This #MentalHealthMatters was written by Marlena Reickman, Registration Specialist at Ravenwood Health.

My therapy success story continued about a week ago when I started my own services at Ravenwood. I can only imagine what it must be like to be a therapist with a new client; building rapport and trust with a new person—especially a vulnerable person—must be a little terrifying. However, it was not my first time in therapy. I am used to the intake questions at this point and continuing my care after my move a few months ago, so nothing too major. Hopefully. After she got a general idea for why I was in therapy and my mental health history, she asked me when the last time was that I had a panic attack. In previous intakes with previous therapists, I usually responded rather quickly with an exact date. This time though, when I went to open my mouth, I realized my mind was completely blank. That’s a great question, I thought. When was the last time I had a panic attack? I went down my list of triggers to see if maybe I could jog my memory. First trigger is bad weather. Second trigger involves sickness and anything to cause it or indicate it (aka being a hypochondriac): mold, bad food, weird bumps on my skin, feeling like I can’t breathe right, etc. Third trigger is flying. Even thinking about the last time that I experienced each of these triggers, I responded with what I had learned and while I was uncomfortable, I managed to stay calm and go about my day. The answer for the first time in ten years since my anxiety disorder manifested was: I don’t remember.

I. Don’t. Remember. I don’t remember when the last time was that I had a panic attack. What a powerful realization. Sounds like I’m cured, right?

I wish that were the case and it used to bother me that it isn’t. Now it’s something I comfortably accept, and I have shared the experiences with so many others. Looking back on my past now, I was probably doomed to have panic attacks at some point in my life. In the eyes of Ravenwood Health’s Trauma-Informed Care, it was likely the result of my unstable and chaotic upbringing that would eventually lead to my breaking point.

Therapy, while not always the band-aid to fix all my problems, was a godsend. It started out a little rough—my first therapist when I was sixteen ghosted me and my second moved away shortly after I began. Yet they still started me off with tools that would lay the essential groundwork to my future successes. And as I grew and matured and gathered more life experiences (and more therapists as my life situations changed), each new tool would be added to my belt. Some were refined or retired.

Sometimes the tools are specific to the environment. When I want to go to sleep, I pick one of three video games to help the sleepy chemicals flow. When I get anxious on a hike, I put on my favorite episode of my favorite podcast (The Dollop, Episode 323, “1908 New York to Paris Car Race,” not for kids). If I’m anxious at work, I step outside to get some fresh air. If I’m anxious while driving, I call a friend, my husband, or my mom. When I board a flight, I ask a flight attendant my go-to grounding question (“were you afraid to come to work today?”). Simple cognitive tools did not always work though. Prior to medication, they were successful about forty percent of the time.

Four years into my therapy journey, I had to add medication into the tool mix to bring that success rate to ninety-five percent. At that time in my life, my go-to, last-resort tool was driving. If all else failed, the moment I got behind the wheel of a car I was at ease. However, the stress of college quickly changed that. I was having multiple thirty-minute-long panic attacks a day and I started to get them while commuting to and from class. It was then that my current therapist and I decided that it was time for me to see a psychiatrist.

Our culture tends towards a belief that mental health medications change a person for the worse or are a form of “giving up.” I have two responses to that: one, I would hate to think that who I truly am is someone whose life is ruled by an anxiety disorder; we would never say someone who broke a bone or had major surgery is “changing who they are” or “giving up” by taking advantage of pain management. Two, medication allowed me to use those tools effectively. It is impossible to calm myself down when I am in the throes of a panic attack and if you have them, you understand what I mean. It’s essentially like trying to calm someone who has been shot. You think you are dying because your body is responding like you are dying. With a daily dose of an SSRI like Zoloft, my anxiety is at manageable levels so that when I feel a panic attack welling up, I can catch it. If I think back really far, the last time I had a notable panic attack was Memorial Day Weekend 2020. I was on the crest of a mountain at Oregon Caves National Monument. A combination of triggers current and old (high elevation, being in a remote location far from park rangers, and feeling like I couldn’t breathe) caught up to me faster than I could react. However, because of medication, a simple break lying down on a bench and the soothing voice of my friend talking about Dragon Age brought me down quickly and I was able to complete not only that trail but another without issue. Pre-medication, I probably would have needed medical assistance to help me off the mountain.

