A Decade

Ten years of therapy.

Three diagnoses.

Nine medications.

Seven therapists.

And two mental health degrees later (psychology and social work)…….

Jane was ready to face the world without a cocktail of medications and strengthen her spirit in psychoanalytic therapy.  She slowly reduced her Lexapro over the course of a month until she was no longer on it.  She began addressing relationship patterns, her absent father, and her anxiety in weekly therapy with a clinical social worker.  The first two weeks without Lexapro were a struggle.  Jane felt a bit on edge, but it was more manageable than the depression she faced for two years.  She had some control issues with cleaning and did not feel like facing the New York City subway.  But she got through it.  Her depression had subsided, and she had learned the coping skills to deal with her panic and anxiety: belly breathing, distracting herself, trying to mentally stay in the moment, paying attention to the five senses, going for walks, etc.  These were the tools she needed to function.  Engaging in psychoanalytic therapy would help her resolve the inner conflicts that were causing this anxiety in the first place.  One struggle that Jane had in therapy was crying.  She was holding in and repressing so much, that it would take a lot of time to truly resolve these deep issues, and the loss of her father in her childhood.

A Heavier Diagnosis

Jane sought help from a new therapist.  The woman was an MFT- marriage and family therapist.  She could not get in the car with anyone, take public transit, or drive long distances.  Each circumstance placed her in a state of panic.  It was taking a toll mentally and on her entire body.  She met with this new therapist who explained that Jane had developed Panic Disorder with Agoraphobia- Diagnosis #2.  They met for two months and worked on the root of Jane’s panic.  Jane felt like the idea of the embarrassment of getting sick again would trigger the anxiety, and the humiliation itself would cause her to lose the relationship of anyone who witnessed an accident.  It was all tied to loss.  It was all tied to fear of losing her boyfriend, family, or her already absent father.  The therapist referred her to a psychiatrist, because her physiological reactions were not under control as of yet.  The psychiatrist was a man.  She had never worked with a man before, and she felt uncomfortable at first.  She had little experience with adult males in her life.  Jane explained her history.  The doctor asked why she stopped taking Prozac after two weeks.  “I felt more energetic, weird.”  The doctor says “Sometimes people with bipolar disorder have that reaction to SSRI medications.”  Jane was furious.  Fifteen minutes into the evaluation, and she felt like he was trying to write this off as bipolar disorder.  She studied psychology, she knew this anxiety was not a mood disorder.  Looking back, she may have been feeling hyper sensitive about the situation as a whole.

July 2013

She met with the psychiatrist again.  He asked her if she felt sad, down, etc.  She said sometimes.  He explained that depression and anxiety go hand in hand.  It made sense to her.  Jane was diagnosed with depression- Diagnosis # 3 and anxiety.  He prescribed her Lexapro 10 mg- Drug #3 and Klonopin- Drug #1 again, to take daily.  This helped reduce her physiological symptoms of panic, but worsened her sadness.  Jane was convinced she was depressed.    She also went to see a gastroenterologist, who diagnosed her with Irritable Bowel Syndrome or as he also said “a nervous stomach” and prescribed her an antispasmodic drug and probiotic to take daily- Drugs #4 and #5.

August 2013

A month passed and Jane explained to the doctor that she was still not feeling right.  He changed her dosage of the Lexapro to 20 mg.

October 2013

Jane went to see the doctor with some feelings of relief.  “I haven’t had a panic attack in a bit.  I have to stop seeing the therapist for a while, money is tight.  She doesn’t take my insurance.”  He asked about her mood and sadness.  Jane still had some bad days.  He gave her a free sample of a vitamin/drug called Deplin that was supposed to increase the efficacy of SSRIs- Drug #6.

December 2013

Jane did not have any panic attacks since the summer.  She attended an intake at her graduate school counseling center to receive free therapeutic services.  She was in a social work program in the city.  Jane starting experiencing feelings of emptiness, loss of hope for a happy future, and dread.  She was now struggling with depression.  This was drastically extenuated by the “anti-depressant” drugs.  They numbed her panic, but worsened her sadness.  Jane spoke to the doctor about these feelings.  He explained that some people need to try different SSRI’s before finding the right one.  He prescribed her Venlafaxine 37.5 MG- Drug #7.  Jane took it for a week and felt worse.  She cried in her boyfriend’s arms that she did not feel normal, like herself, or safe.  It was like a part of her mind was wiped clean.  She felt as she did in eighth grade when she had thoughts of knives.  Thoughts of death sat on her mind.  It scared her more than anything.  She immediately called the doctor.  He prescribed her Cymbalta 30 mg- Drug #8

Febrary 2014

Jane went to see the doctor and explained that she had a little anxiety and felt kind of sad, but that it was manageable.  He asked her if she wanted to try a higher dose of Cymbalta.  She agreed to try it and started taking 60 mg.

