36 → Boston, Massachusetts, USA → Writer & Librarian→ Anxiety & BPD → Therapy, CBT, DBT, Medication.
R: Hi Kara, tell us a little bit about yourself
K: I am a 36-year-old woman that works as an archivist/librarian, enjoys everything from creating art to playing tennis. I read everything in sight. When I’m home, my mom catches me reading things on her desk all the time. “Kara what are you doing?” I smile and say “nothing.”
R: Where do you live?
K: I live in a Massachusetts suburb South of Boston.
R: What do you do?
K: I work in Boston at a large University as an archivist, which I best describe as a librarian that organizes old papers. Also, I am a freelance writer for a few websites. Topics I enjoy and excel writing about include major league baseball (Go Red Sox!), art, mental health, recovery, and fun places to visit. More on that later.
— Kara Jackman (@KaraJ1979) November 1, 2015
R: When did your anxiety begin? Were you an anxious child?
K: When I was around 16, I first understood that what I had been struggling with anxiety my whole life. I experienced panic attacks as early as 3 weeks old. This was documented in my medical records, which I first read in 2005. I had these records because I was in the hospital just after birth to have a cleft lip and palate repaired. In the nurse’s notes from that hospital stay, the nurse asked my mother why I had an irregular breathing pattern. My mom responded it was something I did when I was scared. Later, as a child, I would worry and worry about things like people living in the woods behind our family home, or going on boats, airplanes, and restaurants. I would also attend high school basketball games with my father. Everything would be fine on the way there then, once court side, I would start shaking, excessively sweating, and experience strong, paralyzing body tingles. I remember my mouth, tongue and throat tingling to what seemed like paralysis. I had to sit on my hands so they wouldn’t ball up. I would ask to my dad if we could leave, but never told him what I was experiencing. I had no idea what was going on and was afraid, and didn’t have the words to explain to him what was happening. He was sure to tell me to shake it off. Once I realized in my teen years that these episodes were panic attacks, it all made sense. I was relieved. There was a reason. I wasn’t going to die. Every time a panic attack hit I was certain that it would never end.
R: In your own words, how would you describe Anxiety?
K: The generalised anxiety that I now experience is like a record replaying the same song over and over. I can’t stop the thinking even though I want to. I want to pick another groove in the LP to move into, but I feel like once I choose that new groove it may put me in harm’s way. In other words, I need to worry about everything or something bad is sure to happen. Things I worry about include my weight, my stomach and health, which is always giving me trouble, my parents’ health, interactions with other people, work, and shameful things from the past. Thanks to my Borderline Personality Disorder, I also believe everyone is out to hurt me in some way. I am afraid to feel sad and afraid, which manifests itself in anger towards other people. In being angry to others, I am trying to prevent future shame. Doesn’t make sense, right? Well, it is not supposed to.
“I am grateful for the therapy and exposure to my emotions that got me to this place, but I still have further to go.”
R: How has your experience with anxiety evolved? Is it the same as when you were a child up until now?
K: In elementary, middle, high school and college it was a lot of panic attacks and worry coupled with depression. You just feel so hopeless and like the world will never get better. I was worried about germs, interacting with my peers, how I look, and pleasing my parents. Now, I mostly experience what I have been told by therapists and psychiatrists is Generalized Anxiety Disorder symptoms, worry thoughts, worry about those worry thoughts, and a very obsessive busy mind. Panic attacks hardly ever happen any more. I have to be about to do something really scary to experience one. I am grateful for the therapy and exposure to my emotions that got me to this place, but I still have further to go. I want to be able to let go of things easier, rather than hold on to them and obsess about them.
R: People with anxiety often experience restless sleep, muscle tension and poor concentration. Do these ring a bell with you?
