Challenge #3: Rock the Bells concert

This was another step in the right direction. When I first got here, I was sweating like crazy cuz it was super hot and crowded. I started getting nervous and decided to leave right away. But I calmed myself down and stayed for 2-3 hours. I had a lot of fun especially seeing Pharcyde. Thanks to Lyla for being supportive during the anxiety attacks. And, thanks to Cyn for the tickets!

Things to Remember

There are a few things that I took away from last weekend that I shouldn't forget.

1. No matter how much I stress and worry and panic the day before a challenging event, I can get through the event. The day before moving day, I was extremely stressed and worried that I couldn't be counted on to drive the cargo van. I even panicked and cancelled lunch with Christian. I thought that panic was a sign of the failure to come. But it turned out much better than I expected.

2. That tingling hands and feet do not, in any way, decrease my ability to use those limbs. I was afraid that they would go stiff and not be able to drive. But it turns out that I can still move my arm. In fact, I prove it to myself by dancing a little.

3. That I can get a good night's sleep the day before a big event. This sort of thing may not be big to you guys, but I was super nervous about it. But somehow I was able to get 8 hours of sleep the night before. I used relaxation techniques and reminded myself that I could get through the day even without sleep. That took the pressure off me to fall asleep and thus allowed me to relax enough to eventually doze off.

I need to use this success as a jumping point to even more difficult challenges. I think the best way to do that is to keep the above in mind to give me strength.

Super tested this weekend

My anxiety was tested a great deal this weekend. I think I drove about 200 miles total this weekend. Maybe more. Here were the uncomfortable tasks:

1. Driving to the airport as a passenger.
2. Driving a cargo van from the airport to Santa Clara.
3. Loading the cargo van with boxes in hot weather.
4. Driving the cargo van from Santa Clara to Union City (30 miles).
5. Unloading the cargo van; weather was better in Union City though.
6. Driving the van from Union City back to Santa Clara (30 miles again).
7. Loading the van again.
8. Driving the van from Santa Clara to San Jose (15 miles).
9. Unloading the van.
10. Dropping off the van back at the airport and waiting at the airport to be picked up by Lyla.
11. Being a passenger in Lyla's car, picking up her friend in San Jose, dropping her friend off in a new area I've never been.
12. Passenger in Lyla's car Driving back to Santa Clara to pick up some final stuff.
13. Driving to San Jose in my own car.

The most difficult task by far was driving the cargo van to Union City. That sucker was huge. Plus it only had two windows in the front, but none in the back, so the blind spots made it difficult to change lanes. About halfway through the trip, I began to feel pretty nervous. I felt my hands go numb and my legs tingle. I also felt my stomach turn. By the time I got to Lyla's aunt's house, I was pretty shook up. But after that, I felt fine driving the van.

I just kept taking deep breaths and reminding myself that the symptoms cannot harm me and that eventually they pass. I feel like I can do so much more now.

Stronger Than Ever

Today I feel stronger than ever. I think confronting my fears head-on has been really beneficial for long term strength. It feels like CRAP at the time, let me tell you. But I think full-on bite-the-bullet type stuff is what it takes to make long lasting changes.

I had like a dozen panic attacks last weekend - from the CAAA Seminar and at church and dinner. I felt terrible those 3 days. Then I was weary on Monday. But Tuesday and Wednesday were shockingly easy - and these are days that usually would have been stress-filled. I had 4 court appearances and plenty of work to do. Yet I got through them with ease.

So, like I said, I'm feeling stronger than ever. I don't think I'll be increasing my medication intake anytime soon.

Challenge #2: CAAA Seminar

I had a pretty big panic attack on Friday at the CAAA seminar in Monterey. I think I had too much coffee too soon and it made me jittery, which in turn made me anxious. Instead of ignoring it or getting up and leaving, I decided to document my thoughts on my notepad:


~3:30 on 6/26/06 @ Monterey, CA CAAA Seminar
Had a panic attack... anxiety attack? Feel fine. A little shaky. I remember this point. This is the point where I feel like I made a mistake in decreasing my medication.

But maybe this is the point where I'm supposed to stick it out and to be cured forever? Let's re-evaluate it again in 2 weeks.

