After my doctor signed off on my physical, he recommended I see the on-site psychiatrist to determine what my course of treatment for Generalized Anxiety Disorder should be.
The psychiatrist was an American Asian woman in her early forties with deep black hair and poorly applied soft red lipstick. Since I was a makeup artist, I immediately guessed that she had probably forgotten to fix it up after lunch. Or maybe she’d recently been kissed sloppily. Generally speaking, when I meet with a professional for their intellectually-based services, I do not care what they look like at all. But the exception, if any, is that they should be reasonably groomed and present a professional appearance.
One of my Department Managers in the store was a sad, middle-aged American white man who very clearly washed his suit pants with his regular laundry. He either sent out his jackets for dry cleaning or did not have them cleaned, but anyway, his pants were all a few shades lighter than his jackets. This glimpse into his personal life, along with his overall ineptitude for managing personalities, made it even more difficult for me to respect his authority. That may not be fair, but it was unavoidable. It was that much stranger because he was pretty steadfast about his appearance. He would never call me into a meeting with his shirt untucked, so the faded pants were just another weird quirk about him.
Upon closer examination of the psychiatrist’s lipstick, I saw that it was not fatigued in the way I’d expect from recently eating a sandwich or kissing someone. It was just ill-delivered. Shaky hands, maybe? Bad vision? Whatever it was, that was the least of it. I also noticed she had a custom mouse pad featuring a photo of herself in a celebrity-sighting type of posture with Rick Springfield. Then I also saw a couple of small, framed pictures of him performing in concert.
This is nothing against Rick Springfield in particular. I’m sure he’s a great guy and I enjoyed him on Season 3 of Showtime’s Californication, which would actually air about five months after this meeting with the psychiatrist (2009) – but I probably didn’t see it until about a year later when it came out on DVD.
Anyway, this psychiatrist with odd lipstick application and several pictures of Rick Springfield in her office spoke to me for about twenty minutes. It felt like one of those job interviews for something so shitty that they’re really just checking to see if you’ll show up. Like dog turd inspector, or something. Although, if you’re inspecting dog turds for some scientific purpose, you probably need an advanced degree and grant money that allows you to live a fairly comfortable existence. Good work, if you can get it.
So she suggested I go on a low dose schedule of anti-depressants. I told her I’m not depressed. “It’ll make you feel better,” she said.
“Listen,” I said. “I don’t want to feel better artificially. I have experience with chemical dependence and addiction and I’m not looking for anything like that. And what’s up with all these pictures of Rick Springfield?”
From what I thought I knew about the intersection of the pharmaceutical industry and some medical practitioners – and what I firmly believe now – this felt more to me like a sales pitch than a clinical evaluation.
She closed her eyes and then opened them slowly. “We can talk about Ricky after the session,” she said. “The idea behind anti-depressants is that you take it once and day and you don’t associate them with treating your anxiety, so you don’t develop a habit.” She smiled and shrugged.
“Taking something every day sounds like a habit to me,” I said.
“It just lowers your body’s ability to react so intensely. But, if you don’t want to pursue that kind of treatment, you don’t have to. There are other approaches. You can see a therapist and attend cognitive behavioral therapy groups.”
“Great, I’ll do that.”
She looked up a therapist in the system, saying that some were better than others. The one she recommended had an opening to see a new client in about six weeks. Until then, I had the prescription of Diazepam (generic Valium) from my visit to the Emergency Room last week.
And she also explained that Rick Springfield is just an amazing person and performer and she has seen him dozens of times and he has a lot more to offer the world than “Jesse’s Girl.” That’s when I realized that the framed photos of him were clearly taken from the crowd during a show, dead center, close up, expensive seats if he still played shows like that. Okay, so I know reasonable people can sometimes have what seems like outlandish celebrity crushes, but I don’t want to entrust my psychological well-being to them, thanks.
