News Day Tuesday: BLOOM by Anna Schuleit

a cure for what ails you, bipolar disorder, major depression, memories, News Day Tuesday, ptsd, rapid-cycle bipolar disorder, stigma, three hopeful thoughts

Hey readers! This week, we’re doing something a little different for News Day Tuesday.

I stumbled across Anna Schuleit’s beautiful BLOOM project from 2003 (yes, I know I’m super late to the party). Today, I want to celebrate that project.

In 2003, artist Anna Schuleit installed 28,000 (28,000! Yow!) potted flowers throughout the psychiatric ward of the Massachusetts Mental Health Center (MMHC).

Anna Schuleit’s installation project was created within the entire building of MMHC, on all floors, inviting former patients and employees, staff, students, and the general public, to re-visit the historic site once more before its closing. There was also a symposium at a nearby venue, and an open forum on the front steps of MMHC, during which the patients were invited to tell their stories. The events were dedicated to the memory of the thousands of patients of MMHC, and included as many of them as we were able to contact, as well as the doctors, nurses, support staff, researchers, students, and the general public. The project was a non-profit effort run entirely by volunteers and all of the events were free and open to all.

Source

As people living with mental illness, some of us with more than one, we know the therapeutic power of telling our stories, of having a voice when we’re so often voiceless. Mindy Schwartz Brown wrote some beautiful poetry about her experiences at MMHC, which you can read here. One poem in particular, “Asylum,” touched me deeply.

ASYLUM
(for Anna)

How did this edifice become “home” to its inhabitants-
the renowned multiply degreed,
the haplessly homeless dually diagnosed,
the walking wounded,
the worried well,
the happy go lucky who cleaned floors,
cooked lunches,
took blood pressures.

How could it contain all of the
the egos,
the disintegrated, the inflated,
occupying one space in parallel play?
MD, SPMI
Ph.D, BPD
MSW, DBT
Tell me in this soup, where does one find one’s ME?

DSM IV, Anybody going for V?
What’s the code for those who close hospitals
then open prisons for the sick?

We all feel so much better now,
knowing our brains are
faulty and we are not.
Structural errors ,
neurotransmittor deficits,
viral origins,
genomic misconfigurations.

So now can we all be friends?
Can we do lunch?
Just as we would with a diabetic?

October 3, 2003

Mindy Schwartz-Brown © 2003

The pain of not being recognized is one we know all too well. The lines “We all feel so much better now, / knowing our brains are / faulty and we are not” struck a chord with me that resonated all the way through my body and down into what some people call the soul.

We are the ones who are forgotten. We are the ones who are hiding in plain sight, not out of our own desire to be invisible, but of the desire of others to make us invisible. We make others uncomfortable, particularly when we don’t outwardly fit the mold of the “mentally ill person.” Whenever I reveal that I have bipolar I and CPTSD to someone, I am typical met with one of two reactions. The person either recoils–the discomfort in their eyes is stark and harrowing–or they tell me how “brave” I am.

I am not brave. I simply live. What choice do I have? I do not want to die, though there are plenty of people who view living with a mental illness as a fate worse than death–and I find that more disturbing than anything going on in my attic. There have been countless times when the hauntings have gotten so noisy that I feel as though my mind may literally split in two. Still, I live. Our lives have worth. We have worth.

I’d like to end by including a few photos of Schuleit’s installation. I spent a great deal of time yesterday perusing the photos and reflecting–not on my own experiences, as I have never been inpatient, but on what others’ experiences might have been like as they lived out their day-to-day at MMHC.

bloom-by-anna-schuleit-red-mums-640x920

bloom-by-anna-schuleit-white-tulips

bloom-by-anna-schuleit-blue-hallway

All images above copyright Anna Schuleit.

Tell me your stories, readers. It’s important.

News Day Tuesday: New treatment for PTSD?

a cure for what ails you, News Day Tuesday, personal experiences, ptsd, rapid-cycle bipolar disorder, three hopeful thoughts

Good morning, readers!

This week, I rustled up an article about some exciting developments in PTSD research.

Basically, scientists are looking at glutamate (one type of those fun little things in your brain that sends signals) and how alterations in glutamate levels affect PTSD. What this means for us is that PTSD is now being studied on a molecular level, which means that new treatments could be on the horizon!

My PTSD is generally well-controlled, as far as “controlling” it goes. I’m still mad-jumpy and don’t have a good time in crowds (the dissociation spikes, and sounds that hit my left ear first seem to make it worse, though my previous psychiatrist had no idea why). I still feel depersonalized/derealized every single day, though the level of detachment varies widely. I haven’t been able to pinpoint exactly what it is that makes it better or worse, but admittedly, I’ve been super lazy about charting it.