I was thrilled to have my anxiety under control. I went from having daily panic attacks to having an average of one or two a month. I started riding the bus and walking to class from the downtown station. I was enjoying a lot of time alone and enjoying the freedom. The adrenaline was no longer ruling my life (nor destroying my heart) but its absence revealed a beast that had been slumbering for a while: depression.

I hated college. I was constantly flip-flopping between majors hoping that I would find the answer to my problems with boredom and low self-esteem in Music Education, then Music, then Psychology, then Writing, and finally a Music and English double major. My plate was beyond full: two (sometimes three) jobs, multiple rehearsals, a fraternity, violin lessons, voice lessons, homework, required readings, and so much more yet I was only successfully accomplishing maybe three of those activities at a time. Everything else went to the wayside which meant I felt inadequate and because of this inadequacy I felt less and less motivated to pick up the slack. I cared so much about succeeding that I was too stressed to make an effort. Thus, the cycle continued until I eventually dropped out of college the summer before my senior year to join a Renaissance Faire band. I left behind a 2.7 GPA (compare that to the 6.3 GPA I graduated high school with) and a major helping of suicidal ideation and self-hate.

I thrived on the road. With my doctor’s help I weaned myself off Zoloft. I was still maintaining my low number of panic attacks without the medication and was capable of things I never thought I would be able to do because of the tools I had developed from my years of therapy. I drove hours upon hours by myself, explored the United States without a care in the world, got up on stage thousands of times a year, made new friends, and occasionally pulled out what I had learned to calm myself down when the anxiety threatened to rain on my parade. I thought I had finally found my calling, but after a while, the familiar dread and itch started to creep back in. It was like I could never maintain a feeling of accomplishment for too long.

It wasn’t until a few years later when I got married and moved to Washington State that the real villain became apparent. Before it had just seemed like an anxiety disorder with some depression thrown in every now and again (a common misdiagnosis for women with my condition). I even started taking Zoloft again because moving 3500 miles across the US had uncovered a lot of my old triggers. However, when I got my job as a housekeeper in 2018, depression and anxiety could not explain my experience.

Contrary to popular American belief, housekeeping is a very difficult job to learn. It also did not help that I worked at a military hotel with one, high standards and two, large rooms that contained features such as kitchenettes and living rooms. There were so many things to memorize such as color-coded cloths for specific areas such as blue for toilet and pink for shower, how to properly make a bed that a drill sergeant would be proud of, and which of my ten cleaning products was to be used for each item. It took me a month to get a mediocre-at-best routine down without forgetting anything. Once I got that routine down was when I started noticing the problems.

If I was left to my own devices, I could complete a room following my exact routine in the time allotted. If any step of that process was changed or interrupted, I was doomed. It could be the simplest of changes such as a coworker coming in to take my trash out before I was ready and suddenly I was forgetting to replace soap or to dust or sometimes even to put clean sheets on a bed I had stripped. I would start snapping at coworkers to go away or even just close the door to the room I was in and cry. Some days it would happen so frequently where coworkers would be coming in to assist me with rooms that I would spiral myself into a brain fog that would shut me down for the entire day. This was not anxiety or depression. At the time, my brain resorted the answers it always had: I’m just lazy, irresponsible, incapable, and stupid.

Over the next year as my jobs and life became increasingly more difficult, I began to experience more and more of these issues that could not be explained by anxiety and depression. At the youth center I struggled greatly to remember even the most basic of items. Even though I had my own house, I was not motivated to clean it or to cook in it. I was on the verge of being reprimanded for tardiness…again. I was finding myself interested in one career path, burning out quickly, and then changing my mind. I began to forget appointments left and right. My home was riddled with unfinished projects and my garden was overgrown (but thriving, I had so much catnip). I was ruining fun activities with my husband because I would either shutdown when things didn’t go right or meltdown when we tried to learn something new, and I didn’t get it immediately. I set up an appointment with my doctor shortly after realizing I had accidently stood up a friend on a coffee date and finally asked to be referred for an ADHD evaluation.

In December of 2019 I saw the therapist my doctor recommended. I could tell that he instantly knew what the outcome would be. He still handed me the extensive questionnaire for my husband and I to fill out and before I left said, “I’m 95% sure you have ADHD but I won’t be able to make a diagnosis until I get that.” He then chuckled and told me not to forget it at my next appointment.

