RUSP: Rainbow Unicorn Sunshine Palace 3: Getting Better Every Day

[Perrydotto]

I'm very glad you are not giving up on this opportunity, Madeline.

[Madeline]

I'm very glad you are not giving up on this opportunity, Madeline.

Thank you.

In addition to prazosin and fluoxetine, I’ve also been started on lamotrigine (aka lamictal) and my prazosin dose was upped. Maybe it will help.

[Mr. Big]

That's good to hear, Maddie! Rootin' for you!

[Madeline]

I’m keeping in mind that it can take weeks and weeks for these meds to hit therapeutic levels in a patient, but man this week has been rough. Flashbacks and nightmares every single night. I gave up on doing anything yesterday because Wednesday night was so bad.

I got outside for a little bit this afternoon, at least.

[Perpetual Motion]

So, I'm feeling really weird right now. Conflicted is probably the right term. About a month ago, I took on a programming project for a friend in order to develop a better portfolio and learn new techniques. I'm nearing the end of that project now, and it's gone really well! I should be happy and proud of what I've accomplished! But I'm not. It doesn't matter how good I am at programming when my aspirations lie elsewhere. I still want to write. I still want to make art. I want to create. But no matter how hard I've tried, I just can't manage to pick up and learn those skills, while programming just comes to me naturally. That's not to say I don't enjoy programming, but if given the choice between software development and writing as careers, I'd gladly choose writing. I just wish I wasn't so trash at the things I like.

[Princess Flufflebutt]

The problem is, you're probably not as trash as you think you are. Also isn't success in programming a lot easier to spot? Either it works or it doesn't sorta thing? Correct me if I'm wrong. I know very little of it Art on the other hand is kinda harder to gouge, I´d think anyway. Some things are appealing, some are not and the only thing to really do sometimes is to throw stuff at the wall and see what sticks.

What I'm trying to say is there's no need to be so hard on yourself. You can pick those skills up. It may take some effort, yes. I found sharing it with other folks can help (folks you can trust that is, not random Internet strangers. Even though the folks you trust can be from the Internet. I hope you get what I mean).

[Madeline]

ed: I’m feeling a little bit better now, and this wasn’t a wise thing to post.

[Perpetual Motion]

I can't do it. I just can't. I can't work. I can't have fun. I can't fucking live. I'm just a pathetic pile of failure and wasted potential. Everywhere I look I see people more capable and skilled than me. "But PM," you say, "Everyone has to start somewhere! Just practice and you'll get there eventually!" Well guess what. I'm not mentally capable of practice. Every fibre of my being screams at me about how everything I create sucks and is worthless and is a waste of everyone's time. Call it a "cognitive distortion" all you want, that doesn't make it stop.

And that's another thing. I'm just wasting everyone's time with everything I do. It's why I don't have any friends off of the internet. At least here you can skim my posts and respond with minimal effort required. In real life you actually have to spend time around people and hold conversations. I'm not capable of that, either. It'd be easier to list the things I am capable of, and it'd be one hell of a short list.

[Madeline]

You’re catastrophizing and declaring yourself incapable of success when you aren’t even 30 years old yet. That is distorted thinking, even if you don’t believe it. And you actually are performing a sort of self-harm by beating yourself up like this. And you also don’t get to decide if you’re a waste of time for other people. You are not a waste of time. You aren’t even remotely a person I would consider to be a waste, and I’m sure other people would agree. You’re an incredibly nice person who helps others and who already knows more about programming than I ever will. Adult life is way harder than school, and it’s okay to be frustrated and unhappy. It’s not okay to beat yourself up or leap to absolutes.

You need to stop and do something else for a bit. Listen to music, watch cute fuzzy animal videos, play a game, watch a show, whatever it is that helps you relax a bit. If that doesn’t work, why not try this: Stop and make a list of things you can experience with your senses. Five things you can see, four things you can hear, three things you can taste, two things you can smell, and one thing you can touch. Nice things, things you enjoy. That’s a nice bit of distraction, right?

[Perpetual Motion]

I just don't know what to do with myself. I can't get a job doing the one thing I'm good at, and even if I could, I'd probably just break under the pressure again like I do with every job I get. My dreams of writing or game development are all pretty much bust, since I'm just too mentally handicapped to even get good at them or even finish some poorly made piece of garbage as a starting point. I wish I didn't want to do things with my life that I can't do. Dreams are worthless if you can't act on them.

