The Elephant in the Room

In my last blog I wrote about sleep.  Or the lack of it, to be more precise.  As little as four months ago I had no idea that sleep was such an integral part of mental health.  It's one of those neato arrangements where Circumstance A affects Circumstance B and Circumstance B affects Circumstance A, and round and round we go.  I wasn't really familiar with this pattern because my first bout of depression and anxiety was accompanied by an ability to sleep at the drop of a hat.  No, truly...my boys would walk in the door after school, throw their hats on the floor and I would be out faster than a narcoleptic on a date with a glass of tepid water.

We pick up with me plugging along through the dwindling winter and waiting for the warm breezes and extra sunlight of spring.  For years now I've contemplated getting one of those lights used by people with Seasonal Affective Disorder.  Then I convince myself that I feel just fine - just fine, thank you! -  and don't want to shell out any money for something I don't really need.  Then spring shows up in all her colorful glory and I realize how totally down I was all winter and that Damn It!, I really need one of those lights.  But now that spring is here I don't need it anymore, so I'll just remember to buy one at the end of fall for next winter.  And God laughs.

So here I was, sleep-deprived and feeling low.  Winter in Minnesota is about as cheerful as the 183rd bowl of oatmeal I had during the season in the hope that if something warm was going into me maybe the cold outside would be easier to bear.  Not so, my friends. Not so.  

Along came March and with it, an elephant costume.  The elementary school where I work had just finished "I Love to Read" month.  To celebrate the end of a successful campaign, we decided to have an assembly on March 2nd.  As part of the program we library chicks dressed up as Elephant & Piggie, two characters from the imagination of author Mo Willems. Mr. Willems has several different childrens' book franchises and as I remark to my co-worker on a regular basis, dude must be absolutely rolling in dough.  Seriously, the kids cannot get enough of his books. I have seen tears, heard threats and broken up 2nd grade fisticuffs over the last book on the shelf.  Although it's a harder sell because it's not part of a series, I must say, 'Naked Mole Rat Gets Dressed' is my personal favorite.  Truth.

I digress.

For the Elephant costume I fashioned ears, a tail and trunk out of old gray fleece pants and wore newer gray fleece pants and pullover.  There seems to be an abundance of gray fleece in my home that I don't completely understand except to tell you that Troy's favorite color is gray and that for comfort, fleece rules all.  On that momentous day, anytime a class or even a lone student would come into the library, I put the trunk on.  Otherwise it was stifling and ridiculously uncomfortable with its elastic face manacles and toilet paper roll frame which dug into my nose without mercy.  Somewhere in the late morning, I started feeling panicky.  I had not had one of these episodes in years and it was about as welcome as several little black curly hairs on your pristine white pillowcase when you check into a 4-star hotel.

I had several episodes of panic that day.  I'm not what you could call an natural optimist but after every episode that day I assured myself that this would be the last and my life could go on, replete with hours on Facebook, too many fast food meals and ignoring the dirty dishes piled precariously on the kitchen counter.  The next day and the next and the next - you get the idea - brought mornings brimming with hope and not-much-later mornings with the hard smack of reality in the shape of panic attacks that increased both in frequency and intensity.  I blame the elephant trunk.  You see, for many people shallow breathing is a hallmark of anxiety.  That stupid trunk had me breathing CO2 and for all I know it triggered a memory from 8 years ago when shallow breathing was a result of my anxiousness.

Looking back I see things that contributed to my state of mind as much and probably more than the trunk.  These include: the aforementioned lack of sleep, a falling out with my best friend that fell right back in but was sad and upsetting nonetheless, and fears about my health.  The anxiety & depression I experienced in 2007 it was triggered by medical issues.  I had gone to Urgent Care with chest pains and in the course of doing diagnostic tests the doctor informed me that it looked like I had an enlarged heart.  I lost my shit big time, right there in the examination room.  For some reason I'm not nearly as scared of cancer, diabetes, ALS or a host of other shitty diagnoses as I am of having heart problems.  Over the next several weeks, many more tests, calls to come in to the clinic Right. Fricking. Now. and consultations with multiple specialists, it was determined that I had a pericardial effusion (copious amounts of fluid in the sac around my heart) brought on by a virus.  Despite one of the doctor's assertions that if that much fluid suddenly (key word: suddenly) accumulated around his heart, he would drop dead, I was not in any immediate danger.  I was monitored over the next few months to see if they would need to get in there with a needle and draw off some of the fluid.  It never came to that and life resumed right where it left off.  Or it should have.  By then I was so freaked out and focused on what was going on in my body I was experiencing panic every waking moment.  Hence my desire to sleep like I was trying to set a world record.