November 2014

Six months had passed.  Jane was going through the motions of every day life.  Every day she tried to make the best of the situation.  Her mood was off, her feelings were numb.  She had not cried or felt emotional in a long time.  She explained to the doctor that she felt numb.  He decided to have her try Zoloft, since the Cymbalta may have been affecting her by numbing everything.  She was taking 50 mg of Zoloft now- Drug # 9.  She was still on the Klonopin as well.

April 2015

Jane had some relief after taking Zoloft, but it began to fade yet again.  Nothing seemed to work.  She reflected on starting with Lexapro back in the beginning and asked her doctor if she could go back to it.  He told her that there was a reason they stopped-it was ineffective.  She insisted that she try it again.  He respected her wishes and prescribed her Lexapro.

June 2015

Graduation had passed, and Jane had plans to move in with her boyfriend.  She felt emotionally strong enough to try handling herself without medication.  She ended counseling at school-where they had been finally exploring feelings of her absent father.  Jane had pushed back most of these feelings and separated herself emotionally.  The biggest step in the therapy was Jane accepting that her absent father had an impact on her.  Just stating that fact was the break through.  It had been so repressed.  Jane stopped taking her stomach medication, Klonopin, and birth control.  She let her body adjust to that change.  She wanted to stop the Lexapro but was scared.  Jane also did not want to tell her psychiatrist about ending all medication, thinking he would advise against this.  But she wanted to start this new chapter of her life clean and free from medications.  School was over, she had a new job, and she was moving away from home.  She felt positive for the first time in a long time.

Not a one time deal

A month passed and Jane had no panic attacks.  She was taking things day by day.  Her mother and mother’s boyfriend decided to go out a half hour away from the house.  Jane got in the car and felt a bit uncomfortable.  Having someone else driving made her anxious.  It reminded her of feeling stuck on the highway.  Fifteen minutes in, and Jane’s heart began racing.  Her stomach was turning.  She took two Imodium to avoid feeling an upset stomach.  Five more minutes pass, and she is in full blow panic mode.  “I think I am having a panic attack.  Can you pull over?  I need a bathroom.  I need air.”  Her mother’s boyfriend did not pull over right away.  He offered to find her a nice and clean bathroom.  This was the final straw.  A clean bathroom is not the priority.  Waiting for a clean bathroom did not help Jane feel in control  The world spun out.

They turned the car around to take Jane home.  They had to make a few stops along the way for her to pace around parking lots.  Being in the car for more than 5 minutes at a time was unbearable.  She got home and laid down.  Jane pulled the covers over her head and curled into a ball.  She wanted to hide.  Knowing her bedroom was next to the bathroom was the most comforting and comfortable feeling in the entire world right now.  This was the start to a big problem.

These Castle Walls

Things stayed about the same until graduation. Jane’s stomach issues worsened though.  She would get debilitating pains and upset stomachs whenever she felt anxious.  On graduation day, Jane arrived to the check in area with a bagel and ginger ale.  She was already stressed.  She met two of her friends and they sat on the floor to have breakfast.  Everyone was so excited to be in their caps and gowns.  Jane just wanted the ceremony to be over.  She felt sick again.  The students started lining up, and Jane grabbed two Imodium pills and quickly took them with her ginger ale.  Her stomach was turning and burning.  “This is graduation. I can’t run to the bathroom now” she thought.  She processed into the great hall and sat down.  Speech after speech and her stomach was cramping more.  She turned to her friend and asked if she thought she could go to the bathroom.  No, they said.  You can’t go now, Jane, they said.  She said “F*ck it, I have to.”  She walked back down the aisle and proceeded to the bathroom.  She felt better afterwards, but very embarrassed.  She wondered if her mother and mother’s boyfriend had seen her exit the hall.  Jane thought to herself “I can’t even get through a graduation ceremony without running to the bathroom.”  She felt like her stomach and anxiety issues controlled her life.  It was like a ball and chain following her around everywhere she went.

