Dichotomy

anxiety, ptsd

Is it possible to simultaneously be the most troubled and the most well-adjusted person you know? The deeper I go into my counseling program, the more this question pops into my mind. On the one hand, my demons are legion. On the other, I keep them very well-controlled and they all have little color-coordinated leashes.

Am I well-adjusted because I have to be? Does being well-adjusted look the same, or mean the same thing, for people who have backbreaking loads of trauma and those who don’t?

I used to worry a lot about whether my personal mental health history meant that I can’t be a therapist. I still worry about that, though thankfully not as much. Tonight in class, we were discussing self-disclosure and one of my classmates brought up that exact question–how are our clients supposed to trust us if they know we have our own set of problems?

I guess it’s one of those situations where what you have doesn’t matter as much as how you handle it. I get up every day and even though I do a fair amount of yelling at the intrusive negative thoughts, I still manage to accomplish everything on my to-do list. (Well…most things, anyway. I’m human.)

This has been on my mind for most of the day today, probably because I had intake with my new therapist yesterday and was thinking about the wall between my thoughts and feelings. I depend so heavily on that wall to keep it together, and I’m a bit worried–or, okay, a lot worried–that once I start really delving into the trauma and trying to merge my thoughts and feelings that there will be this monumental change and I’ll basically fall apart. I can’t remember the last time I was able to feel an emotion on an actual deep, meaningful, emotional level for more than a flash before cognition takes over and the brain reasserts control over the “heart.”

I know that’s unrealistic and that no one can do a total 180 in terms of functioning, but the unknowns are scary. As horrible as it is to know certain emotional things but not be able to feel them…better the devil you know than the devil you don’t, right?

I haven’t had self-doubt like this in quite a while, but getting the thoughts down on this little blog has helped a bit. It’s funny how writing about your troubles takes away some of their power, isn’t it? I’m also going to hit the self-care pretty hard tonight because tomorrow I have a phone interview with another prospective internship site–yay! That search is pretty terrifying, but I have a good feeling about the last couple of sites I’ve contacted, so fingers crossed.

Until next time, readers, remember to take good care of yourselves. I will, too.

 

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News Day Tuesday: Acronyms! (Or: MDMA for PTSD)

a cure for what ails you, anxiety, dissociation, medication, News Day Tuesday, personal experiences, ptsd

Good morning, readers!

School started last week and there’s been a lot going on in my life on the personal side–my 94-year-old grandma, who essentially raised me as her own for most of my childhood, has been ill and I’ve once again been dealing with anticipatory grief.

Anyway, on a happier note, here’s some news for you about PTSD. (And it’s literally happy–it’s about Ecstasy!)

In a nutshell: those lovable FDA officials just granted MDMA “breakthrough therapy” status as a potential treatment for PTSD. Clinical trials will (hopefully) be easier to come by now, and I am very much looking forward to seeing how this develops.

Important distinction: MDMA isn’t FDA-approved, but this is a huge step in a very promising direction.

Right now, PTSD treatment options are super-limited. My brand is pretty wicked, but my only option for dealing with the symptoms is lorazepam/Ativan. I count myself lucky that I only have depersonalization/derealization, anxiety around crowds, and the occasional nightmare. It could be a lot worse. I’ve written extensively in the past about my experiences with dissociation (hence the name of the blog), but like most things, you get used to it.

But it’s not something anyone should have to “get used to.” None of us should have to accept the symptoms as our “new normal,” and for many, the symptoms are debilitating. That pretty much goes without saying (though of course, I decided to say it anyway).

I recently completed a research proposal for one of my summer classes, and while it was a painful process for someone who’s not a big research fan, it was definitely eye-opening. There has been shockingly little research done on depersonalization/derealization; most of what I encountered deals with “dissociation” in broader terms and the individual disorders are either not specified or are all lumped together in a mass that ultimately provides no insight about the actual conditions.

Anyway, that’s a post for another day. What I’m getting at is that PTSD is an incredibly complicated beast. While some symptoms are consistent, it never looks the same in two different people. Anecdotally, the symptoms can look different at various stages in a person’s life.

Seven years ago, I was having flashbacks (not the dramatic Hollywood kind where you’re literally in the memory–the kind where you sort of space out and the memory plays out in your mind’s eye while you’re pretty much unresponsive to the real world). Then, in 2012, the flashbacks stopped and the depersonalization/derealization got its hooks into me and has been hanging on for dear life ever since.

Like I said, you get used to it. The pain fades. You adjust to never really feeling “real,” to being in this perpetual dreamlike state. When it spikes, I try to welcome it as a new adventure and pay attention to what feels different without getting anxious or judging it as “bad.”

Still, it would be nice if there was something out there that could help just a little. I’ll be keeping my eye on the MDMA  breakthrough and keep you posted on further developments.

In the meantime, readers, what helps with your symptoms? Grounding exercises are one of my favorite things to do if I start to feel anxious. It’s less tedious than counting things.

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: 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.

