Curious creatures

What curious creatures we are. We all have our little ways and eccentricities. I'd like to tell you about one of my own. If I have mentioned it before then I apologise in advance. Above is an item I bought on holiday eight years ago in Prague. The little shop is in part of a museum in the old town square and as the lady wrapped it in brown paper I realised I was never going to open it. Why this is I am not sure. A voice somewhere inside said to leave it wrapped. Almost a decade later it sits still housed in the brown paper.

Recently I have been thinking about it. Why on earth would I buy something and not unwrap it? It is in fact one of the few things I have ever bought on holiday to keep long term. Apart from a football shirt, few prints of the Charles Bridge and some prints we bought in Paris I can't think of anything else. So it makes it all the more peculiar that I would never open it.

Maybe I like the mystery of which I have little in my life. Maybe I want to have something personal, again I have few items like that. On pondering I've come to another conclusion. Its because I know what is inside and I have read the story. There is nothing new in there for me. There will be no little jump of excitement on opening it. That is for someone else- and probably disappointment too. Someone, maybe on of my children, will one day find it and open it up to see what it is. The surprise is for them.

So what is in there? Oh the suspense! I did think about playing a little guessing game but won't. For one I can't remember if I've already mentioned it and also the clues are there to make the guessing game very short. From the image its not hard to guess its a book and as I bought it in the Czech capital the chances are it was written by one of her most famous sons. This one is "Die Verwandlung" by Franz Kafka- or "The Metamorphosis" as us English speakers know it. I can't even remember if I bought the English translation- I've always had an urge to buy a foreign book in its native tongue and go through it with a dictionary of that language by my side. This would have been perfect as it is a novella.

For those who don't know Kafka he was an existentialist and this came through in writing by the use of metaphors in his stories. This book is the only one I have read from the author. Its not, in my opinion, great but I liked something about it. Today it resonates.

"One morning, as Gregor Samsa was waking up from anxious dreams, he discovered that in his bed he had been changed into a monstrous verminous bug."*

That is the opening line and it sets the tone quickly. Its also something I think a lot of us can relate to. From there Gregor, who has become some sort of giant cockroach stuck on his back in bed, lives in his room listening to the world carrying on as normal outside. Over time he becomes something forgettable to the rest of his family because he serves no purpose (or no longer fits in to societies view) and his room is only ever entered to use as storage. Then...well I could spend another few paragraphs going over the content.

*The translation for old German varies per translator and there is no straight exchange. This line is taken from the link provided at the end but the bug has been described in many different ways.

Grant me the serenity

Anyone who's life is restricted by frequent panic attacks, or any other mind block, has most likely been told or has read that the only way to rid themselves of them is to see them through. And this is what we believe. Within this belief self doubt is born and the path to hopelessness is tread because for a lot of us we have tried this and failed every time. Hope dies with each failure. So for us it would appear that the solution is beyond our grasp and what a big hole that blows in our view of the future.

I know at least that is how it has been for me. Over the past few years I have put myself in situations that are panic inducing. Sometimes I can cope but mostly I can't. The one thing that remains though is that every time I do it the intensity of the experience remains high and I have yet to see panic through. Or at least that is what I have thought. Its actually not true.

Since my first panic and learning that I have to pass through panic I have thought myself unable to do it. I've looked back at the many occasions in the car and out walking when I have had to flee. Sometimes I have tried to stay with it but eventually given up and ran. Partly I don't quite believe it will pass and also if it does pass then I may be left shattered by the experience leaving me of little use to anyone. What I cannot believe is that I have failed to see the many times I have passed through panic. All the failed times I recalled were those situations where I had the choice to get out and did. But what about the times I had no choice? What about the times when there was nowhere to run to or run from?

For a lot of us, if not all, the place we flee to when we panic is home. What happens though if the panic surfaces in the home? There is nowhere to run to and there is no way out of it because your instinctive safe place is actually where the fire is. Its the worse kind of panic in my experience. It is more agitating that panic outdoors and lends more to the sense of despair. There is no choice. You have no option but to see panic through.