A week later was moving day.  Jane packed up her belongings into her boyfriend’s car.  Moving home was causing her extreme anxiety.  She was going to be far away from her boyfriend and friends.  Her relationship with her mother was very rocky.  She did not understand Jane’s anxiety and was very insensitive to it.  Jane felt like her whole world was falling down.  This was a life change she was not emotionally prepared for.  Three hours into the drive and they hit bad traffic.  Jane felt nauseous and had a stomach ache.  She closed her eyes and leaned her head up against the car window.  The traffic became bumper to bumper, and they were stuck on a highway surround by these high brick walls.  They were close to a bridge.  The car looked like a mouse stuck in a maze.  There were no trees or houses in sight.  Jane looked around at the miles of cars.  Her stomach began turning.  It had just stopped raining.  The air was hot and humid.  The temperature was in the high eighties.  Jane suddenly felt her heart start racing.  It was pounding out of her chest.  Her mouth because desert dry.  Jane turned around looking at the back seat of the car.  It was packed to the brim with their belongings.  Jane said “I think I am having a panic attack.  Talk to me.” She now felt like she was being swallowed up by the bricks, those castle walls.  She was trapped.  “What am I going to do?  I feel stuck! Oh my God, this can’t be happening.  There’s no way out.”  The car had not moved an inch.  Her stomach began spasming.  Jane began to have a full blown panic attack.  Her breaths were quick and short.  Her stomach was out of control.  She ripped open a plastic bag from the back seat to save herself from an accident.  They drove another hour and a half with the bag in the car.  The nausea never subsided.  This was the worst experience of her life.  She was still sick and the humiliation was torturous.  She wanted nothing more than to forget this day.

Secret Therapist

Jane’s episode of intense anxiety passed, and she made it through the summer.  In the following school year there was an underlying tone of anxiety, and she began to suffer from terrible stomach pains.  Sometimes Jane would have crippling stomach aches where she couldn’t move.  She rarely wanted to leave the house, because she was more comfortable in bed.

Jane was now approaching her twenty first birthday.  It was winter.  She was able to get through her days.  But there was a sadness in her.  She had the urge to cry when she woke up in the morning, but she would swallow it.  Jane would get dressed and do what she had to do.  Much like the sky in the town where she was attending school, her mind felt foggy and gray.  She didn’t have the desire to be adventurous or party like her friends.  She wanted to be home in bed.  All the time.  Her friends didn’t understand why she was shutting down, and she didn’t explain it to them.  She feared they would judge her, and she liked keeping this to herself.  It felt safer . Jane decided to see a therapist in her school’s counseling center.  She told her friends she was meeting with a social worker there for grad school advising.  Jane didn’t want anyone gossiping about something so important to her.  This was her secret therapist.

January came, and Jane decided to see a psychiatrist on campus.  Her depressive symptoms were getting too strong.  One appointment and fifteen minutes later, she was prescribed Prozac.  Drug #2.  She took it for two weeks and stopped.  Jane had a few dizzy spells and suspected it was making her feel funny.  She was already on the fence about medication.  That same week Jane quit smoking.  She just stopped.  She never picked up another cigarette again.  She started binge watching shows on Netflix, and it calmed her.

Why Can’t I Stop Shaking?

Confused is one way to put it.

Jane sat on her boyfriend’s bed watching tv with him and his friend.  She was nineteen years old.  Thoughts of things she said and did years ago started creeping into her head, and she couldn’t get them to go away.  “Think about something else” she told herself.  She didn’t make the connection that these thoughts were washing over her the same way that the intrusive thoughts did when she was thirteen.  She had this terrible feeling of impending doom wash over her.  Her heart started beating faster.  How could she get the thoughts to go away?  Why was she thinking about stuff from two years ago?  What relevance did it have?  None.  But Jane felt helpless.

Jane was cooking dinner for her and her boyfriend.  Tacos.  Every time she touched the raw meat she had to wash her hands.  Make a patty, place it in the pan.  Wash hands.  Pick up the spoon, sprinkle seasoning.  Place the spoon somewhere clean.  Pick up some meat to make a patty.  Realize she didn’t season it.  Put meat down, wash hands.  Sprinkle seasoning.  Place patty in the pan.  Wash hands.  Grab spoon.  Repeat repeat repeat.  Any risk of raw meat touching anything else meant impending doom.  What if she got her boyfriend sick?  There could be no risk involved.

The next day was spring break.  The thoughts kept swirling through her head.  Her stomach turned and turned, and her heart never stopped pounding since the day before.  She got on a greyhound bus and put on music.  She texted her boyfriend that she felt so sick.  Four hours later she gets off the greyhound bus and is greeted by her mother.  She runs into her arms and starts crying.  “Something isn’t right, something is wrong with me.  I can’t stop.”

