The problem is, I can't tell what's real anymore, and what's made up.
― Suzanne Collins, Mockingjay
I have always dealt with anxiety. Always. My very earliest memories are filled with the emotions of fear and anxiety. Anxiety may have been present in my life for as long as I can remember, but about two and a half years ago, it almost swallowed me whole.
I have always been what I would have described as avoidant of all things vomit. I'm one of those people who simply doesn't puke. Ever. I can remember every time. I remember throwing up in my grandmother's kitchen after eating popcorn one afternoon. I was five. I didn't eat popcorn again until I was 19 years old. See? Avoidant. On some level I knew that it was unlikely that popcorn made me ill, but why risk it? I simply avoided it. Avoidance became a part of my life. I avoided things that had "proven" to make me sick, and at some point, I began to avoid things that made other people ill too. I was probably about 12 years old when my mom shared that she avoided orange juice for a long time because she had been sick after drinking it. I had never had that experience, but suddenly OJ didn't seem worth the risk either. It wasn't until about a decade later that my mom shared the full story...a night of youthful exuberance and one too many Screwdrivers.
I've never had a night of youthful or even not-so-youthful exuberance. I've never been drunk. Ever. When questioned about my lack of fun, flirty, and free-spirited beverages, I typically think of my choice to eliminate alcohol from my life as a means to eliminate the opportunity for alcoholism, as the family proclivity for such addiction is undeniable. And that is 100% true. But I think it's also true that if my dad had never been an alcoholic, I would still likely have been timid around alcohol. Where is this line between a good time and a hangover spent clutching the toilet? As I never knew where the imaginary line fell, I never felt the risk was worth it.
I deflected opportunities from friends or family to ride roller coasters. I bypassed vacation options including cruise ships or fishing boats. Flying made me nervous simply due to the presence of vomit bags. I was avoidant of things that could potentially make me vomit, but was I phobic? I would have said no. And I was likely right, though my fear verged far closer than normal...but all of that ended in February 2016.
I remember almost every detail about the week in stark, graphic detail. I'll spare the details in case anyone reading struggles with that, but basically, I was preparing for Garrison's first birthday. The weekend prior he became ill. The first time he vomited, I questioned if he might be sick, but ended up assuming it was the transition from formula to whole milk in combo with his reflux. The second time, only a few hours later, I knew he was sick. I picked him up armed with my belief that, "I don't get sick." 36 hours later, I was learning the fallacy of that claim.
I remember almost every detail about the week in stark, graphic detail. I'll spare the details in case anyone reading struggles with that, but basically, I was preparing for Garrison's first birthday. The weekend prior he became ill. The first time he vomited, I questioned if he might be sick, but ended up assuming it was the transition from formula to whole milk in combo with his reflux. The second time, only a few hours later, I knew he was sick. I picked him up armed with my belief that, "I don't get sick." 36 hours later, I was learning the fallacy of that claim.
I survived my first stomach virus in a solid twenty years. I was admittedly weak and leery of all food, but I was functioning. I returned to work. I was sleeping. I was able to care for my son. Until suddenly, I wasn't. I woke up Wednesday morning, two full days after I had been ill and I had my first panic attack in five years. I was scared to death. We say that phrase a lot, obviously not meaning it literally. But I can tell you what is real and what is worse: being so scared, you think death might actually be better. I've been there a time or two.
Something was very, very wrong. I was terrified of getting sick again. My previously held notion that “God made dirt and dirt won’t hurt” went out the window as I became obsessed with washing and sanitizing everything. But I was so embarrassed. Why was this happening? Who was this person? I spiraled quickly. The next six months were a desperate attempt to keep my head above water. I had dealt with anxiety my entire life, but this was the first time I was face to face with a phobia and I. was. losing.
Having experienced panic attacks years before, I knew that medication could help. I scrambled to find a doctor willing to prescribe my old antidepressant medication. It took several weeks, by which time I was already not sleeping, avoiding all food that I didn't prepare myself, only eating and drinking a limited number of "safe" foods and beverages, researching norovirus like I was receiving a PhD, washing my hands two and three times before touching food, and fighting an ever losing battle to hold and care for my son who suddenly became the equivalent of a nuclear bomb to me. It was bad. Really bad. I got a prescription for my medication along with a new one to add to the mix. I was suddenly the reluctant owner of a schedule IV controlled substance.