I feel trapped, so I took a walk to my car (cross the street from WAMU towards Taco Bell. Stay on that street, take a left @ Jamba Juice. Take stairs on left @ public parking on Tyler/Franklin. Car is on the right).

Symptoms: hands are tingly, haert was pounding (but not right now), mind is racing;

Maybe I drank too much coffee.

I can lose out on 4 MCLE credits if I leave without signing out.

Still a little shaky. Every bone in my body is telling me: run home!

Let's wait it out another 10 minutes.

Doing deep breathing - I'm supposed to be doing this. First thing to do is to control my breathing.

8/10 anxiety right now. Let's see where it goes. The lady in the elevator was able to handle it.

There's gonna be traffic on the way home. No easy escape this time.

Remember how well you did in Gilroy the past couple times.

Why didn't I Change the batteries on my phone?

I'm going to take a few minutes to relax for a bit.

Anxiety always passes; it's just a matter of time. 1. I won't die. 2. I won't faint. 3. I won't go crazy. Therefore, if all 3 are true, there is no reason for me to immediately leave.

What if somebody sees me nervous? So what? Everyone panics. Even if I appear extremely nervous, it's very unlikely they'd remember my "strange behavior". Plus I probably appear "normal".

Ok, wow I feel better.

I feel alot better.

I feel better than I did before the anxiety.

I must remember this moment the next time I feel the symptoms.

I feel kinda bad that I got up and walked around to my car - but I'm proud of myself for coming back and sticking it thru.

Some fears that come to mind: what if my legs "freeze" as in, I can't control them? What if I end up locking myself up in a bathroom? What if I end up hiding in a corner of Alvarado street? Cops might have to show up and take me away for loitering. What if I can't drive home? I wish I didn't eat that philly steak sandwich - I might have a heart attack.

Things I've decided to do that haven't been done:
1. Meditate more
2. Decrease coffee in-take
3. Get adequate sleep
4. Get adequate exercise
5. Eat more healthy foods.

End of my panic notes.


I guess I wasn't panicking at 10/10 or else I would have probably been to nervous to even write so much. It's interesting that I felt great after the panic subsided. I'm a little nervous about the next few days: court appearances tomorrow and Wednesday, then Modesto this weekend. I'll let you know how it goes.

Realizations

I don't know if I've ever acknowledged this before. It's so basic. I've got a fear of 2 things that seem to be impacting my life right now: sleepiness and stress.

Sleepiness
I tend to sleep in more if I can possibly do it. Part of it is because I feel lazy in the morning. Another part of it is that I hate to feel sleepy. I feel more susceptible to panic attacks. I tend to worry more about driving. I worry that I won't be at my sharpest or wittiest. I worry that the sleepy Jason is no fun to hang out with.

Stress
Nobody likes stress. But for me, I tend to avoid it because again, I feel more susceptible to panic attacks when I'm stressed out. I allow myself to get a little stressed doing tasks that need to be done. I try not to push my stress limits too high, in fear that I may cause myself to panic or lose sleep.

So what do I do? Should I stress myself out on purpose to prove to myself I can cope? Should I force myself to go through a few days on very little sleep?

One thing's for sure: I need not to fear the stress symptoms like tightened muscles, stomach problems, etc. I need to just embrace them as part of life. I need to acknowledge that stress symptoms will go away on their own and just let them be.

For example, this weekend, I had a great time at the Aquarium and Fisherman's Wharf with Lyla. But I felt stressed when I got home because I was feeling anxiety throughout the day. I spent time with crowds all day long and I think the clam chowder was irritating my stomach. So today, I feel a little stressed from fighting the anxiety. My back is tight, my stomach isn't 100% and I feel a little worn out. I just went to the Appeals Board and I was afraid people might think I'm weak for not being 100% alert and sharp and happy, etc. But I realized... who the crap cares? No one probably even noticed. In fact, people who come off as perfect all the time are actually less relate-able. They don't seem real.

So I've made a decision to stop judging myself. I've decided to just be. I'm going to stop trying to be witty and funny and cheerful all the time. I think it will be less stressful and less anxiety-producing in the long run if I just relax and just be whatever I am.