Apart from sleep issues and shallow breathing, another physical manifestation of anxiety is a supremely fucked up gastrointestinal system.  In my case, food would go in and everything would immediately shut down.  I felt like I had a cork in my throat and a stomach the size of a thimble.  Eating would produce a panic attack faster than you can say "yes, I WOULD like fries with that!"  It was not long before I was drinking a nutrition shake or eating a cup of yogurt and maybe some fresh fruit.  Not for a meal, for the day.  Exercising made my endorphins flow so I walked, lifted and/or did aerobics twice a day.  I lost 40 pounds in the amount of time it took you to read this sentence.  People who were envious of my spectacular new physique were met with a withering glare coupled with the pronouncement that they would not like to lose weight in the manner that I was.  I may also have flounced away once or twice.

This time I had another heart-related episode.  Last October I was in the middle of a "get healthy" competition with a friend, my sister and various others vying for a cash prize.  It was a common sense 12-week program of eating fruits & veggies, exercising, tracking all food eaten every day, etc.  Of course, drinking water was a big part of the deal as evidenced by me setting up camp in the bathroom and coming out only long enough to drink more water.  On this particular night I was getting ready to go to bed and realized that I was 16 ounces of water short for the day.  So I poured me a nice tall glass of icy agua and chugged. Before I even got to the bottom of the glass I could feel the rhythm of my heart change.  I've had this sensation scattered through the past several years for a couple of moments at a time.  Not so this night.  Normally your heart has its boring little ba-bum, ba-bum, ba-bum rhythm.  This was more like jazz phrasing: ba-bum, ba-skiddly-whappo-do-dat-dowwwwwww.  And repeat.  Friends, it scared the shit out of me.

After a solid 45 minutes of Ella Fitzgerald scatting in my chest I woke Troy up.  We decided we should go to the ER so, leaving the boys sleeping and unaware, off we went. Luckily there were very few other patients there that night, though I now understand that when you walk in saying anything about your heart you will likely find yourself stripped down and lying on a gurney with every manner of wire attached to you in short order.  The nurses determined that I was in Atrial Fibrillation and after consulting with the doctor it was decided that they would put me to sleep and shock my heart back into rhythm.  I was also dehydrated and low on potassium but getting those in an IV drip is decidedly less glamorous and barely worth mentioning.  Right before they put me out, one of the nurses said "This is an anesthesia.  You're going to sleep like Michael Jackson."  To which I said, "What?  Permanently?"  Her fellow nurses glared at her and I would like to place a bet that she hasn't used that particular analogy since that night.

I have had no further A-Fib episodes, not that I'm 100% certain of, anyway.  They can be fleeting and hard to pinpoint.  But my crazy, overloaded brain wants to attribute every feeling, every sensation from my neck to my undercarriage, to my heart.  This is unreasonable, particularly with the way anxiety messes with my GI tract but try convincing my gray matter of that.  It's funny, because we came home from the hospital at about 3 a.m. and took the next day off to get some sleep, but after that I really didn't give the episode much thought.  I attributed it to a one-time phenomenon of guzzling so much ice water. My brand-new, hot-as-a-ghost-pepper cardiologist said it could definitely be.  I think it was hugely half-glass-full of me to think that my subconscious hadn't glommed on to the fear of having something wrong with my heart and leaving it right at the doorstep to my brain, just waiting for lack of sleep, SAD, a row with my bestie, a costume and a boatload of stress to come together and make an utterly disgusting stew of mental illness.

Depression & anxiety, people...the elephant in the room.