I found a counselor and started therapy. I was fighting, but I was still losing. I dropped thirty pounds in a matter of weeks, which was startling to say the least. I wasn't sleeping, even with sleep aids. I was having nightmares and warding off panic attacks with every method I could find. I was dealing with an upset stomach (a common symptom of anxiety, which is SUPER awful when your anxiety is triggered by a rumbling stomach) almost daily and swallowing pepto bismol pills like they were the elixir of life.
In August, I switched to another therapist, one with lots of fancy accreditations and experience. Kasey rolled into my life like a freight train. Well, actually, knowing what I know now, she breezed in with restraint as she slowly offered me tiny steps to crawl out of this pit. She saved the no-nonsense attitude until I was a bit more sane. That fall I received a diagnosis of emetephobia, or a fear of vomiting. The DSM-5 categorizes this in the specific phobia "other" category. Other simply meaning that it doesn't fall into one of the other four categories, animal (e.g. dogs, snakes, or spiders), natural environment (e.g., heights, storms, water), blood-injection-injury (e.g. fear of seeing blood, receiving a blood test or shot), and situational (e.g., airplanes, elevators, driving, enclosed places). The criteria are:
Unreasonable, Excessive Fear: The person exhibits excessive or unreasonable, persistent, and intense fear triggered by a specific object or situation.Thankfully, in 2013 with the publication of the new Diagnostic and Statistical Manual of Mental Disorders, changes were made. In previous DSM editions, adults with specific phobias had to recognize that their fears are out of proportion to reality. Guys, I'll be honest, in the comfort of my counselor's office, on her nice, comfy, likely semi-clean couch (because you can never be 100% sure, even if you cleaned it yourself with a bottle of Clorox when you have this special phobia), I could identify that my fears were out of proportion with reality about 80% of the time. But when my brain was cycling the drain, ready to swallow me up and spit me out into the black hole, I couldn't tell you what was real and not real anymore. Everything and everyone became a threat. I could no longer trust my mind. I had to trust others around me to tell me the truth until I could see reality again.
Immediate Anxiety Response: The fear reaction must be out of proportion to the actual danger and appears almost instantaneously when presented with the object or situation.
Avoidance or Extreme Distress: The sufferer goes out of her way to avoid the object or situation, or endures it with extreme distress.
Life-Limiting: The phobia significantly impacts the sufferer’s school, work, or personal life.
Duration: The fear, anxiety, or avoidance is persistent, typically lasting for six months or more.
Not Caused by Another Disorder: The disturbance is not better explained by symptoms of another mental disorder.
In the beginning, I had to identify safety behaviors. Things that I was doing (or not doing) that made me feel safe (while actually exacerbating my anxiety and making me more fearful). Once the behavior was identified, I had to rate it on a scale of 1 to 10 on how risky the behavior seemed, or how likely the worst case scenario in my mind was to happenening because of X behavior. I'll give you an example. I spent ages selecting cups, plates, and silverware to eat off of. Inspecting them. Rewashing them by hand. Even when they were from my own home, where no one was ill, and I knew they had been washed and sanitized in the dishwasher. The amount of perceived risk directly correlated to the amount of anxiety I experienced if I did the opposite of the behavior I wanted. So I might have identified selecting a glass out of the cabinet at random and drinking from it as a 7. My brain said that was a very bad idea...almost certainly bad things would happen and my anxiety would be really high because of it. The risk was just too high to do such a foolish thing. Who cares that I had done that for thirty years without anything bad happening? It was too risky now. And so I had to do that very thing over and over and over again. And every time I did, my anxiety spiked, but the return to baseline level came faster each time. And eventually my mind no longer saw that as a scary or threatening behavior. I had pages of safety behaviors to work through by repeating this same scenario over and over and over again for each one. Tedious and hard freaking work.