Now, as for the sleepiness thing - I guess the most important thing to change would be to try to get the right amount of quality sleep and if I happen to not get enough sleep, just use that day as practice to combat the fear. I plan on hitting the bed around 10:30 pm every night and waking up every day at 7. Even on the weekends. We'll see how it goes.

Rapid Heartbeat at teh Drive-Thru

Yes that typo in the title was on purpose.

So today I went to Carl's Jr for lunch. I was feeling pretty tired and weak. I had gotten only 3 hours of sleep, and I had barely eaten anything in the last 16 hours or so. So I was already physically shaky. I was also pretty stressed: I had some arguments with close people recently, I had just gotten a speeding ticket like 2 hours before, and my sleep schedule has been completely out of whack.

That being said, when I pulled up to the drive-thru, my heart started to pound. I looked behind me and there was only one car and I could easily just drive to the side instead of going through the drive-thru. But instead I decided that it would be good practice. I pretty much knew why I was having anxiety: lack of sleep and excess of stress, and I knew nothing terrible could happen. It was just a matter of reminding myself of that while my heart pounded.

So I drove forward. I have to admit; i did have my $20 bill ready so that way I could get through it as fast as possible, but I still got through it. I just sat through the 5 car line drive-thru while my heart beat rapidly against my chest. I reminded myself that it's not a heart attack; I didn't have any chest pain. Plus, my heart beats rapidly all the time when I exercise. I also read that people's hearts can beat rapidly for a long long period of time without any damage... days even. Hearts are stronger than people give them credit for.

So I got through it and actually I feel great now. I think I tend to feel worse when avoid situations rather than when I confront them.

Late Night Panic Attack

Last night I had trouble sleeping. It might have been the venti ice coffee I had early afternoon plus a double workout. Not sure. But I finally fell asleep around 1:30 AM.

I woke up in the middle of the night with a panic attack. I get these episodes where I wake up confused and not knowing exactly where I am. Even though I'm looking at my own bed, my own computer, TV, etc... It takes about 10 seconds to realize that I'm in my own room. It's a weird feeling.

Anyway, I woke up, heart thumping and in a state of fear. It quickly passed though and I went back to sleep. I feel fine today despite the small episode.

Challenges give me strength

I think confronting difficult situations like the CAAA dinner has given me strength to go out and do other things more easily.

Yesterday, I went to church, then Costco, then saw Iron Man, then In-n-Out (super crowded too), with very little anxiety.

I think these challenges are a very good thing.

Challenge #1: CAAA Dinner

So, I feel really good about how challenge #1 went. I had a notebook with me to take notes on the lecture, so I was able to make notes on my anxiety at the same time. I tracked my level of anxiety from 0-10, 10 being the highest level of anxiety, i.e. a full-blown panic attack, and 0 being completely relaxed, i.e. almost falling asleep.

5:20 Anxiety level 6. Anticipating my dad picking me up to head over to Watsonville for the CAAA dinner over at the restaurant. About 20 lawyers will be there with a well-known Internal Medicine doctor giving us a presentation. I have never been to the restaurant and I don't know Watsonville very well.

5:30 Anxiety level 7. Dad picks me up and we start heading towards Watsonville.

5:45 Anxiety level 7. Stuck behind a truck on the highway. Going about 30 mph in traffic in an area I don't know.

6:00 Anxiety level 8. Arrived at the restaurant. Feeling a little shaky. I'm greeted by the CAAA president. I make a few jokes despite feeling nervous.

6:15 Anxiety level 7. I'm seated, making conversation with different people at the table. I'm drinking alot of water. I tend to get dry mouthed when I'm nervous.

6:30 Anxiety level 5. Lecture started. I'm starting to feel comfortable.

6:45 Anxiety level 3. My steak and salad are brought to me. I'm comfortable enough to have an appetite. I eat and take notes.

7:00 Anxiety level 2. Taking notes on the lecture.

7:23 Anxiety level 5. Having thoughts about feeling "trapped" because the bill isn't paid yet and needing to go to the restroom in the middle of the lecture. I drank too much water.

7:25 Anxiety level 4. I feel less anxious all of a sudden.

7:35 Anxiety level 3. Lecture is finished, bill is being paid.

