Health

Things I need to tell myself while facing diagnosis for a child

First: Realize that you have a battle to fight with denial. You really want to be imagining things. Any time things are normal for a while, you will doubt the diagnosis, doubt the need to seek treatment, decide to just let it all slide for a bit.

Second: You will grieve when you finally hear a doctor confirm what you already knew, but wanted to pretend wasn’t so. It feels more real when said by someone else. Then all the denial washes away and you have to know that your child will struggle with this, perhaps all her life. And it isn’t fair. It isn’t what you wanted for your child, but it is now fact.

Third: You will react to any behavior from any of your other children which mirrors the disordered behavior. Watch that.

Fourth: Diagnosis is a tool, a lever you can use to shape the public school system into something that will work for your child. Make sure it stays your tool rather than being used against her.

Fifth: It is going to be okay. Really it is. Remember the inspirations you’ve had. It’ll probably all settle down before summer.

Sixth: Don’t get so absorbed in the difficult things that you forget to see the wholeness in your child. Consciously think of the strengths she already has that will carry her through.

Finding Levers to Remove Anxiety and Depression

When I had my first panic attack it was an extraordinary event. I choose that word carefully, because anxiety manifesting as body panic was an event outside my usual experience, thus: extra ordinary. Unfortunately it was an experience that lacked any of the positive traits that the word extraordinary usually implies. There was nothing fun or exciting about it. All I knew for sure was that my body was behaving in an alarming fashion. My heart raced and beat irregularly; my breathing constricted; I was cold; and I could not stop my hands from shaking. I knew that something was wrong, so I saw a doctor who found nothing in the physical data to explain my experiences. He suggested stress. I remember him suggesting it, but the suggestion rolled right off of me only to be remembered months later after I had already figured out that anxiety was the problem. I found ways to de-stress my life and the anxiety went away. Mostly. Until it came back and I realized that I had to address it instead of trying to ignore it out of existence.

It is easier somehow with an extraordinary event, some thing we can point at and say “That is outside of usual bounds.” But most mental illness does not manifest suddenly and dramatically. It creeps in, becomes part of the fabric of life, erodes what we consider normal. I saw this with my anxiety. After entering with a bang, I adapted to it, got so used to it that I hardly even noticed it anymore. “I’m better now.” I’d say, while adjusting my schedule to give myself extra space. If pressed, I would acknowlede that if it ever again got as bad as that original onslaught, then I’d have to do something. I wonder now why I did not take that lull as a chance to dig in and find ways to heal. Truly heal. As I’m trying to do now in the wake of the second extraordinary onslaught. I’m a year and a half into that healing process and I’ve still got terrain to cover.

Howard’s periodic depression has been part of the patterns of our lives ever since I first met him. We built our lives around it, planned for it, explained it in a dozen different ways. “Everyone has good and bad days” I assured both him and myself. Eight months ago Howard began to call out his depression for what it is. He started recognizing it as a thing to be faced and changed. The more he called it out, the more we saw it, and we had to wonder had it gotten worse or were we just noticing instead of ignoring? We spoke with our regular physician and got on the waiting list for a psychiatrist. Howard has been amazing through this process. I’ve watched him spectate and analyze as he carefully deconstructs his old coping mechanisms. We’re beginning to build new ones and I am very happy to see him healthier in both mind and body. It takes amazing courage to look at a long standing pattern and choose to change it, particularly if there is no extraordinary event to spur the change.

I think Howard’s courage is what lets me be so calm as I look at my daughter Gleek and see the patterns around her. Just as our family structure has been built around his depression, it has also bent around Gleek’s intensity. Her ADHD was diagnosed years ago and treatment helped, but more is needed. Over the last two weeks her anxiety both at home and at school has pushed out of the ordinary. Her teacher has noticed, the school psychologist has noticed, and my own observations concur. She needs something different, more than I can fix by making sure she eats well and exercises; more than me helping track her homework, buying her books on stress management, more than yoga sessions, a sand garden, and long rambling talks at bedtime where I help her sort through her thoughts. As I type this list and it gets longer, I see how very hard we’ve been working to give her good coping strategies. And it has worked. Gleek is amazing. She is able to spectate and analyze with a maturity beyond her twelve years. Her innate strength lets her keep it together and choose the least destructive coping mechanisms when the anxiety strikes. After all of that, she still needs something more, something different. I’ve scheduled a full evaluation for her. We’ll be re-visiting the ADHD diagnosis and considering possible treatments and therapy for anxiety.

