Intersections between mental illness &, well, me

[Bored Of Education]

A couple of different current threads recently have made me realise that it is time to write this post. I am actually quite nervous. It is very long so don't feel you have to read it

Since I was 15/16, I have suffered from panic attacks, at the time being the heart palpitations variety. I have always been nervy and a hypochondriac so these obviously scared the shit out of me. However, a visit to the doctors assured me that they were just panic/anxiety attacks*. I am sure he gave me some good advice like cutting down on the booze and whatnot which I completely ignored.

During my teens, 20s and 30s, these heart palpitation-based panic attacks came and went with varying degrees of regularity depending on how much I hated my job at the time or, often, whether I was playing in a band or not.

I never really did much about them apart from on a couple of occasions, checking them out with the doctor and also trying out valerian and all these sorts of things but never any chemical remedies. I have always kept away greatly from such remedies, even painkillers, for various personal reasons. One large one having grown up at a time when Valium seemed to be given all too easily to housewives who then got ever so slighltly addicted.

However, in my mid 30s, I went through some hugely truamatic times emotionally - the details of which don't really add much to this. During this, I drank too much, now realise I suffered quite a bit of depression and, to put it bluntly, went a bit mental. Bizzarely, the panic attacks didn't increase during this time, mainly I feel as I had somewhat "closed down" emotionally to get through the events in my life at the time

After these issues had been sorted out, on the surface at least, the panic attacks returned in a much more horrendous fashion. I started to feel physically sick in certain public situations. It started in restaurants where I just could not eat as I felt I would be sick (obviously this was because of an extreme nervous stomch) and I felt hugely claustrophobic and had to get out of those restaurants. Straight away. Now.

This panic attacks spread thought out the years to pubs, cinemas, meals at home, friends and family's houses, buses, tubes, football matches, gigs, meetings, etc. As you can imagine, it pretty much ruined my life.

I tried everything - homeopathic stuff, herbal remedies, acupuncture, hypnotherapy, NLP, counselling etc etc. Now you may be thinking "What a twat, why didn't he get some heavy duty prescription drugs". Well, there are three reasons for this.

Firstly, as I mention, I have, rightly or wrongly, a bit of an inbuilt dislike for long-term prescription drug use. Secondly, by definition, when you are in such a mental state, you are no longer thinking logically or rationally. Thirdly and most importantly, if you are having your life ruined by a set of symptoms and, as happened twice, you get some drugs prescribed that have in the list of possible side effects the same panic attacks that you are suffering but worse, you don't want to risk it.

Anyway, two years ago, around Christmas (always the worst time for my attacks), the situation came to its peak. I was somewhat self-harming (the pain caused takes your mind of the panic), I couldn't travel on any public transport or even be in any public social places and the attacks were now more like terror than panic or anxiety

I realised that it was ruining my life, my wife's life and, possibly worse, I felt that my son was picking up on it and the last thing I wanted was to have him repeating what I was going through.

I went on Citalopram, a SSRI anti-depressant that is also used to treat panic/anxiety attacks. Interestingly, it has also been tried in the treatment of autism. I say this as there are a few symptoms that I had that are shared with this and OCD e.g. I needed to have certain rituals and routines in order to feel in control of my life.

This was just before Christmas (which also happens to be my birthday) so I had to put my family on alert that I wasn't sure what I would be able to do during this period when the initial side effects would kick in. As it happened, there were very few side effects but my family were extremely supportive.

I have now been on Citalopram for 2 years and gradually I have got my life back to normal. I am pretty much doing everything I did before and it is still a thrill to be able to things that people take for granted - having a meal, going to the cinema etc.

Initially, I only wanted to go on for 6 months but, to be honest, I am not in a huge rush to get off them. Not for any addiction reasons, there is still a long-term plan to come off them, but mainly because my new clear thinking has taken me to college and University so I want getting into the routines of these first.

I have had no side-effects. The fuzziness or confusion that I have seen in a friend (which also put me off somewhat before) haven't come.Indeed, as I say, I am thinking a lot more clearly and logically if anything. I can eat and drink quite normally, even booze.

