It’s a lot to write about, so let me first set the scene.

Copyright: 2009, Florida Center for Instructional Technology.

I’ve been aware of anxiety’s presence in my life  since 2005 when I was working in the games industry and suffered my first panic attacks. Panic attacks are often the terrifying first sign that something is not quite right with how you’re thinking and are often triggered by extra stressors and things to worry about.

Looking back before 2005, I can recognise the beginnings of poor thinking habits that make me far more worried than should be normal. That said, working in games (the stress, the late hours etc) definitely provided a good trigger for overthinking and made it much harder to maintain good mental health.

I’d been working the ridiculous hours that somehow add to the glamour of technology jobs, particularly games development. Then I went to hear Greg Bourne deliver the Hawke Lecture and then spent the evening and next days in total terror of climate change. And that weekend I woke up so so sure that my heart and lungs were being squashed by everything that was wrong with myself and the world and that I was going to die.

One of the things to know about anxiety disorders is that you take a normal, healthy amount of concern required to manage a difficult situation, and multiply that by many factors of overthinking and add reactions evolved millions of years ago.  Evolutionarily anxiety worked for us like this: see a tiger pacing by, start thinking of places to hide or sticks to use as weapons, then release a bunch of adrenalin as you fought or fled. The problem is that tiger-appropriate adrenal responses – increased blood pressure and heart rate, restlessness and muscle tension are inappropriate for most modern challenges. Today, tigers aren’t an everyday threat, so a difficult situation might just involve applying for a new job or discussing a problem with a friend and normally we don’t need the fight or flight response in those situations.

Work and environmental and social collapse as a result of climate change are two of the main spaces where I see tigers and am always pretty sure things are going terribly, horribly wrong. See, it’s logical that work and enviromental contexts are both very important spaces in which you should be concerned about threats and make appropriate responses. The problem for people like myself is that the thinking gets stuck in the identifying threats mode far too much of the time and makes it harder to actually get anything done.

Luckily for me,  panic attacks are relatively few and far between but as with that first panic attack when they do appear, it’s to signal that I really do need to start paying attention to my mental health. Of course, there are other symptoms but despite being really quite serious they are easier to ignore than a feeling of imminent doom: -

• • holding your breath and grinding your teeth while emailing?
    this email had better be perfectly worded and leave no room for misinterpretation. That next email is far too scary to answer. I’d best ignore it.
• Feelings of mild paranoia while in face to face and online meetings?
  They’re going to realise I know nothing about doing this job, I’ll get fired and no-one will ever employ me again.
• Hiding in bed in the morning
  It’s not worth getting up, everything I do is worthless and I’m sure something terrible will happen if I even just go to the shops and have to speak German.
• Lying awake at night feeling very aware of all the things that could go wrong ever.
  I don’t have proper curtains, people will come to visit will see this,  tell Tim I’m an unfit fiance and he’ll break up with me and we’ll never live the rest of our lives with the happiness we deserve or the family we were meant to have and our children would have been born with major health issues anyway. Really, it’s all fucked so why even bother with the curtains let alone eating breakfast tomorrow?

In between panic attacks and weeks of feeling generally horrible and exhausted there are times when I feel totally fine: confident and powerful enough to change the world. I’ll be happy and calm, inspired and productive at work,  I meet new people without fear, leave the house and confidently speak poorly structured German, face the world and the future full on and trick myself and others into believing that everything is okay and will forever be amazing.

These days exist and they are what I want to have more of. Too much of the time though I’m not okay, I’m not getting things done in the way with the ease or capacity I should.

Sometimes I feel like a mouse being played with by a cat – the type of play where the cat seems to take a vicious delight in playing with the mouse and then seemingly ignores it before pouncing again. I’ll get over a phase of anxiety without much effort on my behalf and feel great. Then, weeks or months later I realise I’m not free of worry and I find myself hopeless, unproductive and tense again and I know that I never really solved the problem.

I’m hoping that by writing more publicly about anxiety I will actively do more to challenge my experience of this disorder and to follow through with the positive behaviours  and thinking changes that will help me improve. When I next return to this topic, I will write about how I hope to improve this situation, the tools I’ve used to good effect and the challenges with maintaining and setting good habits and living in the real world.

Autumn Cheer, originally uploaded by Fighting Tiger.

