depression

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Self-Care: What is it and Why Aren’t You Doing It?


Self-care is a very simple concept. As it says, it is all about taking care of yourself. But most Americans, and probably others around the world, are not do much.

To be in good health is that you are doing three things: a mind not cluttered, a body in good health, and a spirit that thrives.

You would think the first thing would be the easiest, but it is not. Many people do not get an annual physical. Young people are especially guilty of this. They think they will live forever and since they feel good then everything must be good. Not true. First, you must look at your family history and see if there is any medical or psychological history of disorder. For example: my father had heart disease which killed him at a young age, 57. At age 49 I nearly had a heart attack too. But did I even consider it before that? No! In fact, after I left the army, I was guilty of not having physicals. I was most fortunate on the day of my “almost” heart attack, I was very close to Massachusetts General Hospital. That ended in surgery, a cardiac catheterizing when a stent was place in the problem area. Since that incident, I have had a physical every year and seen a cardiologist regularly. Two years ago, I needed a second surgery and last year a third. My heart is strong and heathy.

You say you are 20-somthing and what could be wrong? Cancer, heart disease, kidney issues, lung issues, and other problems which show up in simple blood tests. All doctors who are in primary care always want your history and that of your family. It helps them when they consider possible issues.

If there is a history of mental illness in your family, make sure that you are in strong psychological health. Simply put, if you have periods of depression, that is not normal. If you have fears you find impossible to overcome, that is not normal. These too are things to discuss with your primary care physician. Oh, you must get a primary care physician.

Do you find your mind racing? Do you feel weighted down by problems? This is something which needs attention. Sometimes talk it out with a friend will do the trick. But many times, it is time to call in a professional of some kind. It could be a financial professional, a lawyer, or even a psychologist. There are times when we have lived with some feeling that is uncomfortable, we come to believe it is normal. It is not. If you are known to say or thing that you have no friends, it is time to get help.

Finally, there is the spiritual portion of your life. Spiritually is not owned by churches or synagogues, it is a state of being when you are comfortable with yourself, know how to deal with your own problems, know how to reconcile with people in your past where harsh words were exchanged. This calls for a personal inventory. It is simple in concept but difficult in execution. You have to go through your whole life, look at your shortcomings, look where you have wronged somebody, and focus entirely upon what you have done to people or institutions, and not what they have done to you be it real or imagined.

You can be neither too young nor too old to start doing these things. It all comes down to desiring a better life. If you think your life is as good as it is going to be, do the things about and you will probably find that your life could be better.

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Dealing With Death and Depression


I write this today because a longtime friend of mine died yesterday. I had known him since 1964. My heart is heavy today, but I can find solace in the fact that I knew a kind and gentle person for so many years.

Death is a part of life. It is the earth moving around the sun. It is always in motion and there is nothing we can do to change that. It was here and moving before life even formed on earth and will continue long after all life is extinguished.

My father died when I was just 20. He had heart disease, and his 3rd heart attack ended his life. I cried, I got mad, and I got depressed. In those days I had no idea of how to handle death, or depression for that matter.

The is a single word that we all need to use in dealing with death: “acceptance.” I have heard so many people say that death is not fair, but I always say that, except when death is caused by another human, it is always fair. It is that sort of acceptance that keeps depression away. My friend’s death has given me a heavy heart and with that I can feel the strings of depression tugging but I respond by not allowing such a thing. It is pretty easy actually. A heavy heart is normal and acceptable. When we allow ourselves to have that and to grieve our loss, we can avoid depression. But the grieving process must have a shelf life. If it goes on too long, it becomes self-pity which is always an unacceptable position.

Death will come to each of us and we should all prepare regardless of our age. No one knows the mind of God and therefore, we know nothing of our future or that of anyone else. I am 74 years old and each time I talk to one of my daughters the words, “I love you” are always a part of the conversation because were I to die, even today, they will know of my complete love for them, and for my grandchildren for that matter.

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Wither Mental Health in the United States


We are by far the richest nation in the world. But we are 20th in the world in dealing with mental health issues. What countries do we trail? Pick pretty much any country in western Europe plus Japan and you start to get the idea. According to the Well Being Port, which is based on the well-being of any one country versus its mental health care. We are number 3 in well-being worldwide. That means that we rank 20th in mental health paints an even gloomier picture of our approach.

