The current state of my health

For those who don’t already know, I have pretty severe anxiety.
Anxiety.
A word I’ve uttered so often over the last few years, that it has almost lost its meaning.
As far back as I remember, I’ve always been “a little” on edge and over-concerned how things may turn out, regardless of how little or big that “thing” may be. You can also say I’m pretty neurotic to a noticeable degree.
Add into the mix a history of cocaine/ecstasy use and heavy drinking (bourbon was my drink of choice), a daily caffeine dependency (we’re talking eight shots of espresso a day plus a Venti sized iced coffee), topped off with a traumatic divorce and a severely emotionally abusive two year long relationship that ended in February of 2014, I had the privilege of experiencing my first real panic attack a couple months later.
I was 28 years old.
I remember it distinctly: I was working the morning rush at Starbucks, in my usual position on bar, when I suddenly felt nauseous — followed by an overwhelming sense of dread, then confusion.
I felt my heart rate and my pulse go up as my heart began beating faster and faster. I could feel my skin go clammy while beads of sweat ran down my forehead.
Then I had chest pains and I was convinced I was going to literally die right there, at that moment.
I’d asked my shift lead if I could take a few minutes in the back and I sat in the back room, counting my pulse, not sure what was happening.
My shift lead instantly recognized it as a panic attack and assured me that I was not going to die.
I was sent home early that day and spent the rest of the day in bed before going to my second job later that afternoon.
Over the course of the next few weeks, I had repeated panic attacks. I had to work to identify what the triggers were and to avoid them, if the triggers were anything in the realm of my control. I hadn’t used illicit drugs in several years and I’d been alcohol-free for about a year at that point, so those weren’t an issue.
Namely, I had to avoid caffeine which helped quite a lot although there were occasions I would feel the onset of an attack even if I didn’t have any caffeine that day (being around the espresso machine at work would sometimes trigger it).
For almost a year, I avoided caffeine and other stimulants and I was mostly fine. I went to Hawaii in January of 2015 where I was able to indulge in freshly brewed Kona iced coffee without any consequences. I began drinking coffee again, although not in the same quantity as before — I was totally fine.
It wasn’t until I went to London in August 2015 that I’d had another panic attack. It was after I’d had a falling out with a friend in London and it happened at 7:00 AM in the middle of London Stansted Airport — all by myself.
Imagine me sitting there in the middle of a crowded airport in a foreign country alone, people buzzing by, and I’m on the floor with my index finger to my pulse waiting for everything to return to normal.
After that, the panic attacks were not as frequent. Maybe every few months, but certainly more than normal when I was waiting for my Swedish residence permit — and of course, after “L” and I broke up.
Funny story that one: I had just come back to LA from Sweden and not a week later, I was on my first date with “Nils” (with whom I’m very good friends now). We were driving back to his place when suddenly the attack hit me as we were on the freeway. He immediately recognized what was happening, held my hand, and talked me through it as he tried to pull off the freeway into the nearest town so I could get out of the car and get some air. Fun times.
“Most memorable first date ever!” he always says.
But who could blame me though? My emotions were delayed and I was traumatized.
I’m sure it’s already clear, but I also suffer from depression and have suffered from it probably since I was about ten or eleven years old (yes, childhood depression is a thing, guys).
There’s nothing noteworthy about it — it was the usual smattering of feeling hopeless and the occasional suicidal ideation (which has made an extremely rare appearance these days). It seems that anxiety and depression are a standard pairing.
During my time in the United States, I’d never been treated for it because I couldn’t afford to. I’d lost my government-subsidized health insurance when I turned 21 and I was pretty shit-out-of-luck after that. I was fortunate enough that I qualified for free visits at Planned Parenthood, but PP can do little in the way of treating a woman with mental health problems except give referrals to other places who maybe could.
I did the usual things that people recommend in lieu of not being well-off enough to have health insurance: I exercised, I ate well, I developed a social life — but it was never sufficient. I simply couldn’t find joy in anything and I could feel myself and my mental health start to deteriorate.
It wasn’t until I began working at a mental health clinic that I took talk therapy into consideration — and, well, going through a messy divorce.
I paid $15 per session to talk to a Ph.D. in Clinical Psychology candidate at a private university in LA for about nine months and I found it beneficial for a time, but abandoned treatment once I felt it was no longer making me feel like I’d accomplished anything.
I’ve also been an on-again-off-again smoker since 2005 which, of course, got the attention of my new general practitioner who then prescribed me Wellbutrin in an effort to reduce my desire to smoke and my depression in February of 2015.
Unfortunately, the dosage was too high and I ended up flying off the handle. I stopped cold turkey because I couldn’t bear the idea of putting more of it into my body, even if it was just to taper off.
$100 out the window.