A couple of years ago I posted a step by step approach to dealing with bouts of anxiety or depression. It was some home brewed cognitive behavioural therapy that got me through some heartbreak. The bad times passed and then I deleted the post.

And even though I still followed some of my own advice, I’d forgotten how specific and useful a paper (or electronic) set of the reminders could be in times of the crazy sads.

A few months back an old housemate asked me where the post was and I couldn’t find it in either my archives or anywhere online. But yesterday I hit archive.org paydirt and found the text again. I twittered it and was told by a follower that she’d forwarded the link to a friend who’s going through some tough times – and that her friend had printed up two copies to keep by her side.

Which of course made me feel all happy, that maybe this list of actions might help more people than just me.

So… here is the In Case of Emergency list again. Please feel free to leave comments or further advice.

Seriously, it’s fortunate that I live alone otherwise I’d probably be up for manslaughter charges as a result of me destroying anyone who crossed my path earlier in the day.

For a young woman who is trying to increase the amount of happiness and joy in her daily life and making an attempt to spread positive feelings to the world at large – yesterday did not bring a good mental space at all.

You know what, I’m beginning to [re]learn that holding back from discussing issues for the sake of avoiding potential conflict is not always a good thing – even if it maintains a sense of order at the time. Those bits of frustration with the world at large and people nearby just build up and get stored away around one’s shoulders – kind of like the hump on a camel’s back. Of course – a camel’s hump has a positive moisture and fat storage purpose – but still, the irritation storage hump looks just as ungainly.

Oh! I admit that there was a whole lot more at work in yesterday’s hideousness than just held back conflict, boys of course, too much work lately and not enough sleep or good things like gardening and creating. I hold myself to some ridiculously stupid standards. And there’s always there’s the frustration that ‘most everyone else in the world is letting things get more fucked up and the few who make the effort are going to be left in the rubble with nothing to show for their lives. All of those things go into humps of their own – and not the sexy lady lump kind.

Eventually I guess you just have days when there’s too much stuff that you’re carrying around – and you just have to give into the weight and sleep the day away.

Luckily, [as this metaphor is getting kind of tired] – some of the particular straws that broke The Camel of Peace and Serenity’s back yesterday have been picked up and swept away. And you know what – The Camel of Peace and Serenity ultimately shouldn’t be burdened with a hump of negativeness, if it’s going to stockpile anything, it’s going to stockpile more goodness.

Earlier this winter I’d hopefully planted seeds primarily so I could use the nettles as a nitrogen rich green compost, but they didn’t grow very well, so I’ve been looking out for some wild plants to harvest from. I’d seen some nettle-like plants by the side of the road earlier in the week, but my tentative stroke of the leaves didn’t result in any stings – so yesterday I took a braver approach and put my hand flat onto the leaves which did confirm my suspicion that the plants were indeed nettles.

It’s not that painful. I figure that nettle stings are the discomfort equivalent of eating warhead lollies – some people are braver or have a higher tolerance than others – luckily for me the sting is bearable.

So I borrowed some rubber gloves (I’m not yet brave enough to enter a nettle patch with bare hands) and scissors and picked a bag full of prickly leaves, ready to be dried and made into tea.

What did seem really weird that it was just over a year ago, in Finland’s early summer that I helped Ninnu prepare nettles for tea. But temperature wise I figure that there’s not much difference between July in Australia and early June in Finland.

Now of course I’ve remembered that nettles can be added to soup (fresh and dried), risottos, pancakes and used as a hair tonic as well as being a tea for people and gardens.

Aliese, it looks like I’ll have to come over this weekend and do some “weeding” for you!

The recovery from LLETZ, at the same time as starting travelling, definitely influenced the way things turned out between Dan and I. It’s impossible to go back and make a different decision. And that definitely changed my life.

When I found out about the second bad PAP smear, I bought my girl bits a present and that’s changed my life in an incredibly positive way. For the last couple of years since I found out about them, I’ve been intrigued by reusable menstrual cups. There’s a few on the market, The Moon Cup, Diva Cup or The Keeper, and because there was a South Australian supplier and I only had two weeks to go until I left Australia, I bought The Keeper.

I’m not going into gory details, but let me just say, using a cup is so much better than tampons. It’s cleaner, there’s no waste, it ends up being cheaper and most importantly, it’s reusable and environmentally friendly. If, like Jeimz dreams of, I had a store which sold stuff I loved and recommended – there would definitely be menstrual cups for sale.

