The following entry was written at the time period in which I knew that I had major health anxiety, but did not understand yet that it had turned into generalized anxiety disorder. At that point, I had continuously pacified the anxieties by constantly going to doctors for reassurance. But at this point, my subconscious had taken over and my worry and anxiety was on autopilot. The feelings experienced with generalized anxiety are doom, dread, gloom, depression, lack of will to live, and the feeling like you are going crazy. To best understand the feelings I was experiencing at the time of this writing, I will quote what someone posted by a user who calls himself Styrofoam Jones in a forum called "Mark's Daily Apple":
"I'm dealing with some pretty hardcore anxiety issues as well, and have been for some time now. I get panic attacks to the point of derealization and depersonalization. Whenever I start moving towards a panic attack it's like I've stepped back or "zoomed out" from reality as if it were a movie on a screen that I've been sitting way too close to my entire life. My body's still in the real world, but my "soul" feels a million miles away. It's like... I'm dreaming that I'm in a movie theater all of a sudden and I'm watching my life from afar up on the "screen". Everything in the world feels unreal and completely alien, when I look at an object it seems loose and fake, as if I could just reach out and put my hand straight through it. Even when I touch it and feel that it's solid, it doesn't register as such. My own house looks like the surface of another planet, like something I've only heard about or seen in pictures, and I start to become unsure of every thought, every memory, every single part of my identity. That's the best I can explain it. This started happening after I had my first major panic attack. It's terrifying and incredibly intense, it literally feels like reality is falling apart around you. Truly a living nightmare, and it adds a whole new, completely unnecessary level to panic attacks. I thought I had literally gone insane the first time it hit me, I never imagined such a feeling or state of mind could exist. I've heard this is somewhat common among people with panic and general brain disorders, it's supposedly some kind of fucked up defense mechanism of the brain to reduce the impact of a life-threatening or traumatic situation, and I guess some people are just more prone to it than others.
Now that you've read this description of what I was experiencing at the time, you can better understand the rambling nature and the context of the following entry. Since it was not written in a structured, paragraphed form originally because it was a constant flow of thoughts, I will post it in its raw form to best capture the emotions being experienced at the time:
Keep in mind that this type of writing did not help alleviate any of the anxiety since the only way to ultimately "cure" anxiety is to understand it, acknowledge it, address it, challenge it, and modify the thinking and reaction patterns in the brain as you will see in future posts):
It’s either cry or write. And since I can’t exactly cry right now, I guess I’ll just write. I’m sitting in my office on a Friday surrounded by 6 employees who look to me for guidance. I need to be strong, in charge, in control, and okay. At home I have a wife and four young children who love me and who need me. My wife needs me to be a man for her and a head of household, and my children need me to be strong, to be a father. But inside I feel weak, depressed, on a downward roller coaster headed toward an abyss of emotional darkness. I feel like I’m in a riptide threatening to pull me under while I hold onto a small plank, my fingers slipping off. But drowning is not an option. It’s not a devastating option or an option with horrible consequences. It’s not an option at all. I can not and will not allow this false, intangible force to take me as it has many others. If I were to be physically injured, that injury would result in a tangible, actual damage to flesh and organs which would explain any negative outcomes. But when everything in life is going well – I am married to my wife whom I love and cherish, I have four beautiful, healthy children, I have a beautiful apartment in a great location, in a great neighborhood, on a nice block within feet of my office, my landlord is nice, I have an excellent position at a great company where I worked my way up and have a great team of employees, an amazing employer, and an excellent salary and good benefits, good health, the children are in great schools and camps with amazing teachers where they are really growing in all ways, they have door-to-door transportation and my 2-year-old’s playgroup is right across the street from my house, and I am able to go home whenever I feel like it for the most trivial of matters, and I have a great relationship with my contacts at the city program with which my company is affiliated – it would be absolutely disastrous if something as relatively minor as unrealistic feelings were to destroy all of it. If I were looking at myself from the outside, I would mock myself and kick myself in the ass