Exposure Therapy for Panic Attacks and Agoraphobia.

Carry on Carrying on.

I've had a week off from writing. I have had aunty Tre down. Which has been wonderful as always. I have been out and about, not a million miles from home, but still pushing those boundaries. 

One of my targets is to be able to make it to the hospital. Having three kids, and me being like I am, I think the fact that I cant make it to the hospital should I need to plays on my mind a lot. As a parent, and as a citizen of a first world country with state of the art healthcare, it is important to be able to access a hospital for treatment if necessary. 

I seem to have a habit of going a long long long way round when I try to go anywhere. I will take back routes, through semi-rural roads and lanes, in order to avoid things such as traffic lights, roundabouts and the potential for heavy traffic. This adds loads of time to the journey, obviously, but at the moment, its the only way I am able to make it. 

So off we went 'for a drive'. The aim was to make it to the hospital, although we didnt confirm that with each other. I never dare say out loud where I am going, or where I am trying to reach. I simply leave it as 'going for a drive'. Then if I make my goal, thats brilliant. If I dont, its fine, I am simply out for a drive, and that is what I have done. 

I didnt make the hospital. I did, however, make it as far as the roundabout before the hospital. Which is the furthest I have been since being in the cuckoos nest. So since early 2014. I guess that in itself should be an achievement, although I do still feel a tinge of failure that I was so close and yet still so far. 

Im not giving up there though. I shall carry on trying to make it, I have made it that far, it would take me literally a minute at the most to make it to the hospital from there. Thats what I need to hold on to. So close. Closer than I've been in ages. 

I made it there through using distraction techniques, asking Tre to talk to me about something if I felt the anxiety and panic start to rise. Bless her, sometimes we'd have just been sat there listening to music and admiring the scenery, and all of a sudden Id almost bark at her 'talk to me! Quick!'. I don't know how she pulled topics to talk about out of thin air, but she did! 

I also attempted to use mindfulness. I am still very much a beginner when it comes to mindfulness, but with the little bits I have been doing, I have found it the most effective therapy for me so far. Whilst CBT works to change your way of thinking, and alter your thoughts and words, mindfulness encourages you to accept the thoughts and feelings, yet remain grounded, concentrating on you in right this second. Not what 'might' happen to you in a minute, five minutes, an hour, a week or a month ahead. But right now. And you can accept that you are anxious. You can accept that you are panicking. But RIGHT NOW, right this second, you are fine. Don't concentrate of what may happen. Concentrate on the present, and face what 'may' happen if it happens. 

I think I prefer mindfulness, as CBT is essentially reinforcing  to you that your thoughts and feelings are wrong. It encourages you to change your way of thinking, which almost makes me feel like there is something wrong with me, something that needs to change. That I am wrong. I don't explain that very well. I know for lots and lots of people, CBT is a very effective therapy, and has helped them loads. But as with medication, I dont think there is a 'one size fits all' approach that works with psychological therapy. You need to find what works for you, by trying something, sticking with it for a while to give it a chance to work, then try something else if that particular therapy is not successful for you. For me, CBT is the mirtazapine of the therapy world. It didnt work, it made me feel worse, it made me feel like my thinking was disordered and that I was wrong in thinking like I did, despite not being able to help it. 

Mindfulness, however, doesn't make me feel like that. I feel like it empowers me to accept my thoughts and feelings. They are not wrong. I do not have to battle with myself to change them. I do not have to get myself worked up because I 'failed' in not being able to change my thoughts, and not being able to banish them. Mindfulness is about accepting those thoughts. But in a controlled and rational way which actually works. For me. It works for me. I cant say that will be the same for everyone, but if you are struggling and havent tried it, then give mindfulness a go and just see how you get on. Theres nothing to lose and everything to gain!

Exposure Therapy for Panic Disorder and Agoraphobia.

Day Two.

Today is day two of me actively trying exposure therapy. I have gone out, and attempted a walk. (Actually, this was yesterday, I am writing retrospectively). I decided to take my phone, and just record how I got on. I don't know why. Perhaps seeing me do it could help someone else try it?

If anyone would like an exposure therapy buddy, I am happy to share my contact details, you can send me an email on here, or a message on Facebook, and we can see how we get on together. If there is enough of us, perhaps we could even start a small group. Lets see how it goes.

