Let’s Talk About Generalised Anxiety Disorder

I can relate to this article. Generalized Anxiety Disorder (GAD) is the medical term for my chronic “free floating” anxiety that I complain about so often. Believe me, it’s a lot worse than it sounds.

Please leave your comments on the original post.

The B Journal

If there is one thing that has been like my on-off toxic partner for the past 5 years (apologies to my boyfriend), it has been the complex condition known as Generalised Anxiety Disorder. Also known as GAD, in a very brief summary, is defined as exaggerated anxiety, and worry about everyday life, that may affects your day to day living.

In a world where mental health, and emotional stigmas are being more discussed, we often talk about how we are becoming more self aware about ourselves, and we are becoming more open to talk about how we are feeling. This may cause people to explore their mental health, and in particular in times of stress, and low moods- we are becoming more and more open as a society to look for a diagnosis, and try to find a remedy for how to combat this.

Unfortunately, as with everything in society…

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Panic attacks, dissociation, and my son’s anxiety issues.

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Geometries by M.C. Escher

 

My son, who already suffers from OCD and ADHD (both diagnosed) tweeted this the other night:

I just had one of the strangest things happen… and it was the scariest experience of my life. I just had a Depersonalization/Derealization episode. It was SO FUCKING TERRIFYING. I thought I was gonna wake up in the ER or never sleep again.

Then later:

Other than OCD, ADHD and depression i have no psych disorders i know of. That shit LITERALLY made me feel like i’d lost my grip on reality and self.

The next day:

I’m going to the emergency room.

A few hours later:

Guys, if anything happens i love you all. Absolutely terrified in the waiting room rn feeling like death.

Late last night:

I got released. They gave me an anxiety pill. It was officially diagnosed as an anxiety attack.

Today:

Looking into therapy. my anxiety is getting REALLY bad.

As his mom, of course I was alarmed by these tweets.  But, as someone who used to suffer from panic attacks just as debilitating during my 20s and 30s, I KNOW HOW HE FEELS!  Panic attacks suck, and the type that involve dissociation are absolutely the worst.   For me, the dissociation usually involved derealization (feeling like your environment was unreal) but sometimes depersonalization (feeling like you’re disconnected from the world or like you’re not in your own body) too.

The panic might be hereditary.  His father suffers from anxiety attacks too.   I used to have exactly the kind of panic attacks he describes — always some kind of dissociative hell where I felt like everything was a dream and the people around me suddenly looked very frightening — either robotic or demonic.  Sometimes they looked like wax figures or seemed like they were being run by machines, and the environment itself became very surreal and dreamlike.  Sometimes it looked like a cartoon or two-dimensional.

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Museum installation by artist Peter Koler

During the worst attacks, I used to feel like I was literally outside of my body, and that really freaked me out.   I actually would have trouble controlling my body.  I remember once this happened to me on the subway in New York (which is scary enough as it is!) and I literally had to run off the train as soon as it stopped and ran into a corner and started whimpering.    Sometimes I used to have to bite my hands to feel “real.”   There were a few times I actually drew blood from doing that.    These dissociative episodes felt just like a bad drug trip, and I’ve had a few of those too.

I suffered from my first dissociative panic attack at about age 10.  I was playing outside in the early evening in the driveway and suddenly I felt like I wasn’t in my body.   But I wasn’t able to find the words to describe the feeling, and when I tried to tell my mother about how “weird” I felt, she had no idea what I was talking about and said I was being overdramatic and imagining things.   Eventually it passed, but from then on, every so often I’d get that weird feeling again.   As I entered my teens and twenties, the attacks became worse and more frequent.   They eventually tapered off when I reached my thirties and I haven’t had a full blown panic attack in years.

In my case, the episodes may have been due to my generalized anxiety disorder (GAD) or possibly from C-PTSD and/or BPD.    I don’t think my son has BPD, but he likely has PTSD or C-PTSD (his father is a narcissist and we had a very toxic marriage when the kids were young, which I have described elsewhere in this blog).   OCD can definitely cause a person to have anxiety or panic attacks, and I’m sure having ADHD just exacerbates the tendency.