7:40 Anxiety level 2. I have an epiphany: my goal should be to try to make more conversation and stay longer than anticipated. If I make this a habit, then it will counteract my habit of wanting to leave the situation as early as possible.

7:45 Anxiety level 2. Proud of myself for not overeating. Left 1/3 of my steak on the plate. Noticed that the lecturing doctor did not eat most of his meal. Maybe he was nervous about lecturing.

7:55 Anxiety level 1. Everyone is getting up to leave.

8:00 Anxiety level 1. Heading back to Salinas. Taking a new route back home but I'm not bothered. Everytime I have anxiety that goes up as high as 7+, I feel great if I just let it pass and I feel stronger the rest of the night.

Anyway, I got home and felt great. I hope all my future challenges go this well.

New Tests

Okay, I think I'm getting stagnant with my agoraphobia progress.

So, new goal: once every 2 weeks, I'm going to do something that is likely to bring my panic to a level 7 or higher. E.g. take a bus somewhere, go to a new place where I'm not driving... maybe even ride a rollercoaster if I'm feeling tough enough.

Tonight, I'm attending a lawyer's meeting for CAAA (California Applicant Attorney Association). It will be in Watsonville at a restaurant I've never been and my dad is driving. Now I know it would seem like having my dad drive would be a comfort, but it isn't; I'd much rather be the one driving. The reason is because I have always had this thing where I don't want to show any weakness in front of my dad. I feel like I'm letting him down. Therefore, I end up putting pressure on myself not to panic.

So that's challenge #1 for the new goal. I'll let you know how it goes.

Too much water anxiety

Sometimes I have this thing where I think too much about having to go to the bathroom. I try not to drink too much water before going to a place I know I'll have to sit still for a long time. For example, before I take a road trip or before mass. But the more I think about it, the more it seems like I have to take a whiz.

Yesterday, I went to church with the family: there was me, Lyla, James, Lory, Mom and Pops. I went to the bathroom before leaving but around 30 minutes into the mass I started to worry about having to get up to go to the restroom. I was sitting in the middle pew, and there were 5 people to the left of me, 5 to the right of me. So I began to feel a little cramped. I also imagined that I somehow would lose control of my bladder and would have to immediately go home and it would cause a scene.

I'm not sure why that thought frequently hits my mind: the idea that I have to have an immediate escape and that somehow I will act upon that idea. I can't think of a time where I panicked and immediately insisted that I leave or someone take me home. I guess once in high school before I knew what panic disorder was, but that was 10 years ago.

Anyway, I decided that I would prove to myself that I can hold it and that I can just let the panic thoughts pass by as I observe the symptoms. I ended up holding it from 5:30 to 7:00 pm. I should remind myself of this time that I can wait it out and there is no emergency to go to the bathroom or leave the situation.

Avoidance

I'm at a point where I'm pretty comfortable doing what I need to function in society.

I can go out for meals with friends and family (99% of the time I like to be the one driving for easy escape). I can appear at legal conferences and depositions. I sleep well at night. I drive easily back and forth from San Jose to visit my girlfriend. I can go shopping at the mall (preferably by myself with a car). I can go see movies (preferably not on opening night). I can go on trips to Reno and play poker in the casinos (though I'm usually exhausted after the weekend). Elevators have rarely bothered me like it does most agoraphobics.

But there are things I'm still avoiding. Like: public transportation, large social outtings where I'm not driving, trips out of town where I've never been, airplanes, swimming in the deep end... that's all I can think of for now.

I'm going to make a promise to myself that I'm going to do one new thing every month. I am not content with staying at the same level. I have to keep moving forward with my goals.

PF Chang's... zomg got nervous

So Lyla decided to make spaghetti for dinner on Sunday and we invited Christian to come eat with us. But he said that he was a picky eater and said it'd be better if ate out instead. I think he was scurred that he wouldn't like the food and might offend Lyla. Anyway, we decided to meet up at 6:30 pm at PF Chang's. Lyla invited her brother and his girlfriend along as well.

Anyway, I started to get nervous around 4:00 because I had a feeling I'd be the one driving me/Lyla/Bao/Han to Sunnyvale. I tend to get nervous in a full car especially when people are present that don't know about my panic attacks. So I started sweating alot. I'm not sure how much of the sweating was due to anxiety or due to the really hot weather, but I began to panic.