However, I’m sleeping soundly for the first time I can remember. I think a lot of us can relate to the hypervigilance and, by extension, light sleeping. Loud noises still startle me awake and my fiance sometime scares the bejeezus out of me by touching me–gently–to wake me up. But! and this is good news–the sounds of the cats wheezing or vomiting or fighting don’t wake me in a panic. It’s more of a “God, this again?” reaction, which, while not fun, is better than waking up with a racing pulse and momentary confusion about where I am.

As far as journaling about symptoms goes, I’m still trying to figure out a system. How many times in a day should I note what’s going on upstairs? I don’t want to become obsessive about it, as I did with my mood journal when I was first beginning treatment for bipolar disorder. At the same time, I want to make sure I have an accurate log of my symptoms and the events that may have caused an increase/decrease in the weird floaty feelings of unreality.

That being said, it’s sometimes hard to notice the changes because they’re subtle. Because this has been chronic for six years now, it often takes an absolutely massive spike before I notice anything is off. On a related note, I often don’t notice the symptoms decreasing because hey, it’s my “normal” now.

Any ideas or tips, readers? Should I follow the standard day/time/preceding events/level (on a scale of 1-10) format I’ve used in the past for mood tracking? What system(s) do you use?

I look forward to hearing from you! I’ll see you next week and as always, stay safe and remember to say one nice thing to yourself every day. Today I have two: “My new DIY manicure is bangin'” and “I am surviving my fiance’s work trip with zero negative emotions!”

It’s important to focus on the positive, especially when our emotional weather is often stormy.

News Day Tuesday: BiAffect App Links Keystrokes with Bipolar Episodes

a cure for what ails you, bipolar disorder, News Day Tuesday, rapid-cycle bipolar disorder, three hopeful thoughts

Greetings, readers!

It was a bit of a challenge to find an article for this week, but I finally stumbled upon something that could make a huge difference in how we track our moods. There’s a new app called BiAffect that uses your keystrokes, frequency of texting, and social media app patterns to track manic and depressive episodes.

To find out whether a user might be experiencing a manic or depressive episode, the app tracks typing speed, how hard keys are pressed and the frequency of the use of backspace and spellcheck.

chicagotribune.com

I know there are a lot of people who dislike the idea of being tracked in any sense, which is totally fine. However, I feel a bit more comfortable with it knowing that it comes directly from a research group. It’s only available for iPhone, which is kind of a bummer because I’m a die-hard Android user.

I wish something like this had been around in 2013, when I was deep in the throes of exhausting rapid-cycling episodes. I was newly diagnosed, but the challenge of finding the right combination and doses of medication, the loss of my job (probably due to my cycling), and the overall disintegration of my marriage had more or less temporarily erased any benefits or relief I found from my diagnosis.

One of my long-time friends mentioned that he noticed I was posting a lot more on Facebook when I was manic than when I was depressed. Like, a lot. Even now that I’m stable and successfully medicated, I still pay close attention to what and how often I post. When I’m more energetic and feel like interacting with others, I find myself wondering if it’s because I’m manic, hypomanic, or just…not depressed.

When you’re living with bipolar disorder, it’s a constant question of Column A, Column B, Column C, or a bit of each. You learn to analyze your moods and energy levels, and this tracking can quickly become obsessional.

I see this app as a double-edged sword. On the one hand, it would save those of us who pay attention to our moods a ton of work. On the other, those of us who are prone to preoccupation and overall obsessional thinking could end up checking in a lot more often than usual.

If BiAffect is released for Android, I’m for sure going to jump on it, at least for a trial run. It seems like it could be a useful tool for mental health care providers and patients alike–rather than having to drag in pages and pages of mood diaries, we could pop open an app and have the data right there at our fingertips (literally). And, at least in theory, it seems like any sort of self-report bias would be removed, or at least mitigated. I know I’ve been guilty of fibbing a bit in my mood diaries due to the shame that comes from realizing just how sick I am.

What do you think, readers? Would you give something like this a spin, or do you find it intrusive? Let me know! I’ll be keeping an eye on this one.

Until next time, stay safe and remember to be excellent to yourself.

News Day Tuesday: Sick Days

a cure for what ails you, major depression, News Day Tuesday, ptsd, rapid-cycle bipolar disorder, stigma, three hopeful thoughts

Hey readers! I’ve gotten really bad about posting regularly and as we all know, structure is crucial when you’re living with a mental illness (particularly bipolar disorder). I made myself a super-nifty planner before I started school in January and am actually going to start using it to keep myself on track. What this means for you is that hopefully, I won’t disappear for weeks at a time!

Anyway, today’s article addresses the stigma against physicians taking sick days for mental health. While it focuses on doctors in Australia, the topic is extremely relevant to anyone who has ever taken or needed a “mental health” day. According to the article, doctors (unsurprisingly) feel uncomfortable taking sick days for self-care, even when they begin to feel burned out and can’t deliver their usual level of care to patients.