One of the hardest parts about mental illness is that it all takes place inside the brain. It is tempting to believe that we can just think our way out through willpower and motivation, but this is like trying to move a rock with your bare hands. You can do it if the rock is small, but sometimes it is a boulder sunk deep into the ground. Then willpower and motivation must be applied to a lever, for example: a treatment plan formed with the advice of psychological experts. The first step to finding the right lever to remove your rock is being willing to admit that this rock is in your way, that it needs to be moved, and that you probably can’t move it by yourself. The lever you need may be a lifestyle shift, medication, therapy, service to others, restructuring relationships, or seeking healing through faith. Finding which life changes you need–and applying those changes–requires great motivation and willpower. The answers are as individual as the people seeking them.

My family has some rocks we’ve been walking around for a long time and I’d love to take a jack hammer to them, but I’ll settle for some good levers and a solid team willing to help. Now is a good time to get started.

Forty Year Old Eyes

I’ve been looking forward to turning forty. I planned to reach my birthday and proclaim my age in defiance of cultural custom where women either dread their fortieth birthday or lie about their ages, or both. But lately my eyes have been harder to focus. What used to happen in an unnoticeable instant now takes an extra minute. It is like the lag on a slow internet connection. I have also been getting some headaches. So I trundled myself off to an eye doctor thinking that perhaps my glasses needed updating. I’ve had them for eight years. They’re due. I got there and described my troubles.
“How old are you?” asked the doctor
“Forty in two weeks.”
“Ah. The forties are not good to eyes.” He then described how I could expect things to get worse, advised that maybe I could look under my glasses when trying to focus close, and said that when it gets to the point that I’m holding books at arms length it’ll be time for bifocals. He also told me that once a person starts noticing vision differences, things deteriorate pretty quickly.
Why was I looking forward to forty again?

It is silly to be upset by a predictable body shift. I knew that eyes change as they get older. I knew that people have to get reading glasses and bifocals. Yet I am upset and I’m trying to untangle why. Perhaps it is the dissonance. Bifocals, having to hold books at a distance, and large print editions are all things I associate with being old. But I don’t feel old. Forty isn’t old. Yet forty is when these vision changes tend to begin.

The doctor ushered me out to the showroom area saying “If you’re interested in frames, these lovely ladies will be happy to help you.” The lovely ladies in question were completely absorbed by their computers, except for the one who was leaning against the wall and chatting with one of the computer ladies. I shuffled my way down the rows of frames, not really seeing them. Picking out something to wear on my face every day for the next several years felt too daunting. I dutifully looked at each frame in each row while the lovely ladies continued to ignore me. When I reached the last row I knew I was too occupied with the thoughts in my head to be able to decide on glasses, so I walked off into the larger store. Yes, I went to an optometrist inside a big box store. Eight years ago they were fine. This time the service was underwhelming. The only problem was that I’d walked off without paying for the exam, a fact I remembered later when I got home. Which meant I had to go back out into the cold and drive back to the store to pay. It was a forgetful/distracted act of the sort which usually causes me to spout profuse apologies. I couldn’t find the energy to apologize when they’d neglected to provide any sort of customer service at all. I do take a strange satisfaction in the fact that I arrived to pay just after they’d clocked out. So I did cause them some inconvenience, though I’m not sure if that is matched by me having to spend an additional 15 minutes driving in a sub-freezing vehicle.

While I was at the big box store I returned an item and went to go pick up one other thing that Howard asked me to get. I was also supposed to pick up a treat for the kids. Except I couldn’t remember what Howard asked me to get. I called him for help remembering. Then I paid and left only to remember that I was supposed to get a treat too. So I went back into the store and purchased the treats in a separate transaction. Yesterday was not a good day for focused attention to detail.

The next day things look brighter. They usually do. Which is why one of the optical purchases I’ll be making will be a pair of non-metaphorical sunglasses. I’m tired of having to squint will driving in the snow which continues to cover every available outdoor surface. As for growing older, I suspect I’m having the forty year old version of the upset Gleek had a couple of weeks ago when she curled into my lap and cried because she doesn’t want to grow up. All of my kids have had a similar cry right around the time that they turn twelve. I’m having my moment of “getting old” angst. This means it is time for me to get on with living my life so that forty is a good place to be.

