Friday, November 17, 2006

Anxiety

Apologies for no recent updates. It seems I spoke too soon and I am still struggling with my recent bout of exhaustion. I’ve also been very busy helping Mr Man with various projects that he is involved in at the moment.


As usual I am completely baffled by Mr Mans symptoms and how they are presenting. One of the most difficult things about coping with Mr Mans illness is the fact that it never seems to stay the same; we always have new situations that we have to learn to cope with. I’ve often said in the past (although not on here) that his symptoms seem to fluctuate in such a way that he will improve greatly in one specific area but still be very ill in every other way, and then he will seem to improve in a completely different area and the area that had previously improved will deteriorate again.

At the moment his levels of concentration are very good. He has been keeping himself very busy designing websites and writing his own blog. While he’s doing these things he’s fine, but unfortunately as soon as he stops he is back to pacing the floor and checking the window for people watching the house. I know the obvious answer is for him to keep busy, and he has been, but I’m just a little worried that he will wear himself out as he is having to keep his brain occupied from the moment he gets up to the moment he goes to bed.

We haven’t talked any more about his delusions, but the fact that he is pacing the floor and looking out of the window is a sign that they haven’t really settled down completely. They don’t appear to have worsened though, so I didn’t contact his psychiatrist about an increase in medication. One thing Mr Man and I have talked about is his anxiety, and this is something that I keep meaning to blog about, as his CPN (Community Psychiatric Nurse) seems to have great difficulty in understanding this problem.

Having suffered from anxiety in the past myself, I know too well that sometimes it is just a persistent feeling of overwhelming anxiety for no apparent reason, and sometimes it is more like an “attack” which is often accompanied by an irrational fear. I also know from experience that the “focus” of the anxiety is not usually the original source. For example, when I suffered from acute anxiety the focus was on spiders. I have always had a fear of spiders, as do many people, but at this particular time my anxiety had escalated to an unmanageable level which was affecting my ability to function on a day to day basis. I was too scared to open draws or cupboards, fearing that a spider would be inside, or even stand near a draw or cupboard. I couldn’t sit in the garden where I believed spiders to be everywhere, and I feared walking through the doorway of the house, convinced that a spider would drop on my head from its hiding place on the door frame. At this time I had had no recent experiences with spiders to aggravate this anxiety, but Mr Man had been admitted into hospital for the first time. Obviously my anxieties over Mr Mans admission were presenting themselves in a very different way.

For Mr Man, the recent “focus” of his anxiety is travelling by car. Each time we travel somewhere he is convinced that we are going to have an accident. This fear is compounded by the fact that the voices are constantly telling him that we will have an accident. Of course, this isn’t a completely irrational fear, as people have accidents on the road every day, but his anxiety levels are making it nearly impossible for us to travel by car.

The thing is there are different kinds of anxiety. Everyone suffers from anxiety as Mr Mans CPN Mark* is so fond of telling us. If a person were to address a large audience for the first time in their lives you would expect a certain level of anxiety; that would be perfectly normal, but when a person is suffering from anxiety for either no apparent reason, or in an area of life that had not previously caused them any anxiety, particularly when the fear is an irrational one, then there is obviously a deeper underlying problem.

Mark seems to find this very difficult to understand. Everything seems so straightforward to him. He is of the opinion that if Mr Man keeps travelling by car then his anxieties surrounding it will lessen in time. That’s a great theory, but if only it would work in practice. I’m sure that this exposure technique works for “normal” areas of anxiety, such as speaking to an audience for the first time, but as time goes by Mr Mans anxiety seems to increase with each journey, not decrease. We’re not talking about “normal” levels of anxiety here, and of course, if travelling isn’t the original source of the anxiety then exposure to that fear will be of little or no benefit.

Mark also seems to think that anxiety can be worked through with the use of logical arguments; we haven’t had an accident yet so there is no reason to think that we will. I can understand his reasoning behind this, but in my experience anxiety often defies logic. I knew a woman who suffered from anxiety, and again it presented itself in a completely unrelated area of life to the original source; she had a lot of financial difficulties but her anxiety was focused on the possibility of someone climbing in through her windows at night, and so during the heat of the summer months she kept them closed. Logically she knew that it was completely impossible for even a child to climb in through these windows as they were extremely narrow, but this argument did nothing to ease her anxiety.

The only useful piece of advice that Mark has given us is to use music as a distraction from the voices while travelling. This has had limited benefits, but still, it’s better than when we play no music at all.

Previously Mr Man has attended anxiety management classes, but he found that the classes themselves were causing him a great deal of anxiety! He still remembers the techniques that he was taught and he tries to put them into practice, but sadly this offers little or no relief for him.

As time goes by Mr Man is turning me into a nervous wreck as well! Out of the corner of my eye I can see him braking for me, and it’s not unusual for him to shout out “Look out! Look out! Look out!” while we’re driving along. He assures me that my driving is not the problem though! I only wish I knew what I could do to help. I’ve started to brake much earlier and to make sure that I have extra time for pulling out of a junction when I have him in the car with me, and apart from that it’s just the usual reassurances and loud music. I’m sure in time his problems in this particular area will improve though, and we will be faced with a completely different problem, as is so often the case.



* Name has been changed.

8 comments:

angelfeet said...

I'm really surprised that the CPN doesn't understand how the anxiety can't be worked through in that way. It's like saying to someone with depression "Oh it's not that bad, just pull yourself together." CBT won't work for this level of anxiety and of course logical arguments don't really work either - it's the unconscious mind, the one that we don't have direct control over, that is perpetuating the anxiety. Is it possible to get different support in this area? - maybe cognitive hypnotherapy, that works on more than just a behavioural level.

Mr Mans Wife said...

I'm not really sure what the answer is to be honest Angelfeet. He takes Diazepam sometimes to try to settle his anxiety a little, but I realise that this isn't addressing the cause of the problem. Still, it helps in the short term. I'm hoping that maybe it's just another "symptom" of his Schizophrenia that will lessen in time as he continues to recover.

Hypnotherapy isn't something that we would consider.

Rhea said...

Just out of curiosity, if you don't mind me asking, why would you not consider hypnotherapy?

Is it because you don't believe hypnotherapy would help or is hypnotherapy not advisable for those with schizophrenia?

Mr Mans Wife said...

It's just personal reasons really. There's a few "dodgy" therapies we wouldn't consider, hypnotherapy being one of them.

Rhea said...

Fair enough.

I ask because I had gut-directed hypnotherapy (a specialised hypnotherapy technique to help people with IBS) and learnt to self-hypnotise. I found it helped me but it is something that you have to actively work with and implement what you are learning.

Each to their own :o)

Anonymous said...

Hi Mrs. Man,
If I really believed I was going to die every time I took a car trip, and had a voice in my head reinforcing this all the time, then I would be extremely anxious.
So the problem is not the anxiety but the intrusive thoughts - the anxiety is an appropriate response to the thoughts. It is the thoughts that are inappropriate.
So the answer is finding a way to work on the thoughts. Distraction listening to music is one way. Working on identifying the thoughts as a symptom of illness rather than fact is another...I know it's easier said than done, but this is the direction to head in.

Mr Mans Wife said...

Rhea: As you say "Each to their own" - hence the reason for the inverted commas when I used the term "dodgy". :o)

CPNurse: Thank you, your comments make a lot of sense. Identifying thoughts as part of an illness is something that has helped me personally in the past, and it's amazing what a difference it can make just recognising that fact. (Mr Man is not convinced though)

Mr Mans Wife said...

Actually he's just told me that he's not ill - so we're back to that again.