Basically, I have got my life back if not a better version. I can still feel when, beforehand, I would have had a panic attack but now there is an upper limit or safety valve where I come back down again

The reason I have brought this up now, apart from the threads, is that there was a mental health week in University and they were asking people how they control their mental health. A lot of people were saying "Having a bath" and "Talking to friends" etc and I said, slightly tongue in cheek, said "Citalopram". This led me to realise that I am on a medication to make my life normal and, to an extent, I have a mental illness/disability, call it what you will. I appreciate that people may disagree with this.

Therefore, I am sure there are some people on here who are suffering from what they think of as just panic attacks and they are not getting treated or are not themselves treating them with the importance they deserve.

As I say, as far as I am concerned, they are a mental disability that means that you cannot carry on a normal life. Personally, I now put them on Uni/college forms as such as they need to know if I can't ever physically sit though a lecture.

For most people, the attacks won't be as dehabiliating as mine and hypnotherapy, herbal remedies or, certainly, counselling might work but just don't put up with it and let it ruin your life.

Finally, I don't want to put this on a level of importance as Purves' thread and have delayed writing this as I didn't want to deflect away from his as it is very important. He is on the start of his journey whereas I am a way along mine and my life is good so no sympathy looked for or needed.

Sorry for the long post. I am sure that, even now, I have missed some points

*I still am not sure of the difference

[Bruno]

Intersections between mental illness &, well, me

Interesting, and score one for modern medicine. You did the right thing obviously, especially for your family. So is there a medical term for that, and what's the chemical cause?

[Ginger Yellow]

Intersections between mental illness &, well, me

This led me to realise that I am on a medication to make my life normal and, to an extent, I have a mental illness/disability, call it what you will. I appreciate that people may disagree with this.

Would they? It seems pretty obvious to me that panic attacks can be a crippling affliction and certainly shouldn't be left untreated.

[Bored Of Education]

Intersections between mental illness &, well, me

I don't know, to be honest. I just thought there may be some people, certainly outside OTF, that feel that it is something that you just need to "pull yourself together about"

I haven't looked to much into the definitions of what is or is not mental illness or disabilty as it doesn't help me much but something that stops you from living a "normal" life fully certainly seems like a disability to me.

So is there a medical term for that, and what's the chemical cause?

Don't know definitely on either count to be honest with you.

In layman's terms, panic attacks are driven by the same "fight or flee" instincts that we would have needed when huntung tigers and whatnot so I assume that there is too much of whatever causes that in me. Equally, there would be emotional causes as well.

[Guest]

Intersections between mental illness &, well, me

I just thought there may be some people, certainly outside OTF, that feel that it is something that you just need to "pull yourself together about"

I think there are very probably very many of them. I have often come across people with the attitude that people with severe depression just need to have a word with themselves, count their blessings and cheer up and, likewise, that an anxiety attack counts as self indulgent showing off.

[Ginger Yellow]

Intersections between mental illness &, well, me

Definitions of mental conditions are notoriously slippery, but panic disorder is in DSM IV.

[The Exploding Vole]

Intersections between mental illness &, well, me

Lyra wrote:

I have often come across people with the attitude that people with severe depression just need to have a word with themselves, count their blessings and cheer up and, likewise, that an anxiety attack counts as self indulgent showing off.

Yes, so have I.

How much Citalopram are you taking, BoE?

[Ginger Yellow]

Intersections between mental illness &, well, me

I have often come across people with the attitude that people with severe depression just need to have a word with themselves, count their blessings and cheer up and, likewise, that an anxiety attack counts as self indulgent showing off

Well, sure, but I didn't think BoE was talking about dicks who reject the whole idea of mental illness outside psychosis. I thought he meant people who take depression seriously but not panic attacks.

[Bored Of Education]

Intersections between mental illness &, well, me

Yes. I am sure that people are belittling about the symptoms of depression if not upon knowing the person who has it but I was talking about panic attacks particularly.

Having said that, I have had a lot of support and sympathy from people who I have discussed it with and it has been treated seriously by everyone. If anything, I was the person treating it lightly by adopting a "Get on with it" attitude and only recently looking it as a mental issue.

panic disorder is in DSM IV

Disorder is quite a good term but I am not so bothered about a definition for me but it is useful for others. What is DSM IV? Is it a medical dictionary?

How much Citalopram are you taking, BoE?