K: Yes, I have trouble sleeping and take medication and supplements for sleep. I also experience episodes of chronic, diffuse, full body pain. When this happens, I experience pain all over my body and I feel extremely fatigued. I also have stomach trouble, namely constipation. I think some of the physical stuff I experience is due in part to my mental health, but I also know my body is a very unique based on the clefting I was born with. Perhaps, there is a midline problem all throughout my body and that is why my stomach does not operate as it should? My stress levels do not help and they are higher than most peoples. On an average day, I probably feel like a normal person does when stressed way out. Then apply some additional, legitimate stressors like work projects and, well, it is not pretty. Concentration, and basic bodily functions are thrown way out of whack.
R: How does Anxiety affect your normal day?
K: I am very distracted and really need to buckle my mind down through mindfulness techniques that I learned through Dialectical Behaviour Therapy. I have trouble concentrating while driving because of my mental health, but over the last few months I have been trying to practice mindful driving, so I am fully present when behind the wheel. Additionally, I do not like to eat out and go to restaurants all that much. I am still afraid of germs and getting sick, so avoiding them affects my social life. I get real nervous around people, so I tend to want to stay away unless the environment is very structured, like at the gym or during a tennis match. My interaction with friends is limited. The two friends that I have do not call often because they probably think I am not feeling well or am not able to go out because I am feeling anxious. It is very isolating. They are great friends and I see them when I can. I know they understand the weight of what I carrying around with me. Most people don’t even want to start the process of being my friend. Luckily, I do not mind doing things alone.
R: When you wake, is your Anxiety immediately present?
K: Yes, the minute I wake up the worries are right there waiting for me. You are not enough. What are you going to wear? What if that outfit makes you look fat? Am I going to be able to go to the bathroom today? Will I be in pain today? It is a life lived with constant uncertainty. Oh sleep, I love/hate you. It is so terribly hard to get to sleep. I try breathing techniques, no caffeine, and reading at night in conjunction with some medications to get to sleep. My mind is always buzzing about something negative. Sometimes I can do everything right, and still be wrong, or hit with some serious stomach pain.
“My brain is a super-charged automobile engine, but all I do is rev the accelerator while the car is in neutral. I could have invented something or written a book by now”
R: Have you found any positive aspects of Anxiety?
K: The anxiety has helped my performance in the past, but I have found the older I get it is hurting me. If I give a presentation and I am nervous or not confident, I do not do well. There is a lack of flow. Recently, I noticed that feeling positive before an event like classroom instruction really helps improve my performance. The same is true with athletic performance specifically on the tennis court. Letting go and just writing is something I have practiced in my last two assignments. Writing and editing are two separate tasks.
R: If you had the option to lose your anxiety would you?
K: I would love to be rid of my anxiety. I say all the time that my brain would be able to accomplish so much more. My brain is a super-charged automobile engine, but all I do is rev the accelerator while the car is in neutral. I could have invented something or written a book by now. It definitely holds me back from fulfilling my dreams, like the book, and meeting my everyday needs, too.
R: Do friends or colleagues notice?
K: Yes, my boss and colleagues definitely point it out to me. I also own it, though. Recently, I have been more open about my anxiety about big projects like my most recent exhibition for the school and library. My boss reassured me that everything would turn out fine and it did! Now I just need to remember and believe that when the next exhibition comes my way. Tough stuff.
R: Does it affect your relationship with them?
K: Yes, I do not get along with my boss very well. I get along with my other colleagues much better, now, after many years. I tend to lead with anger and people are pretty put off by it, but follow through with a great product. Some people put up with it because they see how hard I work, and how good the end product is for us as a team. I have learned that the anger is a secondary emotion. The primary emotion for me is always fear. I have received some terrible performance reviews. I do very well on my work productivity, but not so great with playing well with others.
“There is great reward that comes with struggling with something for a lifetime. You get to see all this amazing progress when you look back upon your life.”
R: Do you think your life would be different without anxiety?
K: I think my life would be a bit better. Perhaps, a great weight would be lifted from my shoulders. I would very much like that. I also know that I can achieve a better mental health and thus a better life with hard work on myself, too. I would prefer the magic wand approach, though.