[Perpetual Motion]

Feeling a bit calmer tonight. Not necessarily better, but less panicked despair and more resigned fatigue. Sorry that I keep dumping my problems on people here expecting other (non-professional) people to have answers for me. That's not fair of me to expect of you all. I'm going to try and take it easy until my next therapist appointment on Friday. Hopefully she'll be able to help me come up with some sort of actionable plan.

[theGECK]

Hey y'all. So, I recently found out that I've been having panic attacks my whole life and didn't know it. I just thought they were "bad nights" or "days when I felt really off and tired" or "one of my times where I felt like I had to get up and do something weird or specific" or something along those lines. When I was extremely religious, I chalked it up to spiritual attacks. When I was depressed, I just used it as more proof that I wasn't normal and shouldn't have a life that mattered.

I found this out because I was having a sleepover with a friend and had a bad attack. The type that I've only had 1-2 other times in my life. Hyperventilating, convoluted logic, a tremendous fear that anything I did would have horrible repercussions, fetal position on the floor, etc. It took about 2 hours, but my friend got me to the ER. I had a hard time walking because everything was the literal worst thing I could think of and horrible things might happen. And once I was in there, and somebody was able to look at me, they gave me some medication and within 5 minutes I had my brain back and thinking was normal again.

After I found out it was a panic attack, I realized that what happened felt almost exactly like something that had happened 2 months ago, which I thought was just one of my "bad nights", but a really, really, bad night. It had lasted for almost 8 hours, and I'm sure that this would have been the same.

My sister also deals with panic attacks. She recommended that I get a fitbit, because it's helped her. It's been really helpful for me so far - for example two days ago when I was sitting on my bed and suddenly started to feel that weird feeling in my head I watched as my pulse went from 80 to 130 in under a minute, and I thought that maybe it was a panic attack, and the feeling wasn't something I had to act on right away. It was ok for me to sit on my bed or do/not do whatever it was I was afraid of. And as I've been learning this about myself, I'm seeing that these things I thought were normal, actually weren't.

The worst part is that it seems to be getting worse. I don't know if that's because I just went through a divorce that's been pretty traumatic for me, or if it's because I'm living on my own for the first time ever. I know that being around somebody who can just talk to me helps out a lot, so living with people might have helped to prevent a lot of them in the past? And now that I'm not living with somebody, they're just happening without anything to stop them? I don't know, and that's part of the problem!

I'm figuring out if I can go see somebody professional to talk to about this. After the first of the year I'll have better insurance, but the insurance I currently have is what I had from before the divorce, and that was chosen with the expectation of 2 incomes to cover the out of pocket expenses, which I don't have anymore. But I worry that, because I'll probably go to a therapist at the clinic I know I can get things covered through, they'll want to put me on some sort of medication but I don't want to do that if I don't have to because I worry about what it will do to me and if it'll change me or interact with anything else I'm taking? IDK.

I don't even know if it makes sense? Because I don't really know what's going on. My friend works with people and some of them have panic attacks, and she said it was a classic panic attack. Does anybody else deal with them, have any advice?

[diribigal]

But I worry that, because I'll probably go to a therapist at the clinic I know I can get things covered through, they'll want to put me on some sort of medication but I don't want to do that if I don't have to because I worry about what it will do to me and if it'll change me or interact with anything else I'm taking? IDK.

I haven't had regular panic attacks, but there are some things I can speak to.

• If you haven't had a regular checkup recently, I'd do that first to make sure there isn't anything physical that could be interfering.
• A therapist isn't usually someone who can prescribe you meds on their own.
• Medication usually isn't the first thing a therapist would suggest.
• If medication does come up, your concerns and the likely effects and pros/cons of the medication is something you could discuss with your therapist (and psychiatrist?).

---

Meanwhile, though I had been totally fine for a while, and it's not as extreme as for many people, but I think it's fair to use the word "triggered" for something I experienced last night. And I'm not super looking forward to bringing it up in my next therapy session because it's not my primary focus, but I know it's something I should bring up now to save time if it becomes a bigger issue later on.

[Madeline]

Meanwhile, though I had been totally fine for a while, and it's not as extreme as for many people, but I think it's fair to use the word "triggered" for something I experienced last night. And I'm not super looking forward to bringing it up in my next therapy session because it's not my primary focus, but I know it's something I should bring up now to save time if it becomes a bigger issue later on.

Make sure you’re feeling up to it before you tell your therapist. My psychiatrist advises against trying to unpack feelings like that until you feel stable, because it can trigger something again. But I’m sorry that happened.