I went to the store and bought a plastic pill container and put one pill into it, just in case. For emergencies only. I did not want to rely on drugs to treat my anxiety disorder, because I did not (and do not) believe that benzos are an effective long-term solution — nor did I want to go down the SSRI rabbit hole. Then I went home and told Magnolia about my treatment approach and timeline. I could not start the CBT classes until I met with the therapist, and that would be in a month and a half.
When I quit smoking weed about seven years earlier, I had a smaller, but significant, panic attack. It was a week after I’d stopped smoking every day, usually all day. I was eating a burrito and I was so freaked out that I left the house and went to the movies to chill myself out. That worked after about an hour. I concluded from that experience that my moods and emotions were directly matched to my smoking regimen, and the highs and lows – including anxiety – were obviously mapped onto when I’d smoked last and when I was going to smoke next. That’s probably obvious to an outside observer, but experiencing it, understanding that emotional highs and lows (including pronounced anxiety) could be so random, that was something of a revelation. But I did not understand it to be symptomatic of Generalized Anxiety Disorder.
I did not think that I’d been self-medicating that whole time. I did believe that since then, I’d been adrift without some kind of crutch; a chemical mood stabilizer would be convenient. However, addiction was unpleasant and I’d rather find something more natural. You often hear that activity is the antithesis to anxiety, and to me there’s no better activity than sex for that. Or maybe gardening, but gardening is a lot more complicated. Writing requires too much mental acuity and physical idleness. Walking around a strange city or kayaking are probably good, too.
My anxiety tends to come on mostly when I’m alone and idle. Sex is both social and immediate, physical, mental, and emotional. It requires attention to the present moment, and can be tiring, so the natural state of relaxation after sex is a great reducer of anxiety. And it provides natural chemical rewards like dopamine and oxytocin.
I’ve spent more time, energy, and pixels musing over the demise of my relationship with Magnolia than I’d care to claim, and I’d rather not add to it or revisit the details much. But I will offer the following tidbits for clarity and intrigue.
On our second date, Magnolia told me she’d been molested by her maternal grandfather when she was twelve, and then, in his advanced years of senility a decade later, he thought she was a boy. Then she laughed it off and said she took his pencil box after he died and now she kept condoms in it. Her father also savagely beat her and her brothers, and he was her mother’s second husband, but now she’s on her fifth, and on and on.
I assumed, naively, that despite all of these assaults and challenges, Magnolia was at least in somewhat working order for dating. I assumed this simply because she was dating. We’d met at a bar, I asked for her phone number, I called her and invited her out and she agreed enthusiastically. When we began hooking up, I found her to be more than a consensual participant, but often an aggressive pursuer of sex and intimacy.
Of course, I did not know she was seeing a handful of other guys at the same time. I may not even have had a problem with that if she’d been open an honest, but that wasn’t her style. I did not bring it up and she saw no reason to back herself into an uncomfortable conversation.
Probably, I was much too dismissive about her traumatic background, partly because most women I’d known well had confessed experiencing similar events in their personal lives. They all seemed functional, although I guess I don’t really know what sort of personal struggles and individual anguish any of them were going through aside from what they shared. Often that wasn’t much more than the event itself as an explanation for aggression. I didn’t see these as a red flags, or associate them with myself or why I was attracted to and/or attracting women with this type of history. I’d later learn about co-dependence and, much later, understand likely reasons why I was often in the role of the enabler.
So. Four and a half years later and Magnolia and I had been sharing an apartment in San Francisco, having moved there together from LA. I started experiencing something of an existential crisis in the form of severe panic attacks, now diagnosed as Generalized Anxiety Disorder. I believe I needed connection and support. Activity. I did not recognize any seemingly significant triggers to these panic attacks, which made them that much more frustrating, but I did notice I was developing a fear of experiencing another one whenever I began to recognize an arbitrary physical indication like increased heart rate.