There is great reward that comes with struggling with something for a lifetime. You get to see all this amazing progress when you look back upon your life. I am always working very hard to overcome what is going on between my ears. It is a journey that will never end.
R: You’re a writer – How does Anxiety affect your work? I have anxiety and it often causes procrastination, hesitation and doubt. Do you also experience this?
K: Anxiety and writing means I am constantly procrastinating on my work. I get so nervous in front of keyboard sometimes. More and more, I notice that I am editing the sentences while I am writing them. This is not conducive to good writing. As I said above, writing and editing are two separate tasks. I get so in my head, and I start to over think everything I am typing. I forget how to spell (why God why!) Then I question whether the whole piece should be structured differently, and then I start sweating even more. I single-handedly keep the deodorant companies in business
“I would like to write a humorous book about my experiences with surgeons and doctors, after what has been a lifetime of sitting in waiting rooms.”
R: Does Anxiety ever appear in your writing?
K: It has provided some great entries for my blog. I wrote a piece about going to the dentist and how scary it was while infusing some humour into it. It was a big hit on my blog. It is called “Going Mental Over Dental.” Hopefully, some day, I would like to write a humorous book about my experiences with surgeons and doctors, after what has been a lifetime of sitting in waiting rooms. Hmm…might not be a bad title.
R: You have also been diagnosed with BPD. How do you best manage life with bpd?
K: The short answer is I am in a lot of therapy. I also work very hard every day to improve my interpersonal communications. It is really hard because I will suddenly feel things or get confused by what someone is communicating to me. My emotions get in the way. My biased thinking gets in the way. I have all these beliefs that everyone is out to get me.
I have to challenge those beliefs before, during, and after every interaction with someone or something. I am not going to give up. I try every technique and skill that my therapists provide. My life has improved, but it is always a fight. If I am not struggling then I am not engaged in getting better. I refuse to lie down and take it…though there are days I want to.
R: Does your BPD affect your anxiety?
K: Absolutely. I think the two are very intertwined. My mind loves to chew on doom and negativity. These thoughts feed my beliefs and assumptions about the world. When I do have moments of hope, I am sometimes disappointed. I get angry and lash out. I used to act out with alcohol and sex. Instead I exercise, take care of myself by taking baths, doing my nails, writing, and reading.
Rules? Please who has time for that
— Kara Jackman (@KaraJ1979) October 11, 2015
R: Have you officially been diagnosed by a health professional?
K: I was officially diagnosed in 2008 by two different psychiatrists. I do not think that I currently meet 6 of the 9 criteria in the DSM V. I believe meeting 6 of the 9 criteria is what tips the scales in favor of diagnosis. I still treat it because those criteria that I do meet overwhelm me. I want to do everything I can to get better.
“DBT has allowed me to be more open-minded about myself and the situations that I encounter every day.”
R: Have you sought treatment?
K: Yes. I am in a Dialectical Behaviour Therapy skills group. I work on a combination of Cognitive Behavior Therapy and DBT with my therapist. The dialectical approach has helped me see the world more broadly. I am open-minded about politics, art and music. DBT has allowed me to be more open-minded about myself and the situations that I encounter every day.
R: Did any treatments work?
K: They help. I still have roadblocks because my mind is a confusing place. I think I have implemented and have been successful in many areas of my life thanks to DBT. I know my therapist and I have done some great work together. The progress is hard for me to see. Recently, since I put down the alcohol, I have seen dramatic improvement. Now I feel like anything is possible if I put some effort into it.
R: Have you been to therapy for Anxiety also? and did it work?
K: Yes, I have sought therapy for anxiety beginning as early as 8 years old. In childhood I was in and out of therapy. It was not until I was 17 that I started to really tackle the panic and anxiety with cognitive behaviour therapy and some medication. I was able to get over many of my OCD-tendencies with the help of these therapists.