I don't even know if it makes sense? Because I don't really know what's going on. My friend works with people and some of them have panic attacks, and she said it was a classic panic attack. Does anybody else deal with them, have any advice?

Panic attacks can often present with physical pain, nausea, rapid pulse, chest pain, GI tract issues, sweating, and other symptoms, often with many happening at once, sometimes with just about all of them in combination. You’re right to wonder if trauma makes them worse and more frequent, because it does. So do major life changes, like moving, divorce, and living on your own after living with someone for many years. Depending on how traumatic these experiences have been for you, you might want to ask about being evaluated for PTSD when you are able to seek treatment. I’ve got some experience with them.

I’d been having them for years before I had a big one, but when that hit, I was sure it was a heart attack because my chest hurt so much. Went and got an EKG and blood work, and lo and behold, my heart was in excellent shape for my age. Before that, it had manifested as physical illness, mostly diarrhea or vomiting (sorry for the TMI).

Whatever the cause, grounding exercises are an excellent way to reorient yourself. All of these exercises work for anxiety and panic as well as PTSD because they force your body to physically relax, which also will lower your pulse and any tension in your muscles. You are forcing your brain to relax by concentrating on something other than fear or racing thoughts, and that in turn forces your body to release tension. Even a stress ball or a silly fidget spinner can help. The important thing is to focus on the present moment, not your past experiences or fears about the future.

Think about things that you enjoy and that relax you, and do one of those things when you start to panic. Listen to music, take a shower, watch a movie, whatever works for you. Guided meditation is also a great way to relax, and there are a lot of apps available with different meditations, like Insight Timer or Calm. You can also find guided meditations online.

[Princess Flufflebutt]

I´ve called in sick three days in a row now. Anxiety*s been getting worse. I messaged my friend about the clinic he works at. It's time I actually do something about this garbage. Try to talk about these things instead. Gonna try to not feel too guilty today and try to take care of myself.

[Madeline]

I´ve called in sick three days in a row now. Anxiety*s been getting worse. I messaged my friend about the clinic he works at. It's time I actually do something about this garbage. Try to talk about these things instead. Gonna try to not feel too guilty today and try to take care of myself.

I’m pulling for you

[Princess Flufflebutt]

Thanks. I'm not gonna go for a psychiatrist this time. I'm not against meds by any means, but like they're not gonna fix the core of the problem. I'll give em a chance if a therapist recommends them alongside whatever it is that I'll be doing.

[Madeline]

Anyone think that some other country might start offering asylum for Americans yet? I mean, I doubt it, because we kind of suck really hard, but I’d like to get out of here now, before things get even worse. I’ve been voting and giving money and writing letters and protesting for 23 years, it hasn’t made a damn bit of difference, and it just keeps getting worse.

[Perpetual Motion]

It's so hard to keep trying. Every time I get a second (third, fourth...) wind, I find something to drag me back down again. I was excited to work on a game project again after taking a long break from them, and it was a great pick me up from the downswing my mood had when the regular programming work I had to do dried up temporarily. I was excited to show off the basic thing I had set up and working, so I showed it to my dad and sister the other night. My dad's response was basically "Didn't you already make something like this?" It was an honest question, so I'm not holding that against him. Especially since he's right. I have made something like this before. Multiple times, in fact. I just keep doing the same thing over and over and fail every time. How many times do I have to fail before it stops being worth it to try at all? I'm never going to wow anyone with my squares jumping around blank voids. I can't write a story, I can't draw art, I can't write music. All I can do is program super basic things that other, more well-rounded people can run circles around.

There isn't a single thing in my adult life I've done that hasn't ended in failure. I'm not even sick enough to get on disability, which means that I get to sit at home and be a useless shut-in who mooches off the generosity of my family.

[Princess Flufflebutt]

Perp. I can´t even program squares jumping around. And believe me I have tried. The thing is, you haven't even failed yet. You got some neat prototypes to work with. Fun ideas to build on. You can do it. But first you need to stop beating yourself up every opportunity you get. I know it's hard. You gotta be your best friend since you´re gonna be living with you for the rest of your days.

Also my friend shared this with me: https://drive.google.com/open?id=1r8f7O ... jIyzSD9Ar4 It's a helpful thing.