I am now addressing you as readers. In previous posts, I have covered my history, and just talked about what had gone on in my slightly dysfunctional life. Now we are bang up to date though, I am reaching out to you. All of you. I don't know if anyone even reads this. Perhaps I am just talking to myself. Even if that is the case, its fine. Its quite therapeutic just writing it all down. But I'd love to think that there may be some readers out there who can relate, and I want those people to reach out! Click on 'follow', leave a comment, send me a message, follow me on Twitter. Lets reach out.

For any of those interested, here is a video of me trialling my first exposure therapy. Its not taken at the most glamorous of angles, and I look like crap, but do you know what? I don't care! It is very unlike me to publish even pictures of myself, let alone a video. But as part of facing this social anxiety head on, I am going to bite the bullet, and just put it out there. Its all part of the recovery.

Since this video, I have done the walk down the road again, very very comfortably. I am literally heading out the door when I finish this post, to try the walk up the road again towards the park and to see whether I can get a bit closer to the gate. I shall let you know how it goes!

Recovery from Panic Attacks and Agoraphobia.

Its Not as Easy as I Hoped.

So the key to my recovery lie solely with me. I spent years waiting for a magic potion, or for someone to miraculously waft away my fears and troubles. That didn't happen. The only one that could help me, was me. Which was incredibly daunting.

 

Now. One thing I will say, is that you have to be ready to start your recovery. You have to WANT to get better. I know that sounds silly, as we all want to get better. But many of us want to get better without actually acknowledging that it is all in our hands. We rely on health professionals and medications, we live in a time where if we want something, we want it now. But recovery from mental health illness doesn't work like that. There isn't a specific medicine that we can take to feel better. We may trial several different medicines throughout our time, until we find one that helps to some degree, but no medicine can alter your thoughts. Only you can do that.

 

Our mind is the most powerful thing we own. More powerful than even the worlds most powerful computer, developed by the worlds most intelligent people. Unfortunately for us, our mind is so powerful, sometimes even we have trouble controlling it.

 

Learning to get that control back is the first step in recovering from mental illness. And its not easy to do. Its something I have been practicing for a while, and I'm slowly starting to get the hang of it. But again, its not something you can learn overnight. Taking back control of your mind and your thoughts is something that will take practice and time. I know when you are living in the hell that is mental illness, that you don't feel like you can cope with the practice and time, but bear with me here, it is doable.

 

I know how you feel. I know how terrible it is living with a mental illness, such as panic disorder, anxiety and agoraphobia. I am still living it myself, every single day. I have been so low that I have been admitted to the mental health hospital on two occasions. But I reached the point that everyone needs to reach. To want to get better, and to have the motivation to pursue that.

 

Early on in my recovery, I visited my uncle. He lives just outside of my comfort zone, but not too much out. I had my Aunt Tre with me. Aunty Tre is one of those magical people. I don't know how, but when she comes down to stay, she has an effect on me that is hard to explain. I almost feel like I can do anything. She builds me full to the brim with confidence and love, and actually makes me want to do anything. I am still very much confined to my comfort zone for 99% of the time she comes to stay. But there is 1% of time that she enables me to push myself, comfortably, and do things I never thought I could. I think everyone in life should have an Aunty Tre. Unfortunately for all of you, this one is mine!

Immerse yourself in someone who does to you what Aunty Tre does to me. Be with someone who gives you confidence and self belief. Some one who loves you for you. Someone who teaches you that it is perfectly OK to fail. Failure is a normal part of life, and just brush it aside and forget it about it, and try again another day.

 

Anyway, I digress. Aunty Tre and I went to visit my uncle. He is a tattooist. We went to his home which was just slightly outside of my comfort zone. I don't see much of him in all honesty, so going round his was a big step for me in itself. I stressed myself out to the max before hand. I had multiple get out clauses along the way, and forced Aunty Tre to agree that if I said I needed to leave, then we leave, straight away. She agreed, and off we went. And do you know what? I had a great time! As is so often the case with panic disorder, the 'what ifs' and the anticipation of leaving and getting there was FAR worse than the actual event. Was it worth all of the stressing and worrying I did? Absolutely not. Would I do it again? Absolutely I would (and I have done a few times since, all with that same silly anticipatory anxiety but was fine when I was there).

 

And whilst I was there, between us, we designed this, and I had this done on my lower leg...