The Cycle of Abuse

abuse, ptsd, relationships

Last night, I had the privilege of counseling a young woman named Jane (not her real name). Without giving too much away, Jane’s fiance had recently been abusive toward her and she was wondering what to do. They’d been together for several years and this was, she said, only the third time something of this magnitude had happened. We talked for a little over an hour and she asked me several times what I would do in her situation.

I told her that only she could make that decision, but we explored her support networks (friends, family, and so on). She said she doesn’t feel comfortable telling them about what’s been going on because she wants her friends to like her fiance and, in her words, she wants everyone to get along. She wants the abuse to end, not the relationship, which is not an uncommon sentiment.

This got me thinking about my own experiences with relationship abuse and, by extension, the cycle of abuse. My fiance and I spent some time discussing the cycle of abuse after my shift had ended; I don’t often identify strongly with my texters, let alone experience such a visceral reaction to their stories, but my conversation with Jane really got to me.

My fella stated he doesn’t quite understand why victims of abuse stay with their abusers, so this morning we had a follow-up conversation about the cycle of abuse (pictured below).

Cycle-of-Abuse.png

Source

I explained to him, using my own experiences, how someone can end up so thoroughly entangled in the messy web that is an abusive relationship. The concept was so utterly foreign to him that he’d never given much thought to it, and we had a very productive and healing (for me) dialogue about it.

At the Risk! live show in Milwaukee in November 2015, I spoke about my relationship with “Chad,” which was profoundly abusive in every way and lasted from when I was seventeen to age nineteen, when I had a moment of clarity and decided I was too young to live that way anymore.

In the beginning, there’s the “honeymoon” period. The exact length of this period varies from person to person; in my case, things were dysfunctional from the very start, but I also grew up in a fundamentally dysfunctional family and was already carrying around over a decade of trauma from my childhood. To this day, I believe that those early experiences led me into the relationship.

I’m not blaming my family at all–I was loved and cared for, though there were some serious problems (mostly stemming from witnessing my mother’s own abusive relationships and later, her internment in a state correctional facility). However, early relationship modeling is profoundly important when it comes to developing a lovemap (a person’s view of an ideal relationship or partner), and I simply didn’t witness any functional, respectful romantic relationships when I was growing up.

Back to the story. You can listen to my Risk! story here for a more in-depth description of the abuse–obviously, the content may trigger some people, so please listen at your own discretion.

My “honeymoon” period with Chad–that period where the excitement of a new relationship is especially intense–lasted only a few months before the emotional and verbal abuse began. He never trusted me around other men; even being friendly and occasionally chatting with coworkers was a cause for suspicion and accusations of cheating (which I later learned was him projecting his own behavior onto me).

As this was my first “real” relationship where I actually cared deeply for and trusted my partner, his words were incredibly damaging. Deep down, I knew how wrong this was, but my self esteem had already been so low when I entered the relationship that I didn’t think I deserved better. I remember crying a lot in those days. After a while, I just went numb.

I can’t even remember how many times we broke up and got back together over the course of those two hellish years. Every time, I begged for him to come back. He apologized, albeit in the “I’m sorry, but you made me ____” way that is so typical of abusers.

One time, we were having our reconciliation in the basement of my grandmother’s house, where I grew up and lived until age 20. We were sitting on a couch taken from my great aunt’s house when she moved in with us, and I remember him brushing my hair away from my face as I cried and apologized over and over again. I had no idea why I was even saying “I’m sorry.”

He looked into my face and said, “You have the most beautiful eyes. They’re like glaciers, and when you cry, those glaciers melt.” I will never forget those words. I knew how messed up the whole thing was, but all I felt in that moment was relief–relief that he had taken me back, broken as I was, and relief that I had someone who truly cared about me (although I suspect some part of me knew that this was nothing like “love” was supposed to be).

We went back into the honeymoon period, and then the whole mess repeated itself. Over and over and over.

In May of 2008, when I was nineteen, there was a huge thunderstorm. The power went out and I was sitting on the floor of my bedroom, back propped against my bed, looking into a candle. At that moment, for no particular reason, I decided that I didn’t want to live like this.

I went into my aunt’s bedroom, which was across the hall from mine, sat down on her bed, and said, “I don’t think I want to be with Chad anymore.”

She looked up from her book, patted my hand, and said, “That’s okay.”

He was on his way home from his cousin’s graduation when I called him. I broke it off and actually told him verbatim that he’d been abusive to me. He freaked out and accused me of being the abusive one. Other words were exchanged, but the point of the story is that I finally broke it off.

In the weeks and months that followed, he blew up my phone with apologies, claimed that he was going to hurt himself, and eventually threatened suicide a few times. I responded by calling his parents and telling them what was up. He never bothered me again.

But I still feel those effects like an aftershock to this day. They don’t come knocking often, but when they do, I instantly feel like that sad teenage girl who was so lost and frightened and desperate for love that she stayed with a profoundly abusive man for two years. Two years.