[Madeline]

It's so hard to keep trying. Every time I get a second (third, fourth...) wind, I find something to drag me back down again. I was excited to work on a game project again after taking a long break from them, and it was a great pick me up from the downswing my mood had when the regular programming work I had to do dried up temporarily. I was excited to show off the basic thing I had set up and working, so I showed it to my dad and sister the other night. My dad's response was basically "Didn't you already make something like this?" It was an honest question, so I'm not holding that against him. Especially since he's right. I have made something like this before. Multiple times, in fact. I just keep doing the same thing over and over and fail every time. How many times do I have to fail before it stops being worth it to try at all? I'm never going to wow anyone with my squares jumping around blank voids. I can't write a story, I can't draw art, I can't write music. All I can do is program super basic things that other, more well-rounded people can run circles around.

There isn't a single thing in my adult life I've done that hasn't ended in failure. I'm not even sick enough to get on disability, which means that I get to sit at home and be a useless shut-in who mooches off the generosity of my family.

Girl, something about your treatment is not working for you. It could be an issue with meds, with whatever coping skills you’ve been taught, or maybe something else. I am not competent or trained to be able to tell you what might be going on there, and you should talk to a professional about that. But you shouldn’t keep making posts like this. They are not helping you. People have called me out for it and it was a good thing they did, because now every time I have the urge to make one, I put down the phone or log off the computer and do something else for a while. I’m not cured, the urge is still there, but at least it is a step in the right direction. And it has helped me feel better because I am not devoting so much time and effort into running myself down before anyone else can.

The only thing stopping you from doing all the things you want to do is that nasty voice in your head telling you that you can’t do it. But some of those things are objectively wrong. You used to write fanfiction, and that is more than what most people will ever be able to write. Writing narrative fiction is hard, and writing it well is harder than that. And I can’t even program at all. I can’t even wrap my head around how it works. You are that person who programs rings around me because I will never be able to set up a working prototype, no matter how hard I try. Programming is also hard. There are at least 2 things you have told yourself that I can point to and say, “you’re wrong,” and I bet I could find others.

As far as “when does it stop being worth it to try,” my personal answer is “when I’m 125 and on my deathbed.” That’s not being cute or facetious (although I doubt I’ll even get within hailing distance of a century ). You don’t learn by succeeding, you learn by failing. That voice is looking for someone else to give you an out and nobody is going to do that. Those programmers you mention? You have no way of knowing what their experiences were. They could be gifted, they could have worked steadily at it over the years, they could have been putting in stressful 23 hour days in college and afterwards to get to that level (and they would’ve had years taken off their lives for that). There isn’t any magic path to success. But you also can’t succeed at anything at all if you refuse to try. Trying is the superior option 90% of the time, leaving room for obvious silly things not to try like “skydiving from 20,000 feet without a parachute or specialized equipment” or “attempting to swim to the bottom of the Marianas Trench by yourself.”

And yeah, it hurts and it sucks when people don’t recognize your hard work. Especially when it’s your family. I’m not going to downplay that at all, I’ve cried over it often enough. But please stop telling yourself that your self-worth depends entirely on some self-selected measure of success. You have worth and value as a person independent of anything else you do. Bolding is obnoxious, true, but please pay attention to that bit. You are not your stories, or drawings, or programming efforts. You are an independent person, with independent thoughts and feelings, and you’ve got demons on your back holding you down.

It’s okay to feel sad. It’s okay to be upset because your dad didn’t recognize how hard you work, and he might feel bad about what he said if he knew that, too. It’s okay to be frustrated, and fed up, and to need to take a break from your projects. Those feelings are part of you, just like the things that make you happy. But they aren’t all of who you are.

I don’t always feel up to the challenge of responding to everyone who needs it. I don’t feel strong enough to do it much, lately. I don’t have money to give anybody. Even when I can help and try to be a friend, I’m still just a disembodied wall of text in the Internet, and it’s not the same as hearing it in person. But, for whatever it’s worth, I am not giving up on you and I refuse to just let you give up on yourself after you’ve come so far. I wish someone had done that for me when I was younger, so I’m doing my best to help you and believe in you now.

You do have worth. You do have value. You might not believe it right now but you absolutely do.

[Perpetual Motion]

Thanks, both of you. I hate how I struggle so much with this and how my first instinct is to beat myself up in text form. Another thing I'm garbage at is self-care, I guess. I think I'm going to talk to my therapist about applying for disability again. It just never ends, and I need to stop being a burden to those around me. I've never been able to recover for more than a few months at a time, and it's been consistently like that for years now. I was denied the last time I applied, but I never appealed, since the process was too stressful for me (ain't that a lovely bit of irony?).