I talked to him tonight for a while about this, and suggested some mindfulness tools that have helped me.   I think CBT could help him with this.  Thankfully, he has health insurance with his job, and has set up an appointment to see a therapist.  The emergency room gave him a short term prescription for some anti-anxiety meds (not benzodiazepines though).   But there are many things he can do to help himself too.

He has never sought therapy for his anxiety or OCD because he’s been able to deal with it  on his own until now, but he does need help with the panic and dissociation.   He also admitted his new job is much more stressful than he expected, and he is already looking around for something else.

If you pray, please send your prayers his way.  No one ever died or went crazy from a panic attack, but as someone who’s suffered from them, I know they can certainly feel that way when you’re in the midst of one!

*****

Further reading:

Derealization and Depersonalization in BPD and NPD

The “Four F’s” of C-PTSD

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I just began reading “Complex PTSD: From Surviving to Thriving” by Pete Walker. I can already tell I won’t be able to put it down (I will write a book review when I’m finished, which shouldn’t take long). I’m also going to bring this book to my next therapy session because I want my therapist to see it.

Walker, who is a therapist and also a survivor of narcissistic abuse and sufferer of C-PTSD, is an engaging writer and definitely knows his subject matter. In one of the first chapters, he discusses the “Four F’s”–which are four different “styles” of coping that people with C-PTSD develop to cope with their abusive caregivers and avoid the abandonment depression. Whatever style one adopts may be based on several factors–natural temperament, the role in the family the child was given (scapegoat, golden child, “lost” or ignored child), birth order, and other factors.

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Available on Amazon

The Four F’s are:

1. Fight (the narcissistic defense): often “golden children,” such children learn to project shame onto others; may go on to develop NPD
2. Flight (the obsessive-compulsive/anxiety defense): these children will grow up to become highly anxious, obsessive-compulsive, and avoidant.
3. Freeze (the dissociative defense): these children “protect” themselves by dissociating from others, themselves, and their environment.
4. Fawn (the codependent defense): the child learns to avoid harm by people-pleasing or siding with their abusers.

Walker speculates that if C-PTSD were recognized in the psychiatric literature, the DSM could probably be reduced to the size of a pamphlet, for many people diagnosed with other disorders actually have C-PTSD, which encompasses symptoms of many other disorders and have common roots.

What you may have been misdiagnosed with (or diagnosed yourself with) if you have C-PTSD (these are the most common):

Personality Disorders:
Borderline Personality Disorder
Narcissistic Personality Disorder

Dissociative disorders

Anxiety Disorders:
Generalized Anxiety Disorder
Panic Disorder
Social Anxiety
Obsessive-Compulsive Disorder

Mood Disorders:
Depression
Bipolar Disorder

Developmental Disorders:
Autism Spectrum Disorders
ADHD
ADD

Codependency

Addictive Disorders

While any or all of these diagnoses can be co-morbid with C-PTSD, they miss the mark or don’t tell the whole story. Personality disorders such as BPD can develop from severe, unrelieved C-PTSD and they do share many similarities, but personality disorder labels are stigmatizing and not very helpful for someone who has suffered prolonged childhood trauma and abuse. Labels like “panic disorder” or “depression” aren’t helpful because they only address one or two symptoms of C-PTSD and therefore can’t even begin to address the roots of the depression or anxiety. You can treat anxiety or depression with drugs or short term therapy, but you can’t cure the person of the C-PTSD that’s causing their chronic anxiety or depression. The same goes for labels such as alcoholism or codependency. These are merely symptoms. People with C-PTSD are also sometimes erroneously diagnosed with developmental disorders such as ADHD or autism, which not only don’t address the trauma that led to the ADHD- or Aspergers-like behaviors, but also have completely different causes.

Fear of death.

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Fear of death, called Thanatophobia, is a common fear, especially in younger people, who under normal circumstances have their entire lives ahead of them and don’t have to worry about the inevitable event happening any time soon.