Most importantly, one of the ways in which my life has been changing lately is that I realise that by writing I’m helping people think about what’s going on in their own life, whether that be a breakup or a sad cervix or a job they aren’t happy in. That’s an amazing thing, to have people write to me and say “Hey, thanks, what you wrote really helped me out.”

A week or so ago, I got an email from a young woman who’d just had the LLETZ procedure and she emailed asking me for advice. And I have to admit, I was way less gung-ho about the entire thing than I was when I wrote that post back in March. However, the email I wrote in response helped that girl, so at a later point I’ve pasted in the email I sent her, pretty much verbatim (names have been protected to change the innocent). If it helps another woman, I’m really glad. If I get statistics wrong or something – don’t shoot me.

I had exactly the same problem when I had to have the procedure. What information was on the web was really scary. I ended up getting into a kind of flame war on a cervical cancer support group because they were all quite negative about the procedure and the recovery.

Um, it was made a hell of a lot worse for me in that I got on a plane two days later and left Australia indefinitely. To go to China. Said goodbye to my mum and my bestfriends and everything familiar. So my romantic reunion with my now ex boyfriend was delayed by a month and god there’s a whole bunch of reasons, but to a certain extent that month of being exhausted and bleeding whilst travelling and not having sex did start off the end of our relationship. But then again, the reasons that we parted ways are far more complex than just my cervix needing surgery.

So my advice… Do not start travelling for a couple of months! Do not make any major life decisions for the next couple of weeks!

Physically I’m all recovered. Most of the time I completely forget about what happened. Though when I was recovering and bleeding it did occupy my thoughts a lot. And there’s a whole lot of other personal reasons why the first time we had sex was weird. But because I was stressed about it (oh my god, is my vagina broken etc), I did tense up a bit and that made it a little uncomfortable. And while we were doing it a mouse came and stared at us and did a mouse poo on the bed. Which was not the romantic reunion I had in mind at all.

But it was kind of funny.

I still have to go to the ob gyn for a checkup. That’s made a little bit difficult as I’m now living in Finland and have to deal with their medical system (luckily I can use my Australian Medicare card here). But my obgyn was sure that I would be fine.

What was reassuring was a friend who told me she’d had LLETZ a couple of times. And she said that while it is a little messy for a couple of weeks and invasive and everything, it isn’t that bad. And she’s due to have her first child soon. So everything must be good. The risks associated with pregnancy freaked me out… though now I’m not with the person who I intended to spend the rest of my life with, so it really isn’t an immediate issue at the moment. It’s a very common procedure.

It is one of the realities of HPV that for some people it can recur. Particularly if you’re stressed, unhealthy etc. It is a virus and like a cold sore it can return. But as I’m sure your doctor has told you, just go and have your regular checkups. My GP also recommended that I take 500mg of Vitamin E a day. Vitamin E helps with tissue healing and there’s anecdotal evidence that it can reduce the scarring from HPV & LLETZ. I figure that all that Vitamin E will keep my skin good, so it has a double benefit.

Emotionally, I did initially feel a little bit “dirty” and like I was too promiscuous or something. But if you are feeling that way you have to remind yourself that you could get HPV the first time you have sex. You don’t even need to be penetrated and you could still get HPV, especially as over 25% of the population has been diagnosed with it.

I’m so glad that they’re about to release a vaccine for HPV. While I wish I could have had access to it, I’m glad that other girls (and presumably guys) are going to have reduced risks of catching it.

So my immediate advice…

• Look after yourself.
• Get others to look after you too.
• Cry if you need to. But laugh too.
• Buy yourself presents. When you stop bleeding buy some new underwear! Let yourself feel as sexy as possible.
• Buy your vagina and cervix a present (ahem, a vibrator, a moon cup – diva cup (reusable menstrual cups – a million times better than tampons. Both for you and the environment! Ask me more questions if you’re intruiged…).
• Talk to your girlfriends about what you’re going through. They might have similar experiences, but they might also be prompted into getting a pap smear themselves.
• Be honest and loving with your boyfriend – not just about your physical feelings, but about any emotional or psychological issues that come up.
• Give your son hugs and marvel at how awesome your reproductive system is. Your body was able to make him, so your body will also recover from this. You are a woman and able to do anything!
• When you do return to having sex, make sure that you feel comfortable with the situation. Leave your son at your Mum’s or something. Have a date with your boyfriend, drink some wine or smoke a joint or something. Feel relaxed. Demand a massage and hours of foreplay! And be honest with your partner about how everything is feeling.