Not Coincidence

I finally dragged myself out to the gym today after two weeks of anxiety and four days of low grade depression. (The kind where I get things done, but every time I stop moving I feel like I want to cry a little. Then getting moving is even harder because I have a hard time believing my efforts make things better. I kind of earned this depression with all the non-stop to-doing, but it still doesn’t feel fun. Catching up on sleep was not making it go away. Hence: gym.) I went to the gym around noon. I took a nap. I dragged myself through making dinner. Then I sat down and wrote 2500 words. In the middle of that I folded some laundry and put kids to bed. The sadness had ebbed and the world feels good again.

This is not a coincidence and I need to point it out so that I will stop forgetting. Exercise and writing = well being and happiness.

Anxiety Follow Up

Writing the list of why I am doomed and then mocking that list was extremely helpful in establishing perspective. It let me quell the fears and move forward with the day. However it also revealed something else. I expected the list to be much longer because I thought the anxiety was a generalized mood for the day. Instead I found it to be very localized to those specific things. This means that later, when I was feeling more stable, I needed to come back to those seemingly ridiculous things and dig to find out what in them was an anxiety trigger for me. I did it by writing extensively about every detail of what I was afraid would happen for each thing. I also wrote out any wandering thoughts which were attached to the subjects. This process helped me dig out the not-ridiculous things which were at the root of the ridiculous things. Figuring out the roots is important in the long-term strategy of reducing anxiety. In this case, I am once again assigning myself responsibility for things which are outside my control. I need to figure out how to stop doing that.

Poking in the Irrational Recesses of My Brain

I really should not have written that post about how I was not feeling afraid. I summoned it, or taunted it, or something. Today everything terrifies me, even though some part of my brain can step back and see how completely irrational all the fear is. So I am going to make a list of my recent decisions and how those choices will obviously lead to my ultimate doom. Then I will mock the irrationality and maybe when I’m done things will feel better.

I paid a large bill. It reduced the number in the checking account significantly. Therefore our business is doomed, we’ll never be able to get ahead, all my efforts are in vain. (Which makes complete sense, because hey I paid a big bill in full and had money left over. That’s always evidence of financial doom.)

I made a request of Howard regarding social media. Therefore I am a horrible over-controlling person who is neurotic and needy. Also interrupted his writing in order to make the request and therefore I’ve thrown him out of the writing space and he will not be able to complete the work he needs to do today and that will be my fault.(Because it is unheard of for spouses to ever need things from each other. Also, the request took him less than a minute almost two hours ago. He’s been writing this whole time.)

I agreed to baby sit my sister’s kids while she goes to a job interview. But instead of it occurring during the already chaotic afternoon hours, the kids will be here in the middle of the day. Therefore I’ve just ruined both my work day and Howard’s which will ruin the entire rest of the week because we’ll be thrown out of kilter. (Borrowing trouble anyone? The kids in question are much quieter than mine and we manage to work with mine in the house.)

I engaged in a business discussion via email. Therefore our business is doomed because…I have no idea. It just somehow is. (Yeah I can’t explain this one. The discussion is friendly with no horrible outcomes. No clue why so much doom has become attached.)

I was up until 2 am last night because the brain hamsters were running on their anxiety wheels of doom. Therefore I will never get a good night’s sleep again. (All the nights when I sleep fine are insufficient evidence to counter this.)

The laundry overfloweth. Again. Always. Therefore I am an awful slovenly person who will never accomplish anything good. (The clean kitchen does not count just the grubby carpets.)

Huh. I just ran out of reasons to be doomed. Either making this list helped and my brain is no longer seeking evidence of doom everywhere, or it really was just those things bugging me and I now have a list of things to complete/adjust in order to feel better.

Exercise and Mental Health

Several years ago I met an acquaintance as I was headed out of the grocery store and she was headed in. She was obviously on her way home from exercising at the gym. We chatted for a minute about her regular trips to they gym and about physical fitness in general. “a gym membership is cheaper than depression meds.” she quipped. I laughed and we parted to go our separate ways.