What is mental health? According to the report cited above, 1 in 5 Americans will encounter and mental health crisis at some time during their life. But among those figures, and one least written about is addiction which includes alcoholism. According to the World Population Review, the rate of alcoholism and addiction in the U.S. is among the highest in the world. I think this speaks loudly to our desire to take on these health issues directly. Again, countries such as Sweden, Austria and others have a much lower rate of these diseases. This is not a statistic anomaly, but a reality.

It is strange that anytime a Republican speak of mental health, it is only when there has been some sort of mass shooting. They are most certainly only trying to curry favor with the NRA and have no real empathy for those who suffer a mental illness.

The streets of the cities of the U.S. are littered with the mentally ill. There was a time when such people could be institutionalized until they were stabilized and of no danger to themselves or others. But in the 1970s Democrats in particular, viewed this as involuntary incarceration. If you care to wax philosophically about the, yes, that state is true. But is that good policy for those who suffer? It definitely is not. But also in the 1970s, there was a lack of psychiatric facilities for pure mental illness and a lack of facilities to treat those with drug and alcohol addiction. That has changed somewhat, although medical hospitals are want to treat the mentally ill past 2 weeks and almost uniformly refuse to provide in-patient care for drug and alcohol abuse.

This year, as our debt limit crisis is apparently avoided, Democrats refused to cut back on funding for mental health. But that is like saying, I will pay you 25 cents for your $1 product. Republicans on the other side, tried to reduce funding for those on public assistance. Well, news flash to the Republicans in denial, many of those on such assistance get government aid in the form of public assistance. The answer here is, if you want to reduce how much you pay into public assistance, put more into programs that directly assist those with mental health issues.

In a chapter of the Big Book of Alcoholics Anonymous, written over 80 years ago, Dr. Silkwood, at that time, described alcoholism as a health issue and not one of moral character. And yet still today we treat these individuals as pariahs of the general public. Many employers upon discovering an employee with drinking problems that lead to substandard work, fire such individuals rather than help them find assistance. They simply cite the lack of quality work as the reason for the firing. In truth, it is the combination of these factors. If a person get cancer, they cannot be summarily discharged because they miss so much work. There is a little known law by the public which is a portion of the American with Disabilities Act call the Reasonable Accommodation portion of the law which requires companies to work with people who present every sort of disability. Alcoholism and addiction are most definitely disabilities.

In short, we are failing all around to treat the most treatable illnesses today. Some mental illnesses, such as schizophrenia and psychosis, defy physicians best efforts to contain them. But for the most part, people with mental illnesses can be fully productive provided they receive proper mental health care. Personally, I have what is called, Post Traumatic Stress Disorder (PTSD). I have been on medications for over 40 years and there is little likelihood that I will ever fully recover. And yet, I lead a quiet but happy life. That is because via good health insurance and the Veterans Administration, I am fully cared for. But I believe I am in the minority who receives such care.

It is long overdue that our politicians, of any stripe, step up to the plate and put forth a rigorous plan that attacks the root forms of mental health in our country. We would do well to publicly fund treatment facilities for anyone who suffers any sort of mental illness. The result of this would be two-fold, they would get well and they would become healthy supporters of our economy. This might sound like a huge influx of cash by our federal government, which it would be, but it will reduce the costs of funding other portions of our public sector.

We each have a duty to help those in need. We cannot turn a blind eye to such problems and call ourselves good people. It is good to practice the help as you would wish to be helped thinking we must embrace.

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You Do Not Ever Need to Feel Lonely Again


I am struck by how many people say they feel lonely a lot. Why is this? Is it because they do not have a mate? Is it because they do not know what to do with themselves? Is it because they are depressed?

I will start with the last thing first. Depression is a medical condition which requires treatment, first and foremost, by a psychiatrist. I hear many people say they went to their primary care physician to deal with it. If the primary care physician is not immediately referring such patients to a psychiatrist, shame on them! But once that condition is stabilized, the following suggestions apply to them equally as with someone who does not have depression.

The first thing you might do is read a book. Figure out which types of books are likely to be of greatest interest to you. Expect to find some that, after reading a book or two, did not hold you as you had hoped. Move on to another genre and do not stop until you have identified at least two genres that please you. Once that is accomplished, play a game with yourself to read as many of these books in a month as you can. Of course, libraries are a great resource in finding books but if you end up like me, you use your local bookstore to find them. And once you are done with them, please, do not throw them away. Simply put them in the library’s return book area or drop off device and be certain they will be welcomed.