“I’m completely supportive, but I’ll admit I’ve never been brave enough to take a mental health day,” one doctor said, adding, “How can you dump your workload on a colleague who is going through much the same things as you are?”

– abc.net.au

I find this extremely relatable because I’ve always felt awkward calling into work or needing to leave early because my brain has decided that doing anything other than crying in bed is just not going to happen. It doesn’t happen often, but I’ve always felt the need to claim another reason–usually migraines, which I used to get several times a week–because we’re conditioned to believe that depression, anxiety, and other disorders of the mind are not a valid reason for absences. We’re taught to believe that we need to suck it up and get on with our lives, even if that means hiding in the bathroom to cry or have a panic attack.

Naturally, this poses a huge problem for anyone in the workforce, but it’s especially problematic for health care providers. It’s something I’ve often thought about as my clinical practicum draws closer. How can I best serve my clients if I’m experiencing the same symptoms as they are?

I also fear that even in a mental health facility, where one would expect supervisors to be a bit more sympathetic, I’ll come across as weak or unsuitable for the job because of what’s going on in my brain. There’s an indescribable level of self-loathing and shame that comes with mental illnesses, and I’m sure all of you can relate. It’s the feeling of being less-than, the feeling that you don’t deserve to have a job because some days, you just can’t handle the world. You begin to question everything about yourself–am I being weak or overly sensitive? Am I doing this whole “adult” thing wrong? The fear of losing your job is a constant presence, which only makes things worse.

So what can we do about it? Unfortunately, there’s no easy answer to that question. One would hope that with increased media exposure, employers will become more understanding, although every boss is different and there are zero guarantees.

When I was first diagnosed with bipolar disorder, I loved my job. I was working as an editor at a translation company, but my symptoms were so severe that I actually had what I called my “Oh shit, I cried at work!” kit, which I kept in my desk so I could patch myself up after crying jags. Some of the items included eye makeup, because it’s embarrassing to have streaked makeup after crying (even though I became very good at crying without messing up my face). Although my employer was aware of my struggles, I still lost that job due to absences, which sent me into a horrific downward spiral that took over a year to break.

Since then, I’ve become quite anxious about divulging any information related to my mental health to anyone at any job…and that’s problematic by itself. Why should we feel ashamed of something that’s beyond our control? The answer lies in the stigma.

It’s going to be a long, uphill battle, though the fact that today’s article even exists gives me hope. Exposure and time are the only things that are going to remedy this issue. It’s an unhappy thought, but I sometimes find myself wondering if mental health issues will ever be considered as legitimate as something as simple as food poisoning when it comes to work absences.

I’d like to end on an up note with another quote from the article: “If we can’t help ourselves, how can we help others?”

Self-care is so important, readers. The Compassion Project offers a list of self-care activities that you can check out to build a plan for yourself. Here are some of my favorites.

  • Reading
  • Baking (I’m a huge stress baker, though I haven’t done it in a while)
  • Knitting or embroidery
  • Crafting
  • Cuddling with a pet
  • Going for a walk (which you can even do at work–take a five-minute break to stretch your legs)
  • Doing a crossword puzzle

What are some of your favorite self-care activities? Let me know–I’m always looking to add to my list!

As always, readers, stay safe and I’ll see you next week.

Those Old-World Blues

a cure for what ails you, anxiety, major depression, memories, personal experiences, ptsd, therapy

I won’t lie, readers; I’ve been down quite a bit lately. Most of it stems from deep-seated guilt that’s been playing the long con on me for most of my 28 years–it likes to pop its ugly head up and hit me so hard that sometimes it feels like I can’t breathe.

I’ve been carrying around a back-breaking load of guilt since I was a child. Some of it was inflicted by others, some of it by myself. There were so many little things–messages, perhaps–that sneaked in and grabbed me when I was at my most vulnerable.

When my mother went to prison, one of my maternal aunts abandoned her life in Chicago–what I perceived to be a vibrant life of friends and work and independent living–to return to her hometown to help my grandmother raise me. She never tried to make me feel guilty, but the damage had been done long before her arrival. I felt that there was something “wrong” inside me, that I didn’t deserve to be treated well, that I had done something to deserve the early childhood abuse and neglect that made me into a cautious, anxious, hypervigilant kid.

It all began to snowball from there. Anytime someone would do something nice for me–even something as simple as buying me an ice cream cone–I would immediately feel terribly sad for reasons that my child’s mind couldn’t comprehend. (Fun fact: To this day, the music from an ice cream truck makes me want to cry. Brains are weird.)