Perhaps I should have delayed meeting Dan in China for a month, my life might be different, I might still be with him. But all of the choices we take in life lead us to the now and the now is always perfect. I’m living in Finland and I’m enjoying myself so much.

Because I’m not happy, because I’m unsure of what to do with my life, because when I think about trying to do something I talk myself out of it, just because of all this and more I’ve realised I’m not truly myself yet. That’s frustrated me. There are moments, days, weeks even, when all of the insecurities disappear and I am happy and confident and attempting to do things I want to do. Then that happiness gets covered up by all of the insecurities and bad experiences again. Confusingly for Dan, he fell in love with me at one of those high points, and has been so confused and frustrated when the rest of the time I’m a different person.

When I’ve been at my worst Dan has been there right next to me and he’s held me and tried to help me to break free of everything which binds me up inside. I’ve pushed him away and only called him closer when I’ve needed him again. It hasn’t been his job to fix me up, but he’s tried and it hasn’t worked. The only one who can make me do the things I want is me.

It’s that simple and that scary.

All along I’ve wanted to write about this on Battlecat but I felt scared to. That people would think that I was hopeless. Really, why would anyone who gets to travel the world feel so sad, surely she’s already living the dream? So I didn’t write what I really wanted to, even when writing that down would have helped so much, been a form of therapy in itself, maybe prevented Dan and I from falling apart. Unsurprisingly, the post about biting the Chinese man on the Great Wall, my last real post, pretty much marks the week in which everything began to get really bad. Already I was not able to work things through logically, so I ended up biting a person because I didn’t know what else to do.

Dan is being so sweet, and proves again and again why I love him. He’s trying to help me as much as he can. Even now. Though it hurts to know that I’m not going to be with him. I’m forcing the maybes and what ifs and when I’m better, maybe we cans out of my head. What I really want (but am not sure about yet) and what Dan wants are very likely not going to match up. He wants to spend more time travelling and I think that the things I want to do aren’t that portable. I’ve tried following him when it hasn’t been right for me, I’ve resented him and things have fallen apart in a most terrible way. If he hadn’t travelled and we’d stayed in Adelaide, he would have resented me for preventing him from doing what he wanted.

This situation is a horrible catch-22 . Dan and I can only be together if I’m happy. But I can’t be happy if I’m with Dan. Realistically I have to replace Dan with “A Someone”. Though the thought of anyone else turns my stomach. It just doesn’t feel right to think of anyone but Dan as my lover.

It feels even worse than how I feel about my heart, to think that his heart is breaking because of this. I didn’t mean for this to happen.

It did happen though. On Wednesday, Dan is going to fly down to Germany to catch up with some friends who are going to the World Cup. After that he goes travelling where ever and however he pleases. He can hitchhike, skydive, sleep rough… whatever, I won’t be there to freak out. It’s what he needs and wants to do.

I think that I’m going to stay in Finland for a bit. I like it here. I feel at ease too. I’m making friends with some of the people we’ve stayed with and that is an awesome thing, to make new friends. Whether I get a job here or go off and teach English somewhere else (which seems to be the choice of the lost young Australian) I know that it would be unwise to return to Adelaide straight away. I’d feel disappointed about quitting and worse of all I’d return to a cold, dreary winter and my old patterns.

At the moment, things are just okay. I can survive. I want you all to know that things aren’t just going to be okay, they’re going to get better and then they’ll be good. I’m going to make you all so proud of me, but most importantly, I’m going to be proud of me.

I’m of the opinion that after about two days, whomever one is travelling with, the conversation will primarily be focused on toilets: proximity, cleanliness, paper quality, Western or squat and frequency of use. Successful travel is linked very closely to basic comfort, and basic comfort, in my opinion, is highly dependent on a healthy digestive track.

Travel with Dan is no exception. When we took our road trip over Christmas, we both ended up with “travel lockdown” after the first 3 days. That first week was spent discussing about how much we needed to poo, in between drinking prune juice and strong coffee and driving along the Great Ocean Road. We were out of our comfort zones and eating an awful lot of pizza and deep fried roadhouse food. Luckily, we improved our diets (lots of fresh fruit and water) and things returned to normal soon enough.