I still have trouble seeing how my skills amount to much, considering my success in applying them, but I realize that I need to stop lamenting that and just try and keep working with them.

[Madeline]

Thanks, both of you. I hate how I struggle so much with this and how my first instinct is to beat myself up in text form. Another thing I'm garbage at is self-care, I guess. I think I'm going to talk to my therapist about applying for disability again. It just never ends, and I need to stop being a burden to those around me. I've never been able to recover for more than a few months at a time, and it's been consistently like that for years now. I was denied the last time I applied, but I never appealed, since the process was too stressful for me (ain't that a lovely bit of irony?).

I still have trouble seeing how my skills amount to much, considering my success in applying them, but I realize that I need to stop lamenting that and just try and keep working with them.

It’s hard and you’re going to have low moments. It’s okay. Talking to your therapist about this is a great first step.

[Perrydotto]

I got nothing helpful to add because Madeline said it beautifully, so here's a general "you can do it" message. You're awesome, and I believe in you.

[Madeline]

I wish I could feel confident in my own future. I’ve been frightened every day for the last 2 years, and it’s getting worse, and my therapist still doesn’t understand why.

Also, I made the mistake of spending all day yesterday reading up on politics and I was not ready to do a thing like that. Now I don’t even want to get out of bed. I’m so tired of being scared, but I just don’t see things getting better in this country for a very long time now. I can’t even feel energized by voting, because I voted by mail last week. I don’t want to have to think about this for every minute of every day, but lately, that’s all I’ve been able to think about, and it is wrecking my mental health. I’m not sure what I need to do to cope with this. Completely unplugging from the rest of the world seems like it would endanger me by encouraging me to socially isolate myself, but staying informed is making me isolate myself anyway because I can’t deal with it any longer. And like I said, my therapist hasn’t been helpful on this. She is on the “it’s just a different opinion and they won’t really dare to do anything” train still somehow.

There’s no realistic chance I can leave, and lots of people have the same or worse problems to work through. Even if I could somehow get a passport and a visa and tens of thousands of dollars to be able to afford it, I don’t think I could handle just the logistics of moving right now, forget anything political. I’d have another breakdown from the stress. I’m ashamed to say that right now I don’t even feel up to catching up with my emails or forum notifications or whatever, because I ought to be doing something. It’s difficult not to berate myself or feel useless. I keep telling myself that since I did at least vote, it’s okay to take some time for self-care, and it’s okay to be scared sometimes, and I do have people who care about me. I’ve already lived in the closet for decades, and if I have to go back to that to protect myself and help others who are in the same boat, I think I can handle that, if that’s what it comes to.

Just trying to work out my feelings in a constructive way. I can’t help but wish I could wake up in a good timeline for once, though. For once I kind of want a real, physical hug from somebody irl.

[Perpetual Motion]

Knowing your limits is probably a super important thing. If you can't take any more of the political climate, and if you can't just ignore the news, consider just unplugging and doing something else for just a little bit, not completely. Just take some time to center yourself, do some CBT, read a book/play a game, and try to reconnect somewhat refreshed. You're not obligated to immerse yourself in politics, especially if the process is damaging to you. You've fulfilled your obligation and voted, so you've already done more than the vast majority of people in the country will do, anyway. You can take a break from the process without hurting anything. Nobody is going to hold that against you.

---------

One of the scariest things for me, with regards to applying for disability, is that I basically have to advocate for myself by advocating against myself. If there's one thing I'm good at, it's putting on a brave face when around other people. My breakdowns are almost always private (which is kinda why they tend to spill over into online spaces first and foremost), so it's really hard to convince other people in my life that anything is wrong. And so, for disability, I have to go and emphasize that, yes, I am a broken human being who needs support. And when that fails, which it will, I will have to go to court and tell a judge that I'm broken, all while outward appearing fine and perfectly capable. All I have to back me up here is my employment records and the word of my therapist and psychiatrist, who I have also been appearing outwardly stable in front of for as long as I've been seeing them. I really don't know the correct strategy here.

[Madeline]

Knowing your limits is probably a super important thing. If you can't take any more of the political climate, and if you can't just ignore the news, consider just unplugging and doing something else for just a little bit, not completely. Just take some time to center yourself, do some CBT, read a book/play a game, and try to reconnect somewhat refreshed. You're not obligated to immerse yourself in politics, especially if the process is damaging to you. You've fulfilled your obligation and voted, so you've already done more than the vast majority of people in the country will do, anyway. You can take a break from the process without hurting anything. Nobody is going to hold that against you.