As many of you know, I’m studying clinical mental health counseling at Hopkins. I never expected to get in, but I was ecstatic! (I still am, though thankfully, the disbelief has faded a bit.)

My fiance has generously offered to support me financially through this time, as it’ll be probably another year until I can land a paying gig in my field. He’s told me time and time again that he doesn’t mind doing this because he’s financially secure enough to do so and because he loves me (and I suspect it also helps that I’m incredibly low-maintenance–see above paragraphs on guilt). I trust him and try to take him at his word.

But more and more frequently, the old guilt starts to creep in, which leads to devastating lows. Lately, I’ve found myself wanting to cry but not quite knowing why. I think it’s because I’ve suppressed so many emotions. I deal with everything by not dealing with it, which I recognize as alarmingly unhealthy behavior. Once I’m added to his insurance plan, my first order of business is to find a really good trauma therapist (that isn’t based out of one of the sites I’m looking at for practicum/internship).

Today, my fella told me that he thinks I have things “more together” than I think. And he’s probably right–I feel very good most days, although there are little nagging low points on even the best days. I can usually brush them aside using a couple of methods I’ve learned, which I’ll describe below.

Tonight is a rough night. He’s at dance practice, which is awesome–I’m glad we each have interests of our own, and it gives me time to practice the piano without being embarrassed about how rusty I’ve become. It also means I have time alone to cry everything out without worrying about making him worry.

Earlier, I went out on our balcony and looked up at the sky. It wasn’t quite dark but the moon was out in full force. It reminded me of my Great-Aunt Mare and how she’d come to the house twice a day when I was young–once in the morning for coffee with Grandma (her sister) and once in the evening to watch Wheel of Fortune with us. (Side note: I was awesome at Wheel of Fortune.)

I decided that a good cry would be the best medicine, since I’ve been feeling kind of weird all day, emotionally speaking. Shortly after her death, I made a small album on Facebook of the best photos of me and my great-aunt–Halloween at a pumpkin patch, hugging me close for a photo at my eighth birthday party, holding me when I was a baby. I looked at them and I let myself cry. I let myself howl my sadness into the void. And then I sat up and said, “That’s enough; let’s go write a blog post about it.”

I find that if I don’t come up with ways to distract myself, the sadness will become endless waves of grief and shame and all of the emotions I’ve been hiding away all these years. Once it’s out of the box, it’s so hard, so exhausting, to put it all back in.

I apologize for the downer post, readers. I haven’t had a personal post in quite a while but I feel as though being open and honest about my emotions, good or bad, can make others feel less alone. There have been so many times when I’ve been endlessly Googling about a specific worry or fear and bam, there’s a blog post about it. Though it may not help right away or offer solutions, it does make me feel less alone.

I hope you’re all staying safe and doing at least okay tonight. We all need to support each other, at our best moments as well as (and especially) our worst. We’re a community. We survived horrific things, and we continue to survive. Never forget that.


A Few Coping Techniques

  • I saw this one on Reddit last week and loved it. In a nutshell, the poster’s therapist advised them to think of someone they really dislike and imagine that all of the negative thoughts and worries are being spoken aloud by [whatever person]. The person this poster chose to use is Trump.
    • The way it works: Whenever worries or negative self-talk pop up, you go, “Shut up, Trump! [or whatever person you’ve chosen].” It actually does work, and it’s great for shutting down those thoughts at the drop of a hat. Of course, it’s always good to revisit those thoughts at a calmer, more appropriate time, but it’s nice to have a method to use when you’re in a situation where you can’t fully emote.

 

  • Another method I love (and promote to others quite frequently) is Ellis’ A-B-C-D-E method of challenging distressing thoughts. It comes from Rational Emotive Behavior Therapy (or REBT). Here’s the breakdown.
    • Step A: Identify the activating event–this is the event that triggers anxiety, depression, etc.
    • Step B: Look at the emotion you’re feeling and combine it with the activating event. Then, try to identify the beliefs that go along with that event and examine how they cause anxiety/etc.
      • For example, someone buying me something makes me feel guilty. This feeling of guilt and sadness comes from early childhood experiences. The end result is that I feel as though I don’t deserve kindness.
    • Step C: Look at the consequences of your irrational beliefs and realize that they can become a self-fulfilling prophecy. Because my response to kindness has been guilt and sadness for so long, I expect to feel that way every time someone is kind to me.
    • Step D: This is where you start to challenge those irrational beliefs and replace them with other, more positive ones. In my case, I need to work on building up my self-worth (long term) and thinking about the symbolism behind gifts and acts of kindness–“This person loves me and cares for me, and this act of kindness is coming from that place of love, not from a sense of obligation.”
    • Step E: This is basically the end goal and is usually called “cognitive restructuring.” At this point, you put all of the steps together and take special care to notice how the process has affected you and whether or not it has helped you to combat all the pieces that bring on the negative emotions (in Steps A and B).
      • You’re essentially re-conditioning your brain to replace negative associations with positive ones. It’s definitely a long road, but I’ve found it to be extremely helpful. However, it’s less useful to me when I’m in a crisis moment.
  • The last one is very calming to me, because a lifetime of CPTSD has led me to an incessant and sometimes self-destructive need for control. I worry endlessly about bad things happening to loved ones (because abandonment issues are fun!), so this little mantra really helps me chill out and remember that I can’t control every variable in my life.
    • Essentially, the saying goes, “If you can change something, do not worry, because you will find a way to change it. If you cannot change something, also do not worry, because there’s nothing you can do about the situation.”
      • This takes some getting used to if you’re like me and overanalyze and catastrophize everything, but once you’re there, it can be a very powerful tool for derailing anxiety before it hits its boiling point.