R: How do you best manage it? (medication, meditation, yoga, alternative medicines, or something else)
K: First and foremost, you have to laugh. If I didn’t have my sense of humour, I would not be able to get out of bed in the morning. All of the crazy things that have happened along my journey have required levity. I credit and thank my Dad for his great one-liners. My mom is pretty hilarious, too.
As far as medication goes, I take Cymbalta. I do not know if it helps. I just know when I do not take it, “Look out!” My brain is on fire with negative thoughts, and I am in a world of physical hurt. I challenge my thoughts constantly. The more I practice this the better I get at it. I have to ask myself, “Are those people really talking about me? Or is that just what my brain wants to believe? Or are they (far more likely) worried about themselves?” Now, I know there are other points of view. I do not have to believe the American Horror Story episode that my brain is telling me.
Other ways I improve and manage my mental health, I exercise a ton. I need to release the anxiety and clear my head. I love to play tennis, hit the elliptical and spin bikes at the gym, and yoga when I can get it in. I wish I could do more yoga classes. I love everything about the experience of going to the studio near my house. It is not the same when I do yoga at home. I know this practice could mean a significant upgrade in my life and sanity, if I could commit to it every day. I feel unbelievable after those restorative yoga classes. There is no reason I could not feel like that every day in my own home. It is a goal.
Oh yeah, I love to journal, too. It is important to my mind and my writing.
R: Do you feel like you’re in control?
K: Some days I feel like I am driving the bus. Other days I feel like I am running after the bus yelling, “Hey, hey…Stop, I’m right here.” Those are the days my brain is in control and I am along for run beside it.
There are many factors to feeling in control. I have to manage my stress level, my exercise, food intake (don’t want to get “hangry”), and mastery of things I enjoy doing like tennis and writing. Right now the biggest issue I have is my stomach issues (constipation) flaring up. This is well out of my control. I do all I can to try to take the best care of my body as possible, but even that fails. Sometimes all you can do is get comfortable, grab a book, or the remote and ride it out.
R: Where does your Anxiety come from? Did any health professionals explain where your Anxiety originated?
K: No. I always suspected that it is a combination of environment and genetics. I look at the reason for a complex issue, like anxiety, manifests in many different ways. I see it as a pie. There is the cleft lip and palate slice of the pie, the parenting slice of the pie, the school and peer interactions slice, the physiological slice, and so on. It is one, big crazy Thanksgiving dessert.
R: Do family members have Anxiety?
K: None of my immediate family members have been formally diagnosed, but I know they experience it. I know they get anxious and overthink. I had a great conversation about this with my brother the day he came to my condo to celebrate before his proposal to his now wife. Admittedly, we talked about everything that night, but I really walked away from that conversation knowing that he overthinks a ton, too. And not just about getting married, which is totally normal. I am talking everyday work, family, and life stuff. I had no idea he over thought as much as he did. He doesn’t show it. It kind of clicked for me that night that all four of us do it. I wasn’t alone.
My mom, dad, and brother all are able to keep it under wraps. Sometimes, it does come out in the form of anger. Sometimes I get angry, too. It is a lot easier and more energizing to access anger. Recently, though, I have begun to see the power in crying and tears. It is very cleansing.
R: Anxiety can result from a difficult childhood. Did you experience trauma as a child?
K: Well, I am so glad you asked! Yes, I did. I was born with a bilateral cleft lip and palate. I was born with breaks in the lip where it did not close in utero, and little in the way of hard and soft palate. The holes in my palate were connected to my nasal cavity. The lip and parts of the palate were closed at 3 and 6 months. At age 6, I had a pharyngeal flap surgery to improve hypernasality in my speech, swallowing function, and repair more of the soft palate. At 13, I had a bone graft to close the remainder of the hard palate at the roof of my mouth, right and left sides. Prior to that surgery I got food stuck between my mouth and nose all the time. I always snorted it loose and kept on trucking. I went on to have two more bone grafts, rhinoplasty to repair the inner anatomy and the outer appearance of the nose. I had laser treatments for the scars and braces twice. The second set was on from junior high to my senior year of college. Finally, I was done at the age of 26 after I had four implants placed in my month, a process that took a little over a year.