I’ve thought about that conversation quite a bit lately, particularly on the days when I’m pounding my feet on a treadmill. Over the past several months it has become clear that I have two choices to regulate my emotional state. I can either exercise three to five days per week, or I can find a doctor and get anti anxiety/depression medication. When I try to avoid those choices my emotional state vacillates wildly. My capabilities change. I hate it. I don’t think it is fair. I know that declaring life as unfair makes me sound five years old and I’m mad about that too. I remember the days when I was an extremely stable person emotionally, but things are different now. So I get mad about it and I use that anger to get me to the gym where I’m allowed to be angry at every running footstep I need to take.

I choose exercise, it has better side effects. When I’m not being angry that life is not fair, I am able to be very grateful that exercise does work. Not everyone is so fortunate. I know people who struggle with brain imbalances much worse than mine. I also know that my choices may change in the future. Physiology and psychology are in constant flux. There may come a day when instead of either/or I’m faced with and. In the meantime, I’m once again being mindful and getting my exercise, because taking two weeks off landed me in a place where I wondered if I was going crazy.

I finally understand the quip my acquaintance made. She was not joking at all. She masked it as a joke, passing it off lightly because we didn’t know each other well and parking lots are not good for deep conversation. Now I understand her, because on the way home from the gym I stop at the store and run into acquaintances.
“Oh you’re so good. I should get to the gym more.” They say.
I smile and sometimes I make a light comment, because I don’t want them to feel bad about their choices. My exercise is not about being good and doing the things I’m supposed to do. It is definitely not about being better than anyone else. If I could choose to stay home and stay emotionally stable, I would do that. It would be so much easier. Instead I run because running is better than feeling like I might be going crazy. Running is better than crying.

It feels wrong to be praised for this thing I feel forced to do and which I often do resentfully. I also know how recently I’ve become regular about exercise and how easy it is for me to fall back out of the pattern. Exercise is a new habit and it wears on me in unfamiliar ways. Howard thinks that the resentment will wear away and exercise can be something I just enjoy. Maybe he is right. I know that used to be true. Perhaps it will be true again. A few times I’ve felt the edges of enjoyment, I definitely feel satisfaction some days. Mostly I just get moving because whether or not I enjoy it does not matter as much as the fact that I need it. Perhaps these other emotions will emerge when exercise is a familiar part of my routines, like a comfortable pair of shoes. Right now I need to be grouchy about exercise, because the anger gets me out the door, and when I come home I am more able to do everything else.

Take Two Doses of the Gym and Call Me Next Week

I went to the gym today, for the second day in a row. I feel quite grouchy about it, because the gym trips were not the result of some reasoned decision to be more healthy. They did not spring out of self control or determined change. My choices were either to run until I was sweaty and endorphinated or to sit down and cry. Howard persuaded me that the running option was better. It was a near thing, I’ve resisted this sort of “go to the gym” suggestion for months, like a child faced with vegetables she didn’t want to eat. I don’t know why. I used to love going to the gym. It represented freedom and self mastery. I guess it has just gotten hard to want to leave my house, which should probably have clued me in. I last went to the gym…a year ago? Longer? Howard has been convinced that regular exercise is part of the solution to my anxiety troubles. I know he’s right, yet it took an attack of depression to get me actually moving.

The medical stuff: A year ago a blood test showed that the dosage for my thyroid medication was too high making me mildly hyperthyroid. We lowered the dosage and my anxiety abated. I then employed thyroid dosage as one of my anxiety control rods. Two weeks ago I tested in the Hypothyroid range, which explains the weight gain, and makes the continuing anxiety feel like a mystery. It also showed me that I need different anxiety management methods. We raised my dosage, and now, ten days later, I’ve been beset with depression. This feels so backward. And dumb. Hypothyroid is associated with depression and the medication Maybe it is a coincidence, or maybe it is not. But the depression would have me believe that I am doomed forever and will never figure any of it out. My logic brain says we are going to continue to take our thyroid medicine, let things settle, exercise every (expletive) day as part of the medical treatment, then take all the data to our doctor’s appointment in a couple of weeks. At least this way when my doctor asks if I’ve been exercising, I can answer that, yes I have, and it still has not solved everything. Or maybe it will have solved everything and then I can just have a pleasant chat with my doctor and not see him again for another year.

