Bipolar 2 From Inside and Out

Posts tagged ‘phobia’

Down in the Mouth

Tomorrow I’m going under the knife (forceps, pliers, whatever) to get teeth removed. I’ve written before about my severe dental phobia, but this time there is no other solution. My teeth are bad; my gums are bad. Hell, even my breath is bad.

For this procedure, I will have IV sedation, which is a great relief. Nitrous oxide has never had any effect on me. I have had IV sedation for a dental procedure once before, so I know it works for me.

Due to COVID restrictions, my husband (my emotional support animal) is not even allowed to come into the building or the waiting room. For other, less drastic procedures, he has even been allowed in the treatment room with me, to pat my foot and offer me encouragement. This time he has to wait in the car until the nurse brings me out. That means he stays in the car for up to two hours while I am worked on. I’m glad he has an e-reader and that it’s recently been updated and charged, but still I would prefer a pat on the foot to knowing he’s several doors and a parking space away.

Oddly, I was not nearly this fearful when I had two operations (microlaminectomies) on my back a number of years ago. Perhaps that was because the pinched nerve caused me untold physical pain. That was pain I could understand. All I have with my teeth is emotional pain. For now. I’m sure physical pain will come later, after I regain consciousness.

My memories of dentists and former dental procedures are not good. There have been both physical and psychic pain, shaming, guilt, assorted bodily reactions, and a creeping physical numbness that had nothing to do with Novocain. I have been through procedures both with and without IV sedation. I’ve had my wisdom teeth removed, and another tooth removed and replaced with a partial bridge. I had a tooth that broke and I had a tooth bonded in place, designed to get me through a month or two until I could do a reading from my book. Through careful eating, I made it last five years.

Now, though, there is no getting out of it. I was unable to get these expensive procedures in the past because of a lack of money. Now I don’t have that excuse. Money has been set aside and no other emergency has arisen that requires using it for something else. Needless to say, my insurance doesn’t cover this, and especially not the traveling anesthesiologist. Once I had to abandon fixing my teeth because our transportation gave out, but that’s not a problem this time.

Do I want to get out of it? Yes and no. Dentistry is one of my major phobias (which has no doubt contributed to how bad my teeth are). This has been true since I was a child, and has only grown more extreme. It would be understating the matter to say dental procedures are a major trigger for my anxiety and panic attacks.

I’m also unnerved by how the procedures will resonate through my life for an unknown time. That dental bridge was a significant factor in my self-esteem. If I forgot it, I had to turn around and go home. More tooth extractions will no doubt feed into my isolation. And then there’s the indignity of eating applesauce, soft-boiled eggs, and chicken broth until my poor, abused gums heal. As little as I leave my house now, I will be even less willing to do so for quite some time.

So, wish me luck. Both my husband and I are taking a few days off work, on the theory that the sedation and analgesics may leave me woozy. At least I will be able to keep up with my blogging, since that doesn’t require going outside.

I’ll get through this. But I’m afraid it will leave my emotions as disordered as my mouth.

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Anxiety, Fear, Panic, and Phobias

I’ve heard it said that you know when you’re a problem drinker when your drinking causes you problems, whether of the emotional, legal, financial, or several other varieties.

Similarly, I think anxiety, fears, panic, and phobias are problems only when they cause you problems.

Let me unpack that a bit.

Phobias are considered to be a type of anxiety disorder or panic disorder. For example, social anxiety is sometimes defined as social phobia. Everyone has anxieties. Many people have at least one phobia. And most people can avoid these triggers with little or no effect on their daily lives. There are habits they can cultivate to avoid the things that make them anxious or phobic.

For instance, someone with acrophobia, a fear of high places, isn’t usually incapacitated by a stepladder, and can fairly easily avoid standing on cliff edges, rotating top-floor restaurants, and hotel rooms over the first or second floor. (When the anxiety/phobia extends to fear of flying, or aerophobia, the person can limit or eliminate air travel from their lives, usually without much difficulty.)

Crippling phobias, however, are generally classed as mental illnesses. My panic around bees (apiphobia) does not rise to that level; I would call it an anxiety reaction or a panic attack, not a phobia. It usually only manifests as bodily stiffening, tremors, and immobility, and pleas for anyone in the area to shoo away the offending insect. (I once took a beekeeping class to try to get over my phobia. Big mistake. Didn’t work.)

Agoraphobia (fear of unfamiliar environments or ones where you feel out of control), however, can be socially and psychologically crippling. The Mayo Clinic says that agoraphobia “can severely limit your ability to socialize, work, attend important events and even manage the details of daily life, such as running errands.” (Technology has made these constrictions less onerous, what with doorstep delivery and Skype.)

Anxieties as a symptom of mental illness are harder to define. While some anxieties have triggers, others simply don’t. “Free-floating” anxiety comes on unexpectedly, like the depressions and manias of bipolar disorder. This doesn’t mean that the anxiety isn’t real. It certainly is. It just means that the anxiety has no identifiable cause such as high places or bees. It is simply (or not so simply) a panic attack, which the Cleveland Clinic says is “sudden, unreasonable feelings of fear and anxiety that cause physical symptoms like a racing heart, fast breathing, and sweating. Some people become so fearful of these attacks that they develop panic disorder, a type of anxiety disorder.” They add, “Every year, up to 11% of Americans experience a panic attack. Approximately 2% to 3% of them go on to develop panic disorder.”

Sometimes I have anxiety that is attributable to triggers, such as financial difficulties, which are relatively easy for other people to understand. Who wouldn’t be anxious when the bank account is dry and a bill is due?

Other times, free-floating anxiety or panic simply descends on me, with nothing that triggers it. It’s an awful feeling, like waiting for the other shoe to drop when there has been no first shoe. Like a cloud hovering around me with the potential for lightning bolts at any time.

The thing is, I don’t know how to get rid of my anxieties, fears, or phobias. There are desensitization procedures that are supposed to work by getting one used to the trigger gradually. (I think that was my idea behind taking the beekeeping class. One of them, anyway.) There are antianxiety medications, including antidepressants and benzos, designed to take the edge off, if not remove the anxiety. (I take antianxiety medications. I’m still afraid of bees. Not that it affects my daily life much, but I’m never likely to visit that island off Croatia that’s covered with lavender.) For phobias, Cognitive Behavioral Therapy (CBT), as well as exposure therapy, has been recommended. This is usually a short-term procedure, according to the Mayo Clinic. But I have an aversion to CBT.

Still, despite my therapy and medications, I have to live with my anxiety and phobias. I’ve probably not reached the point where the anxiety causes me severe problems, like bankruptcy, though I have been known to overdraw my checking account on occasion and run my credit card up too high. These, of course, are signals that I may have a problem or am beginning to have one. It’s something to explore with my therapist, anyway. Maybe she can suggest ways I can deal with my anxieties before they turn into more significant problems.

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