I have had panic at home many times so I have therefore passed through panic many times. And from my own experience I can see it is not a solution for me. So if that is the only way I am indeed stuffed. Repeated passing through has not made the intensity any less, my fear of a return any less or the actual return any less frequent. This GAD is just a fancy umbrella term for that constant threat, the high state of alert. But this knowledge is good because I now know at least that running into brick walls outside is doing me no good. Avoidance and fleeing are not doing me any good either but they are better than the alternative which is not a long term answer either. In my case both are futile so I might as well take the option with the least torment. The only negative in fleeing and avoiding is guilt but I can now chip away at that in the belief that I have nothing to feel guilty about.

When my mind is free of anxious and negative thoughts throughout the day it usually turns to looking how to change my situation for the better. Its a bit like the prisoner going through the monotony of the day in solitary while having those little moments to plan an escape. Nothing has changed and nothing ever seems to change regardless of effort. Maybe it about time I stopped planning the escape and just get used the the idea that this is how things are going to be. Like the proverbial prisoner it might be better just just serve my time with minimum fuss and no add more time to it with repeated failed escape attempts.

Recently I have started to question everything again. For a few years now I have assured myself that I understand my state but this understanding alone is not enough to find a solution. Over the last week or so though I have started to question that. The logical part of the brain is not happy as that statement does not compute. What if this understanding isn't right? I am just reading what are considered the expert views on the subject which are general rather than specific to the individual. What if the reason so many people are still stuck is because they are buying into something they believe is right but actually isn't? At some point when you are not moving forward and are indeed still stuck I think you have to question the situation. I am not religious but I am starting to see the sense in the following quote which has popped up three times this week in my life alone.

"Lord grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference"- St Francis of Assisi

Trust

I drove, we all do. In the beginning I drove as fast as was humanly possible in order to see just what the machinery under my control was capable of. The boundaries stretched to breaking point before easing off the accelerator so as not wreck the engine. Then it was time to slow down. There was no point rushing the journey with so much to see. The longer I drove the more I slowed and the more of the surroundings I observed at a leisurely pace. At some point there may have been warning lights flashing on the dashboard but I was too wrapped up in the new wonder to notice. And then suddenly out of the blue I came to a halt. There was no more fuel, the tank was empty. That was a shock but never did I believe half a decade on I would still be sitting there on the plain with nothing but hills, dust, sky and sun as far as the eyes could see.

The days changed from there. In general observation you may say they were always the same but they were not. They all had their little differences. It was like a recurring dream that is familiar but somehow different in its own way. Each day started with awakening there and all day long I would desperately turn the ignition. Over time this is where the change occurred. In the beginning the engine would not start. Over time though I would get it coughing enough to start moving forward. There I would bump along awkwardly on an empty tank before finally coming to a halt once more. The fumes taking me so far but not far at all in the scheme of things. Some days I got further than others, some days less. Always though I knew in the back of my mind that no matter how far I got it was never going to be enough and I would awake the next day back where I started.

That is how it has been each and every time. In the early days I clung to the hope that another vehicle would drive my and lead me out of there but as time passed I learnt that no one was coming- ever. Sometimes I'd turn on the radio and a voice would promise me that the future would be different. Sometimes I believed and sometimes not but alas nothing has changed except the sound of the voice. Endlessly I would sway between the two truths until one day I turned it off altogether. But the next day I turned it on again in hope. This is the agitation of being caught in bewilderment and desperation.

And so today I woke up and I am still here- in this place. It is no surprise. My vehicle has bumped along a few feet. Nothing much and a futile task as I know I will be back here at the start again tomorrow again but it beats sitting still. Over 1000 days of 24 hours have strangled all but the deepest set belief that things might one day change. Repetition does that. Life is about learning and that is what my mind has been told. I cannot help but see the endless repetition of more days like this lying in wait.