I told Lyla to tell Bao and Han to take a separate car. I felt ashamed and I felt grumpy. I felt like blaming Christian for not taking the free spaghetti that would have been comfortably eaten at Lyla's apartment instead of at a public restaurant. I felt like blaming Lyla for inviting Bao and Han knowing that it might put me in this situation.

But the good thing is, I acknowledged all this emotion right when they hit me. I didn't end up blaming Lyla. I didn't end up blaming Christian. I didn't beat myself up for giving myself a break to take separate cars. Instead, I vowed to make sure this situation happens again but with me driving everyone and decided to just have a good time at dinner. And I think we all had a good time there.

I think I handled this situation quite well.

A metaphor from Tony Robbins

While I was working out at the gym today, I was listening to Tony Robbins' audiobook and he talked about a metaphor that pretty much applies to every form of conditioning: mental conditioning, physical conditioning, emotional... etc.

He talked about how he has an old grand piano that had been out of tune for years. One day he decided to have it tuned by a professional because his kids wanted to learn to play. So the piano tuner came by and adjusted the tensions of the strings. Surprisingly, the tuner said he had to come back the next week. When asked why, he answered that it had been out of tune so long that he would have to repeatedly tune it, more-so in the near future. So he would have to retune it a week from now, then 2 weeks from now, then a month from now, then 2 months from now... until it comes to a point where you only have to tune it twice a year.

The same kind of principle can be applied to working out. If you haven't worked out in a long time, it can take a great deal of effort in the beginning to get back into shape. Once you're in shape, all it takes is a little fine tuning here and there to stay fit.

It also applies to panic disorder. In the beginning, it's REALLY tough to get yourself back out there. There's a great deal of fine-tuning to be done in the beginning. Alot of meditation, alot of exercise, alot of relaxation, alot of exposure. After awhile it gets easier, but it still requires hard work.

Successful BBQ Weekend

Went to Modesto with the family + Lyla. Went really well. I think I was most anxious the day before we left to Modesto. That Friday, I think I was feeling the anticipatory anxiety I get before a big social weekend.

We left San Jose around 9 am; the Starbucks we stopped by was really crowded, but I had no anxiety. The drive was little to no anxiety. I did feel a little anxiety when it was just me and Lyla taking care of the babies, but I think that's normal because Spencie was crying out for his mommy.


Sunday was exhausting. We woke up early to go to church, then had lunch at Chili's. Then we played poker all afternoon (where and Lyla won $24 combined off the family). Then we had dinner at Chevy's. Then I drove back to San Jose after pumping myself up with diet pepsi. When we got there, me and Lyla had to move a couch, a mattress and some other things to the sidewalk for annual clean-up. I almost got grumpy but I think I maintained my cool pretty well.

All-in-all, I'd say it was a great step in the right direction.

Sleepy today

Skipped my meds last night. Was really tired this morning. I'm not sure if skipping meds has that effect on me or not. I'm going to talk to my doc and see if splitting the dosage into 12.5 mg tablets and take it everyday is better than skipping every once in a while.

On a good note, I hit the treadmill yesterday for 1 hour. I did some sprints on it and just felt the heart rate and sweat. Feels good not to ignore the symptoms and just let it flow naturally.

Restless night of sleep

Sunday night was one of those nights; where no matter what you do, you can't fall asleep. Tossed, turned. Then got up for a while, then went back to bed, tossed and turned. Monday wasn't too bad, but I was pretty much out of it the whole day. No real anxiety, just spaced-out.

Zero mg

So I didn't take any Zoloft last night. I don't feel any different today than I did yesterday. I think I was sleepier this morning. Me and my doctor are working on getting me to be Zoloft-free eventually, and he instructed me to stay on 25 mg and to just skip a dose once in a while when I plan on having a pretty stress-free day.

I plan on keeping up posts on days where I skip my dose vs. days where I take the full dose and see if I notice any difference.

More Tennis and Facing the Gaggy Feeling

Played tennis again today. Felt pretty anxious because I was already pretty sore from working out at the gym twice over the weekend. I was afraid I would over-exhaust myself and get some panic symptoms.