and say, “Come on, man, you have it all! Why would you let something so stupid, intangible and unsubstantial kill it all for you! Get your act together and snap the hell out of it!” I have a brother, the one right under me, who is and has been in a depressive funk for years. He’s tried the tapes, the programs, medications and psychotherapy but has just been unable to get it together and break free of the darkness and gloom that has enveloped him. He stays in his cluttered room for most of the day, is glued to his electronics and iPhone, hardly leaves the house, has trouble holding onto a job, and despite girls being interested in him, he just can’t get it together to go out, get married and start a family. I’ve screamed at him to just snap out of it, to stop the excuse of “I’m working on myself”, or “I started seeing a therapist” and to just get the fuck up, go the fuck out and start living already. But now I realized that I misjudged the severity of where he is mentally, psychologically and emotionally. When you don’t understand what someone is going through it’s easy to be simplistic and judgmental, but when you truly understand them, you realize that it’s not as simple as it seems from the outside. That is not to say that it is impossible, but it’s definitely not as easy as it seems. I went through absolute torture and hell both physically and emotionally as a child and when I turned to people for help, they all had simplistic solutions, and I learned very fast that people who are not in your situation are in no position to “solution” the issue for you with suggestions like “why doesn’t your father just leave your mother?” or “why don’t you just move out of the house?” My unsaid answer is always the same “it’s not that simple”, as I realize that no one else will ever truly understand because they are not there with you. Another way that I find myself being judgmental and simplistic is with celebrities who have it all and then ruin it all with something as simple and unnecessary as drug abuse, crime, suicide, etc. “You fucking had it all: health, fame, assistants, fans, wealth – whatever the hell you could ever want or need at the snap of a finger – and what do you do? You do drugs, kill yourself by overdosing, steal and go to jail? Why?!” But now I understand how you could seem to have it all but inside you are in the abyss, in the relentless darkness. The fans screaming are a blur and you are numb to your possessions. It’s a scary numbness because you are cognitively aware of what you have going on and how good it is, but you just don’t care. You feel like you would rather trade places with the poor nobodies who are at least happy, than to have it all but to be dead inside. No one except the one in the situation could ever comprehend or believe that you would make the trade in a second, but you know it’s true. So you would like to just curl up in a ball in your bedroom and never go out. But your manager pulls you out when it’s time to go out there and greet the fans. So you get up and go out and smile and wave and perform to the masses and it looks like you’re having a good time and living it up, but only you know that inside you are in the quicksand abyss of darkness, sadness…you just want to die….but you can’t because they’re pushing you to the next interview, the next crowd, and you go and you smile….then when you’re alone and have to face your demons, there are no crowds, no noise and no flashing lights…it’s only you and your dead innards. So some turn to illegal drugs, some turn to prescription drugs, some turn to suicide – and in many cases they all go hand in hand. Some just go away, leave the scene, and perhaps find happiness – perhaps not. But I now see that we can’t judge – you really never know until you are there yourself. I always judged Britney Spears, for example, over how she had it all and just threw it all away by “snapping”. But who am I to judge? When the lights, sounds, screaming and fanfare go away it’s just you and your demons, and you say fuck it! I’m depressed! I’m sad! I’m lonely – believe it or not, and I know you don’t! And I’m tired of making believe I’m happy and that everything is just fine and dandy. In fact, I now believe that what Britney Spears did by “snapping” was the alternative to suicide, because had she continued to play the happy-go-lucky girl who has it all, and did not take the opportunity to act on her internal feelings, there would have been no other way out but suicide. I sort of feel that way to some extent: my wife made it clear that she is not going to stick with me if I go down a self-destructive path of depression and darkness. You have a wife and four kids who need a husband and a father and there is no place for pointless darkness. If you go physically sick or injured that would be one thing, similar to my opening sentence about the tangible, practical damage that is understood and justifiable. But absent a clinical reason for depression – i.e. a pointless, useless, unnecessary self destruction has no place. It doesn’t have to happen and it cannot happen. And if that’s the path you choose, then you’re on your own. This sounds harsh, unsupportive, disloyal and like