Andrea Gibson – The Nutritionist

a cure for what ails you, three hopeful thoughts

Hello, readers!

Today, I want to share with you a poem/spoken word piece that has always deeply resonated with me. The first (and second, and third…) time I heard it, I was reduced to helpless tears. I had the privilege of meeting Andrea Gibson and seeing her perform about six years ago, when she was doing a show in my hometown of Dubuque, Iowa. I ended up getting a comforting hug and crying on her shoulder when I told her how much this poem means to me, and I will never forget that moment.

“The trauma said, don’t write this poem. No one wants to hear you cry about the grief inside your bones.” This, and the final lines: “Live. Live. Live.” will always make me cry–not from sadness, but from relief. This is the single most reassuring thing I have ever read (and heard) in my life.

When I discovered Andrea Gibson I felt, for the first time in my life, that I was not alone and that everything was going to be all right in the end. It was the first step in my long journey that eventually culminated in the ability to just sit with the pain and accept it for what it is. I have learned that no matter how low I feel, how dark the dark nights of the soul get, not every day will be like today.

The Nutritionist

The nutritionist said I should eat root vegetables
Said if I could get down 13 turnips a day
I would be grounded,
rooted.
Said my head would not keep flying away to where the darkness is.

The psychic told me my heart carries too much weight
Said for 20 dollars she’d tell me what to do
I handed her the twenty,
she said “stop worrying darling, you will find a good man soon.”

The first psychotherapist said I should spend 3 hours a day sitting in a dark closet with my eyes closed, with my ears plugged
I tried once but couldn’t stop thinking about how gay it was to be sitting in the closet

The yogi told me to stretch everything but truth,
said focus on the outbreaths,
everyone finds happiness when they can care more about what they can give than what they get

The pharmacist said klonopin, lamictil, lithium, Xanax
The doctor said an antipsychotic might help me forget what the trauma said
The trauma said don’t write this poem
Nobody wants to hear you cry about the grief inside your bones

My bones said “Tyler Clementi dove into the Hudson River convinced he was entirely alone.”
My bones said “write the poem.”

The lamplight.
Considering the river bed.
To the chandelier of your fate hanging by a thread.
To everyday you could not get out of bed.
To the bulls eye on your wrist
To anyone who has ever wanted to die.
I have been told, sometimes, the most healing thing to do-
Is remind ourselves over and over and over
Other people feel this too

The tomorrow that has come and gone
And it has not gotten better
When you are half finished writing that letter to your mother that says “I swear to God I tried”
But when I thought I hit bottom, it started hitting back
There is no bruise like the bruise of loneliness kicks into your spine

So let me tell you I know there are days it looks like the whole world is dancing in the streets when you break down like the doors of the looted buildings
You are not alone and wondering who will be convicted of the crime of insisting you keep loading your grief into the chamber of your shame
You are not weak just because your heart feels so heavy

I have never met a heavy heart that wasn’t a phone booth with a red cape inside
Some people will never understand the kind of superpower it takes for some people to just walk outside
Some days I know my smile looks like the gutter of a falling house
But my hands are always holding tight to the ripchord of believing
A life can be rich like the soil
Can make food of decay
Can turn wound into highway
Pick me up in a truck with that bumper sticker that says
“it is no measure of good health to be well adjusted to a sick society”

I have never trusted anyone with the pulled back bow of my spine the way I trusted ones who come undone at the throat
Screaming for their pulses to find the fight to pound
Four nights before Tyler Clementi jumped from the George Washington bridge I was sitting in a hotel room in my own town
Calculating exactly what I had to swallow to keep a bottle of sleeping pills down

What I know about living is the pain is never just ours
Every time I hurt I know the wound is an echo
So I keep a listening to the moment the grief becomes a window
When I can see what I couldn’t see before,
through the glass of my most battered dream, I watched a dandelion lose its mind in the wind
and when it did, it scattered a thousand seeds.