Of course, the grim reaper can claim anyone at any time. There are no guarantees in life, and even if you’re a gleaming example of perfect health in your prime and never take dumb risks, a concrete block could crash down on your head while leaving your house tomorrow morning. But the likelihood of sudden (or even protracted) death when you’re young is small, so the young can afford to fear death, as long as their fear isn’t so overpowering it makes it impossible for them to enjoy their time being alive.

It’s been said that the older we get, the less we fear death. In the very old (and those who have been suffering with chronic illness for a long time, including terminally ill children), death is even welcomed and looked forward to. That’s understandable, especially if you believe, as most people do, that the afterlife will be better than this world. Unless you fear going to Hell, you probably shouldn’t be afraid of passing on to the “other side,” whatever it may be. Even if the atheists are right and there’s nothing at all after this life, well, what’s so terrible about that? It’s like an eternal sleep and you won’t be aware of anything so not being able to wake up won’t bother you.

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I think people fear death for three reasons:

1. Fear of the unknown.
Humans have an instinctive fear of the unknown, and no matter how much faith you have that you are going to heaven when you die, the bottom line is, no one really knows what happens. And that’s scary. I think that on a deep level, even the most religious people with the strongest faith still struggle with the knowledge that one day–a day that could be tomorrow or in 50 years–they will pass into something that’s a complete unknown.

Not only that, dying is an act that is always experienced alone. No matter how supportive a family or friends you have, no matter how many people surround you with their love as you prepare to die, no matter how much comfort is given by loved ones to the dying person, they are not going to be joining you on that journey. Other than God and the angels (if you are a believer), you are going to be taking that journey into the unknown all by yourself. Even if you die with others, such as in an accident, your journey to the other side is yours alone. Their journeys may be very different from yours.

2. Fear of the process of dying.
I think for many, it’s not so much death they fear, but the way they are going to die. Are they going to get cancer, be hit by a truck, be murdered by a burglar on meth, or suffer a sudden massive heart attack? There really is no pleasant way to die. It’s almost always either quick and terrifying; or long and incredibly painful. If you spend too much time thinking about the fact that one of these two things is going to happen to you before you die and it is not going to be pleasant, you can drive yourself crazy. That’s why it’s much better to focus on living a good, fulfilling life and not think too much about the way you might be leaving earth someday.

Some people think that by choosing the method in which they die, they have some control over the dying process and thereby make it less scary. That’s why right-to-die organizations and assisted suicide exists. If you have terminal cancer and know your death is going to be protracted and painful, why not just take some pills or hang yourself instead? Sure, it won’t be pleasant, but at least it might be quick. While this reasoning is understandable, many religions object to this because suicide, even suicide when you are going to die anyway, is considered a grave sin and God will make you accountable after death. But other people don’t believe this and think that God, if he exists, wouldn’t want them to suffer needlessly. Again, there’s really no sure way to know. I doubt I’d ever do it though, since I’m one of those who thinks God would make me accountable.

3. Fear of Hell.
Most Christians (and people who follow other Abrahamic religions like traditional Judaism and Islam) believe in some form of Hell and that some of us are going there after we die. Some Christians believe that all you need to do is accept Jesus as your personal savior and you are automatically saved and admitted to heaven. Others believe works on earth as well as grace are important. A few liberal Protestant denominations believe Hell is a state of mind (a separation from God) rather than an actual place, or they don’t believe in it at all. Jehovah’s Witnesses and Seventh Day Adventists believe if we are not pleasing to God, we will simply be annihilated after we die (much more palatable, imo, than the concept of eternal torment). I’ve always had problems with the concept of Hell and simply find the idea that God will be sending good Buddhists, Hindus, atheists, Unitarians, and liberal Christians (the kind who don’t believe in Hell) to be tortured for all eternity extremely disagreeable. Not everyone, especially skeptical types like me who tend to need concrete evidence before they believe anything, is able to blindly embrace the idea of a savior or the words of the Bible (which can and have been interpreted in different ways) and even if they are willing to believe, some simply can’t. Should they be consigned to eternal torment for not being able to believe something because they think about everything too much?