---------

One of the scariest things for me, with regards to applying for disability, is that I basically have to advocate for myself by advocating against myself. If there's one thing I'm good at, it's putting on a brave face when around other people. My breakdowns are almost always private (which is kinda why they tend to spill over into online spaces first and foremost), so it's really hard to convince other people in my life that anything is wrong. And so, for disability, I have to go and emphasize that, yes, I am a broken human being who needs support. And when that fails, which it will, I will have to go to court and tell a judge that I'm broken, all while outward appearing fine and perfectly capable. All I have to back me up here is my employment records and the word of my therapist and psychiatrist, who I have also been appearing outwardly stable in front of for as long as I've been seeing them. I really don't know the correct strategy here.

I struggle with the same problem, but that’s because my strategy was always to repress everything and never let anyone see anything out of me after the experiences I had as a kid. I always go hide and turtle up by myself. You could copy down some of the posts you’ve made and show them to your therapist and psychiatrist. once you’ve made your case to them, they can help you with the next steps. Right now, just concentrate on that first step so you don’t overwhelm yourself.

Also, I failed at doing any kind of self-care today because the Title VII news made me alternate between anger and some very dark thoughts. I wrote some emails about it to at least try to do something positive, but it didn’t work. I feel like 2018 is just going to tear what’s left of me into pieces. I might cancel my appointments with my therapist and find someone new tomorrow, because I am so not in the mood for that “different opinion” horseshit she keeps offering. My life is not a matter for public debate.

[Madeline]

Update: My therapist felt bad that she made me feel bad, so I’m going to keep going. It is a bit disconcerting that she’s gone from saying “you should be ready for x, y and z, including working” when we first met, and now she’s ordering me to not do anything major outside of transition-related stuffs until next year. I’m to keep working on my coping skills and mindfulness stuff for an hour every day, which is fine and I do that already.

But she also told me not to go out of my comfort zone more than 3 times a week for now, and that twice a week would be fine for a little while longer. I’ve been doing the thing I normally do, where I start trying to show my compliance and eagerness to impress by trying way too hard, because I feel like I’m being judged and graded all of the time. That leads to feelings of guilt and me constantly apologizing for what I see as shortcomings. She thinks we should work on that problem first.

I’m also supposed to stop watching the news entirely for a while; stop reading political things online; and to do a lot more writing and reading. So at least I have some constructive things to do.

[diribigal]

It sounds like your therapist is helping you prioritize and take things at a reasonable pace. That's great to hear!

[Perpetual Motion]

I talked with my therapist about my plans to quit my job and apply for disability again, and she's behind me 100%. The problem is that she informed me that as a therapist she is not included at all in disability proceedings. Only my psychiatrist is, and I have a far more distant and impersonal relationship with him. He never asks questions to try and explore my emotions, only to try and treat symptoms in a purely medical sense.

On a related note, I'm just fed up with medications in general. Various doctors have been at this for over five years now, and it's never been successful. There have been periods of time where I thought things were working, but I was only doing better due to external factors, and always crashed just as easily and to the same depths as before regardless of what I was taking. Instead all I get from them is an inability to drink alcohol, a dependency on them to think straight, and tremors in my hands. I'm not about to quit them because as much as I hate them I at least know that doing so may just destroy me, but I fantasize about it. I take five different psychiatric medications every day, and its a physical reminder of the shackles of my condition built into my daily routine.

[Perrydotto]

Can your therapist help you establish that better connection with the psychiatrist?

[theGECK]

Panic attacks can often present with physical pain, nausea, rapid pulse, chest pain, GI tract issues, sweating, and other symptoms, often with many happening at once, sometimes with just about all of them in combination. You’re right to wonder if trauma makes them worse and more frequent, because it does. So do major life changes, like moving, divorce, and living on your own after living with someone for many years. Depending on how traumatic these experiences have been for you, you might want to ask about being evaluated for PTSD when you are able to seek treatment. I’ve got some experience with them.

I’d been having them for years before I had a big one, but when that hit, I was sure it was a heart attack because my chest hurt so much. Went and got an EKG and blood work, and lo and behold, my heart was in excellent shape for my age. Before that, it had manifested as physical illness, mostly diarrhea or vomiting (sorry for the TMI).

Whatever the cause, grounding exercises are an excellent way to reorient yourself. All of these exercises work for anxiety and panic as well as PTSD because they force your body to physically relax, which also will lower your pulse and any tension in your muscles. You are forcing your brain to relax by concentrating on something other than fear or racing thoughts, and that in turn forces your body to release tension. Even a stress ball or a silly fidget spinner can help. The important thing is to focus on the present moment, not your past experiences or fears about the future.