So the next time I tell you how easily I come out of my skin, don’t try to put me back in
just say here we are together at the window aching for it to all get better
but knowing as bad as it hurts our hearts may have only just skinned their knees knowing there is a chance the worst day might still be coming
let me say right now for the record, I’m still gonna be here
asking this world to dance, even if it keeps stepping on my holy feet

you- you stay here with me, okay?
You stay here with me.
Raising your bite against the bitter dark
Your bright longing
Your brilliant fists of loss
Friend

if the only thing we have to gain in staying is each other,

my god that’s plenty

my god that’s enough
my god that is so so much for the light to give
each of us at each other’s backs whispering over and over and over
“Live”
“Live”
“Live”

You can watch one of the many versions of Andrea performing here, and I encourage you to check it out! It’s a great reminder that no matter how lonely we get, none of us exist in a vacuum.

Continue to raise your bite against the bitter dark, friends. Fight as hard as you can, because the world sees us as broken. Refuse to give up. Fight to show everyone that you matter, that you are more than the sum of your parts or the chemicals inside your brain. You are more than a diagnosis, a code on a medical chart, the endless insurance claims and the bills and the medications you swallow every day just to feel okay.

You are a human being, first and foremost. I hope none of you ever forget that. You matter. Your life matters. You are worth something to the universe not because of who you are or what you’ve done, but because you’re here. And you’re going to be okay.

News Day Tuesday: Election Anxiety

a cure for what ails you, anxiety, Uncategorized

Good afternoon, readers! It’s that time of week again!

First of all, for those of you who don’t follow the Facebook page for The Dissociated Press (and if that’s the case, why not?), I have some exciting news to share: Last night, I found out that I’ve been accepted to Johns Hopkins’ Master of Science program for Counseling Psychology! I’ll be starting in the spring.

Now, on to the main event for this week: election anxiety. I’m sure most of us have felt it at one time or another, and for many, it’s probably coming to a head right about now. Today’s article comes from K5 in western Washington state.

Bernice Imei Hsu, a registered nurse and licensed mental health counselor, stated that around 85% of her new patients come in to discuss anxiety related to this year’s presidential election. Some of the clients began presenting with these concerns as early as May of this year.

Hsu has some great tips for helping with election anxiety:

Hsu first assesses how well her clients can handle conflict and change. She then helps them come up with a plan for how they might react to election results.

She asks clients to identify people in their lives who can help them discuss their anxieties and needs. She also encourages clients to practice “relentless self-care.”

“Maybe they need to take a little break, maybe they need to turn down the volume a bit of their social media feeds, stop screaming in all caps, or reading other people scream in all caps, turn it down, tone it down, and take care of themselves,” Hsu said.

The first time I voted in a presidential election was in 2008, and I remember being incredibly anxious. That anxiety was even worse in 2012. This time, I’m feeling oddly calm about it, though I think that’s because I’m in a better place mentally and have already set up some fun activities for tonight to keep my mind off the results (even though I’ll inevitably end up watching them roll in).

I have coloring and cross stitch on the list, as well as my ever-expanding Netflix queue, which is always a good distraction. I’ve realized that while I can vote, I ultimately can’t do anything about the results and that it’s better not to waste my energy worrying excessively about it. Whatever happens is what happens; I find this point of view very calming.

What about you, readers? Do you get election jitters? How do you combat them?

News Day Tuesday: More Progress on Mental Health Care Parity?

a cure for what ails you, three hopeful thoughts

Good afternoon, readers!

It’s no secret to most of us that securing quality mental health care can be frustrating, if not seemingly impossible. In 2008, the Mental Health Parity and Addiction Equity Act was passed, which basically ensured that insurance companies were not allowed to discriminate against mental health care when offering coverage–benefits for these services had to be more or less equal to the benefits offered for standard medical and surgical care. (You can read more about the act here!)

I was nineteen years old when the act was passed, and it was a huge moment in my life. But things are still not great; many insurance plans have extremely strict limits on the number of counseling visits allowed per year (the insurance plans I’ve had in the last ten years have placed a limit of twelve appointments per calendar year), and there is still much to be done before we can honestly say that mental health care is equal, in the eyes of insurers, to other types of medical care.

For one thing, enforcement of the parity law tends to leave much to be desired. The task force, which formed in March of this year, has identified the following objectives in reforming mental health care parity:

  • The Centers for Medicare & Medicaid Services is awarding $9.3 million to states to help enforce parity protections. California, New York, Massachusetts, Oregon and Rhode Island were cited as models of promising enforcement efforts.
  • A new government website will help consumers identify the right agency to assist with their parity complaints and appeals.
  • A newly released consumer guide will help patients, families and providers understand their rights and look into whether they have experienced a parity violation.
  • The Department of Labor will report each year on its investigations into parity violations

-npr.org, “Federal Panel Calls For Stricter Enforecement of Mental Health Care Parity Law”

Though I am a bit skeptical that any great strides will be made in the immediate future, I am trying to remain cautiously optimistic that within the next few years, we’ll be able to enjoy equal benefits for mental health care.

