I’m Still Here

To borrow a rather brilliant title from what is sure to be a rather horrendous mocumentary, “I’m Still Here.”  I know you’ve been missing me terribly!

I’ve made no secret of the fact that I have struggled with clinical depression in my lifetime and as many of you probably know, anxiety, in one form or another is often the evil handmaiden of depression (as if Depression on its own isn’t evil enough.)  I have been no exception to that rule.  Pretty early into my relationship with Deb, my therapist (like, probably 5 minutes in) she “diagnosed” me with Social Phobia.

For some reason this frequently comes as a surprise to people, but I’m actually quite shy.  In person, anyway, I am very uncomfortable meeting new people, or putting myself in situations where I’m going to have to meet and interact with strangers, and even though intellectually, I know I shouldn’t worry about what people think of me there’s still that small, insecure, child-voice in the back of my head that remembers every tease and taunt and abuse I suffered at the hands of other, cruel, children as I was growing up and fears experiencing more of the same.

Deb also diagnosed me, to a much lesser degree, with generalized anxiety disorder.  It’s nothing major.  In fact, for the most part I think of it as buzzwords that loosely translate to “I don’t like the unknown!!!”

Who does?

Honestly, I am most aware of anxiety in the car, as I drive to my therapy appointments.  I don’t know what I’m going to talk about (which is actually a better way to go in, even if it doesn’t feel like it) and therefore I don’t know what our 50 minutes holds and it makes me anxious.  I feel a sense of needing to “do it right” even though there supposedly is no right or wrong way to do it and I worry that I’ll get it wrong and that it will be bad.

I occasionally realize, especially when I’m deep in thought, that I’ve not taken a breath in a while.  Quite literally, I forget to breathe.  My mind mulls over the situation, sometimes a very stressful thing, and I start to feel cramps in my stomach, both a feeling nausea and the potential on-set of diarrhea, and only as I feel a sense of panic start to come over me do I realize, “oh hey! I haven’t inhaled recently.”  A couple of deliberate, deep breaths, and the cramping starts to subside, the nausea disappears and the need to rush to the toilet subsides.  And then I continue to mull over whatever I’m mulling and I forget to breathe again and the whole cycle repeats itself.

Now, let’s be fair.  I’ve learned a lot in my… five(?) years of therapy and the anxiety, both social and generalized, has lessened quite a bit (though, sadly, not been completely dispensed with.)  I know what the physical symptoms mean, and I know that, usually, a few deep breaths will go a long way to remedy them.  Sometimes that’s enough to do away with the anxiety and sometimes it’s just enough to make me aware that it’s happening and to try to manage it as best I can.  (By the way, I’ve had to remind myself to breath, no fewer than 12 times just as I’ve written this much of this post.  Almost a “chewing gum and walking” effect.  I can’t seem to breath and type at the same time, right now.  I realize I’m not breathing, I have to stop typing so I can focus my energy on taking a deep breath.  There’s a reason for this.)