Next, get outdoors and walk. Even walking is a great source of exercise but as another use, you can get out into nature and enjoy her. Most people own an automobile, so if you live in a city, make no excuses about there being nothing to find in the city. I can easily combat that idea, but that is for another time. In the countryside, find a walking trail. Walk slowly with the determination to find as many different animals as you can. Even when I am riding my bicycle, you would be surprised by all the animals I saw. And oh yes, bring a camera with you. You may see some animal you have seen frequently, but this is a photographic notebook of your travels. And no time of year is not good to do this. Once you start see certain animals and birds, of course, many times, find a spot where you can rest and watch these creatures in their habitat. Note how they move and which of their species they move with and how they do it. One thing you will find, birds love to be in the company of another of their species but of the opposite species gender. Note the color differences. If the bird is brightly colored, most likely it is a male. But do not stop a birds, notice bugs, and if you have the stomach for it, spiders, they are the most resourceful and creative of all insects, in my opinion. And for a mind blower, remember that scorpions are related to spiders!

Another thing to take note of is the flora of the woods. In northern climes, see if you can spot a lady’s slipper, a type of orchid which is rare but not impossible to find. If you see one, there are probably others near it. But do not pick them! They are an endangered species. Of course, also in nature are trees. There are nine different types of conifer trees, pine trees. There are 35 different species of elm tree, there are 600 different types of oak tree, there are 17 types of walnut tree, there are 13 different types of cedar tree, and the list goes on.

Can you find edible plants? There are 120,000 types of these plants.

Wild flowers abound and figuring out what you are looking at is a challenge unto itself.

I recommend that your purchase some of the different books that apply to each of the things above: trees, birds, wild animals, edible plants, rocks and other things.

Finally, if you find yourself “stuck” in the city and cannot get out for any reason, take a walk along the sidewalks. As you do and come upon a building you think is old, look up and find some of the most amazing architecture. Modern buildings are cold and without merit. But buildings dating back to the 1930s and earlier, were built with a lot of pride. You will find cornices, finials, balustrades, arched windows, colored glass, and windowed and non-windowed domes, some with bells. There are many other parts as well but that is what you will need to identify. Start with the easy buildings, old public libraries and other public buildings. Take pictures of these buildings, make a written note of them, such as what the picture is, and take them home and research them. It is not impossible to find a building dating back to the 1850s, or earlier! Note the progression of styles. Find out what their original use was. Let’s say you live in New York City. There are two buildings of note that I would bet most New Yorkers know nothing of their history. The first is the Flatiron building and the other is Grand Central Terminal.

Each of the things noted above are things you can do alone. And some beg you to do them alone. But the important part of all these exercises is that you will not feel alone while doing them and you cannot help but learn something new, never a bad thing.

One last important note. If you find yourself drinking every night or everytime you feel lonely, consider the case that you might be an alcoholic. Call your local Alcoholics Anonymous Service Center and talk to whoever answers. They are alcoholics in recovery and can give you some useful guidance.

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What’s Killing Our Teens and Young Adults? Hidden Secrets.


This is one of those little things that I created entirely from personal experience.  But it is also the preface to my next offering.

I loved my parent and they loved me. But neither of my parents had a clue about bringing up children. There were three of us and for much of our adolescent and teen life we were latch key kids. But my parents were horrible with communications. I doubt they ever knew what was going on in my life, what I was thinking, what I feared, what I wanted or even what I needed. It’s not their fault. Theirs was the generation of “pull yourself up by your bootstraps” and I cannot fault them for that. It was all they knew.

What they did not realize is that they had one very troubled child in me. I had been sexually taken advantage of by a couple of neighbor girls who were twice my age, I was 5. I did not recognize it as abuse at the time, and even thought it to be fun. The fun stopped when certain neighborhood boys decided to sexually attack me. It was when I first experienced depression, a depression that lasted for decades. The sexual abuse end when I was 15. I had gotten mad at my mother and decided it time to run away to New York City; we lived near Boston. I was hitchhiking my way there, of course, and was picked up by a man who overpowered me just by his very presence, and my past experiences. He took me to a remote cabin in the woods near a pond and raped me for hours on end. In the morning all I wanted to do was get home.

When I got home my mother asked me where I had been all night and I lied and said I had slept on a park bench in a neighboring city. Not entirely unreasonable since I was a headstrong boy and rode by bicycle everywhere or took the bus where ever. Upon reflection I wondered why she had not bother to call the police to report that her 15-year-old son had not come home that evening. I never did ask her that. But some weeks later I told her of the incident, fighting back enormous fear, only to have her say “boys don’t get raped.” I was brought up Roman Catholic so the next place I sought out help was from a priest at Merrimack College. After I told him what had happened he suggested I ask God forgiveness for my sin.