My current insurance plan offers a very limited selection of counselors and psychiatrists, and wait lists are often several months long. I had an intake appointment a few weeks ago and am still waiting to hear back on whether or not the counselor in question will even accept me as a patient. I know my experience is not unique and, even more disturbingly, there is the continued dearth of hospital beds for people struggling with severe mental illness who need immediate hospitalization to survive.


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News Day Tuesday: Ohio State Mental Health Triage

a cure for what ails you, anxiety, News Day Tuesday, therapy

Good afternoon, readers! Today, we’re tackling the concept of mental health triage for university students. Ohio State University has reported a 43% jump in the last five years in the number of students seeking mental health care. Needless to say, that’s huge.

The question of how much academic demands contribute to anxiety levels among the student body is a complicated one. Parenting styles have definitely changed over the last decade or so–I’m 27 and when I was young, “helicopter parenting” really wasn’t a thing. My peers and I were allowed to walk alone to and from school and play outside unsupervised, often late into the after-dark hours. My family placed relatively few restrictions on how I spent my free time; reading and viewing choices were left up to my own discretion, with the assumption that I would make good choices for myself. As a result, I didn’t have much trouble adapting to the freedom that comes with college life, though I did live at home for the first two years of my undergraduate program.

As a non-parent, I can’t speak personally to what parenting styles are in vogue these days. However, it seems that (for very valid reasons) parents have become much more cautious and protective. This naturally leads to students feeling anxiety over the unprecedented freedom that comes with college and living away from home for the first time. Tuition and student loans are also enormously stressful–I know I’m not the only one who had a bit of a freak-out upon receiving that first scary bill after the post-graduation grace period ended. The overall “climate” of university life, combined with the myriad of complicated developmental changes adolescents and young adults have to navigate, creates a perfect storm for the emergence of mental health issues.

This brings us back to the subject at hand: mental health triage. It’s an intriguing concept and one that’s particularly timely; with so many patients in need being turned away from psychiatric wards due to lack of beds, it’s clear that we need to figure out a way to prioritize who needs what kind of help, and how urgently they need it.

Ohio State’s triage consists of determining whether students require more intensive one-on-one therapy or more general group-based therapy and seminars. The university offers a workshop called “Beating Anxiety,” which is something that I’d love to see implemented at more schools, particularly as part of the standard first-year curriculum. During my first year of undergrad, I saw many of my peers struggle with taking full responsibility for every aspect of their lives. It can be overwhelming to navigate roommates and coursework as well as meeting daily needs for the first time. Add to that a work-study job or two to supplement financial aid, and it’s not hard to see why so many students are stressed.

Another aspect of Ohio State’s program that I love is the “Recess” event:

On a grassy lawn, there are tents where students can make balloon animals, blow bubbles and play with therapy dogs and a large colorful parachute. The event is designed to help students relieve stress and to introduce students to counseling center services and staff in a fun way.

– Students Flood College Mental Health Centers, The Wall Street Journal

You can read more about the impressive range of resources offered to students at Ohio State here.

Readers who have a college background, what kinds of programs do you think are most valuable? What was/is available to you?


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News Day Tuesday: Bipolar Awareness Day!

a cure for what ails you, explanations, major depression, medication, mood diary, News Day Tuesday, ptsd, rapid-cycle bipolar disorder, stigma, therapy

Happy Tuesday, readers! Today (October 4th) is Bipolar Awareness Day, so I wanted to share an article with you that outlines the basic symptoms (for the uninitiated, as I know there are some new readers here) as well as what’s on the horizon in terms of treatment.

First of all, let’s hear about what bipolar disorder actually is. I’m referencing bt.com for the purposes of this tidbit, as the article I found gives a really great Reader’s Digest condensed version of the illness.

National charity Bipolar UK characterise the condition as “a severe mental health illness characterised by significant mood swings, including manic highs and depressive lows”, and note that, “the majority of individuals with bipolar experience alternating episodes of mania and depression”.

According to this article, it takes 10.5 years on average (in the UK) for people with bipolar disorder to be properly diagnosed. The National Depressive and Manic Depressive Association (NDMD) paints a similarly grim picture: it can take ten years or more for a diagnosis to be reached, and 69% of cases are misdiagnosed.

What are the symptoms?

There are two sides to bipolar: mania and depression.

During a bout of depression, it is possible to feel: grumpy, without hope, guilty, self-doubting, suicidal, pessimistic, worthless, lacking curiosity and concentration.