Up until recently, I’ve felt like I had a much better handle on these feelings.

~~~~~~~

When I decided to take this EMT class, I knew I was signing up for a lot of work.  I knew it wouldn’t be a cake walk and that I’d have to put a lot of time and energy into it.  I had no idea how much time and energy it would require.  We have to cover three chapters of textbook a week and we have tests over each chapter each week.  THREE TESTS!!  These chapters are anywhere from 40 to 70 pages long and they’re filled with information that is important and needs to be retained and remembered.

My instructor goes out of his way to be an asshole and his general attitude and demeanor are very difficult for me to tolerate.  He’s not friendly, or kind, or supportive.  He’s determined to make the class as uncomfortable and unwelcoming as possible.  He’s doing it on purpose because the job is a high stress job and he thinks he’s preparing us for it by doing things this way, he has said so, more than once.  He might even be right and I understand that way of thinking.  But on the other hand, wouldn’t it be better to make the class as conducive to learning as possible so that we can know our stuff and then when we get out in the field we can focus solely on dealing with the stress, because we’ll have the knowledge down?

The class is very disorganized.  We have the tests first thing Monday night, usually and then if there’s time and he has his act together (which he frequently doesn’t) he’ll lecture, but there’s never time to do lecture on all three chapters that we’ll be testing over the following Monday night, so it really does depend on the reading.  Wednesday nights are supposed to be about Skills.  We break up into groups and he assigns each group to one of the volunteers from the last class who go over the skills with us, which is all well and good, except they’re not experts and as likely as not, they’re not getting it completely right anyway, and then when we demonstrate what we’ve learned for one of the two instructors we get called out for doing it wrong and made to feel stupid when in fact we demonstrated it exactly the way the volunteer had shown us, (for example, using a pediatric non-rebreathing mask on an adult sized mannequin – thanks for that, volunteer whose name I can’t remember!)

So every Monday we have three tests, one over each of three chapters that we’re supposed to read and learn and then we have not very good lecture over the materials in one (maybe two) of the next chapters.  Wednesday we go over skills and are constantly reminded that there’s going to come a time – though I’m not at all clear about when that is – when we will have to actually test over these skills and if we don’t get them right on the first or second try (except for airway at which we only get one shot) then he will kick us out of the class.

The purpose of this class is not to qualify me to get a job as an EMT if that’s what I decide I want to do.  The purpose of this class is to qualify me to take a National Registry exam to become licensed as an EMT.  As if the stress of this class weren’t enough, there is then additional stress about when and whether I’ll take and pass the written and demonstrative portions of the National Registry exam.

I’ve heard conflicting reports about what the pay for an EMT is.  Some reports have it as low as $16.00 an hour while others have it at $60K a year.  If I decided to pursue a job as an EMT that means a cut in pay, but how much of one is still up in the air.  And while I decided to take this class first and foremost because I wanted to know the information, the more time and energy I spend on it, the more I think it might be the direction I want to go and if I go through all this and then can’t make the career change, then what has been the point?  (I do recognize that this is not entirely rational thinking, but it’s still among the thoughts that are going through my head.)

I spend hours and hours and hours reading my textbook and highlighting information (I’ve completely drained three highlighters, which either means I’m highlighting too much (likely) or there’s a lot of important information that needs to be marked.)  I spend at least two hours a day at work, most days, reading or working in the work book.  I have hardly watched any television at all in the last three weeks and once I finish preparing food for the next day (or on the nights before a class, the next two days), cooked and eaten dinner, I spend a couple of hours at night reading and have been staying up way too late.

I read and read and read, and then when I’m finished with a chapter, I go through the review materials in the back of the chapter, I go over the sample questions on the last page (to which I have found no answer key, so I have no idea if my answers are correct or not.)

Then I break out the work book which does not get turned in, but is purely for my own study purposes.  I go through the materials in the work book, anywhere from three to twelve pages and then check my answers in the back.  I usually do pretty well on the mix and match, multiple choice and true and false sections, though not as well as I feel like I should be doing.  But the critical thinking sections are harder.  And the written answer questions are —  I don’t even know how to explain it.  I read the answers they give in the back and I realize it made sense and I remember all the information from when I was reading…  But I couldn’t formulate it into an answer on my own…  I don’t know what that means for my ability to make use of the information in the real world.

And then as if that weren’t enough, I download the three chapters of the book I’m working with to iTunes and then into my iPhone and I listen to them. ALL. THE. TIME.  I listen when I’m working.  I listen while I’m driving.  I listen while I’m grocery shopping.  I listen while I’m preparing food. AND I LISTEN IN MY SLEEP.  All in the hopes of retaining most of the pertinent information.  I never feel like I am.  I never feel like I know this stuff backwards and forwards and every Monday I walk into class worried that I am not going to pass the tests we have to take that day.

When I’m reading, I stress because I don’t feel like I’m getting it and I think about all the other things in my life that I’m not getting done and then I realize that my mind is wandering so I have to stop and go back to the last thing I remember reading and start over.  (By the way, I read out loud to help focus my attention on the text.  How can I read out loud, say the words, and not be thinking about them at all?  Doesn’t seem like that should be possible.  But apparently it is.)

When I’m not reading, like right now, I feel guilty, like I should be and that if I don’t get to it, I might not finish reading in time and it stresses me out.

I worry that I’m not reading enough.

I worry that I’m not learning what I’m reading.

I worry that I’m not going to pass the tests.