20mg. Obviously, my first move is taking it down to 10mg but myself and my GP have decided to leave it until after NY, if not in the summer

[Bored Of Education]

Intersections between mental illness &, well, me

Double post

[Bored Of Education]

Intersections between mental illness &, well, me

Ditto

[Guest]

Intersections between mental illness &, well, me

Oh OK. Not no sympathy for anything at all people. People who do anxiety attacks the even more insulting disservice of dismissing it whilst being perfectly right on and understanding of depression. fair enough

Several people have told me citalopram has been very good for them. it sounds good that you are not in a hurry to come off it before you are ready.

[Tubby Isaacs]

Intersections between mental illness &, well, me

Very similar to you, Bored. Suffer very badly from anxiety when under any pressure (luckily a cash cow called YATR shields me from that). But trying to change my situation makes me very unhappy. Just today had an interview for a very easy job in ESOL, which I anticipated would be a new career. I got so anxious, I couldn't go.

I have had 7 years worth of Citalopram. Take 40mg. Can't imagine life without it.

My condition has been loosely called anxiety disorder.

[diggedy derek]

Intersections between mental illness &, well, me

Nice post BoE.

I think you might be right that panic disorders are sometimes treated without the seriousness they deserve. I do wonder if, as 'straightforward' mental disorders such as depression become more understood and discussed, people become more adept at blanking them out, masking them basically. And sometimes these conditions manifest themselves in other ways, I think – panic disorders, and less 'normal', by which I mean less obvious, conditions. I've had friends who've had pretty crippling panic disorders, for what it's worth.

I guess there's a lack of a good name for a panic condition, isn't there? Saying you've got an anxiety problem sounds, for some reason, rather wimpy. The terminology doesn't really convey the seriousness of the condition.

[Taylor]

Intersections between mental illness &, well, me

Glad to hear things are better than they have been, BoE.

Without wanting to enter to the sound of a tolling bell, let me offer one word of caution: however slowly your GP advises you to come off the citalopram, when you finally do, it probably won't be slow enough. SSRIs are better than valium in that some people can come off them with no problems at all, so hopefully you'll be lucky. Some people find it very difficult indeed, though, and if you're one of them, just go slow slow slow. I came off too fast, because the stuff had stopped working for me after ten years - it was the worst experience of my life (against some stiff competition) and I'm still suffering post-withdrawal effects four years later. Very unlikely you'd have anything like as much trouble - lower dose, much shorter time on, less nasty brand of SSRI - but antidepressant withdrawal can be indescribably horrible, and if you turn out to be prone to it, the only way is to come off very, very gradually.

I think the mistake I / my doctor made was staying on this stuff far too long, but that was the fashion at the time ("maintenance therapy"). The several times I started a new antidepressant which worked for me are the only times in my life I can remember feeling happy (as opposed to "OK"), and I wish I'd been encouraged to do some therapy there and then, then come off the pills as soon as it was feasible. Instead, I got all sluggish and zombified for the best part of a decade, threw away my career, screwed up a couple of relationships, endured a monstrous withdrawal that made bad LSD trips look like fun, and now my mental illness is worse than when I started off (I also have an anxiety disorder which I didn't have before, to go with the depression) - but I can no longer tolerate medication, so I have to plough through unaided.

Er, sorry to bring everyone down. I'm just very keen that people on SSRIs should get the benefits from them without getting the potentially horrific after-effects. Don't wait until they've stopped working before you come off, and don't do it in two weeks or whatever insane schedule you might be offered. Do it when you're feeling OK, do it as slowly as you can, and you should be fine.

[Bored Of Education]

Intersections between mental illness &, well, me

Thanks ever so much for sharing that, Taylor. That is exactly the sort of insight that you just don't get from GPs. As you say, it all might be different for me but that is excellent to know.

I genuinely hope that things get better for you

Tubby Isaacs wrote

I have had 7 years worth of Citalopram. Take 40mg. Can't imagine life without it.

40mg and you are still getting anxiety, fucking hell. Having said that, you are obviously getting benefits from it and if your life has returned to normality then that is great news

One thing that this has proved is, as I have found in real life, as soon as you open up about this, you find people who are going through similar.