I saw a commercial for depression medication which used animations for the visuals. It was a woman with a sad blue umbrella over her head that rained on her. Then she started taking medicine and the umbrella rested closed near her instead of looming over her head. I loved how the commercial implied that medicine was not a magical solution. It is a much more realistic expectation than images of happy people running through fields of flowers. My depression experience this week has been like that. It loomed over me making everything wet…until I ran on the treadmill and it all backed off. I can still sense the sadness out on the horizons of my brain. I could go fetch it and wallow in it if I wanted to, but I can also function and get things done. All the important and urgent tasks are easy. I even feel satisfaction and accomplishment for a brief time afterward. But for anything long-term or creative I’m having trouble wanting to get things done. It is the classic “loss of interest” symptom of depression. I’d suspect this of being a hypothyroid depression, except for the stuff in the medical paragraph. Brains are complicated and weird. Last week I was normal for me, which means mostly happy with occasional anxiety. This hit me Monday afternoon.

So once again I’m in a diagnosis cycle. I seem to spend a lot of time in those for either myself or those near and dear to me. I’m a bit cranky at having to deal with it, so I use that crankyness to get me to the gym where I can pound a treadmill and weights for a bit. Hopefully it is a prescription for better health.

Mind and Body

Hi! I drank caffeinated soda this morning. Can you tell I’m on caffeine, cause I can totally tell I’m on caffeine. I can tell because the clouded and lethargic thoughts of yesterday have turned into the sharp, focused, and highly distractable thoughts of today. I chose caffeine this morning because Howard leaves for GenCon in just five hours and yesterday I accomplished none of the preparatory tasks I was supposed to complete. Some of that was because of pre-convention stress and denial, but the larger part was something physiological. There is a bug which has mowed down Kiki, Link, and I. Link fell asleep while playing a video game and stayed asleep for the next sixteen hours. Kiki and I did not fall asleep, we just felt like going to sleep, or like crying about everything. We’re sick. It will pass. Unfortunately I have to fulfill my role as talent wrangler and business manager before I can collapse into sleep for sixteen hours like Link did. So I am medicating myself with caffeine in the hope that I can consolidate my limited energy for the day into a small enough time span to get the necessary work done. After that, I’ll collapse into a heap and watch movies for the next day or two. This is the theory, thus far my brain on caffeine has scampered like a squirrel across the necessary tasks, but has also darted all over the place composing parts of blog entries (such as this one), done math to figure out how old my kids will be in 2020 when WorldCon may take place in New Zealand, contemplated a major clothing sort, planned how to repaint my bedroom, and made a list of things to do today. At least I’m moving, which is an improvement over yesterday, but it does highlight the connection between mind and body wellness.

This time last year I experienced a major physiological and psychological event. I had a panic attack during the Hugo ceremony. The experience threw me out of balance, or rather, it demonstrated in a not-to-be-ignored way how out of balance I had been for a long time. I’ve spent much of the last year trying to find the hundreds of small ways that I’d pulled myself out of kilter and to set myself to rights. The process has been slow and has required me to rearrange my physical spaces in order to figure out my emotional spaces. I’ve had to isolate stresses and determine why they are stressful. I’ve deliberately shaken up my usual patterns of behavior and thought, making a River Song journal, maintaining a Pinterest board, eating new foods, going new places. Then I watch my reactions to these new stimuli to see if they will lead me to hidden pockets of grief which have been driving my behaviors. I’ve learned that my body will tell me when I am stressed even if my mind is too busy to notice. When my teeth ache, it is because I’m pressing them together subconsciously while sleeping or doing other things. I do that when I’m carrying suppressed stress. This means that aching teeth is a sign that I should stop and dig around in the back of my brain to see what else is going on. There are other physical signs, I’m actually kind of amazed how accurately various kinds of stress manifest as different aches or strains in my body. Paying attention to my body teaches me things about myself.