To backtrack a bit, I had been an excellent student thought my first 5 years of elementary school, almost always getting an A in every subject. In the 6th grade my grades slipped to all Bs and by the 7th grade the Bs and Cs, mostly Cs. By high school I was narrowly avoiding outright failure in every subject.
In the 7th and 8th grade I was the constant target of boys who were looking to make fun of someone. I was actually fairly good at softball but because I could not throw a ball properly, I was always the last kid picked. When high school rolled around I dared not even try out for any of the sports teams, football and baseball I would have enjoyed. Instead, I went where all the other “losers” went, the school band, at which I excelled. In another attempt to be socially accepted, I joined the extremely popular, or so I thought, drama club. I got a speaking roll the first time I tried out and worked my way to the leading roll by the time I was a senior. But my social life still lagged and I had failed to realize that being a member of the drama club was just another collection of misfit toys but still more acceptable than the band.

In the 7th grade we had our first dance. It was held at a student’s house as were the others that year and the following. I didn’t have a girlfriend, I didn’t dance, and I didn’t feel like I fit even. I must have had some sort of self-abuse ideal because I kept going. In high school it was more of the same only worse. Starting in Freshman year my fellow classmates flouted their “steady” relationships. The boys began to brag about all the girls they had had sex with. It was not until my junior year that I had my first date. The idea of asking a girl out was just to scary. When I finally got up the courage, she said yes and not long after became my first, and only, girlfriend in high school. We went to the Junior-Senior Prom together, had a wonderful time, and I thought I was on my way. She broke up with me shortly after that but at that point I didn’t care too much because I had badgered my parents into sending me 300 miles away to a boarding school so I could get into college.

When I graduated from high school I was still a virgin, not a bad thing, but had had only kissed a girl once. I was too fear filled to just try to kiss a girl and anything more serious, which I did daydream about, was just out of the question. I limped through high school with just a few friends and even some of them picked on me, made fun of me. They knew I would neither stand my ground nor fight back.

Shortly after I graduated from high school, with honors, and then flunked out of Boston University, I became suicidal. I didn’t understand there to be any good reason for me to go on living. I had on and off bouts of suicidal ideation, but I never tried to do it. I always felt a greater desire to live, even though life continued to feel pretty miserable.

What was missing from my early years was structure and help from my parents in understanding the basics of living. Everything was trial and error for me. My mother never missed a chance to punish me when I was wrong but never knew how to praise my successes which meant I did not know when I was doing something the right way or that if I made a little correction in my direction, things would work out really well. I don’t blame them though. No one had given them instructions on child rearing. They did they best the could and I loved them just as they were, although I had a strange way of showing it at times. The thing that hurt me the most is that I never as a child heard my mother tell me that she loved me, my father either. My mother could not even show love via a hug which is the one thing my father could do. I later years I learned that both my parents were broken, my mother being the worst by far.

As it turned out, my mother’s secrets became mine, even though at the time I was entirely unaware of them. But what I do not understand, to this day, is how every teacher I ever encountered never pick up on what a depressed kid I was. Or if they did, they did nothing.

I carried a heavy load of secrets into my adult life and those secrets nearly killed me. To mask the pain I felt, I drank to excess. I find it amazing that I did not start drinking in high school considering how miserable I almost always felt. I had all these secrets, none of which I was trying hide, and yet they remained hidden because I knew of no way to release them, there were no outlets available.
An inner strength kept me alive but not everyone has such strength. To many teens and young adults today have secrets they are unable to release. As a society it is our responsibility to find ways, attractive ways, for them to let go of those secrets and kill of the demons inside the before those demons rise up and kill them.

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Bring Mental Illness Out of the Closet


What is mental illness? “Mental illnesses are health conditions involving changes in thinking, emotion or behavior (or a combination of these). Mental illnesses are associated with distress and/or problems functioning in social, work or family activities.” (https://www.psychiatry.org/patients-families/what-is-mental-illness) This definition is what the American Psychiatric Association declares.

 
But mental illness has yet to gain full acceptance among the general population and, of course, insurance companies. People fear going to see a psychiatrist, psychologist or social worker because to the stigma attached. That is the thinking, but it is incorrect, and I will speak on it a bit later.