It's been two and a half years since all of this started. Two and a half years. Week after week of therapy, and praise God for a counselor who knows her stuff. I likely owe my life and my marriage to Kasey. She has patiently brought me back. I'm not back to "normal," but I am better. Some days are better than others, as with anything in life. My heart still accelerates when someone mentions the stomach bug. I still wash my hands before eating, even when it's inconvenient (Imagine the hundreds of times you go through a drive thru and eat in the car. Yeah, I don't do that.). I still struggle to eat sometimes, which also means that I struggle to maintain my weight through much of the year. I still wash my kids' hands before every meal and I still cringe when they put their hands or toys in their mouth. I still have a bottle of meds in my nightstand, because some nights, the black hole snags me before I see it coming. We've warded off one stomach bug since the original and it was H-A-R-D. Terrifying even. I crawled into Kasey's office considering running away to a deserted island and leaving Sam to deal with it all before she kicked me square in the pants and told me to go home and deal with my fear. Neither Sam nor I caught it, and so I continue to dodge bullets. Continue to worry about the next time and if we'll be so lucky while trying desperately to live my life. So yes, better, but I've still got work to do.
This fear pretty much derailed my life. It became the single lens by which everything was viewed, including growing my family. Two years ago, I couldn't really imagine adding another kid to our family, no matter how desperately I might want one. Kids are germ factories and their presence exponentially increases my risk. I made it 20 years without getting sick, but didn't even make it one year as a parent. The odds were just too high. Adopting Joel was hard. Coming to a place where I could realistically consider adding another kid to our family was so difficult. Coming to a place where Sam felt like I could handle it and he could handle me was hard because this wasn't just affecting me, not by a long shot. With a hell of a lot of work, I eventually got there. Ready to move forward. Second guessing myself all of the time, but ultimately unwilling to let fear control my family.
China was crazy hard. Like probably the hardest thing I've ever done. The flights. The hotels. The food. It all presented itself as HUGE risk factors. I was terrified of getting sick in China. Various China Adoption Facebook groups often seemed to be overflowing with posts and comments about getting sick in country. "Don't eat the street food" one would say. Another would swear it was the watermelon. Or the water. Or a specific restaurant. The feeds were filled with people sharing about kids puking in cars or on planes, as these kiddos have often never experienced travel and the sensations are hard to acclimate to. It seemed not only possible, but likely, maybe even unavoidable some days and I was so, so scared. I knew this child, this son, was worth it, worth every moment of fear and anxiety, but gosh it was hard preparing to go.
As we drew closer, it became more and more evident that we would likely travel in winter. Ughhhh. Winter used to be my favorite season. Give me a good scarf, some boots, a fire, hot chocolate, and a beautiful white snow and I was content. The happiest person alive. But as my research revealed that norovirus is also known as "the winter vomiting bug" and that cases go up significantly in the winter months, winter quickly became my least favorite season. Give me 100 degree days and endless sunshine all the days. I was wracked with guilt as I simultaneously prayed to get to my son as soon as possible, while hoping our timeline would end up in the spring. And then the phone call came. Travel approval was in. It was time to schedule flights. And don't you know, the day that I would board not one, but two planes, trapped for hours with my anxiety was the "anniversary" of when Garrison got sick two years ago. Kasey chuckled at that. No, not a sign of doom and gloom and imminent death, but just one more opportunity to shove anxiety further down and declare that I can do really hard things.
Kasey would say that I'm significantly better. She would argue that the evidence is before me. I faced my fears and flew across the world. I spent 17 days in China living in hotel rooms I wasn't cleaning, eating food I wasn't preparing, traveling with people who were in fact sick. I did what I would have once sworn was impossible. And every day, I make conscious decisions to push the envelope. To make myself just a little bit uncomfortable. To acknowledge my fear and to choose the hard anyway. My therapist says "feelings don't matter." And no, I don't think she shares that with someone in the clutches of depression. It's the kick in the pants that I need over and over again to remind me that feeling anxious isn't wrong. It isn't my fault and it isn't even in my control. What is in my control are my actions. I can be afraid and brave at the exact some time.
