Routine: Interrupted

I love routine.

In the morning:

At work:

  • 10AM - Tea break

  • 1PM - Lunch

  • 3PM - Simple stretches

Before bed:

It thinks it’s so superior because it uses “electricity”…

It thinks it’s so superior because it uses “electricity”…

Due to my love affair for routine; travel has generally been a disruptive force for my mental well being. Not only am I in an unfamiliar environment, I am also unable to follow my routine exactly. Up until a year ago or so, I struggled when traveling. Building up anxiety until I had an inevitable panic attack during my trip, or not long after returning home.

One of my areas of personal growth has been becoming more mentally flexible. I do not follow the routines I listed to the letter, every day. I tried that, and anytime I missed something I felt like a failure.

Now, I try to hit for five hundred instead of one thousand. That has helped me tremendously when traveling.

I am writing this from my Dad’s office, overlooking the back porch, while listening to a bunch of dogs bark. I woke up this morning, stretched, meditated, cleaned myself up, took my meds, used by sister’s old Keurig to brew a latte. The big change is the manner in which I create my cup of coffee, and in the past I would have allowed that change to bother me.

In other words, I thought I was not performing my routine “right”. Which, when you step back from that observation, you realize it is absurd. I cannot tell you to stop judging yourself; that is part of our nature.

I advise you, as I try to remind myself, that you can judge yourself in a healthier manner. I term this

the cultivation of discipline

Discipline - “Train to obey rules or a code of behavior, using punishment to correct disobedience.”

Cultivate - “Prepare and use (land) for crops or gardening.”

Dad’s jersey (7) on the left. Mine (13) on the right.

Dad’s jersey (7) on the left. Mine (13) on the right.

The hard skill is discipline, and the soft skill is cultivation. For too many years I focused exclusively on discipline. Punishing myself for failing to attain the goals I set for myself.

I learned that you cannot have the hard skill without the soft skill. You cannot plant a hard seed in unyielding soil, and expect to find purchase for new roots.

Traveling has become a way for me to practice the soft skill of cultivation. An opportunity to become more flexible. Even the chance to find something new to incorporate into my self-care routines.

So on this day of gratitude. I am grateful for my family, the six dogs at the house, a healthy body, a stable mind, and another day to cultivate discipline in a healthy manner.

This is written at the top of my whiteboard wall in my apartment as a daily reminder.

This is written at the top of my whiteboard wall in my apartment as a daily reminder.

PANIC Attacks!

Not to be confused with worry or concern. Panic, is concentrated fear.

The symptoms can include some, or all, of the following:

managing-a-panic-attack.jpg
  • Palpitations, pounding heart, or accelerated heart rate

  • Sweating

  • Trembling or shaking

  • Sensations of shortness of breath or smothering

  • Feelings of choking

  • Chest pain or discomfort

  • Nausea or abdominal distress

  • Feeling dizzy, unsteady, light-headed, or faint

  • Chills or heat sensations

  • Paresthesia (numbness or tingling sensations)

  • Derealization (feelings of unreality) or depersonalization (being detached from oneself)

  • Fear of losing control or “going crazy”

  • Fear of dying

Panic attacks are extremely unpleasant and can be very frightening. As a result, people who experience repeated panic attacks often become very worried about having another attack and may make changes to their lifestyle so as to avoid having panic attacks. 

https://adaa.org/understanding-anxiety/panic-disorder-agoraphobia/symptoms

All of this sounds bad, but the symptoms and description of “extremely unpleasant’ and “very frightening” does not quite encapsulate what a panic attack truly feels like.

If you have never experienced a panic attack, I wish that you never do. But, you can imagine what one feels like.

Pretend that you are relaxing in front of the television, watching your favorite show; when all of a sudden, a 700 pound Siberian Tiger bursts into your living room. It roars, and your brain quickly realizes that you just got knocked down to the bottom of the food chain. The tiger sits back on it’s haunches, coiling it’s powerful rear legs, and then leaps across the room directly at you.

“I’m going to f____ you up.”

“I’m going to f____ you up.”

It’s mouth is wide open, large teeth clearly visible, and right before you realize you are about to die, the tiger vanishes into a wisp of smoke.

Then, a 700 pound Siberian Tiger bursts into your living room. Roars, leaps, is about to tear you about apart, and then it disappears.

Roar. Leap. Death. Fade.

Roar. Death. Fade.

Death. Fade.

Death. Death. Death. Death. Death.

Panic attacks are the psychological equivalent of this imagined scenario. You constantly ride the edge between life and death, almost 100% certain that you will die. That your death will be both agonizing and slow.

What would you do if a massive tiger leap at you right now? Fighting it is useless. You have no chance of running away. All you can do, is be frozen in place while you get yourself right with your maker.

See how horrifying that is? It is no wonder that a panic attack can be debilitating in the moment, but the effects can linger.

Say the tiger vanishes and does not reappear. Your mind is ready for it to pop back into existence to end yours. But it does not. Tentatively, you stand up, arms in front of your torso to give your vulnerable belly some measure of protection.

Imagine your mind on fire.

Imagine your mind on fire.