Let me stop here before this turns into a religious post. That’s not my intent. My point here is that many people are afraid of going to Hell, even those who don’t really believe in in it. But there’s really no way to know if there is one, is there? There’s really no way to know what will happen after we die, or if anything will happen at all.

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How I wish I could have this attitude!

As I stated earlier, as people age, they tend to come to terms with the inevitability of death, even the inevitability of the process of dying, as they become aware they have many more years behind them than they have in front of them.

But what happens if, like me, you’re in your fifties and are still afraid of death? I’m well aware I probably have, at best, another 30 or so years left to live. Forty or fifty more years is highly unlikely though possible. Twenty years isn’t a lot, but for someone my age, that’s far more likely than living another forty or fifty years.

When I think about how short a time 20 or 30 years really is, it fills me with terror. I know I think about death way too much and should be focusing more on living a fulfilling life. It’s a waste of life to dwell on the unpleasant fact that one day I will die and may suffer a horrible, painful death too. How does one come to terms with the fact they are going to die and it isn’t even that long a time away? How does one get to the point of actually looking forward to death? I know some Christians reading this are going to be thinking, “well, if you were really saved [I consider myself to be], you would have no doubt you are going to heaven.” But no matter how much I pray about it, I still have doubts. I don’t think that’s likely to change either, because I’m the type of person who questions everything. Even my faith. The bottom line is, I simply don’t know what’s going to happen when I die, or when it’s going to happen, except that it’s going to happen. As the saying goes, none of us get out of here alive.

My son didn’t escape unscathed.

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This is not a photo of my son, but it looks a little like him.

My 23 year old son was scapegoated and bullied by his father when he was a child and teen (which I’ve written about before). As the most sensitive and nervous child in the family who was able to see through his father’s malignant narcissism, his father began to target him for abuse when it became clear to him my son had a good built-in bullshit detector.

When he was 17 he moved out of our home to stay with a female police officer who worked at his school. She was very supportive but after awhile he decided to move back in with us briefly. When he turned 18, he moved to another state and has not been back, although he does talk to me on a regular basis. Due to lack of funds, I’ve only seen him 3 times since he moved out in 2010. He is doing well though–working two jobs, one as a management trainee for a chain of convenience stores in the Tampa, Florida area, the other as a Carraba’s server where he sometimes pulls in as much as $700 in a single weekend.

He has many interests and talents, including dancing, animation, and filmmaking (which is what he really would love to do). He came out as gay when he was 17. After that happened, he transformed from being a nerdy, nervous teenager with few friends to a very popular young man with a geeky, eccentric sort of cool and many friends. He doesn’t do drugs or smoke. He drinks, but doesn’t appear to have an alcohol problem.

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Photo of my kids in Texas in 2001.

I thought he somehow emerged unscathed from the family dysfunction. He shows no signs of having any personality disorder, although he has reported having panic attacks and he tends to be obsessive in his thinking. He’s also prone to depressions.

Tonight we talked to each other on the phone for awhile and he described his obsessive thinking. He worries about locking the door, for example, and has to keep going back to check to make sure he locked it. He hates having anything dripped on him, and that can set off a rage attack. They are like panic attacks, but instead of panic, he feels rage. He doesn’t act on the rage, but he feels it. Then he feels guilty for feeling that way. He doesn’t like people approaching him from behind and is jumpy and wants to attack when that happens. He worries incessantly about the impression he makes on others and suffers from occasional paranoia, and thinks others are out to hurt him, even when there is no rational reason for him to think this.

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Sporting kelp “hair extensions.”

It sounds to me like he suffers from a severe anxiety disorder, and probably has OCD. He can afford health insurance now, so I told him to please see a therapist who can find out if what he has is OCD or something else, and possibly give him some medication and therapy. He’s willing to do this. I still think he’s the most mentally healthy person in the immediate family, and the only one who is doing well financially and doesn’t appear to have a personality disorder, but he’s far from unscathed from the abuse inflicted on him, and his hypervigilance and anxiety is no doubt due to that (though there could be a biological component too).