Her mother took her to work with her the next day.  Her boss was out of the office, so Jane sat in his office on the computer.  From the second she arrived she could not stop sobbing.  She was consumed by thoughts and memories involving her relationship with her boyfriend.  Things like not washing her hands before doing something or dropping something of his on the floor and wondering if she should have cleaned it before putting it back-and not telling him about it.  Confessing her actions and thoughts.  Her mother brought her lunch.  “You have to stop. Maybe you need fresh air.”  Her mother took her outside to get food at a cafe nearby.  Jane listlessly walked through the streets of Manhattan, staring at the people walking around, wondering if they were sick in the head the same way she felt she was.  She sat down at a table while her mother got food at the register.  Her mother brought her a sandwich.  “I can’t eat this.”  Her mother encouraged her to try to take a few bites.  Jane couldn’t stomach any food.  She couldn’t believe she was able to stop crying long enough to go outside.

It felt like the longest day of Jane’s life.  She was home laying in bed now, smoking a cigarette.  Halfway through the cigarette, her heart starts pounding again. She puts out the cigarette and decided to take a few days off from smoking.  Her heart palpitations were unbearable.  She stayed up all night staring at the ceiling.  She started to feel like she wasn’t herself.  It was an out of body experience, where part of her brain felt numb, and her thoughts were spinning out of control.

The end is coming.  There is an impending doom.  This will never go away.  Why can’t I feel better?  Why is this happening to me?  Why can’t I stop shaking?

The next day Jane went to see a psychologist with her mother.  She had seen this doctor before in high school when she and her mother weren’t getting along.  She explained the thoughts and physical symptoms to her psychologist.  She told her how she felt out of control and sick to her stomach.  The doctor said she had some generalized anxiety.  Diagnosis #1.  She asked Jane to try some yoga and meditation and to go outside for walks and really take in her surroundings.  She explained that this would help Jane’s thoughts subside enough for her to get through the day and maybe sleep.  She went home with her mother, and they decided to take a walk.  Just like in the city, Jane walked listlessly, feeling disconnected from the entire world.  Her eyes hurt from crying and she felt completely exhausted and drained.  She went home, and her best friend called.  He asked to come over and hang out.  She told him that she really didn’t feel well, but he could stop by.  He came to her apartment, and they sat in silence watching tv.  Jane told him that she didn’t understand what was happening to her, but she felt like she was in a permanent state of fear.  He told her that his mom has cancer.  She looked at him and could not process what he said.  “What?”  Cancer.  They had a brief conversation about it, and she became dizzy.  Her heart was pounding again.  Her friend decided to leave so she could rest.  She always felt bad about how she handled that conversation.

Two days had passed and Jane had not more than two hours of sleep.  Her grandmother took her to the doctor for a blood test.  Maybe it’s your thyroid her family said.  The nurse handed her a checklist of what Jane wanted to be tested for.  She checked off every single box and handed the paper back to the nurse.  Jane immediately regretted that.

What if the results say positive for HIV?  How can I survive that? How can I tell my family?  I’m not ready to live the storyline of Rent right now.

She met with the doctor and explained her symptoms.  He said her results came back negative for everything, and he prescribed her Klonopin to help her get some sleep for the week.  Drug #1.  Jane as relieved and went home.  She took a klonopin and laid down watching tv.  The next thing she knows, she is being woken up by her mother.  “The psychologist is on the phone for you.  I told her about the doctor.”  The psychologist told Jane not to take the klonopin, because she shouldn’t be sleeping during the day.  She wanted Jane to try really hard to stay awake until the nighttime.  She recommended that Jane try the relaxation techniques they discussed in their session.  This week was the first time Jane was being taught healthy coping skills.  She did some yoga, but it was the klonopin that helped her get rest.  The psychologist also told her not to confess her thoughts to her boyfriend. “Tell him that you are going through something right now, and you will tell him important things.”  Just like when Jane was thirteen, Jane was comforted by an “authoritative therapist” telling her it was okay to keep her thoughts to herself.

Two days later Jane’s friend from college came to visit.  They had bought tickets to a concert for the next day, and her friend knew Jane wasn’t doing so well.  They ordered take out from a diner, and Jane got a burger and fries.  She couldn’t stomach the food.  Her friend took a french fry and make airplane sounds with it, trying to help make Jane laugh.  She did.  She was able to eat a little.  This friend literally hand fed her to help her get her energy up.  They went to the concert and back to college the day after.