There is a difference between this present moment and that of 10 or 20 years before. It is one of trust. Back when I was younger I was fearless and I trusted myself to the point that I didn't have to think about it. I was master of my body but now I am not fearless because I can no longer trust my body- or myself. It no longer does as I ask and I have become accustomed to it shutting down on a regular basis and holding me back. I cannot trust it to take me where I want to go. It reacts of its own accord and defies me. Prolonged bewildering illness, that was when the trust was lost. After trust began to dwindle that is when the body started to disobey. It would frighten me for the sake of it. When I was somewhere peaceful in my own head space it would leap, jolt and shake me out of my dreaming with a shock. It is a devious beast of a thing this rebel. And now that I have found the task of taming it or getting it to submit a fruitless one I must look for other options. One thing I know for sure is that something which was one has become divided by mistrust and it is the issue of trust which continues to keep them apart.

What I am trying to say in my own round about way is that I don't see much change nor foresee much change in the near future. I really have to get this clear in my head as I have been approaching this in completely the wrong way. When I looked at my problem I saw two main issues I needed to tackle. Those were getting out and staying out. In order to face them I have walked every day, with the exception of a few, for almost the past year and for the last 6 months been going out in the car. I can see progress if you want to call it that but it never going to be a solution. I have fooled myself. These efforts are worth it and I will carry on doing them but they are not the going to change my situation in the longer term. If I did this for the next 10 years I still would not be very much further forward because I am missing the real issue here. I am not at peace. While I am not at peace I am never going to go far and won't stay out for long. It is this internal issue I must tackle over and above everything else. When I step out of the door or when I get in the car I am agitated by the accumulation of constant nervous tension. It comes with me and even if I go further it is never with ease and will still be as hard the next day to repeat. That is why I wake up every morning back where I started. That is why the vehicle does not go very far and when it does it trundles along bumping on an empty tank. I have been looking in the wrong place. The 'agoraphobia' label is one I have given too much importance too. My primary problem is not that I am agoraphobic as this is just a secondry symptom. Its not that I have panic attacks because this is also secondry. I have constant background anxiety, that is the main problem. I need to fill that tank which is drained daily from general nerves and the tension it produces.

I am lucky to have already had in the past suggestions on this front here which I am most thankful for. One of those is breathing exercises. My problem has been that I have tried to employ those while out rather than the more obvious routine of learning them at home. Routine is the big part. At no point in the day do I put aside time to do things that may help calm me. Relaxation or maybe even meditation. Just something to bring that general anxiety down- even if its just a notch it will have been worth it. This is where I must place my efforts. I see that so clearly now. I have lost trust in my body so every time I go out it works against me. I must gain that trust again and the only way I can see to do that is to treat it better and try to care for it more. Or at least stop tensing up against it. If I don't I am going to wake up every day one that empty road again with an empty tank regardless of how far I bumped along the day before.

This general anxiety is always at a high level I think. When you read self help books they tell you to rate your anxiety. That's rubbish. It changes from moment to moment. By the time I write down it is at 8 it may have already gone down to 5 and as I cross that out jumped back up to 7. Its a constant variant. It does fluctuate so when I say its at a high level what I really mean is that it fluctuates between a moderate and high level. This is what makes even the thought of going out the door difficult and the doing it harder. It is also the reason I cannot enjoy the company of people indoors because I am always feeling it there. It is what lends to the self doubt and lack of confidence. It is was breeds the mistrust. It is the primary cause of all my problems hidden beneath the guises of anxiety buzz words like "panic" and "agoraphobia".

Now I see clearly. I see how it started, progressed and why I have been stuck in the loop. My anxiety problems started with a prolonged illness that soon become buried under the symptoms of the anxiety they created and I didn't see where one ended and the other begun. They persist but I've been looking for a way to get back out into the world to reclaim my life while it is near impossible in this current continued state of constant anxiety. That is the problem I thought I had to overcome but it is not, or at least not the root. Its not about overcoming panic. Its not about seeing how far I can get out. Its not even about seeing how long I can stay out. These things are all about seeing how long I can stand the rising anxiety which is already too high before I have even begun. It is all about dealing with the GAD and that is what it has always been about but I just never saw it until recently. Its time I now learned how to trust my body again and in the process become one with it rather than bitter enemies. My mission is to look for solutions and apply them. It is time I put aside time each day to try bringing that anxiety level down.

