Assertiveness, something I need to learn a little more about.

Many people in my life, especially when I was younger (mostly friends) told me I need to be more assertive. I have learned to be a little more assertive, but I just started reading a book called Your Perfect Right: Assertiveness and Equality in Your Life and Relationships (Eighth Edition)

So far I really like it and the approach the book takes. Here's a quote from the opening chapter:

" Changing yourself is challenging, and not easy, but you can do it, and we'll show you how. This book offers you a proven step-by-step method - assertiveness training - for improving your relationships with others. If you'll follow it, we're confident it can work for you. Millions of folks have learned to express themselves more effectively and achieve more of their life goals using these procedures.

If you're looking for lessons in how to manipulate others, you're reading the wrong book. We believe there's too much of that in the world already."

The book is in the 8th edition, has become a bestseller and is used by many companies and therapists, I'm eager to finish the book and see if I've got what it takes to follow through on what they offer.

Panic Disorder Patients Lack Emotion-Regulating Protein

Link: Panic Disorder Patients Lack Emotion-Regulating Protein

Three brain areas of panic disorder patients are lacking in a key component of a chemical messenger system that regulates emotion, researchers at the NIH’s National Institute of Mental Health (NIMH) have discovered. Brain scans revealed that a type of serotonin receptor is reduced by nearly a third in three structures straddling the center of the brain. The finding is the first in living humans to show that the receptor, which is pivotal to the action of widely prescribed anti-anxiety medications, may be abnormal in the disorder, and may help to explain how genes might influence vulnerability. Drs. Alexander Neumeister and Wayne Drevets, NIMH Mood and Anxiety Disorders Program, and colleagues, report on their findings in the January 21, 2004 Journal of Neuroscience.

There's also some interesting pictures here, helps explain why I think a combination of a MRI and a PET or SPECT scan together would give the best overall picture, but alas that would cost me almost ten grand :(

In a better mood

Well, the day started off with high anxiety, felt like I had too much to do with too little sleep. While I was waiting in the lobby for my group session to start, I even asked if I could sit in a private room because I was feeling panicky.

But the group session started right then, and it turned out to be a pretty good one, we talked about how we sometimes feel hopeless and what we do to overcome that and things like that. There's another guy in the session who sounds a lot like me, where I was about two years ago.

When I got home, someone from the Midwest Center for Stress and Anxiety gave me a call regarding my questions about personal coaching. They have an excellent cassette tape/workbook system and online support forum, and they have this personal coaching thing that takes it a step further, but of course costs more, but they are very good at working out any kind of payment plan that might work for me, their goal is to get people better, not take their cash, and they have a money back guarantee as well. I'm pretty interested in doing this, it'll probably take a month to see whether it's feasible with my budget. I don't think it will be the end-all cure, but I do think it will really help my attitude, but as with all things I'll get out of it what I put into it. The coaching lasts for three months.

What got me so upset...

Well, as you can see from my previous post I was pretty darn upset. The mess people have to go through regarding insurance and what not is right up there with telemarketers for me. Basically, I went to the new doctor yesterday, the one that's approved enough to be able to give me the referral for the MRI. Well, I sat in the crowded lobby for two hours, having major panic attacks the whole time waiting for the doctor. Then they charge me 95 dollars because I have insurance, for a two-minute meeting with the doctor. Basically he told me that with the type of insurance I have, they have to pull teeth just to get a simple urinalysis done, getting approved for an MRI despite how much evidence they come up with is somewhere between slim and none, and if I really want to get a scan my best option is to pick a clinic that does the scan I want and just pay out of pocket, avoid all the hassle, and get the care I want, and maybe work out a payment plan.

Well, that's just what I've been preaching to people for the past five years, if you want medical care, pay for it yourself as a cash patient, you'll have much more freedom, the doctor's will give you a discount, and your quality of life will improve dramatically when you get rid of the headaches of insurance.

So, I'm going to look into ways of getting these tests done on my own, I've got a few clinics I can call which I think will be willing to work out a payment plan with me.