[Ibn Pickthall]

Intersections between mental illness &, well, me

Nothing really to add I'm afraid BoE, other than if you haven't already, I would recommend reading Marcus Trescothick's autobiography

[Bored Of Education]

Intersections between mental illness &, well, me

That's interesting, Ibn. The Spanish footballer Jesus Navas suffers from agaraphobia-related panic attacks that have affected his Spanish international career.

People find it odd that he can play in stadia but, throughout my panic attacks, I could still play gigs, perform stand-up etc.

Put me in a restaurant though and I was fucked

[David Agnew]

Intersections between mental illness &, well, me

Bored of Education wrote:

panic disorder is in DSM IV

Disorder is quite a good term but I am not so bothered about a definition for me but it is useful for others. What is DSM IV? Is it a medical dictionary?[/quote]
Sort of, it's the fourth edition of the Diagnostic and Statistic Manual for Mental Disorders.

And there's a PM on the way.

[WOM]

Intersections between mental illness &, well, me

Your paragraphs on the closing circle of your life had me nodding. As I’ve mentioned a few times on here, I was diagnosed 13 years ago as agoraphobic. I’ve no idea when it began, but it got to a similar place as yours. I just wasn’t comfortable in certain places, for some reason. Other places, I was really uncomfortable, to the point where I’d have to leave. Eventually, I stopped going to them altogether.

Thing is, it’s so slow and insidious that you don’t realize you’re walling yourself off. First you stop going to restaurants, which is easily done. Isn’t it nicer to just have a take-out at home? Then you stop going to movies. Cheaper to rent DVDs and stay in, innit? Then you decline invitations to dinner, or plays, or picnics. Then, if you do have to go somewhere, it’s awful. For whatever reason, your stomach is suddenly fucked, and you spend your night in the solitary comfort of the bathroom. Then the anticipation of having to go somewhere fucks your stomach before you even leave the house, so that’s your excuse, and you don’t go.

I remember how bad it would get if I had to go to the mall to get new jeans. First, I’d never go with anyone. If you’re with someone, you’re trapped. You have to make awkward excuses if you need to leave or if you have a panic attack, or you have to suddenly use the public washroom (which you inevitably will). So I’d go to the mall by myself and walk in to the store. If there was a greeter at the door, I’d just keep walking. No interactions, if possible. I can remember going to The Gap one time. I made it all the way to the back of the store where the jeans were stacked. I almost had my size in hand when a helpful girl walked up. Find what you need? Cold sweats start. Would you like to try them on? Full blown panic. Changerooms…fuck that. Put the jeans down quickly and leave.

Then there’s the pleasant little wild card called ‘feelings of unreality’. This is when you’re walking along in a crowd, and everything seems fine, and you’re exactly where you’ve planned to be, and suddenly nothing seems ‘right’. You exit your own existence and don’t know why you’re there, or what all these people are doing, or what you’ll be doing ten seconds from now. Suddenly you are not you any more and you know that whatever you’re doing right now is definitely not ‘right’. And then, in a few minutes, it passes.

It came to a head when my mate Pete died. I was a pall-bearer and he was being buried at the venerable old Mount Pleasant Cemetery. Narrow roads, tall trees, massive headstones. Close. Crowded. No escape.

The hearse arrived first, and then the black limos, and then a few more cars, and then my car, and then a few dozen behind me. Trapped. And now I have to get out and be somber and civil and do my job, when all I wanted to do was jump down in the hole with the box. Cold sweats. Knotted stomach. Where’s the bathroom? There is no bathroom. There is only the panic.

The next day, I called my doctor. About ten minutes into the visit he says ‘Do you go to the movies?’ Not often. If you do, where do you sit? Aisle seat. Eat at restaurants or take out? Take out. How long since you’ve ridden a subway? Hah…ten years. Drive the car or passenger? Driver…every time…no exceptions.

You sir, have agoraphobia.

So I was sent for hypnotherapy. Ten sessions. Maybe fifteen. By the end of the second one, I could walk in to a store and try on a pair of pants and have a civil conversation with total strangers.

I can’t say I’m perfect now. But I’m worlds better. I still avoid situations where I just know I’ll be out of my element, but it usually doesn’t get weird. I don’t hole myself up in the basement any more and hope nobody invites me out. I also know how to work through the panic if it starts. How to unwind myself before I get into a right state.

