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How Antidepressants Affect IBD

My anxiety right now is through the roof. Just sitting here attempting to write a story about it makes my heart and head pound, and my hands shake. But I’m gonna get through it because I know so many of you are experiencing the same thing.

There’s comfort and safety in numbers and shared experiences.

I want to help in some way. I’m not a doctor or a nurse on the front line, or a stocker at a grocery store. I’d like to deliver food to my elderly neighbors. But I have rheumatoid arthritis and therefore a lowered immune system from that and the meds I take for it. I shouldn’t really be out and about in the world right now.

So, like millions of others, I’m under lockdown, sheltered in place at home, as ordered by the governor of California. I only leave my house to walk my dogs, though I constantly look over my shoulder to make sure I’m socially distanced from others out for a stroll. And the coyotes.

Panick Attack #1

I’ve never been an anxious person. Maybe a tiny bit OCD or “bossy,” as my mom calls me. But since coronavirus took over all of our lives, I’ve been an anxious mess. A germaphobic, agoraphobic, paranoid hypochondriac. As much as I’m posting pictures on social media of all the food I’m cooking, I’m not really eating it. The act of baking is more therapeutic than anything. I lost five pounds last week.

Yay me, I guess.

I had my first panic attack this week. It was triggered by a devastating article I saw about an Italian family in New Jersey. They lost three members to COVID-19 within days of each other. Their sudden and rapid deterioration was heartbreaking, tragic, and scary, and signaled that this evil virus could take anyone, any age, at any time. As soon as I read it, I got clammy. My heart felt like it was going to explode. I trembled, my throat felt weird, I felt short of breath, and I thought I’d pass out.

After about 10 minutes, it stopped. And instantly I felt normal again, the best I’d felt in like a week. I think all that pent-up, toxic anxiety I had stored in my body was finally exorcised.

But the good times didn’t last long. After that incident, I noticed that anything could trigger my anxiety, from coming to the last square of a toilet paper roll to going outside to get the mail. I live with my mom, and when she crinkled a potato chip bag, I nearly jumped out of my skin.

The anxiety was coming from inside the house, outside the house, everywhere. I was surrounded by coronavirus anxiety.

I lived in New York City during and after the September 11 attacks. This reminded me of the feelings of dread and despair I had back then. I happened to be in downtown Manhattan that terrible morning. I saw the second plane hit the Twin Towers. From 10 blocks away, I could see people jumping out of the windows. I couldn’t go back to my apartment in Brooklyn right away so I spent a week holed up inside a friend’s apartment glued to the news 24/7.

This has been feeling familiar, yet also totally different. The “enemy” this time is an invisible virus, stalking us to kill us. It’s like those ridiculous horror movies my girlfriend made me watch — BirdBox, The Happening, or It Follows — had come to life. There was no escape from coronavirus.

Cue anxiety.

Panick Attack #2

My anxiety began to manifest in sleeplessness, not usually a problem for me, and new obsessive-compulsive-like behavior. Wiping down door handles, stove knobs, and fridge doors, even though my mom and I are the only people who have been in the house for going on two weeks now.

I started to take my temperature frequently, because “they” say a high temp is the first sign of coronavirus. Which lead me to my second panic attack.

I stumbled onto another article about how diarrhea was one of the hidden early symptoms of COVID-19 patients in the Wuhan, China, but nobody was talking about it enough. As someone who has IBS and diarrhea pretty constantly, this freaked me out because how would I know the difference? Hence, after a particularly bad bout of diarrhea, I stupidly popped a thermometer in my mouth (for the fifth time that day) and voilà, got a reading of 99 degrees.

I spun out.

Panic Attack #2 was worse than Panic Attack #1 because I was now convinced I had COVID-19. When my throat closed up, I didn’t think, “Oh, don’t worry, that’s the anxiety and not the virus.” Also, my mom thought I was overreacting and was increasingly worried about my anxious behavior. She suggested, mid-panic attack, that I needed anti-anxiety medication. Not helpful.

The good news is that I survived the second panic attack and my temperature went back down to normal. But I was upset enough about my own behavior that I reached out to my cousin Aaron Chapman, MD, a psychiatrist and the medical director of Alameda County Behavioral Health in Oakland, California.

“I’ve had two panic attacks this week,” I wrote him in a DM. “At what point should I get medication? So many of us are anxious like never before.”

“Reach out for support first, don’t reach out for medication alone,” he replied. “Let the decision around medication be left to the professionals. Together you may decide that medication may be part of needed care. If you are thinking that you want medication you may want to talk to a psychiatrist, a psychologist, or even have a discussion with your PCP or rheumatologist.”

He added that because of coronavirus and shelter in place orders, most therapists and psychiatrists were retooling their practices for telemedicine, and that the federal government had loosened restrictions on the use of video-conferencing. “Even FaceTime is now okay for doctors and patients,” he told me.