 
I suffered from depression for most of my childhood and adult life. Several times I had to be hospitalized because of it. This, of course, allows me insight into the disease. I venture to say that every person on earth has at one time or another suffered from mental illness. Many have not recognized it as such because they fully recovered in reasonable time.

 
When the words “mental illness” are proffered, people tend to go to the extreme and think the suffering person likely is schizophrenic or psychotic. But in truth, most mental illnesses are a much more benign form. Chief among these is depression. I think everyone struggles with a bout of depression at some point in their life, sometimes caused by death of a parent or friend, extraordinary stress in the work environment, or financial problems. These sorts of depression can be easily dealt with by short term therapy. And many times, without the necessity of medication.
But when depression causes a person to stop doing normal things for a long term, months, it is likely that the person will need a heavy dose of psycho-therapy combined with medication. Such depressions present in women after birth, post-partum depression, after the death of a child, after rape, incest, attack on the person’s life and so forth. And as funny as it may sound to hear, these depressions are rather normal reactions to traumas. Be assured, the road to recovery from these situations varies but is quite frequently long-term.

 
Then there are two psychiatric illness which most of the public fails to recognize as such: alcoholism and drug addiction. These diseases, however, are the outward manifestation of more serious illnesses. People frequently use alcohol to get rid of the fear they have when entering either a very stressful situation or a social situation. Alcohol does the job, quite well too. And since it works, the person uses it more and more both for the original reasons and then for other reasons their mind says that alcohol would be useful. This is generally referred to as self-medication. The problem, of course, it that the individual is failing to deal with the root problem. And by not dealing with those problems they, like most other illnesses, only get worse and require more “medication.” The person finally gets to the point when he is using alcohol daily because it makes him feel good, until is doesn’t. The, “until is doesn’t” happens when the person gets fired from a job, loses a spouse, becomes overwhelmingly in debt, and many other situations. It is basically the same for the drug addict.

 
It is important to recognize that these are not bad people who need to get good but are sick people who need to get well. But where? A person is declared in need of a detox but when the advocate, usually the person’s physician, calls around looking for a bed is such a facility they find there are no beds to be had. There, of course, are the detoxes where a person has to pay but most people cannot afford the out of pocket expense.
Alcoholics and addicts need a minimum of 90 days in a detox, but most detoxes push these people out after two weeks. Some, state run facilities, allow for longer stays. At the heart of these problems is the insurance companies which refuse to pay for more than a 2 week stay. The likelihood of a person staying clean and sober after a two-week stay is near zero.

 
There is a common theme here. Every one of the various types of mental illnesses I have brought up, the person involved has a feeling of not being worthy, feeling useless, of having something deep within themselves which feels so horrible that they feel shameful and cannot find it within themselves to share their deep dark secrets. And in the end, it is one of these deep dark secrets, their demons, that turns the person either suicidal or alcohol and/or drug dependent.

 
The bottom line is that we are doing a horrible job in helping these people. We must remove the stigmatism attached to mental illness. We must get all insurance companies to treat mental illness the same way they would treat any other illness. We must insure that there are sufficient facilities to deal with those who sick and suffering.

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How Many Americans Are Truly Unemployed?


During the years 1929 to 1935 as many of 25% of America’s able working public was unemployed.  How did they get that number?  Simple, if you did not have a regular full-time job, you were unemployed.

That, however, is not how we do it today.  Today’s figures are gathered entirely from America’s who are receiving an unemployment check.  It does not include the homeless, who were counted in 1933; the chronically unemployed, who also were counted in 1933; or farm workers, who were counted in 1933.  Why then, you ask, are we not counting those people now?  The simple, and most truthful answer, it is not convenient.  You see, if we did count those people we would have to acknowledge an unemployment rate of well about 15% and that, regardless of what they say, is something neither political party is prepared to cope with.

When John Glenn went into space the first time, the heat shield of his capsule malfunctioned and there was worry that he would burn-up upon re-entry into the atmosphere.  NASA leadership haggled over what to do when one of Glenn’s fellow astronauts told them that they had an obligation to inform Glenn of the condition of his ship, and that Glenn, being the outstanding pilot his was, would assist in the decisions that needed to be made.

The United States is owned by the people, not but 535 congressmen and senators.  The people have a guaranteed right to assist in decisions made for them.  That, however, is difficult to do when complete information is denied them.  The American people do not know the condition of their ship, although Congress probably does, or should.  They forget, it seems, that they are servants and not masters, although it seems they believe they are the latter.