Your senses are heightened, blood is pounding, and fear compels you to either sprint or freeze.

At that point, you don’t think that you have to pick up your kids from school later that day. You aren’t worried about that staff meeting at 2pm.

Your brain is on overdrive, trying to find the TIGER THAT WILL KILL YOU!

It takes some time to come down from that state.

In my experience, there is no immediate “snapping out” of a panic attack. You need to let it run its course. It will be awful, but, I promise you, it will end. You will be okay.

Life in a Psychiatric Hospital - Part 3

My seclusion room story requires a bit of set up.

I voluntarily committed myself to Ridgeview in 2011, and was given a brief tour to get comfortable with my new little world. Part of that world was a seclusion room.

It’s pretty bare, but safe.

It’s pretty bare, but safe.

It consisted of four walls with a solid, rubber mattress on the floor. Why solid rubber? So that someone could not strangle themselves with sewn fibers.

A brilliant white light radiated from the light fixture that was mounted flush with the ceiling. Why flush? So that someone could not hang themselves from it.

A substantial, but easily opened door with a large window separated this little psych ward from the big psych ward. Why the window? So the nurses could keep an eye on the patient. The door was strategically located directly across from the nurse’s station for even easier tracking.

There is no straight jacket, no one is getting chained to the wall, and no one is locked in without round-the-clock supervision. But, I distinctly remember thinking,

“I’ll never be in one of those.”

Life, as I have come to learn, loves irony.

In the fall of 2016, I had the “choice” between involuntary commitment or voluntary commitment at a facility in Maryland. More on that in a later post.

After my release, I entered an Intensive Outpatient Program, or IOP. Basically, you go to the hospital every morning, stay till three, and get to sleep in your own bed at night. This program gradually gets a person into a more regular routine, and they can more easily transition into the life they choose to live.

Bedlam from 'A Rake's Progress' 1733, By William Hogarth - “Bedlam” was the byname of Bethlem Royal Hospital due to the noise. Visitors were welcome! For a shilling or two, you could walk through the hospital and gawk at the crazy people.

Bedlam from 'A Rake's Progress' 1733, By William Hogarth - “Bedlam” was the byname of Bethlem Royal Hospital due to the noise. Visitors were welcome! For a shilling or two, you could walk through the hospital and gawk at the crazy people.


I was there for extreme panic attacks, that were a side effect of a new medication I was cycled onto by my psychiatrist. I have never experienced such terror, and I hope to never experience anything close to the sensations I had while on that medication. I write this because it explains why I needed the seclusion room on a crisp Friday afternoon in November.

“They’re looking at me.”

“They’re spying on me.”

“They’re judging me.”

Such are the thoughts of a paranoid mind in the early stages of a panic attack. Truth be told, the nursing students had no idea who I was, and they certainly had no evil intentions toward me. But, my mind was unaccustomed to seeing them. The unexpected and unwanted presence of several new faces in my safe hospital ward triggered a massive panic attack.

Almost entirely paralyzed by fear, I somehow got a nurse’s attention and communicated with him by grunting and shaking my head “yes” or “no” to his questions. He gave me a high strength, anti-anxiety medication, which was nice, but at that point, it was about as effective as putting a single sandbag in the path of a massive flood. Using our meager method of communication, we agreed that I wanted to go into the seclusion room to feel safe and ride out the worst of the panic attack, but I could not move.

Four nurses picked me up in my chair and placed me in the room. They lifted me out of the chair, removed my clothes and put a paper gown on me. Why paper? Think about it and you’ll realize why.

A nurse asked if she would be safe sitting in the room with me. I grunted, “yes,” but my mind was on fire, and after a few minutes I told her:

“I need you to get out of this room and lock the door.”

She did, and I lost it.

Dramatic recreation

You already know that seclusion rooms are designed to prevent someone from significantly hurting themselves. I knew this too. So I used the room to cause pain that I could control.

I punched the walls. I chained combinations together until my knuckles bled. I screamed. I paced. I raged. When I could no longer lift my hands, I slammed my head against the wall.

I did not feel agony. I WAS agony.

I unleashed all of my panicked energy while the nurses and doctors pleaded for me to stop. Protocol dictated that they stay outside the room. Sure, it would have been nice to have someone restrain me, but the safer course is to let a person burn themselves out until they are no longer a threat to themselves or their caretakers.

Most hospital protocols specify that restraints be used for the least amount of time necessary.

Most hospital protocols specify that restraints be used for the least amount of time necessary.

Eventually, everything slowed down. I collapsed onto the mattress and the door opened up. Several large men secured my limbs and put me on a gurney, to which my wrists and ankles were strapped.

Didn’t I write no restraints earlier? They are used as a final resort to protect a person who has clearly demonstrated the recent capacity to hurt themselves, and to protect those around them.

A nurse injected me with Haldol, an antipsychotic drug that “decreases excitement of the brain.” It’s the human equivalent of horse tranquilizer - you get real chill, real quick. Then she gave me another injection to counteract the side effects of Haldol.

I woke up two days later with a pounding headache and swollen knuckles, and all I could think of was how wrong I was so many years ago.