Oh, and Magnolia had an abortion about a year and a half before this, and almost every time she had more than three drinks, she’d tell me how much of a horrible person I was because:
a) I did not want to get married
b) I did not want to get a puppy (our apartment did not allow pets)
c) I did not let her to have an Xmas tree.
And here I thought this cool, litepunk indie rock chick with sleeves and a huge back piece was somehow not susceptible to or just disinterested in such pedestrian ways of living. But she was also a 30-year-old woman with a suburban childhood.
Like I said, I don’t want to get into the weeds about this. We both still drank a lot, which I eventually decided was not a good way to have a frank and honest conversation about anything. I drank to have fun and forget, not to get into heavy shit. And Magnolia smoked weed every night even though she said she wanted to quit. And although I had a few more awful panic attacks while waiting to begin my therapy and CBT training, Magnolia took most of my Valiums herself. Most nights she’d eat dinner and pass out on the couch in front of the TV with a bowl of weed smoldering.
Magnolia said that sex now gave her debilitating anxiety. Fight or Flight or Freeze. She usually just locked up. Her body would not function and I don’t know if she really wanted it to function, because intimacy terrified her. That made sense given her life experience during important developmental years.
Ironically, or so I saw it at the time anyway, she was capable of having intense sex with other guys who did not share with her the burden of living together and so forth. But this drive only seemed to surface every few years. To be clear: I was not demanding she have sex with me, but I was confused about why she was no longer capable or interested.
Her previous two boyfriends, both of whom she’d been with 2-3 years each, and both of whom she’d lived with for most of those times, had experienced the same issues with her. Her answer to them, as it was to me, was that she knew she needed therapy to “fix” her and that it just was not available to her at the moment. Her job provided no healthcare benefits and she assumed options.
This might have frustrated or fascinated her as, over the following several months, she watched me get a better sense of my anxiety disorder by attending weekly group meetings and monthly counseling sessions. I began to understand my condition and learn and develop healthy techniques to manage it. It was not easy and in no way complete, but it was an introduction to process. Ongoing, endless process. The most important thing I learned was that Generalized Anxiety Disorder as I was experiencing it had no triggers. This is challenging because it’s natural to look for agents of cause and to subsequently try to avoid them.
But my therapists said this was the wrong approach. It’s how Generalized Anxiety Disorder can become a phobia. My therapists told me that in the study of psychology there are differing schools of thought on managing anxiety. One is to experience it without drugs, and learn how to de-escalate unwanted physical responses. The other is to reduce physical response through chemical intervention.
Magnolia always had a taste for cocaine, but usually that was just a special occasion kind of thing. During this time, however, special occasions became more frequent, probably because she began drinking more heavily, often right after work. She believed – erroneously, in my opinion – that doing cocaine will sober a person up. I believe that drunk is drunk, and getting coked up might give a person more energy and ability to physically function, but it definitely does not clear the mind.
And so that’s how it went. Maybe she did not love me anymore or whatever. Maybe I was a challenge to live with and manage, and a shuddering, claustrophobic lunatic was not a person she wanted to fuck. As she did with her previous boyfriends, rather than consider the situation rationally – like no one does – and just break up because the stress was too much or the situation had become untenable, she drank and smoked and snorted and screwed her way out of it.
Of course, there’s a lot more, but this is not about that. It’s about mental health and a journey to wellness, so we go on.
Transparency: The drug the psychiatrist suggested to me in that initial meeting was Celexa.
“Is Celexa good for anxiety?” By reducing the rate at which serotonin is reabsorbed, Celexa changes your brain chemistry, allegedly improving mood and supposedly reducing feelings of anxiety. Celexa can assist in decreasing the severity of panic attacks and other panic disorder symptoms.
This information was found on verywellmind.com, along with notes about its uses and other effects one can expect. Even if the “common side effects” were not similar to some symptoms of Generalized Anxiety Disorder, I would not have been interested in using this drug to treat my condition.