It was difficult to answer the questionnaire without bias. Everybody always thinks of the boy bouncing off the walls in class as the one with ADHD. I did well in school, I followed directions, my teachers loved me. I know I struggled and am currently struggling but has it ever been that bad? My husband was able to help me be honest with myself. Yes, I do have a lot of trouble listening if I’m not making eye-contact frequently. Yes, if someone asks me to do something, I do forget it almost immediately most of the time. Yes, I do have a bad habit of interrupting people while they are busy or trying to focus. And so. Much. More.

I saw my therapist for my results on Christmas Eve, the day after my twenty-fifth birthday. He took a moment to score all the responses and then showed me a chart. “This,” he said while pointing to the bottom of the chart, “is where a normal twenty-five-year-old female is.” He then moved his pen all the way to top of the chart and finished with, “You are here.” I blanched.
“So essentially what you’re saying is that not only do I have ADHD, I have severe ADHD.”

He nodded.

The remainder of the appointment was him getting more of a feel for how it manifests. I told him about how my birthday went. My husband had treated me to a ski/snowboard trip at Crystal Mountain, a resort on the East side of Mt. Rainier. I spent most of the trip in a complete spiral, tears and runny makeup streaming down my face simply because I could not get the hang of snowboarding. I hated being like that. It isn’t who I am. When I told him I was wary of stimulant medication and not sure if I needed it, he offered me a great analogy—

He started by taking his glasses off. “I don’t technically need my glasses. I can eat, drink, and go about my morning routine without them just fine. However, I can’t work very well without my glasses, I can’t drive very well without my glasses, I can’t read very well without my glasses. Stimulant medication is similar.” I left the office with a letter telling my doctor he felt I would do well with Adderall.

The results didn’t hit me until I was in the kitchen making dinner later that day. I just started crying. My husband was understandably confused. What suddenly hit me was that all the horrible things myself and other people had said about me over the years weren’t true. I wasn’t lazy. I wasn’t irresponsible. I wasn’t “wasting my potential.” I wasn’t uncaring. I wasn’t a failure. I just have ADHD. This disorder causes me to have significantly less dopamine than a “normal” person and this deficit wreaks havoc on my brain.

With this information I was finally able to look at my life past, present, and future. It has allowed me to undo decades of self-hate, plan my life to be successful for me, and make my goals bite-sized so I’m constantly rewarded for my accomplishments. It has also given me tools to explain my condition to family, friends, and coworkers so that those relationships are more successful as well.

Nowadays, I work for Ravenwood Health, I volunteer for Heartland Hospice, and I go to school online for a self-paced program at Brandman University. At the start of this year, I re-kindled an interest in the death-positivity movement I abandoned about eleven years ago because of my mental health struggles (up until eleventh grade, I wanted to be an advocate in the death industry). I not only use the tools I learned from my years of therapy focused on pinpointing my anxiety disorder but now ones that I have learned from my last therapist, the first one I had post-ADHD diagnosis. I included Adderall in the treatment plan back in March and it has been very successful. In my work with my new therapist, I am currently focusing on another issue those of us with ADHD struggle with: learning how to say no to new, shiny projects and opportunities.

I share this story to one, show my clients that they are not alone. Those of us that seek mental health services are everywhere. Some of us have jobs, some of us have children, some of us are in school, some of us have other disabilities both invisible and visible, some of us have active hobbies, some of us are focusing on ourselves before we get back out in the world, and some of us are struggling to get back on our feet. There is a great deal more diversity of individuals but no matter what, we are not the negative stereotypes that are perpetuated, and we have support out there in the world—we need only share the stories we are comfortable sharing and find it. For our supporters, we need understanding and patience.

Two, therapy is not always a perfect journey. I’d argue it rarely is. There will be ups and downs. However, as the journey goes deeper and deeper, the downs get shorter and the ups longer until you reach a homeostasis where life throws challenges your way and you can work through them because you have built a resiliency with the help of caring individuals who have dedicated their lives to giving those who struggle the tools they need to succeed and helping people build strong armors of support and resources. You’ll still need to stick with the plan, but it becomes more about maintaining your new “normal” rather than rebuilding your entire existence.

Thank you for sharing your time with me, reader. My decade in therapy means that each call to my phone has a personal connection with me. I am thrilled to be that first point of contact and to help people begin or continue their own therapy success story. I hope this story encourages someone to reach out whether they are re-engaging in services or starting for the very first time, and if it does, I look forward to hearing from you.

The book I’m currently reading is Smoke Gets in Your Eyes and Other Lessons from the Crematory by Caitlin Doughty