Wednesday, February 06, 2008

Out of the dark

Well, here’s an embarrassing admission: I’m an addict. Or was…or am in recovery... or taking it one day at a time or something. I’m not completely over it – I still indulge almost every day. But in small amounts… for a limited time… and I cut myself off after just one: one sinful, spectacular, perversely satisfying hit a day.

I had to stop. My life had become, to a certain extent, unmanageable. I was miserable, tired, depressed, worried and anxious – virtually all day, virtually every day. And the more it affected me, the worse I felt, the more I wanted; in some backwards Bizarro-world diminishing returns kind of way, (and I can’t imagine why – it wasn't even remotely logical) I was using it to achieve its opposite effect, with spectacularly negative results.

Finally, it got so bad I went to my doctor and described my symptoms – the constant song I couldn’t get out of my head, my worries and anxieties… the physical and mental misery I felt practically bathed in. And all the while I was talking to her, right there in her office, I was on the drug, experiencing the drug – I actually had it on me when I went in – and I never said a word.

My MD began by prescribing other drugs – anti-anxiety medications that nearly pulverised me with exhaustion, but did nothing to allay my symptoms. I awoke each morning as if from a coma, not fully conscious for at least an hour; on some of the drugs she had me try, I’m not sure if I was ever fully conscious at all.

But I continued to take my drug. And I continued to suffer.

Eventually, she sent me to a psychiatrist who spent a full ninety minutes questioning me in minute detail about my symptoms and habits and history. I’d had some of my drug before I went in – I even managed to have some more in his actual office – but I did it surreptitiously and never referred to it. And neither did he.

He gave me a diagnosis describing a serious anxiety disorder and recommended behavioural therapy with some form of medicinal support. He gave me a receipt for services rendered to present to my insurance company. He also suggested the name of a colleague whom he felt could help on the therapy side of things and wished me luck and sent me home. He mentioned that I would likely never be entirely symptom-free, but that I might hope for significant improvement.

I felt I needed another hit of my drug on the way home (I had a few moments of panic as I sought to track it down in the unfamiliar neighbourhood, but eventually scored - it’s easy to find if you know where to look…) all the while meditating on what he had said about the diagnosis and his recommendation for treatment and tried to picture what my life would be like stripped of most of its pointless fretting and worrying and agonizing and realized I had pretty much forgotten how such a state might feel.

I arrived home and took another hit.

A couple of weeks later, holding hope practically clenched in my hands and with my heart beating even faster than its abnormally elevated rate, I showed up for the first meeting with the referred specialist, but was soon devastated to find that not only did our session not offer so much as a glimmer of the happy destination I was imaging myself headed for, but instead made me so much more upset (and worried and anxious and fearful) that I vowed never to return. Whatever chemistry was affecting my brain to the extent that I had needed this man’s help in the first place, did not extend to any actual chemistry between the two of us. I felt worse than I had ever felt up to that point and took the streetcar home in the gathering dusk, sunglasses firmly in place to hide the bitter tears I’d shed as his inability to help me became Waterford-crystal clear. I took another quick hit of the drug on the way home, but as ever, no relief was forthcoming.

I felt simply hopeless. I couldn’t imagine another pill would produce a miracle – I couldn’t imagine there was a pill I hadn’t tried – and the horrible experience with the therapist just compounded my feelings of helplessness. I’d lived with this pain for so long (though it was gradual in coming) that I’d come to accept this state of exquisite hyper-anxiety as normal; but the last few weeks, reaching out to the medical establishment had brought hope back to life.

The subsequent disappointment was devastating.

A friend’s mother – an experienced and caring therapist – took time out of her already full calendar to begin telephone sessions with me. She was marvellous… and her confidence and positive approach were balm to my shredded nerves. But I continued to indulge in my addiction, to self-medicate in the worst possible way, so that even her tender understanding was undermined by my own self-destructiveness. However, with her help and support, I found a level of misery I could cope with and tried hard to accept that if this was where I belonged mentally and emotionally, than I had best make the best of it and find pleasure where I could.

And of course the pleasure I most easily found was in reality the source of my despair.

It was another friend – also sweet, caring and kind – with the added bonus of living relatively close-by, who, in the end, was the one who forced me to face what I was doing to myself and to make the connection between my pleasure and my pain.
When she approached me, she did it without judgment, merely by pointing out what she observed: I was a small person she said; was I aware that I was possibly indulging in this addiction, not only in larger and larger quantities, but also more and more often? How could my body take it? She was worried she said – she just wanted me to think about it.

She was the first person who had said a word – the first person who had even noticed that I was escalating my intake – and she could see it was affecting me.

So she was the first person who made the connection. I was resistant at first: I didn’t want to admit it and I didn’t want to stop what I was doing: it was my one pleasure I told myself, my one restorative – the thing I most wanted first thing I the morning and then all through the day.

I panicked a little; what would I do – how would my days look, feel and start – if I were to give up my drug and nothing much improved, then what would I do?

It was that final question that provided me with the impetus to change: if nothing changed, if all continued as before, then I would just start again. I would give it a two week trial (and I wouldn’t even give it up completely) and at the end of that fortnight, if I still felt the same, it would be back to business as usual. I would just have to get through those fourteen days.

I can’t remember now if part of me wanted everything to stay the same: not from the perversely attractive familiarity of mental anguish, but from the addiction itself – the quick subtle pleasure, the habit, the feeling… everything – or if I sensed that she had inadvertently put her finger directly on the pulse of the problem and that I might once again begin to hope that my days and nights would become calmer, gentler and… better.

It doesn’t matter now – the fact is she was prescient: within a day or two of cutting back I began to feel different. I spoke slower, more calmly, more deliberately; I slept better – and little by little, the constant nagging worries diminished to the gentle roar I now recognised from a seemingly distant past.

The psychiatrist was right too though: it is part of my personal make-up that I am never totally free of anxiety and worry. A normal day for me might feel like a state of uncomfortable unease for someone else – but compare that to how it was: multiplied by a hundred, complete with soundtrack! – and you may have an inkling how deeply, seriously affected I was by my one little pleasure.

From a former high of about six to seven “Venti” sized coffees a day (at 20 – 24 ounces and 415 mgs of caffeine each) I now allow myself just one cup. A small or a medium – never a large – and I don’t allow myself so much as a sip after four o’clock in the afternoon. My life has changed and it is so much better and brighter and more hopeful. My worries and anxieties are manageable and my need for intervention – chemical or cognitive – is just about nil. I am back and I am better.

Still, I don’t think I’ll ever completely give it up.

And screw it: I’ll never drink decaf.


Anonymous said...

Just as there are many people who suffer with social anxiety there are many ways it can manifest in someone’s life. The generalized fear that everyone is watching them and everyone is thinking badly or judging them when they may logically know this is not the case is a very common experience for sufferers.

Anonymous said...

There are a number of stressful medical conditions affecting many of us today. One of the broadest topics is anxiety disorders, with millions of people suffering to some degree or another. Specific symptoms vary greatly from person to person. As anxiety disorders grow progressively worse without treatment you should see your doctor immediately if you suspect that you may be suffering from one of these illnesses.