The life benefits of good diet and exercise are commonly known. There is, naturally, much argument about the definitions of “good diet and exercise.” This is because bodies are different and the perfect diet for one person is not ideal for another. Some of my experimentation in the past year has been figuring out what forms of nutrition to which my body best responds. I’m also observing how stress changes my food cravings, or perhaps eating poorly alters my stress levels. I’m still not certain of the causality. I just know that times of high stress correspond with high chocolate and ice cream consumption. When I am stressed my nutrition deteriorates because I’m less able to spend extra energy planning healthy food. Stress shuts down the food planning circuits in my brain. This means I need to create some optimally healthy for me default meals and turn them into brainless habits during times of lower stress. I think my ideal diet is lactose free, lower carb, and reduced sugar intake. When I’m on this diet I think more clearly. When I’m exercising regularly, this is the diet I crave. Mind and body feed back into each other so that everything either falls apart or works smoothly. I fall into bad patterns and haul myself out of them over and over again. Though, hopefully, my pattern cycles are actually a spiral where I am gradually bringing myself to a healthier place for both mind and body.

I’ve often wished I could separate body chemistry from my ability to think. I usually lament this when I’m dealing with an excess of emotion due to thyroid imbalance or hormonal fluctuations. I can’t separate them. Everything is entwined, which makes change difficult and complex. All I can do is pay attention to the things my body tells me about my mind and vice versa. I can make sure that I don’t try to use a short-term emergency fix, like caffeine, as a long-term solution. And with that thought, I need to take my distractible squirrel brain and apply it to the problem of putting the appropriate clothing and supplies into Howard’s suitcase.

How things are going and cool stuff you should look at.

I have a blog post about anxiety that I’ve been trying to write for two days. It is still a multiple-draft mess. The only solution is to put it down and move on. Hopefully I’ll be able to come back to it in a few days and pull the things I want to say into some better shape. This past week I’ve been carrying anxiety levels which I’d hoped not to experience again. The good news is that this is directly linked to me tinkering with my thyroid dosage. I’ve learned my lesson and now merely need to hang in there while the re-lowered dosages take effect again. Should be better by this weekend and normalized by next week. Also good news is that I spent enough time over the past several months in a non-anxious state that I’m able to recognize my anxiety this past week as Not Normal. This is a huge improvement over thinking that a racing heartbeat and shaky hands were just part of my life. Even more good news: exercise makes things better. Exercise is something which is in my control. So expect to find me dancing to exercise videos later this afternoon. BUT first I have to ship a lot of things, go shopping for supplies to make school treats, and shop for a few last Christmas gifts. (Am I ready for Christmas? The answer to that is still complicated and still wants a blog entry of it’s very own. I’ll add that to the bottom of the to-do list.)

In the meantime, here are three cool things which I’ve been meaning to tell you about:

Last February I was out to lunch with my friends Jessica Day George and Julie Wright.
Jessica was really excited because she had just received a cover image for her latest book, Tuesdays at the Castle. She pulled the image up on on her phone and we admired it on the tiny screen. “I just want to hug it!” Jess said. Both Julie and I agreed that the cover was huggable. That book came out last month. My pre-ordered copy arrived and I read the whole thing. My oldest daughter read it too. We both agree that the whole book is just as huggable as the cover. I love Princess Celie and hope that you will all go out and buy copies of this book so that she can have more adventures.

Last summer I got to read this story which my sister Nancy wrote. It moved me to tears and resonated very strongly with lots of emotional themes which have come up in my parenting. I suppose it makes sense that Nancy’s story speaks so strongly to me, we grew up in the same house, our kids face similar challenges, and we have similar approaches to tackling those challenges. But if you enjoy reading this blog, you will almost certainly enjoy reading Nancy’s story. It is fairly short, but well worth $3. Additionally, if you buy Movement in the month of December, Nancy will donate her profit to a charity supporting Autism research. If you happen to be a Hugo or Nebula voter, you may want to nominate this story. I’m certainly going to.
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Most of my blog readers know that my husband Howard is an amazing and funny guy. So is Howard’s brother Randy. Of late I’ve had the opportunity to be in a writer’s group with Randy and so I got to read a draft of this book before it went live. It was already funny before Randy made it better. Mugging Leprechauns is a tweet-book. It contains bite-sized bits of funny which remind me of those Deep Thoughts by Jack Handy books. Even better, Randy’s book is less than $1. It’s almost like getting funny for free. Of course if you want an advance look at the jokes which will feature in Randy’s next book, you could just follow him on Twitter (@randytayler). That’s what I do and it regularly makes my day have laughter in it.