 

 

She is my little lady! Its an image of a girl, standing, free, as the breeze blows her, and birds fly freely around her. She symbolises the start of my recovery. The point at which I decided to become free of this disorder. She doesn't have a care in the world. Her pose with her arms flung back and head up to the sky is symbolic of someone letting their cares and worries go. Of being at one with themselves. Of being free.

 

Obviously, I didn't have a tattoo and was suddenly cured. Oh no. But having that done was my starting point. Mental illness IS all in our heads. Literally. It causes us physical and psychological suffering. But we can try and reach a mindset where we are strong enough to start facing those demons, and tackling this head on. And I regularly just look at my little lady (who Ive had for just over a year now), and she reminds me of my challenges. To stay strong, to be free, to be careless. And trust me when I say, if I can do this, then most certainly so can you.

The Master of My Own Recovery From Panic Attacks and Agoraphobia.

Taking Back Control.

I was discharged from the mental health hospital, knowing it was time to take control of my own health. I was prescribed 5mg diazepam three times a day upon my discharge, and was referred to the home treatment team, who's job it was to help me keep out of hospital.

 

I didn't take the diazepam as prescribed, but rather, took them as and when I felt I needed them. I had a months worth. What was I supposed to do when they ran out? I felt I'd rather keep hold of them, and just use them when I got into a situation where I needed them.

They stayed in my bag for two years!!

 

I returned home, but I just didn't feel comfortable there. I lived on a busy main road, there was always heavy traffic outside, I was flanked by traffic lights either end of the road, and at rush hour in particular, I felt very 'trapped' there. Trapped by the traffic that was essentially locking me in.

It was April. I stayed at my parents house, until in June, I moved into our new home, tucked away up the end of a peaceful little cul de sac. After several thousand pounds, and several months of renovation, we were ready to move in. I was on my own now with three kids. Tommy had gone off with the bit on the side he had been seeing previously. Her and his lovechild clearly didn't make him happy, I heard through the grapevine that they lasted about two weeks in the end, and that even now, over two years later, he is still single.

This was it. It was just me and the kids. Our new lives were starting.

 

The first night in the new house was a strange one. It was the first time I had been in my own home to sleep for several months. The house is situated within walking distance of my parents and siblings, and getting off that main road made me feel at ease. I went to bed nervous, but slept through, and from then on, I have never looked back.

 

In two years, the house has almost become a prison. I don't like describing it as that, as actually, I still love the house just as much today as I did when I moved in. But its almost like a mental prison, in that my agoraphobia means I am confined within it.

 

Following my discharge from hospital, I had one visit a week from a member of the home treatment team, who gave me small tasks to do, and gave me the mindset to try and break those barriers. And briefly, it worked. Until she was redeployed to another area, and her role was closed down. With that, went my weekly support which helped massively.

 

So. I was on my own. That said, I was quite happy with my little confinement. I bought a marine tank, which took up a heck of a lot of my time. I joined Facebook groups for people who kept marine reefs, and got talking to loads of lovely people. Some of whom now I consider to be true friends. More about that in a later blog.

 

I have a small local shop that I am able to get to. The kids' schools are within walking distance. There is a park less than 30 seconds away to walk the dogs on. But that's it. Those are my new confines. I didn't HAVE to go further than that, so didn't. Or haven't. Whilst living inside this tiny 0.5 square mile is maintainable, it is no sort of a life.

 

I'm finally bringing the blog up to date. I shall write in real time. I am attempting mindfulness and exposure therapy, which I shall blog as I go. I am also now back under secondary mental health care, and have a support worker who I met just yesterday. She is great, a really lovely lady. She offered to take me out for a walk. I originally kicked and screamed internally about it. But I sucked it up, knowing I could turn around at any point and come home if I needed to. And off we went. We walked slowly, with her working hard to keep me distracted. And we walked for about 5 minutes out. A slow paced 5 minutes, so the distance wasn't too great. However, it is further than I have walked in two years since living here. Usually I drive everywhere as I feel much less anxious in the car. I did the walk with the support worker, with some discomfort, but nothing unmanageable. I did it! I pushed that mental boundary, I smashed the comfort zone! She had only met me that morning, yet she was beaming, and saying how proud she was of me. Not half as proud as I was of myself! Two whole years of being scared to walk that far, and all of a sudden, slowly but surely, I did it!!
The support worker left, and I was still on a massive high. So much so...that I only went and did the walk again, on my own!! This time the anxiety was much higher. I didn't have her as a distraction. I only had my mind, which was thinking all sorts. But, I did it! Anxiously, I did it!!