I worry that I’m not getting the practice I need to learn the skills.

I worry that I will learn the skills and still bomb the test, even if only out of stress and fear.

I worry that I’m not equipped to handle what’s coming when we get into the trauma portion of the materials (I don’t have a great track record with pictures of graphic things.  I don’t get sick or throw up, though that might be better.  But in my lifetime I have passed out as a result of looking at pictures or reenactments of serious injuries and I worry that this will be a problem now.)

I worry that I won’t make a good impression, or be able to handle myself, when I have to go on a ride-along later in the semester.

I worry that I won’t make it far enough in the class to have the opportunity to go on the ride-along.

I worry that I won’t be able to pass the National Registry Exam.

I worry that I won’t be able to make a good impression on a hiring manager when I start looking for a job.

I worry that I won’t be able to find something that I want to do with this new knowledge and skill.

I worry that I will get a job, only to find out that I can’t live on the salary, or that I can’t handle the working conditions or the hours or the stress.

I worry that I’ll get to the end of all this and realize that it’s not for me and feel like I’ve wasted my time and energy.

I worry about all of this, ALL of the time and I can’t shut my brain up and focus solely on what’s in front of me, the learning.

I’ve been crampy and nauseated and diarrhea-y for three weeks (you’re welcome.)  And as I was driving over to my therapy appointment on Tuesday and feeling all those things, plus the not at all unusual anxiety of “what am I going to talk about today?”, I suddenly reached the very rational realization that, “Hello!  I’ve been feeling so crappy and stressed out because I’ve been living at a heightened state of anxiety since the class began.”

So I asked Deb about Anti-Anxiety medication.  Deb is a Licensed Clinical Social Worker (what that means exactly I don’t know) so she is knowledgable, but not expert about medication.  It also means she can not prescribe anything.  She told me what she knows, and helped me to eliminate some specific possibilities (I can not go on a benzodiazepine – Valium, Xanex – because they’re too “stoney” and I wouldn’t be able to function, or retain information while taking them.)  But there are some other possibilities and she suggested it might not be a bad idea to talk to my psychiatrist about it.  Honestly, I’m a little reluctant because after five and half years on antidepressants and feeling dependant on them (I’ve now been off them for about 22 months) I don’t want to rely upon more pills to regulate my life.  On the other hand, I’ve never been under this much pressure before and if it’s a temporary situation with a temporary solution, maybe I can work with that.

I contacted the Psychiatrist that I last saw at my healthcare provider and he informed me that because he hadn’t seen me in over 2 years, I had to start fresh with the intake process, which is funny because when it was all said and done, I still ended up with an appointment with him. BUT, the earliest appointment I could get is on Friday, September 17th.  What’s wrong with this picture?

I was actually going to end this post right there, because, I at least, think that’s funny, and I like to end my posts with a humorous note.  However it seems like a good idea to add a little bit of a reality check to this as well…

Up until now, we have taken our tests in groups.  Each week, we split up into our little work groups and we get one copy of the test and put all our names on one answer sheet and submit the one answer sheet with our “collectively arrived upon answers”.  Starting next week we will take our tests as individuals and it will be every man for himself.  (Don’t think I haven’t worried about that too.)  But here’s the reality:

1) I have not once, so far, been unable to finish the reading before Monday night’s class.  (I was going to add some “but”s and some qualifiers, but let’s just leave it at that.  Reading gets done in time.)

2) Somehow I became the default test-reader-out-louder-guy, possibly because I am able to speak clearly and rapidly and buzz through the test at a rapid pace, or possibly because I felt the need to take control and feel like we were doing everything we could to get through the test in the time allotted.  I usually read the question out and then select the answer I think is right.   I told my group-mates, “I’m going to just do this, if you think I’m answering wrong, speak up.”  They were all OK with that, and hardly, if ever, disagreed with my selection.  Either I actually do know the stuff when I need to, or they’re completely clueless and allowing me to lead them down the wrong path, except…

3) We finished our three tests last night (yes it was Wednesday but there was no class on Monday for the holiday) in record time.  We were completely finished more than half an hour before the other five groups.  I started to worry that maybe that meant something bad and just as I was verbalizing that to my group-mates the instructor asked, from across the room, “Are you guys done already?”  We confirmed that we had and he made some sort of comment designed to shake our nerve.  But then the Teaching Assistant spoke up and said, “No, they’re actually doing really well.”  He had already graded our three tests and knew our results.  I asked him, “We did well tonight, or we’re doing well over-all?” We haven’t gotten anything back, or any way of knowing our grades to date.  The TA glanced back at the computer screen and said, “Well, everybody did badly on Chapter 5” (chapter 5 was vitals, so, you know, that’s bad) “but over-all you guys are doing well.”

As of last night, we have an 88% in the class.  Naturally, an A would be preferable but I was a C average student in high school; I will not be complaining about an 88%!

I know all the real, rational facts about this situation.  I have a job that I’m not in danger of losing and that pays a decent salary.  If I fail (or get kicked out of) this class, I can take it again next semester (at a different school where this instructor isn’t teaching).  I’m probably not going to fail or get kicked out and I’ll do OK on the materials and testing and the certification.  I own the textbook so I can review whenever, however often and for however long I want and I can learn this stuff inside and out, at my own pace without all the pressure, once this class is over.  Time and experience and exposure will over-power any anxiety about the job and the injuries I might witness and eventually, it’ll become second nature to me, just like my job today became second nature to me.

It would be nice to think that having this rational knowledge would help to alleviate the anxiety, but you know what?  It doesn’t! Not one iota!

I sure do hope the psychiatrist can give me something to help!