I don’t view that period of time as a “waste” or anything similar. I learned a lot about myself and after it ended, I found a level of freedom and, for lack of a better word, lightness that I had never before experienced.

I plunged headlong into a less abusive but highly dysfunctional relationship only a few months later which culminated in a desperately unhappy marriage. My divorce was finalized in October 2015 after nearly two years of emotional estrangement (we were, for all intents and purposes, broken up but were stuck living together for financial reasons).

I still say that the divorce was the best thing that ever happened to me.

I met a great guy, got into my first relationship that was truly loving and respectful, and got into graduate school. I am now a student at Johns Hopkins and am engaged to said fella–we’re going to get hitched next November!

The point is, readers, that it can take a while. As depressing as it sounds, your first abusive relationship may not be your last. The patterns we learn from being abused “stick,” often in insidious ways. It’s not uncommon to be totally unaware of the lasting effects of the abuse. If anyone has a statistic for this, I would love to see it–for some reason, I’m unable to find the actual percentage of abuse survivors who end up with another abuser.

In my case, I thought I was totally fine–a newly single, empowered woman who had survived something terrible. In reality, I had not given myself enough time to process and heal, which led me into another unhealthy relationship because I was afraid of being alone.

LoveIsRespect.org is one of my all-time favorite resources for abusive relationships. The website provides a chat, warning signs that your relationship may be abusive, and a quiz, among other information that can help you (or a loved one) escape an abusive relationship.

Until next time, readers, stay safe and lovely. And most importantly, remember to be kind to yourselves.

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.

28.

Authoress, ptsd, three hopeful thoughts

Today is my 28th birthday. I generally don’t put much stock in them–it’s just another day when you get past a certain age, in my opinion. But my fella made today really special (breakfast and a mini scavenger hunt to my gift!), so it’s the best birthday I can remember.

Birthdays are significant to me for one reason: they’re proof that I’m still alive. It might seem silly to most people, but as quite a few of you know, those of us afflicted with PTSD tend to also be plagued by the belief that we’re just not going to live very long.

For me, this feeling of dread started when I was in my mid-teens. I thought I wouldn’t make it to sixteen, then nineteen, then twenty-one…and here I am at twenty-eight, having endured three lifetimes worth of horror and survived it all. Every year on this date, I take a moment to marvel at that.

It’s kind of incredible. And you, my readers–all of you–are incredible for hanging on and being alive. Remember that when the bleakness starts to press close and you feel like you’re buried above ground. You are still here, and you should be so proud of that.

Until next time, readers, stay safe and lovely.

 

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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News Day Tuesday: Local Mental Health Resources

a cure for what ails you, abuse, anxiety, medication, News Day Tuesday, ptsd, therapy, three hopeful thoughts

Good afternoon, readers! This time, let’s talk local resources for mental health care.

I saw a wonderful counselor through the Johns Hopkins Student Assistance Program (which I’m eligible for because my significant other is currently a student). I’ll share more of the personal details in a post later this week, but the counselor I met with gave me some information about local resources I had no idea existed, and I’d like to pass those on to you. I feel they’ll be particularly useful to anyone in the Baltimore area, but I’m sure there are similar programs throughout the country.

First is Sheppard Pratt. Being new to the area, I was unfamiliar with this hospital, but they have a program specifically designed to help people dealing with all sorts of trauma.

The Trauma Disorders program at Sheppard Pratt specializes in dissociative disorders and CPTSD, which is exciting because I had no idea these types of programs existed anywhere. They certainly weren’t a thing in the Midwest, where I’m from. It’s an inpatient program, which isn’t a good fit for me for a number of reasons, but I plan to reach out to see if they know of any good outpatient therapists who are well-versed in these issues.

It’s comforting to know that there are facilities that offer support specifically tailored to complex post-traumatic stress disorder, which can present challenges to many therapists. I found one therapist during my time in Madison who seemed to know quite a bit about PTSD, including my dissociative symptoms, but she went on maternity leave shortly after I began seeing her. My subsequent searches for therapists was largely unsuccessful, which is not a negative reflection on any particular counselor–as I said, it can be a tricky affliction to effectively treat. I’ve been told that because of the depth of my dissociative symptoms, I’m not a great candidate for EMDR, which eliminates one of the most widely-used techniques for treating PTSD.

The second resource I learned about last Friday is the Baltimore County Crisis Response, which offers not only crisis intervention (as the name suggests), but also a 24-hour hotline and–this is the most exciting part–one-time psychologist and psychiatrist consults, which are particularly useful for people who are in a transitional period and looking for providers in the area but need refills of medication or therapy. That’s right, readers; there’s actually a place you can go for those all-important refills you can’t get anywhere else, which means no more rationing of medication to make it through.

The counselor at JHSAP was also kind enough to email me a long list of references for therapists in the area. Admittedly, I’ve been procrastinating a bit and haven’t gotten around to checking them out, but it’s on the list for this week.

Are you aware of resources and programs in your area, readers? Are they easy to locate, or do they require a bit of digging?


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