Think about things that you enjoy and that relax you, and do one of those things when you start to panic. Listen to music, take a shower, watch a movie, whatever works for you. Guided meditation is also a great way to relax, and there are a lot of apps available with different meditations, like Insight Timer or Calm. You can also find guided meditations online.

Thank you for this, it's really helpful. And knowing that others have had it happen is helpful x2. And being added to the reprogramming of my brain I'm having to do after leaving my spouse and learning how to be a person who isn't trying to fulfill another person's wants all the time doesn't help, but knowing that adds to it is helpful x3. Yeah, it presented with all of those things except nausea. The nurses in the Emergency Room knew I was having a panic attack, but the doctor still wanted me to get a EKG to rule out cardiac problems. I still think that nurses are smarter than doctors.

The grounding exercises sound amazing to me. I can see two or three of them working well for me. Because I get caught up in the "something horrible is going to happen sometime in the future" aspect of it and not on where I am. It seems silly to focus on the now because everything is pointless because [insert thing] will happen, or not happen, or will lead to something, or something else, etc. Something that has helped me is taking five minutes to meditate before bed. I've started to make it a point to put my phone down and then start a bedtime ritual and go to bed without looking at it to prevent anything external from breaking the feeling of that, and I think it's helped. Of course, it doesn't stop everything. I actually used my rescue medication yesterday before it became a full-blown attack, something I've tried not to do for some reason. And it made it so that I stopped obsessing over the horrible things that were guaranteed to happen if I fell asleep and actually made it to my bed so I could be semi-rested for work in the morning. Yay!

[Factory Factory]

I guess this is as good a time as any to start posting here again, since the subject is panic attacks. I'm always open for DMs or questions about how to recognize them, deal with them, etc. They can be very different, very individual experiences, and one of the most important steps is to figure out exactly what a panic attack feels like to you, specifically - how it affects your body, your mind.

I've been doing DBT (dialectical behavioral therapy, essentially cognitive behavioral therapy through the lens of mindfulness meditation and secularized Buddhist practice) for about a year now and it has helped incredibly. Think of DBT as a rigorous toolset of anti-stinkin'-thinkin' skills. Before then, I did self-guided CBT in identifying my anxiety triggers and using that knowledge to interrupt the cognitive chain of events that would lead to a panic attack. In DBT, this would be an application of a more general structured skill called Chain Analysis, where one rigorously identifies a moment-to-moment chain of events made of vulnerabilities, thoughts, physical sensations, emotions, actions, and consequences and then plans different actions and opportunities to use DBT skills at each link that could have led to a better, less miserable result.

Taking anxiety medication pre-emptively is a good thing. I have a small stock of Ativan, a benzodiazepine, as a panic-management medication, and it works so much better taken pre-emptively rather than as a reaction. Some people take benzos daily as sort of a blunt instrument, and no shame in that, but benzos are highly habit-forming and can be dangerous in withdrawal, so moderation if possible is preferable. There are plenty of long-term, non-medication anti-anxiety strategies to work toward; the medication is there to help you take the first steps.

For me, panic attacks usually happen when I feel like everything is too much, too complex, and spiraling out of my control. With DBT, I've found that one of the most effective stops is simple mindful breathing. There are three important parts:

1) Slow your breathing. Fast breathing can physiologically trigger stress reactions. Commonly you breathe in to a count of 5 (or so), optionally hold your breath for the same or smaller count, then exhale to a count of 6 (or so, as long as it's a smidge longer than the inhale phase).

2) Focus on the physical sensations of breathing. Focus on the air. Give it your full attention, and notice the physical sensations in your body as you breathe. Close your eyes if you want. Right now, breathing is your task, and you are to do it with your entire self and awareness.

3) When - not if - another thought occurs to you - something that makes you fearful, something that makes you sad or angry, or even something interesting - take a moment to acknowledge this thought. Name the thought. Describe the thought. Notice that it made you feel a certain way. Then... Let it go. It's just a thought. Your task is breathing. Return to the task at hand.

[Perrydotto]

Factory covered it excellently, I can really only add this introduction to mindfulness with utmost sincerity:

[Madeline]

Breathing exercises also work better when you keep doing them until you feel your body relax. You can do at least four inhale/exhale cycles, often referred to as square breathing or box breathing, in the way that Factory describes.

