revelation because I was also sleeping much better than I ever have. The two are obviously closely related. I’ve continued to walk (and eat better) for the last couple of years now and I can honestly say this has made a massive impact.

Last year I drove 26,000 km for work alone. I travelled extensively, in the fall worked very long hours. It was the perfect storm for anxiety to return, but it didn’t. I got tired at times, but not anxious.

But I’m not done looking for other ways to keep things going. The biggest recent change is to fly out the day before because the mornings are becoming tough and I’m so spent at the end of those days. It helps me be effective while on site and the extra cost is worth feeling good. Just like eating better takes more money, but the impact of that was worth it too.

For me it turned out I had found a way to cope. The keys were getting regular exercise, getting enough sleep and having control over the things I could control. That may not be your magic formula but perhaps you can find something that helps you out too.

I’m not suggesting any particular idea that I discussed, I’m hoping that you get from this the idea to be proactive about your problems including sharing them with others for support. You’ll feel better knowing that you’re not alone and others are more than willing to help you out including doctors who take the time to help you find the answer that’s best for you.

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