Allison Kugel’s story: After the worst anxiety of my life

The turning point came after the worst anxiety of my life, oddly enough.  It’s hard to say what’s genetic and what's environmental, but I’m inclined to think it’s genetic, as my mother had agoraphobia, like me.  I lived with OCD [obsessive-compulsive disorder] since age eight or nine, and there was always an incident here or there, like a panic attack with friends around, which was embarrassing.  I resigned myself to it.

In 2012 a lot things happened at once.  My job as a syndicated entertainment journalist was very important to me:  it was exciting, and a creative outlet.  But it came to an end, and I had to resign.  At the same time my marriage had fallen apart, and my father and grandmother had gotten ill.  It was a perfect storm!  My anxiety became the worst in my life; I couldn’t function.  I had five or six panic attacks a day, and wound up in the E.R. several times in a short period of time.

I was put on Klonopin to calm down my body and mind.  In that extreme couple of months, I’m not sure what happened inside of me to make it a turning point:  finding the right medication, going to a psychologist who specialized in panic attacks and phobias, reading a lot, delving into the research a lot.  I started spinning in the opposite direction.

Especially when I turned 40, I said, the first half of the ride is over; if you’re lucky, you get 80 good years.  I didn’t want the second half to be like this.   I got my medication re-adjusted, and got into meditation, prayer, spirituality….  And horseback riding--I wanted something symbolic of something I’d never done before.  In the past, I would’ve steered clear of that.

I decided to start taking some reasonable risks, getting more flavor out of life.  I learned to boogey board in the ocean with my son, and do some things against type, which were very freeing!  Writing this book helped me heal quite a bit.  I cherry-picked some stories to explain this journey, and weave in and out some of the fun celebrity stuff. 

When you write a book about your life, it’s like a 3-D hologram, watching a movie of my life.  It’s tricky:  I’m the observer!  It was extremely therapeutic—it enabled me to go back and revisit some moments of my life, which was very cathartic!  It enabled me to find a much deeper perspective, and gave me an answer to the age-old question when we feel we’ve been dealt a bad card:  Why me?!  This answered that question, which was huge, and very empowering!  

Allison’s advice:  If you’re going through hell, keep going!  You don’t get there by standing still.  You have to put one foot in front of the other, and seek help.  Ask for help and advice.  I put myself in the hands of professionals who were helping me.

Ken’s Advice: Read her book, Journaling Fame: A Memoir of a Life Unhinged and on the Record.

Read a story of a hard-won recovery.  Thanks to Jaime Katz of Full Scale Media for arranging the interview with Allison.

Privacy about depression on Facebook: Even to online "friends"

Alex is one of the young people whose experiences with psychiatric medication Kaitlin Bell Barnett chronicles in her recent book, Dosed: The Medication Generation Grows Up.

Alex, who began taking antidepressants for anxiety, depression and obsessive-compulsive disorder at age 10, had been a loner since childhood: He kept to himself and was happy about it. But as he grew older, he had periods of extreme anxiety and depression during which he felt an uncharacteristic need to reach out to others.

While in his early 20s, Alex quit his medications, frustrated that he had tried a series of different drugs without seeing his symptoms disappear. A few weeks after stopping the drugs, he fell into a deep depression. Alex had previously experienced depressive episodes during which he was seriously suicidal, but this time he didn't actually want to kill himself - he was merely having thoughts of hopelessness. Unfortunately for him, he decided to obliquely share these thoughts of hopelessness on his Facebook wall, leading to a harrowing experience:

  

Someone he'd met through one of the social network's groups interpreted the post as a suicide threat and somehow notified the public safety department at Alex's college, which in turn sent the police to Alex's house.  The police took him to the emergency room, where, although Alex insisted vehemently he wasn't suicidal, staff judged him a threat to himself and had him involuntarily committed to a psychiatric ward for two days.  He considered the experience ironic, given his attempt to be hospitalized at the same unit four years earlier, when they told him they wouldn't admit him unless he had a plan to kill himself. The take-home lesson is:  he is far, far more careful about what he discloses, even to online "friends."  

Had Alex actually been suicidal, his Facebook friend's actions might have saved his life. But as it was, it caused Alex a great deal of unnecessary trouble and anguish.

The episode highlights the complications of sharing dark thoughts and musings over social networks - and raises the difficult question of what the networks and the people on them should do to help or intervene. 

Kaitlin's Advice:  If you're feeling like you really need support and want to reach out to people over social networks, you might want to consider contacting people individually through a chat or a message, so there's an opportunity for back-and-forth communication and your words don't get misconstrued. Facebook users should know that if they post an update with suicidal content, anyone who can view their updates can report it to the social network's administrators. If someone does report suicidal content, the user who posted it will receive an email with a link to begin a confidential chat with a suicide prevention hotline worker. Facebook also has a resource center giving advice about how to help someone who has posted a suicidal comment. 

Mental health blogger Natasha Tracy has a great post with advice about how to respond if someone posts a suicide threat on Facebook. 

Read another anti-depressant medication adherence story.  Thanks to Kaitlin for this excerpt from her book, Dosed:  The Medication Generation Grows Up, and to Bethany Sales of Newman Communications for connecting us.

Magic is for fairy tales: A useful placebo

Michael Spencer's story:
Three years ago, a week before Thanksgiving, while I was sitting in my office, my chest began to throb. It was a diffuse pain, but pain nonetheless. I am a middle-aged man with the usual amount of stress (too much) and I handle it in the usual way (denial). My cholesterol and blood pressure are normal, and I exercise regularly and try to eat sensibly. Still, I have read many obituaries of "healthy" men my age who ignored chest pain. So, somewhat sheepishly, I called my doctor and explained the situation, and he told me to come right over.

He conducted a thorough examination, and then we talked. He told me I was fine, that Thanksgiving is often a tense time, and that I should relax. My pain suddenly disappeared. I have written frequently of my belief that magic is for fairy tales and science is for humans. But something about that process soothed me. Of course, it was a relief to know that I wasn't sick. But could words really banish a pain I had struggled with for hours?

After I got home, I realized that I had been given a placebo. Not purposefully, perhaps, but it had the same effect. My doctor told me that I was fine, and that made my pain go away. It also eased my anxiety at least as effectively as if I had swallowed a pill. My doctor takes an extremely science-based approach to his work. That's what makes him so good at his job. But that afternoon we engaged in exactly the type of ritual that, according to Harvard Medical School Professor Ted Kaptchuk, will have to play a critical role in the future of American health care. And, at least in this instance, it would have been hard to argue that it didn't work.

Thanks to Michael Spencer, from whose article in Dec. 12 issue of the The New Yorker this was reprinted.

Most of them love it: A surgeon's use of humor

Here's Nurse G.P.'s letter to a nursing advice columnist:
"Dr. Sam," a good-natured general surgeon in our same-day surgery clinic, enjoys chatting with patients before procedures. To put them at ease, he regales them with humorous stories, and most of them love it. Last week, Dr. Sam told several of his favorite stories to a patient who was clearly anxious. After he left, she confided to me that she was still dreading surgery. "I had some questions that I never got to ask because he was too busy being a comedian," she said.

Advice to patients about to undergo surgery: Bring a written list of your questions to hand to the doctor or nurse, in case it's hard to get a word in edgewise.

Read a story about physicians' attempts to build rapport with patients.

Thanks to Susan Salladay, the nursing advice columnist, for the source article in the July 2008 issue of Nursing2008.