Guess what, you know those dumplings I was raving about a week or two ago? Did you see this delicious pizza thing (tu jia bing)? And I haven’t had a chance to tell you about the delicious convenience of steamed buns with all sorts of different fillings!

Well, it turns out that for some people, if your diet is a consistent mix of refined white flour dough, meat and oil, you will get constipated. Yet it also appears that for other people who travel in China, and who eat almost anything (including dumplings), you do put yourself at risk of diarrhoea. A comfortable balance can be hard to achieve when you aren’t aware of which way the tide is going to turn at any moment.

The other night we were walking back from dinner (where we may have eaten dog due to an ordering mishap) when I felt that horrible lower back clenching sensation that reminded me of a night spent over a squat toilet in Turkey. Luckily, I got back to the hostel and up all million flights of stairs with time to spare. After I’d cramped and pooped and flushed, and come out of the bathroom looking kinda green and with a killer headache that seemed to have appeared out of nowhere, dammed-up Dan had the cheek to say to me. “I’m so jealous that you were able to poo”.

So, jealousy might be the bizarre reason why he tried to flush toilet paper in the squat toilet yesterday morning and blocked the drain, before going off to explore Nanjing without fear of being inconvenienced. Which meant that I’ve not only seen my poo once, but repeated times as I had to find a plunger and unclog the drain.

I’m sure that there will be very many beautiful experiences that Dan and I will treasure for years to come, but I also know that there are going to be reminders which keep resurfacing no matter how hard one tries to wash them away.

I’ve spent over $80 on non-prescription medicines and don’t even want to know how much I’ve invested in “just in case” prescriptions for antibiotics and the morning after pill. I’ve been jabbed with vaccinations for typhoid, tetanus and rabies, had my teeth checked and had two fillings. I’m carrying two months worth of St John’s Wort and Vitamin B and multivitamins for fear of anxiety, depression, exhaustion and getting just plain old run-down.

Remember, apart from the St John’s Wort, all this preparation is not just for me. Whilst wary of getting sick whilst on the road, I also live in fear of Dan catching even a cold and turning into the biggest sook who ever shouldered a backpack.

So, it was in the spirit of “getting a checkup” that I headed off to my GP to get a pap smear done. Towards the end of last year, conveniently occuring at exactly the same time as my work related breakdown, I found out that my previous pap smear had been flagged for abnormal cells. At the time that news just added to a general feeling of ohmygodtheworldisgoingtoend, but I did remember to have another pap smear done about 3 weeks ago. And that came back with another notification of abnormal cells.

Now, because I’m leaving the country this Saturday I needed to get a whole bunch of “examinations” over and done with as soon as possible, you know, just in case. Referrals were made and the ObGyn’s office gave me an appointment for a colposcopy the day I rang up. Which was lucky, because I needed a biopsy on the abnormal cells, and, you guessed it, last Friday I rang up for the results and they showed Cervical Intraepithelial Neoplasia (CIN) II cell changes. And they’re the kind of cells you need to get removed before they potentially turn cancerous.

Since Friday, when I found out I needed to have the surgery, I’ve spent way too much time online looking at information about the procedure and getting distressed by forum responses. Should I, or shouldn’t I postpone my departure for Shanghai? Would I be in terrible pain or depressed? Would it affect my potential to have children a number of years in the future?

Oh, it was a tough weekend. I was moving house. And it was a long weekend so I couldn’t speak to my gynaecologist or my travel agent for three days for reassurance about the procedure and the flexibility of my ticket. I rang up on Monday and was reassured.

Then, I packed and moved stuff. Vacuumed and drove backwards and forwards across town. Went to Womadelaide for a day and visited my grandmother who is almost 99.

Today I had the LLETZ procedure to remove the area surrounding the abnormal cells away from my cervix. It meant that I was knocked out by a sedative and was in hospital for half a day. I’m going to have post operative bleeding or “loss” for a couple of days, and can’t have sex for about a month. I also have to be careful about picking up heavy objects, so I’m going to cart my pack around on a granny cart for the first week or two.

I was freaked out. So scared. But nowhere near as scared as I’d have been if it was cancer, and I’m so glad I found the changed cells when I did.

I feel a little tired and woozy and I have about a million things to do tomorrow, but damnit, I’m getting on that plane on Saturday morning.

For more information about pap smears and cervical cancer screening visit http://www.cervicalscreen.health.gov.au.