Continuing to Cope

Good to know. I didn’t think I was at the point of meds yet and took some proactive yet more basic measures to quell my anxiety. I ordered a comic sketch book from Amazon so I could draw before bed. I also downloaded the Calm app to help me sleep. It’s a $69 yearly subscription but it didn’t seem like a frivolous expense.

It was a hell of a lot cheaper than therapy.

And while both sketching and calming music helped, it wasn’t enough. My household was filled to the brim with anxiety, especially after a swarm of bees came through our chimney and infested our house. Really? This had to happen right effing now? Smack dab in the middle of this crisis, when we couldn’t leave our house, we had our very own Sharknado — or, rather, Viruswarm!

It was the last straw for my mom, who had been stoic up to this point but finally broke down and had a good cry. Even my dog Scooter is riddled with anxiety. All day today he has been stuck to my side like glue, literally sitting on top of me.

I remembered my cousin Aaron’s sign-off DM: “Never hesitate to reach out for help!”

Since he was considered “essential services” and was still reporting to work like a superhero, I didn’t want to bother him again. So I called my favorite CreakyJoints expert, Katie Willard Virant, a psychotherapist in St. Louis who specializes in treating patients with chronic illness, for more tips on handling my anxiety.

“I know you’re not my patient,” she said warmly, “but tell me about your anxiety? What are you noticing?”

I relayed the panic attacks, repetitive cleaning behavior, loss of appetite, sleeplessness, feeling of impending doom, and just overall jitters.

“So many people are experiencing anxiety,” she assured me. The list of reasons goes on and on: being stuck at home with nothing to do, being afraid of getting the virus, negotiating space and boundaries at home, worries of financial disaster.

She gave me a few great pieces of advice to help me get through this unprecedented time of stress.

Realistic Ways to Quell Anxiety

First, it’s important to remember that a panic attack is not a heart attack and does not lead to a heart attack. You just have to ride it out, like a wave. “Your brain goes from zero to a hundred in a split second,” Willard Virant explains. “One of the best things we can do is slow time down. I know everyone’s thinking, ‘But all we have it time and this is the problem.’ Any kind of meditation is good. It doesn’t have to be sitting for 20 minutes saying a mantra. It can be listening to a slow piece of music. Anything to slow your mind down.”

Willard Virant also recommends sitting in a safe spot outside for five minutes, maybe in a comfortable chair where the sun is shining. “Calmly try to use your senses. Close your eyes, then open them. What do you see? What do you hear? What do you smell? Getting into your body can be a really good antidote.”

Next, be mindful of obsessive behavior but also “be gentle with yourself,” says Willard Virant. “Checking your temperature compulsively a million times a day will just put you down the rabbit hole. If you’re tempted to do that, give yourself set times to space it out, then walk away.”

In the beginning, my mom rolled her eyes when I wiped down every single Amazon box with Clorox wipes. Her annoyance annoyed me.

Problem is, everyone in your household may react to the coronavirus crisis in their own way. “Try not to judge yourself or anyone else,” Willard Virant says. “Gently remind yourself, ‘These are extraordinary times.’”

“I’ve worked with some families this week on this very issue,” Willard Virant adds. “Try to honor that people are experiencing this differently and they need different things throughout this. Some people may need to talk about their worries, and they want to get it out and that’s great. But if you are living with somebody whose way of dealing with this is to not talk about it, be open to that. One way is not better than the other way. It’s about how can we somehow meet in the middle.”

Also, whoever is in the midst of a panic attack “runs the show,” she adds. If they want to talk about it, let them and listen. If they want to sit alone in a corner or go off to their bedroom to deal with it, let them.

While you don’t want to tell anyone else what to do, Willard Virant does think it’s helpful to set some personal goals for yourself, physically and mentally, daily or even weekly. “What are the goals you have for your well-being? Maybe it’s walking to the mailbox, maybe it’s drawing. Maybe you can finally learn Spanish. Use all of your senses.”

The Key Way to Handle Anxiety

When you’re at your most anxious, the most important thing is to “give yourself grace,” Willard Virant urges. “This is new for all of us. We’ve never done this before and we’re not going to be skilled at it. It’s something we will have to learn as we go. We’re just bumbling though this and it’s okay to be bumbling through this.”

For now, I’ll bumble through with the best of ’em. And I’m relieved to know that help is out there via teleconference when the going gets tough and the tough get anxiety.

Now that I’ve written this out, I actually feel better. Maybe I’ll go draw in my comic sketchbook. Or check out this #ClubQuarantine all the cool kids are flocking to on social media.

Or bake something and actually try to eat it.

Deep breath, exhale…

Deep breath, exhale…

Deep breath, exhale…

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