And with mania: elation, full of energy, ideas and plans, easily distracted, feeling invincible, risky behaviour including spending huge amounts of money.

Both can feature: lack of appetite, insomnia and delusions.

-bt.com

My experience began very early. I remember fits of agitation and depression as early as eight years old, which at the time was chalked up to the incredibly rough hand I was dealt–a broken home, a mother who struggled with bipolar disorder herself as well as alcoholism, extreme bullying, and persistent nightmares (which were later diagnosed as a feature of PTSD). NAMI states that rapid-cycling bipolar disorder, the most severe form of the illness, seems to be more common in individuals who begin exhibiting symptoms early in life.

From NAMI.org:

Early Warning Signs of Bipolar Disorder In Children and Teens

Children may experience severe temper tantrums when told “no.” Tantrums can last for hours while the child continues to become more violent. They may also show odd displays of happy or silly moods and behaviors. A new diagnosis, Disruptive Mood Dysregulation Disorder (DMDD), was added to the DSM-5 in 2014.

– See more at: http://www.nami.org/Learn-More/Mental-Health-Conditions/Bipolar-Disorder/Overview#sthash.l0XKtkSy.dpuf

When I was eighteen, I decided to see a therapist and psychiatrist for the intense mood swings that had plagued me for most of my life. I was initially told that my deep depressions were the result of PTSD. I was prescribed fluoxetine (brand name Prozac), which only made the agitation worse. And I was still depressed.

At 22, I relocated to Wisconsin and began the search for something, anything, that would finally help me feel “normal.” The misdiagnoses continued: major depressive disorder, for which I was prescribed Abilify and trazodone. I felt amazing on Abilify for about two weeks, and then I crashed. Trazodone made me a zombie. (Note: It is not atypical for antipsychotics to be prescribed to treat both MDD and bipolar disorder.)

Bipolar disorder is most often misdiagnosed in its early stages, which is frequently during the teenage years. When it is diagnosed as something else, symptoms of bipolar disorder can get worse. This usually occurs because the wrong treatment is provided. Other factors of a misdiagnosis are inconsistency in the timeline of episodes and behavior.

-healthline.com

When I was 24 and in my first “adult job” with health insurance, I found a wonderful psychiatrist who, over the course of several sessions, examined my family history and asked very specific questions to find the root of my illness. At first, I didn’t even think to mention my “up” periods, because even with the agitation and sleeplessness, I actually felt good–and no one goes to the doctor when they’re feeling well. But upon deeper probing, he came to a conclusion: first bipolar II, then, after further investigation and a few weeks of mood tracking in a journal, rapid-cycling bipolar I.

That first year was rough. I cycled so frequently that the days were exhausting. One day, I bounced between depression and mixed episodes several times in a single 24-hour period. Slowly but surely, the medications my doctor had prescribed (venlafaxine/Effexor, lamotrigine, and lithium) began to take effect. I began to stabilize. There were no more florid creative periods, but I was also able to sleep for more than an hour a night for the first time in weeks. My misery began to ebb, and though it didn’t disappear completely (a dysfunctional marriage contributed, among other things), I began to feel like a person again instead of a defective thing that needed to be turned off and fixed.

Aside from pharmaceuticals, NAMI’s website mentions cognitive-behavioral therapy, psychotherapy that focuses on self-care and stress management, and, in rare cases, electro-convulsive therapy (ECT). Learning to recognize the triggers for each type of episode is key; one suggestion offered by the numerous therapists I’ve seen over the years is mood tracking/journaling.

However, I had to stop at one point because, in the heyday of my illness, I began to obsess over the cycles, sometimes tracking up to ten or eleven times a day. Instead of the journaling soothing my mind, I began to worry that I was untreatable. I found my mood journal during a recent move and it was difficult reading, to say the least. But it was also a reminder of how far I’ve come and how much my quality of life has improved since receiving a proper diagnosis.

These days, I’m doing much better. My medications have been adjusted slightly to accommodate the deep depressive episodes I’m prone to during the fall and winter months, but I am proud of myself for being able to recognize that the winter storm was a-comin’. Three years ago, I would not have been able to see the symptoms for what they are: a warning sign and a signal that I need to not only keep up with my medications, but to practice good self-care. In the past, I saw fall and winter as something awful that I had to endure. Now, I realize that I can still enjoy life even when the days begin to get longer and darker. The seasons are no longer a metaphor for the overall “climate” in my head.

How long did it take for you to receive a proper diagnosis, readers? Are you taking care of yourselves as winter approaches? I hope you’re all doing well and staying healthy and safe. And spread the word–this illness is massively misunderstood, even by mental health professionals, so it’s our job to reach out and counter-strike against the misinformation and discrimination.


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