The doctor’s appointments from an early age were traumatic. There were these guys in white coats or blue scrubs shoving mirrors under my nose and mouth, and taking pictures, probing in my mouth, face, and ears constantly. I never really knew how to process it emotionally. It wasn’t something mom and I addressed. We just went to the appointment and then to the Swan Boats and Lord and Taylor. She did a great job with everything. She goes above and way beyond as a mother. When God made her, they broke the mold. And when they put the two of us together, no one else had a chance with their relationships. She is my best friend, my confidante, and truly my everything. And what a cook!
R: Do you tell friends, family and colleagues that you have anxiety?
K: I am very open about my anxiety, recovery, and mental health. I think people do not talk about their struggles with mental health enough. There is so much shame in it. It is okay to talk about these things.
I am pretty decent at most aspects at life, but it is not easy, because of my health complications, anxiety, and BPD. Give me chance, though, I am a lot of fun. I just need more breaks and may ask you some annoying questions about what you mean along the way.
R: Or BPD?
K: I don’t usually tell people about this unless it comes up in some way, like I see a book or someone mentions it for some reason. People do not know what BPD is. I hate the “Personality Disorder” in Borderline Personality Disorder. It really throws people. They think, “You have a great personality.” No. That is my sense of humor. Or they think there is something inherently wrong with me, as a person. This also is false. I explain what I have trouble with based on the criteria. I tell people I have a tough time connecting with people. I let them know I lash out. I let them know about my recovery from alcohol. If people do not have a context for things, they cannot relate. You have to make it relatable and the words Borderline Personality Disorder do not accomplish that goal.
R: Do you know others with anxiety?
K: Oh yeah! I am a librarian I think it is part of each library job description. Many of my colleagues battle some of the same demons I do. Sometimes I have the privilege in helping them out. Some of my friends and family (as I mentioned above) have anxiety disorders. I let them know they are not alone. There are many people who come to me because they know that I won’t gossip about them, and sometimes I can even be helpful with their struggles. Mostly I think it is the not gossiping and loyalty that make me a good candidate for deep conversation.
R: How do you educate yourself on management and resources? Do you read specific blogs, magazines or news articles?
K: I am in love with Twitter because it tailors my news to my interests. I read a lot of what gets tweeted or retweeted from the Huffington Post, Elephant Journal, and other mental health-related sites. There are some personal blogs I follow, too. I love podcasts because my commute can be long. I listen to ones on recovery and mental health, including AfterParty Pod, Mental Illness Happy Hour, and Dr. Drew Podcast to name a few. The Mental Illness Happy Hour with Paul Gilmartin is an amazing resource. He really cares about the product he puts out. It does help people. The website is also a great resource, too.
R: Have you read any great books about anxiety?
K: When reading I want to be transported to another place. Still, I enjoy characters that I can relate to. I recently enjoyed best sellers like The Girl on the Train, All the Light We Cannot See, We Are Not Ourselves, and Dark Places. Some of the characters in these books have some mental health issues. The female protagonists in The Girl on the Train and We Are Not Ourselves have elements of anxious thinking which makes them more interesting, real characters. Ultimately, what I feel the world needs to understand is that all of us deal with some type of disordered thinking. Books, podcasts, and other media are great ways to relay that information to people.
R: Or seen any movies?
K: I cannot think of any movies right now. Inside Out did a pretty amazing job with emotions. It is pretty spot on.
For the love of all that is holy, could we NOT let the door slam on the first floor below my couch. I'm watching the #worldseries
— Kara Jackman (@KaraJ1979) October 31, 2015
R: What do you write about?