And “Here Comes A Thought” has helped me calm down by itself many times, because not only does it deal with mindfulness, it’s also pretty soothing and relaxing to hear.

[Madeline]

I apologize for having a depressive breakdown all over the forums. I’m pretty ashamed of myself.

I kind of got it to stop by watching an old Dark Souls LP for a while. I don’t know why that helped, but I’m not going to complain.

[minty]

I was basically kind of denied a therapist earlier this year, but I was given a social worker at the local clinic. The person who helps me at the job placement thing (not sure what to call it, but it helps autistic people) said she'd phone the clinic and help. Turns out, she knows the social worker.

...I want to say that's a good thing but I'm not sure. I feel like I badmouthed the job placement worker person to the social worker, because I feel she discouraged me too much but I probably had that all in my head as usual. A part of me says "okay, maybe now things can get going" and another part says "you badmouthed her, jackass, she's going to hate you and the agency is going to drop you as is the clinic."

I guess we'll see?

[Perpetual Motion]

You know what's worse than being depressed and wanting to do nothing? Being depressed because you want to do everything. My brain is just full to bursting with different ideas and I can't focus on any one in particular, and the inability to decide and actually do something is stressing me out hard. Do I try writing again? Do I focus on game dev that I more than likely lack the ability to follow through on? Do I try art again? And if I choose one of those, what particular project would I tackle? Which of half a dozen stories should I write? What new features should I add to my game, or should I start a new game altogether? What should I try to learn to draw? Traditional or digital? Or maybe pixel art?

The longer I stay like this, the worse my mood becomes, because after a certain point, I'm just frustrated, not inspired. I can't think straight. It's taken me about half an hour just to type this post. Why do I have to be so broken? Why do I want the world when I don't have the ability to conquer my own bedroom?

[Madeline]

I was basically kind of denied a therapist earlier this year, but I was given a social worker at the local clinic. The person who helps me at the job placement thing (not sure what to call it, but it helps autistic people) said she'd phone the clinic and help. Turns out, she knows the social worker.

...I want to say that's a good thing but I'm not sure. I feel like I badmouthed the job placement worker person to the social worker, because I feel she discouraged me too much but I probably had that all in my head as usual. A part of me says "okay, maybe now things can get going" and another part says "you badmouthed her, jackass, she's going to hate you and the agency is going to drop you as is the clinic."

I guess we'll see?

As someone who frequently tries to read into other people’s thoughts without actually having that nonexistent ability, I can’t tell you what’s gonna happen, but I can offer an internet hug

You know what's worse than being depressed and wanting to do nothing? Being depressed because you want to do everything. My brain is just full to bursting with different ideas and I can't focus on any one in particular, and the inability to decide and actually do something is stressing me out hard. Do I try writing again? Do I focus on game dev that I more than likely lack the ability to follow through on? Do I try art again? And if I choose one of those, what particular project would I tackle? Which of half a dozen stories should I write? What new features should I add to my game, or should I start a new game altogether? What should I try to learn to draw? Traditional or digital? Or maybe pixel art?

The longer I stay like this, the worse my mood becomes, because after a certain point, I'm just frustrated, not inspired. I can't think straight. It's taken me about half an hour just to type this post. Why do I have to be so broken? Why do I want the world when I don't have the ability to conquer my own bedroom?

You’re stressing yourself out by taking too much on. Pick one simple thing and just work on that for a while.

[Perpetual Motion]

You’re stressing yourself out by taking too much on. Pick one simple thing and just work on that for a while.

And thus we come to the crux of the issue. Pick what? I guess this is the manic side of manic-depressive. All energy and no focus. It's like I'm trapped in my own body, bouncing around in my head with no way to settle on anything.It'd help if I could ever come up with a fully formed idea to begin with. Everything I think of is half-baked and incomplete, and I'm never able to expand on them. Like, I come up with the idea for a story, but I can't ever make it past the beginning. Even if I sit down and try and write an outline, I'm never able to decide on where I want the story to go, even in the broadest of strokes. Same goes for games. I can whip up some mechanics no problem, but I'm lost when it comes to moving on from there.

I guess the trigger for all of this is a conversation I had with my dad the other night. He was genuinely sad that I had more or less given up on writing, and encouraged me to keep at it. And so I've thought about it. And thought about it. And over thought it, and here we are , completely lost. It's not like I don't want to write, so he's not pushing me to do anything I don't already want to do, but with that seed replanted in my head, I'm all sorts of mixed up.