Finally let me take all that and turn it on its head. I started the last paragraph with "Now I see clearly". Do I? How many times have I thought that and then quickly thought the opposite? Its the strength of finding the truth you have searched for followed by the almighty crushing doubt of finding it was a lie. The anxious mind does that. You think black, it counters with white. This malicious anxious mind may be duping me again. Maybe it is behind it. Maybe it makes me believe that it is all the thought of the body. It is my mum without friends putting thoughts into my dad's head to send him off on one while she stands back and watches the carnage from a distance. This useless rogue body may not be the problem at all. Can I live with these constant sensations of nervous tension? Is it not actually my mind that is telling me that I can't and therefore actually shoveling more coal onto the furnace in the process? A lot of self help books say that if you accept these problems they will go of their own accord because they will no longer matter. Is it really this simple process which has alluded me and keeps me stuck? The mind is devious. It has told me to blame the body and like the innocent sheep I am I followed its lead. Maybe I have lost my trust in the wrong antagonist. The body keeps me alive and strives to do so when it percieves any danger. Its job is solely to keep me alive. The mind though is doing nothing helpful as I see it. Maybe its not my lack of trust my body but that I have placed too much trust in my ego that is the real problem. If I can relax, live with the sensations as they are and stop believing what my ego says then therein might be a better standard of living. One day I may wake up, turn the ignition and drive off with a full tank. Its a state of mind. I know that anyone who has GAD will agree that you will definitely know when you find peace and only in that peace can you truly tackle the outside world. Only from a state of relative calm can exposure really work because without it the exposure means absoloutely nothing. The reason being that the general high anxiety is still there the next day making it hard to repeat what you did the previous day never mind go further.

Happy Pills

I ws recently told of a lady who was a long term housebound agoraphobic and of how she made it down to Manchester from the North of Scotland for a christening- one my family went to last week but I of course didn't. Now that my wife is back I can report that all went well for the lady. Not only did she also go out for a meal both nights while she stayed down there but even went ten pin bowling with the kids the yesterday before coming home. My sister-in-law reports, via my wife, that although she still has her moments her prescription of Prozac has "given her her life back". As I said previously it is good to hear these stories of return to wellness by whatever means. It is another illustration of how the path for everyone is different as I am sure Prozac is not the answer for all .

It got me thinking. I am very lucky to have a good understanding GP. Were this woman to be his patient though she would still be housebound for the simple reason that he refuses to medicate unless under special circumstances. The thing is though I agree with him even though I can see in this case this woman would still be stuck in the misery of confinement. His reasoning is that most medications are addictive and medication is only a short term solution which doesn't actually aide the recovery process ong term unless it is supplemented by some other form of help. That additional help would be CBT, group therapy, counselling or whatever is specific to the patients needs. For this he is not specialised as he is a general practitioner so he refers people with mental health issues to their specialist services- in the UK that being community mental health. Furthermore he sees it as their duty as the overseers to medicate as required. That seems reasonable to me. My next question will be who is medicating this lady and if it is her GP I would wonder what additional long term help she is getting. I will ask. In this type of reasoning I am think of long term agoraphobia rather than other anxiety related issues.

So what about my situation? Well a long time ago I came to the conclusion that I had to go it alone. That is something I have accepted is the best way forward for me. I've heard in the past how mental problems are costing the NHS a fortune but I would wonder why when so many people I have talked to have been picked up and dropped by mental health services never to be contacted again. My first referral led to a couple of months of CBT-lite by a CPN relating back and forth with a collegue via post-it notes attached to things I had written. It was mainly concerned with depression, working out money problems and the like which was of no use to me and I was glad when she said she had done as much as she could before leaving for good. My second referral brought two psychologists who listened to me for around 15 minutes, asked what I wanted them to do for me and then said just keep doing what I was doing before disappearing for good. Between those visits I was in the wake of the crisis which saw my wife rushed into hospital indefinitely and had me left at home with the kids. I phoned the CPN to ask for help and she basically told me it wasn't her problem and to contact my GP instead. That is what I did and despite being against medicating he gave me a few boxes of Diazapam. He saw my plight and at least had the compassion to ease my worry at the time.