K: The quick answer is I write about everything. I have written for small town newspapers, medical non-profit newsletters, and blogs. I write about sports, specifically baseball and do freelance writing for a fleet of real estate websites where I review attractions, restaurants, museums, and retailers near the properties they are advertising. It is interesting to learn about other parts of the country. I have done some other news writing and blogging on mental health and recovery on blog sites I have created.
My favorite topic to write about is baseball. I fell into it in 2013 when I answered a Craigslist advertisement for writers needed for a new program booklet that would be sold outside Fenway Park in Boston. It was a great experience, especially since they won the World Series that year. I made phone calls and attended games in a minor league press box. The following weekend, with the connections I made, I was up in the press box at Fenway Park watching the Futures of Fenway game. Since then, I contribute to Sports of Boston, LLC, and try (try being the operative word) to write entries on a Red Sox blog I manage.
One of my dreams is to put a book together about my experiences with cleft lip and palate, and my other health issues. Many people do not spend a whole lot of time in hospitals and are legitimately scared of them. I would like to find a way to disarm that anxiety they have about hospitals through a humorous account of my years in hospitals. Like I said earlier, the title might be “A Life Spent in Waiting Rooms.”
R: Tell us about the reactions you have received?
K: I have had positive and negative feedback to my writing. Something negative happened between my boss and I from that writing gig I took in 2013. My name got dragged through the comments section mud of a major, regional newspaper, when they wrote an article about his competition with another business. It was not fun. I made it worse, because I do not know how to respond in these complex situations. I was too quick to get in there and try to right the wrong.
Most people enjoy what I write. I get positive feedback. With regard to the sports writing, it is hard to gain respect as a woman in sports media, but I enjoy trying. It is fun. I have a strong following on Twitter. I tweet during games. I am really enjoying the Mets and Cubs this year. The Red Sox are out of it, so I can really sit back and enjoy the game without any bias. I enjoy football and basketball, too. It is fun to tweet those games, too.
R: Where can we read your writing?
R: What are your plans for the future?
K: I would like to make a career change. I would prefer to be a full-time writer. It is very difficult trying to squeeze it in after a long day at work. I love it so much, and I know I have to earn my place in the marketplace. I am ready to make the jump. Does anyone know a good headhunter?
I hope to continue to build my social network through activities I enjoy. It is a far more effective way of meeting people. Everyone is putting their best selves or experiences on social media. It isn’t authentic. Oh nice, you went apple picking, and you went to a restaurant. Great, but what are you passionate about? What makes you get up in the morning? What are you struggling with right now? Let’s do away with the shameless self-promotion. I want to meet three-dimensional people with flaws, struggles, and life experience.
“Everyone is putting their best selves or experiences on social media. It isn’t authentic. Oh nice, you went apple picking, and you went to a restaurant. Great, but what are you passionate about? What makes you get up in the morning? What are you struggling with right now?”
R: What are your plans for the future for your Anxiety & BPD?
K: My goals are to identify the thought patterns that run in my head. Then come up with other ways of thinking about those things I like to ruminate on. Come up with more positive ways to talk to myself. Create affirmations and repeat them until I believe them. I also want to keep challenging the thoughts that come up for me. I want to say “No” more because I am such a people-pleaser. I even try to please people and organizations I do not really care all that much about. I can’t do it all. Another goal would be to get off the Cymbalta, but I think that is a more long-term goal.
R: Any thing else you’d like to add?
K: Things do get better. I cannot believe how far I have come and how far I have yet to go. I am going abroad for the first time in my entire life this December. I will be travelling to Rome with my parents and very close relatives. After all I have been through, this is something I am very much looking forward to, but am also very nervous about. To think I am going to see the very artworks and buildings I have spent half my lifetime studying? Truly, a dream come true. Positive things do happen, and it is my job to embrace them. I have no choice, but to keep on improving myself so that I can take part in those positive events. So…Let’s do this life! I’m coming for you!
Rodger Hoefel in conversation with Kara Jackman
Photography supplied by Kara Jackman