Anyhoo, no real point to this, but good luck BoE. And if anyone sees themselves in some of the above, go talk to someone. I waited years too long.

[Guest]

Intersections between mental illness &, well, me

Panic attacks are the flight or fight syndrome.. in a way it's not an abnormal reaction, the problem is that we live in an abnormal environment which our nervous systems are not designed to cope with. Humans haven't evolved in 10,000 years and we aren't adapted to cope with high pressure modern society.

I started having panic attacks while backpacking in Australia, having been on abender for several months drinking every day.
It continued when I returned to UK, I genuinely thought that it was a heart condition because I kept having the palpitations every day, would just go pale and feel cold, need to go to the toilet, and would lie down for a few hours till it subsided.

I even went to accident and emergency one time to get it checked out and went to see a private specialist.

Eventually the penny dropped... I got some hypnosis tapes and started to listen to those regularly, and got into meditation.
Also doing regular exercise, but mostly, I kept pushing myself to put myself in situations where I would feel uncomfortable,nothing too dramatic, but each time increasing my comfort zone, just a little bit day by day, small improvements.
That was seven or eight years ago, I'm over it now, but I still go to the gym nearly every day, it helps to keep me calm. good luck to others who have suffered with this,hope you come through it.

[G-Man]

Intersections between mental illness &, well, me

Nothing to add here, except to state my admiration for BoE for writing his opening post — it takes courage to do so — and thank others for sharing their experiences.

[Bored Of Education]

Intersections between mental illness &, well, me

Again thank you for all your posts (and PM, Pheobe).

WOM's in particularly struck a chord specifically the bits about finding excuses not to do things (the being a driver in a car struck a chord). Having said that, I still prefer DVDs and there are elements of that time that I still stick to (Why bother go to a restaurant on Valentine's Day or an anniversary when you can go to a spa instead)

Interestingly, it was a funeral that set me off. It was my oldest school friend's Mum's funeral. She was a wonderful lady who I was really fond of.

The train trip to London was OK once I had find a seat near the exit in an empty-ish carriage etc etc but I was still on the blocks ready to sprint off when we got to Paddington. The tube journey was a nightmare. Someone has told me about their panic attacks that resulted in IBS. Like some sort of virus, this, of course, meant that I wanted to go to the loo as soon as I got on the Tube the whole time. I gave up after two stops on the bus as we sat in traffic and walked the 3 miles to the crematorium. Once there, I managed to get a seat at the back but still had to walk out the back as soon as the coffin had disappeared. Needless to say, the meal at the wake was a nightmare until I had necked 4 pints. Even then I couldn't eat much

I was at the GPs the next day demanding Citalopram

One of the ways I know that I am better is that I have attended a couple of funerals (and read at one) and have been on the Tube and buses since.

I am interested to see that hypnotherapy have worked for people. It just didn't work for me, neither did NLP. Indeed, I felt uncomfortable and panicky sitting there. A friend up the road who is an NLP practicioner has said that he will give me a free session when I come off the Citalopram to ease me in. It may help as the cycle of panic hopefully will have broken in the last couple of years

[Paul S]

Intersections between mental illness &, well, me

I've been thinking about your post BOE and it's strange how much I can identify with. I was at a cricket club dinner on Tuesday evening with a guest speaker (Shaun Udal - who was rubbish). When I got there I was terrified of making mistakes in front of people - throwing up, crapping myself, in sort doing something which would draw attention to me. In the end I just stood around watching people and occasionally chatting to the people I did know.

I find I tend to avoid social places - although as I have asperger's I know why I do those. But it still doesn't stop my train of thought being paralysed by the fact I might do something inappropriate, or an inappropriate thought might turn into an inappropriate act.

Does this make any sense BOE?

[Wyatt Earp]

Intersections between mental illness &, well, me

I've been wondering about yer Autistic Spectrum lately. I'm quite socially easeful and everything, that's not it, but I'm incredibly literal-minded, really to the point of eccentricity to say the least, and I can have a complete blindness to the subtext of social situations. I can be staggeringly un-self-aware on here sometimes, for example.

Could just be being male I suppose.

Very affected by your first post, BoE. Glad things are improving.