Those boxes of pills are virtually untouched 2 years after I was prescribed them. I guess I just needed too know they were there in the event of a mental breakdown. A year ago I took one pill and had a bad reaction but that could have been my own fear of pill taking that caused it. Since hearing about this lady though it has put doubt in my head. As I have been resigned to going it alone that means no medication but then I see someone achieve a better standard of living via medication so it casts doubt. Every time I am in the bathroom I see those boxes and ponder. Should I take one?, I think to myself. Remember what happened last time?, I also follow up with. But still I wonder whether a better life in the short term is contained in those boxes. This is where I get annoyed with myself. I think I have something fixed in my mind and then I start to doubt it but I guess that is understandable given how suggestive the anxious mind is. I won't be taking any in the near future but it is a question that will fly about my head for the next week at least until I make a decision- though I should check the best before date first I suppose.

The thing with general anxiety disorder is that some days it weighs heavier than others. There are days you can get by just fine and days where you just cannot find peace anywhere- those are the ones I clock watch hoping for the night to come quickly. Today was one of the latter. The anxiety was in truth overshadowed by the sheer frustration of being. After a few good days I just awoke as a bundle of nerves and in agitation suggested to my wife we go out for a drive. She in turn suggested the beautiful Chatelherault Country Park. Since I have not been there since my problems started it was a reluctant agreement and as soon as I had the seat belt on the apprehension was growing. We were just 2 minutes drive from it when I asked my wife to turn back and I put away my camera losing out on the promise of beautiful views. My wife then got sneaky after I said we didn't have to go straight back home. We then found ourselves on a little country road surrounded by expanses of barren fields and I was quite relaxed. As we turned a corner though I recognised we were at the gates of Calderglen Country Park. Just that knowledge of where we were and the fact that I had not been there for over 4 years was enough to send us back the way again. The lure of owls, Meerkats and a conservatory full of tropical animals wasn't enough to stop the urge to flee. So we headed back home and ended up in a traffic jam and me being me I panicked for a third time until we finally got moving again. It turned out to be a broken down bus causing the hold up but we were lucky as behind us the tail backs disappeared into the distance.

Like I said there are days like that. I've had times in the past year when I have went out further over the course of weeks and got out tof he car too for short walks without so much as a threat of panic. So much again relates to our general state. That is why I think when I got back home I started to mull over those boxes of pills. My mind kept asking whether by taking one of those tiny things I could have enjoyed the day instead of running from it. In turn it would have given my wife and son a better day too. One of those little pills has the potential to do that but at the same time its not the road I want to go down if I can help it. For one what would I do when I ran out because nobody would give me more.

But coming back to community mental health I have started to feel an anger. I made up my mind I will go it alone and that is what I will do. To be honest though I had little choice in the matter and I know that is the case with a fair few people. They don't seem to want to know unless they can provide a short term fix. In matters like deciding whether to medicate and what to medicate with I feel they should be there. As they should also for help in terms of information, strategies and regular check ups- even just an email correspondence every few months. People with anxiety issues need questions answered and direction. Were it not for the internet I think I would be a wreck by now and that should not be the case when there is supposed to be a funded service provided. But they are not there for a lot of people and so a lot of people have to go it alone not even sure if what they are doing is the right thing- that uncertainty alone is enough to keep them stuck. Ideally I think most people would like to do it on their own but some days it seems impossible, other days we are glad for doing so when we don't have to speak to someone taking part in a different conversation. I know that as frustrated with the so called "community" help as I am at the time of writing they will be far from my thoughts tomorrow or the day after. That's just the way it goes. Frustration builds in waves and then crash into the shore. Those little pills will still be there though. Maybe I should just bin them and be done with it.