The anatomy of a freakout
By Mary-Minn Sirag, from “Mary-Minn’s Stim Page”, June 2006
“I lost my ability to anticipate, recognize and ward off my Confusion Triggers. “
The first day after being ill is wonderful, indeed. My senses are alert without being too sharp. My brain can follow a logical pattern again. The temperature outside not only is perfect, but feels perfect. Colors are bright, and spring smells sweet again. I am well rested, after 12 or so hours of sleep, and I could eat a house if only a realtor would give me one to chaw on. My body is clear of aches and pains.
My illness was a four-month flood of high anxiety, depression and freakouts that crested just last night with a skin-crawling darkness of the soul. It started out insidiously as my customary winter depression.
My brain receptors had become immune to the antidepressant I was taking, rendering it useless. I felt too delicate to embark on yet another series of biochemical experiments before hitting on another antidepressant that would hold me until the next crash. Putting this off was my first big mistake.
A friend of mine had successfully diminished a recent trauma of her own with a five-session course of EMDR rapid-eye movement cognitive therapy treatments, which heartened me. I determined that I too could weaken my own freakout triggers with a course of EMDR, since my triggers are specific: losing things, getting lost, and not knowing what I am supposed to do in any given moment. I had even figured out the specific experiences leading up to my triggers. Thinking that five sessions of EMDR would fix me was my second mistake.
In a metaphoric and less than scientifically rigorous nutshell, the rapid eye movement, by stimulating both sides of the brain almost simultaneously, rearranges trauma-induced neural pathways that are activated by stimuli the patient associates with the trauma. The goal is to scramble these pathways sufficiently to disentangle the multitude of triggers from the initial trauma. Later on in the process, reintegration supposedly occurs after the brain has formed new pathways that are squeaky-clean of the trauma and its ramifying surrogates.
The therapist provides the patient with a safe venue to revisit these traumas as the patient’s eyes track the therapist’s rapid back-and-forth hand movements. After helping me to come up with comforting images to keep in mind, my therapist told me to relax and follow my thoughts.
My first serious obstacle was that relaxation is a state of being that is every bit as elusive to me as spiritual enlightenment. My second obstacle was my extreme defensiveness about opening my being to my traumas. Though I can ruminate about them endlessly, voluntarily re-experiencing them in a therapeutic context is a whole other matter. My third obstacle was my innate suspicion of professionals, even when I’m giving it my college best to be open-minded.
During the sessions, however hard I tried to revisit these traumas of mine, my attention settled instead on comforting stimuli–the reassuring tock of a mechanical clock, the bells at St. Mary’s Episcopal Church that reminded me of church bells in the village of my childhood, the warming click of the baseboard heater, even a bus changing gears, so reminiscent of cross-country Greyhound bus trips I took during college. My therapist was astonished at how many mechanical sounds I took refuge in. She clearly wasn’t the John Cage fan that I am. Meanwhile, the trauma I was trying so hard to reframe evaded my conscious grasp.
Alas, the therapy was worse for me than merely ineffectual. As promised, my brain felt scrambled for a few weeks, which was initially reassuring, as something seemed to be happening. The awful part, though, was that it never unscrambled completely to reintegrate its moorings, so my triggers became more random and unpredictable than before. Perhaps the requisite five expensive treatments were insufficient for my slow processing of information; however, by then, I was done with throwing good money–and time–after bad.
My mental health cascaded from there. My anxiety worsened from mere agitation and nervousness to a pervasive sense of im-pending doom and wrenched anguish. Daily, I awoke in a cold sweat of panic and foreboding, dreading the day’s unfolding. Premoni-tions of death loomed as I got behind the wheel, and my mind perseverated on near-accidents. My skin crawled as though trafficked by tiny vermin. My brain felt ready to pop out of its skull. My innards clenched. Things I had said reverberated back at me days later in a hollow mockery of my voice. My heart raced as though my veins were going to explode. I felt windswept from the inside. I developed a gripping and galloping-stampede social phobia. During the last week of my crisis, my anxiety culminated in a low-grade fever that kept me unpleasantly hot, though the ambient temperature was pleasantly cool. Toward the very end of my long episode, I craved solitude but couldn’t stand to be alone.
I lost the ability to keep things properly organized for myself, which fed one of my two worst freakout triggers: losing things. I couldn’t remember where I had–or even should–put things. My visual processing and sense of direction deteriorated, as did my problem-solving and troubleshooting ability. For instance, I often neglected to check the phone book and my various street maps before venturing out into even slightly uncharted reaches, thinking that “everything is going to be alright.” I forgot to eat frequently enough, rendering me woozy, irrational and irascible. Though I continued to print out my checklists for leaving the house in the morning, I glossed over important checkpoints and neglected to close important loops I had opened, such as strapping my keys to my right-hand pocket in order to keep myself safely attached to them.
During this four-month period, my freakouts increased in frequency and intensity as I lost my ability to anticipate, recognize and ward off my confusion triggers. Each freakout left me raw and vulnerable to even worse subsequent ones. They evolved from fits of obscene ranting and high-decibel shrieking at my frozen-up computer; to stapling my wrist, cross-hatching one arm with a serrated knife and bruising the other with the clenched fist of the first hand; to a stomping and shrieking rage of frustration and confusion-panic at a dear friend and her family due to an unreasoned assumption I had made in a state of hypoglycemic exhaustion.
My friend and her family accepted my abject apology. I then dissected and analyzed my recent hell with her, other friends and family. In place, yet again, are my protocols of prevention: When my brain is slower than the world around it, I am to request a smokeless break to sort and map things out in my mind, to look up the address in the phone book and the exact coordinates on a map. Whenever I leave the house, I am to pack plenty of nourishing protein to fuel my brain. Whenever I feel that hazard bubble ascending from my gut to my brain, I am to stop and figure out what my spider sense is trying to tell me.
As the egg man at the Marin County farmers’ market told my sister, “Don’t be too hard on yourself.”