Take your healthcare system and shove it

Screw the healthcare system and shove it up your ass. I'm done with it. Period, end of story. If I want medical services, I'll pay cash, and forget I even have a damn card. Even if it means some day I'll need it to save my life, I'll choose death, thank you very much. I'm done with all the years of struggling through the bureaucratic bullshit for no gain.

Response to previous post.

In response to my previous post, I'm copying and pasting something I posted on the Midwest Center's Attacking Anxiety online support forum, a program I highly recommend.

Hi, my name is Dave, and I am a negative thinker.

Hehe sorry, I guess that's just kind of a poor humor coming from the depression I'm in.

I'm in deep depression, for the past two days. Big time negative dialog.

Do I know better? Yes, by now, I definitely know better. I know how to replace the negative dialog with compassionate self dialog.

But... I don't want to. I think many of you know why, it's the old "old habits die hard" thing. Negative dialog is in its own way a comfort zone.

I really feel like I need someone to kick me in the butt to go back and listen to the tape on compassionate self dialog. Maybe if you guys flood my email inbox that'll be a kick in the butt hehehe. But, then the negative dialog is telling me that that is placing the responsiblity on others and not myself, where it should be... argh. I think too much. Way too much, I'm one of those people that can rationalize anything.

I've beaten negative thinking, at least for a while, more than a few times, I know I could do it again.

But my depression right now is real deep, about the whole human condition, the whole thing about what's the point? The kind of depression where all of those things like sunsets and beatiful forests and good friendships, when I think of or see those things, I only see the negative and not the positive.

Well, I guess I'm just talking out loud.. well, er writing anyways hehe. I know what I'm supposed to do, I just felt the need to say it here.

p.s., just a quick reply... since I've learned earlier that I have to first monitor my thoughts.. oh let me back up a second.

After posting the above, I kicked myself in the butt, went to my bookshelf and pulled out the book on lesson three (I guess I should have posted this in that forum) and the first thing I read was the page on Examples Of Negative and Postive Statements.

The first one was:

Neagtive: "I feel so dependent and afraid. Will I ever be normal again?"

Positive: "Feeling this way is just part of this condition. I am working on getting over this and I will feel "normal" again."

My immediate though after reading this was "I don't want to be normal". "When I look at "normal" emotionaly healthy people, I still don't want to be normal".

So... as I'm writing this, I just thought of a postive response to that negative thinking.

"But I do want to be ME. I have something special, something many people have seen in me and sought out in me. I am special, and what I really want is to just be ME. Due to my condition, it is difficult to be ME with ease, but I must continue to be patient, to allow myself to smile, and when I see a spark of "ME" to let it shine."

Depression city

I'm feeling pretty under the weather for the past couple days, and very depressed. It seems like I'm just depressed about the whole human condition. I've been having a lot of negative inner dialog, with little desire to change things. I find myself thinking "What's the point?" a lot lately.

My joints are feeling pretty achy, perhaps I have a cold. I've been sleeping a lot, tired all the time, although wishing I couldn't sleep because I seem to always have bad dreams... not nightmares, just not good ones. I am once again missing the ability to have lucid dream control that I had in my teens, but I don't seem to be able to muster up the energy to try and re-teach myself how to do that. It seems tied to the same reasons that I don't want to take care of myself or my hygeine.

I have a busy week for me, and I can already hear the negative thinking, setting myself up to make simple things hard. I see my therapist tomorrow, and I see my new insurance-approved doctor the next day to try and get approval for my MRI. I also have to go to the DMV and find out how much they are going to rip me off for new tags for my license plates. And there's a bunch of other little errands I have to do, but I'm dreading them, I'm dreading the driving, dreading the knowing that I'll be dead tired during the times that I have to do these things.

I'm still not exercising as much as I should, but I am taking my vitamins and supplements like I used to, but they don't seem to help as much as they once did, but I've only been taking them for about a week.

Bad dreams

I've been having bad dreams... well the dreams themselves aren't all that bad, it's the feeling that I get when I wake up from them that's bad. I've been dreaming of old friends, lost aquiantences, etc., and when I awake I'm left with a depression, a loneliness, and a feeling that I have dissapointed those people.