abandonment. Did you not vow “for better or for worse”? But it’s the best thing she could ever say. If she were to support this needless behavior she would be enabling it. And the ones who would get hurt would be her and the children. As things are now, we are all so busy and preoccupied with getting through the day, that any other variable, especially when it is at its core nonsense – in that you feel sad when everything is actually good and going well – like someone who just ate a full meal and complains that they are hungry. She said that if something were to happen, G-d forbid, to a family member we would all stand by that person and find the time and resources to be there for them, but if someone makes what is, ultimately, a choice – more on that later, so please hold onto the strong feelings associated with that thought – there is no guarantee of support. I was just looking through my health plan coverage documents and I happened to come across the policy on coverage for second opinions, and it says “our decision – no cost, your decision - $50 copay”. In other words, if something happens to you or if someone causes something to happen to you, then it is the responsibility of your loved ones and perhaps of the community or society to stand by you and support you, but when someone makes a decision that negatively affects them, they are on their own. Perhaps others will support them, perhaps not. But what is definite is that I would never begrudge others for failing to stand by a person like that. Similarly, unemployment benefits are available for individuals who lose their job by no fault of their own, but if someone chooses to quit their job, they are on their own to deal with the consequences of their decision. And that is the treatment and ultimatum that my wife gave me. If something real happens, I’m there, but if you want to jump off the ledge and go down the road which as you will see is an endless one, then you are on your own. Sitting one day and in a bout of anxiety, I actually decided to myself that I would write a letter saying that I had decided that I need to go down the path that I think I need to, be it medical or psychological because I can no longer live this way with this internal torment…I love you and I hope that you will stand by me during any journey, but I will fully understand if you don’t and will not hold any grudge if you choose to leave while I take care of what I feel I need to take care of and then when I’m better you can decide if you want me back. But then I realized that that decision would amount to letting go of the shore and allowing the tide to suck me in for good. You see, there’s no coming back from that endless road. Case in point: my brother and everyone else who is part of an internet forum where a group of nameless and faceless anxiety-ridden hypochondriacs all engage in an endless vicious cycle of what amounts to enabling and scaring the shit out of each other. They each share their vague symptoms, how all tests they’ve taken have shown nothing and their doctors roll their eyes at them and don’t take them seriously, and how they are convinced that their doctor is wrong, that the tests missed something, and that they really are sick or dying. Others buy books, more books, CDs, more CDs, programs, systems, series, etc. only to feel better for a minute then relapse and need another dose of self-help. If it were as simple as taking some time away, following some type of twelve steps to happiness program, then I would gladly do so. But I know that it doesn’t end and never will if I went in that direction. It’s like a depressed person who has a drink because they want to feel better, but since they didn’t actually address the reason for their unhappiness, it creeps right back up as soon as the alcohol wears off and they’re back to square one and for another, stronger drink, and from there it never ends well. There is only one difference between my brother’s situation and mine. He snapped, that is his anxiety kicked in, before he got married, and because of that, he was on his own to deal with it and does not have an anchor, such as a wife, kids, financial responsibility, etc., to keep him grounded. He was left to drown in the quagmire of a depressing home with no mother and an unemployed father. He spiraled into a world of buying distractions, trying books, systems, and programs, and trying various methods, all the while telling people that he’s working on himself or that he needs six months to get things together, and all the while the days, weeks, months and years pass by….I, on the other hand, was fortunate enough o be completely stable for long enough to enable me to get married. Engagement, marriage, infertility, pregnancies, children, and employment all helped to provide enough distraction and preoccupation to keep me on track. With time, as episodes of anxiety try to rear their ugly heads, you can start to feel anxious, but you can’t sink into a hole because a diaper needs to be changed or an employee needs guidance or a child is ill, so you gotta just snap out of it and take care of what needs to be done. Family and a job also take away a lot of the time and money needed to