As expected, I got the usual rapid heartbeat, out of breathedness, dry-mouth, some dizziness, and that feeling that you might not be able to catch your breath. I mean, that's to be expected when you're running up and down the court for a whole hour. Sprinting, hitting the ball, sprinting, etc. This time though, instead of ignoring the feelings, I completely let myself feel the effects. The feeling I think I'm most sensitive to is the choking feeling/feeling like I can't breathe. So while I faced this feeling, I had a flashback to my days back at UCLA. I remember whenever I would start my day and head towards the bus to take to campus, I would have a panic attack and I felt like I was going to puke. I felt like I was dryheaving and my eyes would water. It's weird how that memory hit me right then and there. Like I was peeling back layers of fear and memories as I faced the symptoms.

I feel much more empowered now when dealing with panic symptoms. I feel like I'm facing them head-on instead of just deep breathing and relaxing myself through them. I've been getting by pretty well using my relaxation techniques, positive self-talk and just overall ignoring my symptoms. But now that I'm doing this whole, "let - myself - thoroughly - experience - each - symptom - without - any - thoughts - of - escaping - from - them" thing, I think I'm making even more progress than ever before.

Progress

Had a great weekend. I tried to stay focused on any panic symptom that came my way. I hit the gym both on Saturday and Sunday and just let myself feel the pounding heart, sweating and out of breathedness.

This morning, I went to Mandatory Settlement Conferences on two separate cases. I settled both and didn't panic even a little.

Progress, thy name is... Jason. Or something that makes sense.

How to help alleviate person panicking

Michael just posted a good find on how a safety person/partner/friend can be helpful during a panic attack:

http://dapanicroom.blogspot.com/2008/04/tips-on-how-to-alleviate-panic-attack.html

New goals

Okay so now that I've reached a liveable point in my life with regard to my anxiety, i.e. I can live a regular life and perform as an attorney, I think it's time to set new goals to further my progress.

Next step goals:
1. Be able to take the bus anywhere
2. Be able to fly short distances
3. Comfortably go with large groups to functions without me being the driver and without an easy escape

I think that's good enough for now haha. So how do I reach those goals? I think I need to decide to take on some weekly goals.

Weekly goals
1. At least 3 times a week, practice interoceptive desensitization (i.e. forcing myself into hyperventilation, rapid rate or dizziness)
2. At least 5 times a week, meditate/deep breathing for 10 minutes
3. Get exercise 3 times a week
4. Begin real-life exposure to bus rides, airports and group functions.

First Tennis in about 6 months

Played tennis for the first time in 6 months yesterday. I was a little anxious about it because of the rapid heart rate, out of breathedness and exertion involved. Overall I think it went pretty well. I was hitting the ball well and I only felt maybe a level 6/10 anxiety at a few points. I know now that feeling that kind of anxiety is a good thing because it means I'm making progress. I had to take like 3 breaks to catch my breath, but I think that's more of an out-of-shape thing rather than an anxiety thing.

Intensive Exposure Therapy

This video is pretty accurate on what exposure and desensitization is like. Basically, by confronting the fear head-on repeatedly, you begin to decrease the stranglehold the phobia has on you. Thanks to Michael for the link to this video.

Intro

Hello everyone (approximately, let's say 9 people total will read this),

This is my journal of bouts I've had with anxiety along with some random posts that pertain to panic disorder with agoraphobia. A good friend of mine who is currently struggling with this disorder suggested I do something like this. I thought it was a good idea.

At this point in my life, I felt I've done a decent job handling my Panic Disorder with Agoraphobia. The first panic attack I can remember happened when I was 15. Gradually I developed panic disorder with agoraphobia. But, through help from family, friends, prayer, and a ton of reading on the matter, I've somehow gotten my undergraduate degree and my law degree. I've been working as an attorney for 2 years now and I have a wonderful girlfriend. So things are great to say the least.

That being said, I still feel some anxiety now that I'm down to 25 mg of Zoloft, of which I take only 4-5 days/week on average. At one point I was on 100 mg every day. I've began to feel things more: both the highs and lows.

But! On a scale of 1-10, 1 being no panic at all, and 10 being a full-blown panic attack, I haven't had anything above a 6 in a long time. I can't remember the last time I had a full blown attack. But let's not jinx it.