It takes a few hours, as usual to get over these feelings. Thinking about it now, it seems obvious I should look back and tell myself about all the accomplishments I have achieved in the past.

I'm still, as always, having some trouble doing the little things, like taking care of my own hygeine and such, I really need to clean my room, take a shower and put on a clean set of clothes, and go for a walk for some exercise, but I don't feel like it.

At least I found a way to scrounge up some money to get a month's worth of my vitamins and supplements, that should help me feel physically better, and should help to ward off the winter colds.

Argh... insurance problems again

If it's not one thing it's another with insurance. I found out that none of the doctors at my clinic accept my insurance, whatsoever, even though they had told me before I got the insurance that they would accept it. I also found out that only MRIs and no other types of brain scans (except CAT scans, which are inferior to MRIs) are covered, they are considered "experimental medicine" or something. And, to get an MRI, I need a referral, and since my psychiatrist doesn't take my insurance, his referral won't count, and my regular physician doesn't take my insurance either, so I'm scrambling to find a doctor who will accept my insurance. I finally found one, but their computers were down so they couldn't make any appointments. Really frustrates me, since I've been working with my doctors as a cash patient for over a year now and have developed a relationship with them, and now I have to start over with a new regular doctor and transfer records and all that and hope he will give the referral that my psychiatrist otherwise would give.

I'm really about at the point were I just want to stop seeing doctors and therapists all together, stop taking meds, and just give up on the whole health care system and deal with this myself. It would be a lot cheaper and I could get rid of dealing with all this bureaucratic BS. Ugh! I just want to rant about it I'm so frustrated.

My psychiatrist is convinced I'm not developing Parkinson's, he just said "I can look at you and know you're not developing it", he wasn't willing to investigate or consider it any further. He just said it might happen in my fifties. But he did recommended the movie "Awakenings" which my friend who has Parkinson's also recommended. I can't find it anywhere to rent so I'll probably buy it from the link I just made.

He also said that if I take any medication for ADHD it will just make my anxiety worse.

I'm sure there's some other things I wanted to write, but I'm too ticked off right now to think of them.

Not much of a night out

I went to the open mic night at Border's, but I never came up with anything to use, so I just sat in the audience. The friends I had met last time I was there showed up as promised, we sat together for the first few performances, then they said they were going to move to a back seat because they were talking loud to each other and didn't want to disrupt the show. After that, I didn't see them again. I was hoping we'd get a chance to kick back and chat after the show, but so much for that.

As usual, the whole time I kept thinking of things I could perform, wishing I could go up there and perform... but I couldn't come up with any material, and I don't have a bass guitar any more, I sold that seven years or so ago to help pay for college, so I'm obviously way out of practice. I was frustrated by all this, but at least I was able to enjoy the performances. Heck, if nothing else it gave me a good reason to throw on some clean clothes and shave and stuff.

I hate this feeling of being inspired, inspired to perform, but having nothing to do with that inspiration. Sometimes I'll try writing something, but it just doesn't feel right. I feel inspired to express something, but it's like I'm unable to express that in a way that could be performed.

I wish I could just "let go" like so many people say I should.

another day in the life of anxiety

Well, I woke up late as usual, and my anxiety started because I knew I woke up too late to go grocery shopping before my group therapy session.

I had some anxiety about going to my group session, my second with this small group, because I wasn't sure it would be productive, I didn't feel I had much to talk about and I had doubts about my ability to give advice to the others in the group. I decided to walk to the clinic, listening to my MP3s, I needed a little exercise since I've really been neglecting that lately.

As soon as I got home, my aunt and I had to go right out to get groceries, go to the drugstore and the office supply store. This made me even more anxious, I didn't feel like driving to all these places and I knew spending all that time shopping is really hard for me, and I also knew that that would mean I would be back late to take my medicine.