That was yesterday. Today, I woke up wanting to break another comfort zone. So I walked the same distance, but in the other direction. I walked up the road rather than down it. I had a target in mind, and made it. I only just made it, admittedly, but I made it nonetheless. Again, somewhere I hadn't walked in two years since being here, yet there I was! It was quite surreal! I used the mindfulness techniques I had learnt, which helped immensely. I turned around and started making the journey towards home, but whilst I was out, I thought I may as well do yesterdays walk again too. So off I went, past mine, and back down the road. And again, I did it. That was the third time I had done that very short walk, but this time, it was much easier. Barely no anxiety compared to yesterday. So I returned home feeling very pleased.

 

It is pitiful really. Such a small small walk. Literally about a minute each way at a normal pace. But mentally, it is a huge leap forward, and one I hope to continue to build on. Perhaps this is the finally the start of my recovery? I hope so!

Sectioned Under the Mental Health Act. Part 2.

Back into the Mental Health Hospital.

Well. My discharge from the psychiatric unit was too soon. I was supposed to have follow up support at home. It didn't happen. I didn't hear anything else from the mental health team, until two weeks later, when I was back on the phone to the crisis team, struggling with life again.

 

It took ages to get to the hospital. My agoraphobia meant it took several attempts for me to get there. I had to keep asking to turn around and go back home again, and try again once I had calmed down a little bit.

 

I enter the unit. The wooden lodge was familiar. I knew the routine this time. I waited for a doctor to come and assess me, I had a physical health check, I had my bag looked through and any medication and anything that could form a noose was removed. I was taken to my room. The place of safety I voluntarily went to.

It was late at night by this time, so I settled in my room, setting out my belongings, making it as homely as you can possibly make a room in a psychiatric unit. I was more settled this time, and much more willing to engage and attempt to get the help I knew I needed.

Morning came round. I woke up early as someone came in to administer my prescribed medication. This was medication I had been prescribed by my GP previously. There is a common misconception that when you enter a mental health unit, they 'drug you up'. This is completely untrue. If anything, they go as far as possible to avoid giving medication, apart from previously prescribed medicines. I think the focus has shifted in mental health services now, away from medications, and on to more talking therapy, CBT and mindfulness etc. I know to some who are really struggling, that all sounds like a gimmick. But stick with me here. If medicines are needed, they ARE prescribed. I was written up a prescription for diazepam, to be given on an 'as needed' basis. There are also stronger meds that the staff can give if completely needed. And they will give if needed. They're not there to deny you access to what you need at that time. But they are there not just to get you through the blip in your life, they are there to help you look long term, and make sure you are better equipped for your entire life. Not only the few days you may be in the unit.

Despite my intention to engage fully during my time there, I did lie about having breakfast. Although in my defence, I don't have breakfast at home either. A nurse came round and told me I had been booked in to see the consultant that morning. Anyone who is admitted will see a junior doctor when they arrive, and then see a consultant when they are available, usually within a day.

A therapist came round, and gave me a time table of what was on during the day. Things such as art therapy, CBT, aromatherapy, reflexology, peer support sessions and an organised walk off site. It reminded me of being at Centerparcs again, planning your activities for the day.

I had a shower, got dressed, then ventured out of my room. I went to the communal area where there were sofas, a flat screen TV, a playstation. There were a few people sitting on the sofas watching Sky News that was on. I cant remember the news of the day, I was too self conscious sitting there worrying about people looking at me, and what they must have been thinking. I know now, that that is just classic social anxiety and low self esteem that made me think like that. I am sure they were there thinking exactly the same as me!

A lady came and sat down next to me. I thought she was another inpatient, but she was a nurse. The staff all dress casually in order to break down any barriers that come with wearing a uniform. The idea is that they look like a normal person, like you and me. There is no visible hierarchy, no 'them and us'.
We struck up a conversation. She asked me about what bought me there, about my life, we spoke about the weather, local events, holidays. She wasn't giving me therapy or trying to counsel me. It was just a general conversation between two people. It turned out, that we had a lot of mutual friends. She was a nurse who did two years of midwifery at the same unit I worked at. So we knew a lot of the same people, and we spent a very lovely time, with her telling me funny and poignant stories of some of the people we had both previously worked with, reminiscing about our respective times at the maternity unit. It was nice.
I went back off to my room, and was soon called to see the consultant. I was taken to the 'art room'. I entered and saw the consultant with a junior doctor with her. I looked and admired a lot of the art work that had been done in the room. There were some real artistic people in there!