It still isn’t 100% clear to me whether my depression is unipolar or bipolar, based on my reaction to the Wellbutrin and based on my history of cyclic “highs and lows” (I used to have a few months of hyperactive, irrational, and erratic behavior followed by a few months of deep depression, followed by a brief period of stability; however, I’ve been much more stable in the last few years with any shift leaning more towards depressive episodes).
So, I’ve running around without medication or proper treatment and in an effort to keep the demons at bay, I worked three jobs for a year or two with the goal of saving enough to travel Europe for a month, hoping it would change my life somehow in some way or that at least this goal would give me just one more reason to keep living and to be excited about something.
It worked.
I live in Sweden now — the land of progressiveness; free education; accessible, single-payer healthcare; generous parental leave; and sexy blonde guys with high cheek bones, glowing skin, and who happen to like both Americans and Asian girls (boy, I’m really in the land of milk and honey, aren’t I?).
But I’m mostly excited about the healthcare.
A month ago, I had a doctor’s appointment.
I told him of the injuries I acquired during a trail run ten years ago, for which he did a full examination of my back and my ankle, followed by a referral for a physical therapist.
When I told him of chest and shoulder pains, he took my blood pressure and had me take an electrocardiogram, all of which came back normal.
When I told him of my panic attacks, he prescribed me 25 mg of Zoloft and another prescription for Atarax for instant anxiety relief in the event of an oncoming attack.
The cost of that visit? $10.
The cost of one month’s supply of Zoloft? $9.
I don’t remember the cost of the Atarax — it was some ridiculously low amount.
The cost of my physical therapy visit? $8.
Sweden has a ceiling policy for both doctor’s visits and medication — if you’ve paid the equivalent of $100 for either, then the rest of the year is free. It’s pretty great.
The only downside — as is the case with socialized medicine anywhere — are the waiting times although I do remember Stockholm being remarkably faster than Gothenburg. In my case, when I booked my appointment for the initial visit, I had to wait a month and then my doctor set me up with an appointment to have a spirometry test done (during a routine breathing check, he believes there is an obstruction in my lungs as I am not exhaling at normal capacity) and the earliest appointment they could get for me was in September of this year. Still, considering how much I pay and the quality of care I’ve received? It’s not bad.
Anyway, I’ve been on Zoloft for a month now. The first two weeks, I was a little apprehensive about its effectiveness as the side effects were so overwhelming, I’d thought about stopping it completely. I was nauseous with dry mouth for the first few days, then I couldn’t sleep for several nights, and there were times where I would feel not totally “present.”
When I bumped up to 50 mg, I would sweat profusely and grind my teeth like a raver, all while occasionally feeling the onset of a panic attack that would never come to fruition. I also lost about fifteen pounds in a week.
Then one day, I felt fine — and I’ve been feeling pretty fine ever since.
It isn’t perfect. I’m not a bursting sunshine of happiness and boundless sea of optimism. I just feel, overall, a lot “better” than I have in a few years — whatever “better” may mean. Energetic, confident, and sometimes even happy.
Then a few days ago, I had this crazy idea that I would take up running again, despite not having run in about ten years.
And yet another crazy idea that I would take up swimming again.
So yesterday, I actually went to a specialty running shoe store, got a gait analysis done, and dropped 1400 SEK on a new pair of running shoes. Then I dropped even more money on new running gear from Under Armour and Adidas.
And today, something even crazier happened: I went for a run. I know! Totally crazy! Ten minutes of walking and running in intervals. It was pretty pathetic, to be honest, but I actually went out there and did it.
Old Annika would have scoffed at the idea or been too anxious about aggravating old injuries.
This new medicated Annika said, “Fuck my injury, I’m going for a run!”
New medicated Annika also wants to buy a new swimsuit and procure a year-long membership to Valhallabadet to get back into swimming shape again. She also wants to try pole dancing classes and would like to take up yoga once more (according to my physical therapist, I’m very flexible in the back, legs, and hips — heh heh).
So, I’m better. I won’t say that medication is the answer for everyone, but it appears that it was the answer for me as it seems my mental health was bad enough that it needed it. I understand it’s not a cure, but that I will be forever managed which I am totally okay with as it does seem to be improving my quality of life. The bit of optimism and joy I’ve been able to experience is pretty worth it to me. If nothing else, I’m a lot more motivated.
And really, none of this would have been possible without the single-payer healthcare system Sweden has put in place. I don’t mind paying higher taxes if it means someone in this country can have affordable access to higher education or can have a life-saving surgery or a life-saving transplant or if it means a very mentally ill person can improve their quality of life with the appropriate medication.
It’s just common sense and basic fucking humanity.
(you can consider this my polite middle finger to those who oppose accessible, universal healthcare and to those who have given me unsolicited advice and told me to get off medication because they believe mental illness can be managed and/or cured with diet and exercise alone — what the fuck, people)