pursue the endless anxiety-induced doctor appointments and specialist visits. With me it’s primarily health anxiety and hypochondria. Since I was a very young child, I would feel every little twinge, pain sensation, feeling etc. and assume the worst. Headaches: I believed I had a brain tumor at age 8, chest pains, I was having a heart attack at age 11. As I got older, it evolved: I walked into the wrong room in the house or put or looked for something in the wrong place and I was getting Alzheimer’s at age 24. I put something in a drawer at night and couldn’t find it the next morning and I was convinced that u was sleepwalking. When I couldn’t find it anywhere in the house, I was convinced that I was sleepwalking out to the street and perhaps even driving the car (as it turns out, the magazine that I put in the drawer had slid into the area behind the drawer and was only found when we moved years later and had to disassemble the nightstand). A swollen lymph node, and I worried about lymphoma, and cold that lasted longer than the usual few days and I feared the worst. The worst part is that it doesn’t fucking end! As soon I get over one fear, the next one is waiting in line to crop up. A small freckle evoked fears of melanoma, followed immediately by some minor, occasional heart palpitations (ironically caused by the anxiety itself) caused a heart-related concern. No sooner was that resolved that I started to feel dizzy and lightheaded. The very day that subsided, body-wide muscle spasms (also caused by the anxiety) resulted in fear of nerve damage. The day those subsided, the dizziness and lightheadedness came back. Now here’s the tricky part: my father was diagnosed about ten years ago with a benign brain tumor that had apparently been growing slowly over many years. Thankfully it was removed and he had a complete recovery. That being the case, I don’t want to take any brain-related suspicions too lightly. My wife says I’m insane and that this is just the next in the never-ending series of health anxieties and that if something was seriously wrong, I would have more than just some vague sense of dizziness – I would collapse, faint, slur, etc. Agreed, but it’s hard to walk around feeling like you’re standing on spongy, unsteady ground – anxiety or not. So I went for a physical. Blood tests were normal, except for low Vitamin D levels. I asked the doctor who did the physical if he had any idea as to why I would be feeling dizzy but he was so anxious to get me out of there and move on to the next patient that he didn’t even make eye contact when telling me that he didn’t know. So I went to my kids’ pediatrician who did a vertigo test asking me to follow his finger, follow a light, walk in a straight line, etc. He concluded that it didn’t look like vertigo, that he didn’t seem concerned, and that I should take a multivitamin since vitamin B deficiencies could explain dizziness. I immediately started taking a multivitamin and Vitamin D. my wife said she thought the dizziness could be a result of not eating (most likely resulting from the anxiety), so I started trying to eat better, despite a diminished appetite. After a few days, the dizziness subsided somewhat and the muscle spasms kicked in, so after doing some research and speaking with my primary care physician, I started taking Calcium and Magensium supplements. After a week or so, the spasms diminished and voila – the dizziness reared its ugly head once again. However, since a brain tumor usually results in headaches, waddaya know, shooting-pain-like headaches appeared. After trying to eat right and ignore it for a few days, it did not go away and I worked myself into a panicked frenzy, most likely making things even worse. This time I decided once and for all that I would put the matter to rest. You see, I have this really bad habit of combining and compounding symptoms: for example, the dizziness could be a result of a brain tumor, then the muscle spasms, a function of the nerves which are controlled by the brain, could also be a symptom. Add to that the pinching headache and the occasional sinus or tension headache and you have a cocktail of zero plus zero plus zero equals a thousand! So I decided that enough was enough. I’m going to see a neurologist and get to the bottom of it. But I knew that a neurologist cannot see inside your head, and that a conclusive answer could only come in the form of an MRI that can see inside one’s head. But, I felt that a neurologist could , firstly, give an educated assumption based on my symptoms, and secondly, that I would need to go to a neurologist to get a referral for a brain MRI. I skipped the primary care physician because the most they could do is send you to a neurologist anyway, so why bother? So I scheduled an appointment with a family friend who is a neurologist and hoped that by the time the appointment came around, I would cancel because I was feeling better. The day of the appointment I canceled because my wife decided that she wanted to take the car out and I couldn’t tell her that I needed it because she didn’t know about the neurologist appointment because if she did, she would have considered that as my deciding to go