But, I made it through without having to stop and tell my aunt that we had to leave the store right now because I'm having a panic attack. We had briefly mentioned breathing techniques in group therapy, and how easy it is to forget to use things like that while one is going through bad anxiety or a panic attack, but I was able to remind myself, so I stopped for a moment in each aisle of the store and took a deep long breath and let it out and relaxed my muscles a little bit. That was just enough to get me through it. The anxiety was still there, but I held off a full panic attack.

I picked up some calcium and iron supplements while at the drug store, I think I need them but I'll run them by my doctor to see what he says about that.

Right now, after having finished dinner, I'm fighting with the anxiety to write this post and respond to emails, it's not like it's a big deal, but with my anxiety those little things feel like a lot of pressure, and I feel like I'm rushing through, like I have to get this done right away and I can't stop to relax until I get it done.

OK, there, I just took my own advice and paused for a moment to do a little breathing, that's better. I have to try and not let molehills turn into mountains, and tell myself it's OK to relax while doing tasks and that I don't need to be in such a hurry as I think I do. I've observed myself today having a lot of negative thinking and having to turn those negative thoughts away.

Tomorrow night I'm going back out to Border's book store for their open mic night, a friend is going to play the flute. I kind of promised that I would come up with something like a poem or whatever to do for the open mic, but I haven't gotten any inspiration or ideas, and I feel like I haven't had the time to come with something, which brings with it a little feeling of guilt that I didn't accomplish it. With any luck, maybe something will come up in the next 24 hours that I can use.

ADHD

I met with my therapist today and we went over the results from the first "check the box" test I did for ADHD, and I scored moderate to severe in most of the categories. He mentioned that he thinks it's possible that meds for ADHD might work better than the benzos I'm on, but he's not a doctor so he can't say for sure, I'll have to talk to my psychiatrist about it when I see him next week.

Meanwhile, my uncle is in the hospital after being hit by a car, we're all anxiously waiting to hear how he's doing, he lives on the other side of the country and has other health complications, we all wish we could be there to help, I hope he pulls through just fine, I really enjoy all the times I've gotten to spend with him, he's really smart and we can talk for a long time about a lot of interesting things.

When I got the call that he was in the hospital last night I was just settling in for the night, for a moment I was a little frustrated that I had to get back up and dressed, but then I became very alert and my mind cleared. That's something I've noticed about my disorder, and some others I have spoken to say they've noticed the same thing happen to them... that is, my anxiety is high pretty much all the time, and little things make it worse, but when I'm in a life or death situation or something similar, suddenly the anxiety and panic are gone, my mind clears, I become more observant, and I react calmly and confidently. Pretty much the opposite of "normal" people.

Ah, finally a good night's sleep :)

Well, my anxiety has been really high the past few days, my muscles and joints had become really sore from all the tension, and it's been really difficult to do my relaxation techniques, but finally last night I was able to fall asleep at 10pm and sleep right through to 6am... I haven't done that in a very long time! So, I feel a lot better today.

It's the new year

Well it's the new year... and my resolution is... nothing! Just to not set my expectations, to roll with the punches, and not pretend like I can predict the future.

I saw a clip of the fireworks in Sydney, Australia, boy do they know how to put on a show.

I'm trying to use compassionate self dialog as usual to keep my emotions in balance. I've had some curve balls thrown at me again with regards to my medical benefits, it's like every time I think I've got it kind of sorted out there's some new wrinkle to smooth out or I find out I don't have as much coverage as I thought I did... but I'm trying to roll with the punches, turn negatives into positives. Like when I never got my HMO card, and I called them to find out why, and they told me I'm not qualified for an HMO.. after I had spent a long time talking with people and filling out forms and assurances that I would get my card soon... but I turned that negative into a postive, by not having an HMO, I'm not bound by having to get referals to my doctors, should be less hassle, and the HMO doesn't cover mental health services, anyway, so good riddance to them! :)
(Of course, it wasn't quite that easy, they really ticked me off, but I'm over it)

Now the trick I'm trying to figure out is which of my medicines is covered under my plan, which aren't, so I can plan my budget, I'm going to call the clinic and the pharmacy tomorrow and try to get that sorted out, then in another week and a half I'll see my psychiatrist and maybe we can figure out what testing options are covered.