The consultant looked me up and down. I sheepishly sat there. She flicked through my notes, talking out loud to herself. Then she gave the notes to her junior, and turned to me.

"So. You are here because you had a panic attack??"

 

I suddenly realised that this consultation wasn't going to go well. I explained my history to her. I told her that it wasn't just a panic attack. That it was innate anxiety. That I was severely agoraphobic, that I panicked to the extent that I believed the only way I could ever be at peace, and be free of this horror, would be to not be here anymore. I told her, I went to bed every night feeling relieved that I had managed to make it through another day. That the fact I was still living and breathing was a positive result for me. And that I woke up every morning fearful. Not just a little bit worried. But terrified that that was the day I was going to die. That I would finally reach the point where I just couldn't cope any more, that I just wanted to be free.

I felt the anxiety rising. I felt about an inch tall. I felt like SHE wanted me dead as she turned to me and said;

 

"We do not have the resources here to deal with people who suffer from anxiety. I don't know why one of my staff would even consider admitting you because of a panic attack. I am going to arrange your discharge, you shouldn't be here"

 

I wanted to scream. I SHOULD be there. I am there not because of a panic attack. I was there because I would rather die than have to live any longer like I was. Did she think I was there for fun? Did she think I thought being sectioned would just mean a nice little holiday? Or that I thought it would be a nice place to go to just chill out for a bit?

 

I went back to my room, and sat and mulled over it all. The only place I felt I could be in order to save my life, and I was just told that I would be sent home, I shouldnt be there, that it was a place for 'other people'. What is a psychiatric unit for, if it isn't to keep people safe from themselves? I am 100% convinced, that had it not been for my admittance to the unit on the two occasions, that I most definitely wouldnt be here now. Surely thats the whole idea behind  the unit? Apparently not!

The nurse I spoke to earlier in the day came round to see me and asked how I got on with the consultant. I told her how it went.. She sat and spoke to me, calmed me down, helped me relax. I really didnt want to be discharged. I wanted to stay there. I wanted help. I NEEDED help.

 

I spent the afternoon in a therapy session with five or six others. It was anxiety inducing, but as the lady who was running the session said, we are all in the same boat. I actually found that bit of therapy really quite helpful. It was brilliant at helping me see things in a different light. At changing my interpretation of things. Of helping me see things rationally, rather than in my skewed light. It was just one session, but I firmly believe that a regular therapy session like that would help immensely.

 

Dinner time came round. I reminded myself that I was going to engage. So out of my room I went, and off to the dining area I went.

There were several tables with chairs around them. There were people sitting alone, people sitting in groups. It was almost like a works canteen. I went up to the window where the food was served from. I observed the plastic knives and forks on the side, thinking it was like being a small child again, and not being trusted with real cutlery. No disrespect to the NHS, but the food looked absolutely grim. There was no way I would be able to eat it. Not because I am a snob, but because there were two options, neither of which I could eat even at home, or in a michellin starred restaurant. I told the server that on second thoughts, Id pass on dinner. Bless her, she said she didn't blame me, and popped off to the fridge, bringing me back a sandwich and fruit. That was more like it! I considered going back to my room to eat, but I decided to sit at a table. I sat alone as I picked at the sandwich, again thinking that all eyes would be on me. But of course, that was my interpretation. They weren't. Everyone there had their own worries and problems. None of them were interested in what I was doing. They were all doing their own thing.

Visiting time came round before Id even really settled at the table, and so I didn't get much of a chance to sit and eat anyway. The visitors are not allowed in patients rooms, so they sit in the communal room where the TV is, the dining area, or in a private room like the art room I was in earlier.

 

Visiting time also meant it was time for me to go home. Well, it should have been, although I had to wait and wait for medication to be bought up from the pharmacy.

 

A few hours later, a bag of 5mg diazepam to be taken 3 times a day, and a copy of my discharge summary in hand, I bid farewell to the wooden lodge, feeling more then a little let down, and knowing I was very unlikely to be back. This was it. Kill or cure.