down the endless path of health anxiety, and the ultimatum stood that she would leave me. And if, as I hope and pray, the results come back that everything is okay, then that would just solidify her feelings about me being an anxiety-ridden nutcase. So if all is okay she doesn’t need to know anything ever happened and I get to know for a fact that all is well, and if not, then she would know, but there would be no reason for her to be angry. I am hoping and praying that there is nothing wrong and that there is nothing to ever tell her, and all that comes from this whole secret journey is that I get confirmation that I am 100% okay. But I swore to myself and I had better keep to it: this is it! Now that my heart has been confirmed to be structurally and functionally perfect, the once the same is confirmed for my brain, then the only issue causing any symptoms can be anxiety which I am hoping disappears with the confirmation. And with the vitamin supplements a deficiency cannot be the culprit. So the neurologist said that he is 100% confident that there is absolutely nothing wrong neurologically, but that since he is only human he would like me to take some basic tests in his office and then an MRI for extra reassurance. I took the vestibular test, brain wave test and balance test and when I called the doctor for the results, he said that I had passed them all with flying colors. He repeated that he is convinced that the dizziness is a result of nerves and that the MRI is not absolutely necessary, but since there is no absolute way to be assured 1000% without an MRI, that I should schedule one anyway but that it is not urgent. I decided to schedule it for the following Monday so I can be assured that the neurologist will be around to share the results as soon as possible and that I don’t have to torture myself for an entire weekend while waiting for the results, or if, G-d forbid….so here we are: the dizziness is still there in full force, I have the verbal and basic test reassurance that there is nothing serious going on and that it’s all nerves and the neurologist’s confidence that the MRI will show a perfect brain functioning perfectly to the point that it is needless other than for my own reassurance. Most of all, I have G-d, prayer and hope that everything will turn out fine. And then the secondary anxiety kicks right in: what if as I hope, pray and strongly believe, everything does, in fact, turn out to be perfectly normal yet the symptoms persist, then what? That’s where this writing comes in, because there is the anxiety until the test and the results, and then there is the anxiety about what happens after regardless of the results! As is expected and hoped for, all will be okay, which leaves the dizziness with only one possible cause: stress and nerves. And that’s where the fork in the road comes in: accept the fact that everything is okay and stop worrying so much, stop being anxious, stop fearing the worst with every little pain, twitch, sensation etc. Your heart, brain and blood tests are all perfectly normal. Enjoy your family, your wife, children, great job, the amazing weather, health, etc. Or find the next, even more obscure thing to be anxious about. And at that point, it’s a big decision: do I accept that everything is okay once and for all and start to enjoy life and the beautiful blessings I was given, or do I start on anxiety medication which may or may not alleviate the symptoms of anxiety, all the while creating a stigma, removing my highs together with my lows, and all of that on top of whatever side effect those medications may have. On top of that, the medications don’t even treat the anxiety itself, and psychotherapy is still needed. Here’s the thing: if I thought for even a second that there was an end to that road, perhaps I would exhaust that avenue, but the fact is that the best customers of self-help books are people who bought other self-help books. The people in the worry-wart internet forums are a group of people living in darkness and dreariness each one feeding and exacerbating the others’ fears and anxieties in an endless loop. I am not going down that path! I am a respectable individual with a wife, children and a respectable job and I am not about to give it all up and hurt all of the other people who need me along the way. My wife needs a husband, my children need a father, my employees need a boss, my employer needs a manager for his business and the children my company services need me to ensure that they receive the best quality service possible. And in all that I wouldn’t even be getting the help I need for myself. So what’s the fucking point? Again, I would never again judge someone who does give it all up, like the celebrities who have it all yet throw it all away one way or another, because it is a difficult struggle. But it’s a crying shame when it does happen – when someone who had everything they could ask for and everything going for them, yet the throw it all away and, in the process, they don’t even get what they wanted – happiness – they end up dead, injured, incarcerated, etc. So again, what’s the point? Even if what you have is not making you happy, it’s not like the