Warning Bells

It began in January.  Or perhaps February.  I wasn't paying close attention and the exact date doesn't much matter anyway.  Somewhere deep in the endless Minnesota winter I stopped sleeping well.  I began waking throughout the night and earlier in the morning than I cared to.  You must understand, as sleepers go I reigned supreme, if I do say so myself.  I could go to bed at pretty much any time, summon the slumber of the dead and arise anywhere from 5 to 14 uninterrupted hours later.  It depended on what the day required in terms of me being up and functioning.  Monday through Friday saw me getting 6-7 hours while weekends were Sleepapalooza.  Now, this is not to say I ever felt rested.  Feeling refreshed and re-energized when my feet hit the floor is a concept as foreign to me as shaving my legs in the winter.  Truly, never in my life do I recall getting up and thinking "What a great night's sleep!  I am so ready to tackle the day, even if it means herding wildebeests or counting every single grain of rice in the western hemisphere."  Most of the time I arise counting the number of hours until I can put myself back to bed, even if just for a brief nap. 

I LOVE to sleep.  I attribute some of this devotion to what goes on while I'm "under."  Oh, you guys...I wish you could borrow my brain to experience the funky, psychedelic and highly entertaining playground that is my dream life.  True, I do have a recurring nightmare about our housing situation.  Most of the time we've purchased a new home that is way above our budget and we still have to unload our current house.  The new house is nearly always defective in some way: it was built at the edge of the ocean and is frequently flooded; half of it is without walls and thus exposed to every manner of weather; or it is constructed of cream cheese and melts a bit more each day.  All I want in these dreams is to get back to our current house where it's safe and familiar.  I've had this dream for years and I still have no idea what it means.  Dream interpreters, have at it.  Other than those dreams and the occasional ones featuring car crashes which no one could ever survive, my dreams are technicolor fantasies replete with singing, dancing and original music that I can't recall when I wake up, no matter how hard I try. 

As if that weren't enough, I also am adept at lucid dreaming.  When a dream is getting bizarre I sometimes question whether I might really be asleep.  For example, I once dreamed I was in the lobby of a hotel and had a feeling that all was not as it seemed.  I told myself that if a vase of red flowers rose from the middle of a bare, round table that meant I was dreaming.  Sure enough, seconds later a vase of lovely red roses came up out of the table.  Time to play!  When I'm lucid dreaming I can manipulate the objects, people, sights, sounds, and smells around me.  A lot of times I just make myself thin and try on pretty dresses but it depends on the night.  Even if I'm not dreaming lucidly I can usually remember my dreams in stunning detail and there are LOTS of them.  Not going to lie, it gets weird in there.  With this new sleep disturbance I lost the ability to remember my dreams and it's a loss I'm taking pretty hard.

After a few of weeks of my new and unwelcome sleep pattern I began to wonder what in the hairy hell was going on.  For some time now I have been an avid and dedicated snorer, so of course I considered sleep apnea.  It would certainly explain why I never wake feeling rested.  I also thought about the possibility of menopause being an issue.  I'm one of the lucky ones who went through menopause at a very early age (43) and had no symptoms other than no longer having to trot to Walgreens at midnight to buy tampons.  I consider this karma for all of my fertility issues and the years I went through getting my period every 18 days.  Last summer my OBGYN did a blood test to confirm menopause and we determined that not only was I done with menopause, I was really, really, REALLY done with menopause.  Like the level that came back in the result showed I was on par with 60-65 year old women.  Yay!  The state of my ovaries matching my gray hair is all I ever wanted in life, much like my shoes matching my bag.

In retrospect I realize that this disturbance in my sleep force was probably a harbinger of depression.  Last spring I was feeling pretty good and asked my doctor to wean me off of Zoloft so I could see if I could do without it.  Spoiler alert: I can't.  I had gone through a period of depression and anxiety in 2007 that responded well to therapy and medication.  But mental illness, being what it is, sometimes tricks you into thinking it's no longer there.  Maybe in some people it goes away.  Me, not so much.  I am here to tell you that there is still a lot of stigma attached to mental illness.  Some of the pressure to look at it as a weakness or inability to cope comes from me and my shame but it's external as well.  The malady that you cannot see often gets short shrift in the believability department.  Over the coming days, weeks and months I hope to blog more about my experiences, the meltdown that led to a week of inpatient hospitalization and where I go from here.  I don't know how often I'll write or how much detail I'll include but as long as it's therapeutic for me, I'll try to soldier on. 

Wishing everyone who reads this peace in their heart and good mental health!