The good ship United States is mired in a recession, the stubbornness of which is confounding, but the magnitude of which is being kept from the general public by those in whom is held the public trust.  A person who is chronically unemployed or who has quit looking is not necessarily unemployable.  But when their own government stops counting them then they are right to feel neglected by their own government.  Those people have not given up a single right to which they are entitled and which the Constitution gives them guarantee.  But their government, our government, through statistical trickery, has rendered them unworthy of its time.  Who, I ask, gave them permission to do so?

I recommend, and I know this will be wildly unpopular with my more conservative friends, that any person who is unemployed be given an unemployment check for however long that unemployment lasts.  Then we will be forced as a country to look at all our citizens, without exception, and deal with the entire problem and not just that portion of it that suits us.

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Fear, Panic Attacks, and Other Adventures


This morning I was reading one of James Patterson’s latest murder mysteries, “Kill Alex Cross.”  He is one of my favorite authors.  In the middle of reading something came to mind totally unrelated to what I was reading.  My mind seems to have that tendency, and I have never been able to explain it except to say, I am just a little weird.

Anyway, in the middle of reading I remembered being very sich when I was small.  I do not remember exactly how old I was at the time but I would guess I was no more than six or seven, but maybe younger.  I remember getting very sick, having a high temperature.  But I also remember hallucinating.  I would feel like my fingers had become very thick and that would scare me to death.  My mother used to say I drank too much cough medicine, Vicks Formula 44 which at the time had codeine in it, and that caused me to hallucinate.  I do not remember ever doing that but it is possible.  The thing is, I know for fact that the two incidents are not related because I remember waking up sick in the middle of the night and then hallucinating.

Many years later, when I was in the army in Italy, I would drink a lot at parties I gave.  One day a guy told me I could get a great high out of taking too many sea sick pills.  One day when I did that in the middle of speeding my brains out I got extremely paranoid and had a panic attack.  I was fortunate that at the party there was a physician who examined me and talked me down.  He told me to see him the next day, which I did, at which time he made me promise him that I would never again take those pills.  I kept my promise.  It was his duty to report me to my commanding officer, which he did not do, and I knew better than to abuse his gift.  That was the last time I ever did such a thing.

Again, years later, I had another panic attack.  And a year after that another, and then they started coming with increased regularity.  In the early 1980s medicine was not well equipped to deal with anxiety and panic.  They prescribed Valium, and then when it came into being, xanax.  Unfortunately those medicines only treat the symptoms and not the cause.  I went through a series of antidepressants that were also supposed to deal with anxiety.  First there was Trofanil, then an MAOI, then Welbutron, Prozac, and now Effexor.   The Effexorf, while seemingly very effective, has totally killed off a very important side of the human experience.  The ability to have anything close to a normal sex life is an impossibility.  The libido is strong but the body refuses.

The panic attacks actually disappeared entirely for well over a decade only to re-emerge with a vengeance.  I return to therapy to deal with them but it was ineffective.  The therapist commended me on my total honesty with her but conceded that we had reached a point where continued therapy was of very limited value.  But the anxiety and panic have not yet gone away.

Through many years of introspection I have discovered that most of my fears, if not all, are based in one of two things.  First, my hiding things that greatly embarrass me causes distress.  That part I have entirely dealt with having related every single thing I have ever done that causes me pain.  The other part is talking about those things that scare me.  Intellectually I know that fear happens in the absence of knowledge and I have done my best to become knowledgeable about all things that scare me.  For example, as a child I had an intense fear of the dark which followed me into my adult life.  I have to admit that there is still some of that today but it is far less than it once was.

I am a bit clautrophobic although elevators I find to be particularly troubling.  But that is the only fear I am aware of that I still have these days.  And yet, I still have anxiety attacks, often, and panic attacks occasionally.  Such things are always fear based and yet I cannot get to the base of what is triggering me.  I am frustrated!  I never know when an anxiety attack begins if it will end in a panic attack.  That means my prognosis, barring my discovering what is at the base of all this, is I will live out my years forever fending against the next anxiety attack, the next panic attack.

Ironically, I think of my life these days as generally being really good.  I am never depressed nor do I go a day without feeling grateful for so many things and people in my life.  I know I am not alone it this struggle although sometimes it feels that way.  Even though I am always entirely honest with my psychiatrist, I feel resistance from her in helping me with proper levels of medication.  But even so, there are other physicians, friends who are physicians, who I can rely upon to give me really good advice.