alternative is happiness, so they’d may as well be unhappy and try to achieve happiness with the life they have rather than end up self-destructing and not end up being happy anyway! On a similar note, another situation where I learned one could never judge another, as much as you may disagree with or despise their decision, is when a person has the most beautiful girlfriend or wife in the world, yet they give it all up by cheating on them and what’s more, with someone many times less attractive than what they already have. People admonish them for giving it all up for less than what they already had, but that’s an unfair judgment, since one does not know what the other is going through. They may appear to have the ideal life, family, career, etc. but they could be extremely unhappy and choose a self-destructive, seemingly less-desirable alternative, but that is what they thought would make them happy. Yet it most likely won’t since they now destroyed their wholesome relationship that they had with their beautiful wife and children. Just like the Britney Spears at one point leaving her life of fame and fortune for a trashy life. But the beauty of it all: there are always comebacks. Pitbull, Mary J Blige, and Britney Spears to name a few. And what we see from all of this is that these people are looked down upon while they are in the downward spiral, and then they are honored and adored when they eventually come back. Those who go down the destructive path until the end are never glorified. Only those who stay on the straight path or who come back are honored. So considering the alternatives, one had may as well stay on the path of happiness for themselves and others and to work with what they have, rather than to let go of the shore and start down the slippery, never-ending slope into the abyss. So, I got home today, Friday, after running to a few different stores in weather close to 100 degrees and insane humidity, then carrying my almost-40-pound 2-year-old to and from playgroup, plus running to and from the post office, and I was not feeling so good. I felt like I was walking on a moon bounce, light-headed, and the air quality did not help the matter at all. I panicked. That’s it, I’m dying, and I know it’s not nerves because I tried so hard to calm myself and to go to a happy state of mind, but at my happiest, the second I would stand up that feeling would be there. And now, mood changing wouldn’t even help, so I’m doomed to feel this way for the rest of my life with no solution, no way out…either there is something wrong and I’m screwed, or there’s nothing wrong and I’m screwed! Now the panic set in even more and I was just not feeling too good. I came home and everything was a blur. The kids shouted “Totty’s home!” but I just didn’t care. Deep inside I did, but it was all a blur – I was numb to whatever was happening around me. And it killed me inside that I didn’t care. Here are my children so happy to hear me coming up the stairs and opening the door and to tell me what they did so that I should be proud of them, and I just didn’t feel it inside. I just imagined what it must be like for those on SSRI’s who, as a result of the chemical inhibition of selective serotonin, are unable to experience highs and lows and are reduced to numbness and apathy. That’s okay when the alternative is rage, anger, and causing harm to oneself or to others, where neutrality is the relatively preferable option, or where the highs or the lows are interfering with one’s ability to function. However, where there is no inhibition on function and no harm being caused to oneself or to others, then to be numb takes away the ability to enjoy the happy moments to their fullest and, worse, it does not allow for the correction of the issue. As an example, brain surgery is done without general anesthesia because in order to correct the problem and in order to do so without causing further harm, the surgeon needs to know what their actions are causing in order to ensure that the problem is being fixed by their actions and to ensure that they are not causing additional harm. Likewise, if the individual is neutralized by SSRIs while they go for psychotherapy, then it will be difficult to really reach the core issues and to ensure that they are being addressed appropriately, that they have been corrected, and that no additional harm was done in the process. In short, I don’t like numbness and I have a sense of what that feels like, and I don’t like it even more. Anyway, so now that I was in a full-blown panic, the first thing to go, as always, was my appetite. But I knew how important it was that I eat, since my wife has long suspected that that was the root cause of the lightheadedness issue. So I started eating in a mechanical manner, but she was able to detect that something was not right. She asked if I’m okay, and I said “yes, I’m fine”, but when she pressed further I had to admit that “I don’t feel so good”. “What’s wrong?” she asked, looking annoyed at this ongoing problem.
(This post, as many others, ends abruptly because it was unfinished due to time constraints, distraction, preoccupation, etc.)
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