It’s okay not to go home again.

For Thanksgiving, we flew back to my hometown in the Midwest to visit my remaining family–my mother, the aunt who was my legal guardian when I was a child, and another aunt who lives about an hour away from said hometown but visits regularly.

As I told my therapist this afternoon, “I don’t want to say it sucked, but…it sucked.”

I don’t want to get into any of the messy details, but I realized a few things during our brief Thanksgiving trip.

The first is that my grandmother is dead, like, for real-real. My “mom” is dead. Full stop. It’s not that I was pretending otherwise, but being in her house without seeing her there drove the point home in an unexpectedly painful way, and I had to hold it together while I was there because I knew if I lost it, so would everyone else, and then it’d be this whole terrible thing that I was just not equipped to handle.

The second is that it’s not normal to spend the week up to your flight being anxious and trying to brainstorm ways to defuse any potential arguments. It’s not normal to be five minutes from landing in your hometown and freaking out because you have no idea how many fights there will be this time or how bad they’ll get.

The third is that it’s simply not healthy for me to go “home” again. My therapist agreed with this assessment–there really is nothing there for me anymore. I’m 28 and am building my own life, my own family. If anyone wants to visit me, they know where I am. There are several large airports nearby. I never turn my phone off, though I have become more selective about when I answer calls–if I’m emotionally exhausted and have nothing left to give that day, I let the call go to voicemail.

It’s not like I’m unreachable. I just don’t want to make the effort anymore. I’m tired of throwing myself out into the wilds of my family-of-origin and hoping I come back in one piece. I’m tired of having to tell them, “Hey, I flew all the way here, can we all just get along?” I’m tired of having to put a dog into the fight. I’m tired of there even being a fight.

I went back “home,” and all I got was the flu and three days of crippling anxiety and depression.

Readers, it’s okay to set boundaries. If, like me, you’ve finally hit your breaking point, please try not to feel guilty about it. You need to take care of you first. You can’t pour from an empty cup, and life is too short to spend it with people who make you miserable.

An Audio Post!? 4-7-8 Breathing Exercise

Hey readers! I haven’t posted any sort of “There’s a real person in here!” content in a really long time, so here’s a quick clip of me walking you through an even quicker breathing exercise. Click below for the transcript and let me know what you think!

(Side note: I love transcribing stuff because it makes me uncomfortably aware of my verbal tics. Sorry ’bout that.)

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News Day Tuesday: Election Anxiety

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: Ohio State Mental Health Triage

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: Childhood Mental Illness

Good afternoon, readers! This week, I’m featuring an article from NPR related to the early detection of mental illness in children. Child psychologist Rahil Briggs states that half of all children show signs of mental illness before age 14.

On a personal note, I began experiencing symptoms of post-traumatic stress disorder around age seven or eight. My mother had gone to prison when I was six years old, and I went twice a month to visit her at the correctional facility that was several hours from my home. By this point, nightmares were a common occurrence–I’d had them regularly since age five–so my guardian and other relatives didn’t think much of it when the frequency increased slightly after these visits began. There was some talk of finding a therapist for me, but the idea was abandoned.

One of the earliest memories I have of PTSD-related symptoms was one night when I was attempting to play chess with my aunt in the basement of my grandmother’s home, where I lived for the majority of my childhood and adolescence. I began to feel odd, detached from my own body and my surroundings. I remember saying to my aunt, “Do you ever feel like you’re in a dream?” because that was the only way I could describe it at the time.

She had no idea what I was talking about and gave me a strange look, a reaction for which I can’t exactly blame her–if I weren’t “in the know” about the symptoms of PTSD, I would have found such a statement very strange.

As a child, I was generally calm and reserved, but I did occasionally “act out.” I would get panicky and anxious, a tiny ball of pent-up energy and what I can only describe as rage at nothing in particular. That energy had nowhere to go, so it was directed inward, causing lasting damage before finally exploding outward. I would storm around the house in a dark mood, only to erupt moments later in a fit of crying so intense I felt like I couldn’t breathe.

My family was helpless to help me because they didn’t understand–or perhaps didn’t want to accept–the reality of what was happening to me. Bipolar disorder, which has spread throughout the family tree like Spanish moss, was beginning to wreak havoc on my still-developing brain.

Childhood mental illness is a tricky subject. It’s hard to recognize, and it’s terrifying, both for the sufferer and the child’s loved ones. It can strike anyone at any time, regardless of socioeconomic class or education level or how strong the family’s ties are. Therefore, it’s especially important for parents to remember and impress upon their children that it is an illness like any other and is not a moral or character judgment. It is not evidence of parental failings or proof that the child has not been loved enough. It simply is, and the earlier it is detected, the earlier treatment and healing can begin.

Did you start showing signs of mental illness in childhood, readers? How did your family/caregivers react?

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News Day Tuesday: New drug for PTSD!

News on mental illness (aside from the usual stories about police brutality and the fact that mental illness physically alters your brain) has been somewhat scarce lately, readers. However, I did manage to scare up an article about a new drug for PTSD called TNX 102 SL, which is absorbed sublingually (under the tongue, like lorazepam and other anti-anxiety meds) and reportedly helps with some of the more disruptive symptoms of PTSD, like arousal/startle response, anxiety, and negative thoughts.

The drug is related to a muscle relaxant called Flexeril. I’ve heard of muscle relaxants being used to treat startle response in the past, but I’ve never tried anything of the sort before. I typically rely on lorazepam to control acute symptoms, like when I’m out in a crowded public space and begin to feel the good old irritability and hypersensitivity to sound kick in.

I’m pretty excited that new treatments are even being tested for PTSD, honestly. The startle response is definitely the worst symptom for me–any sudden noise, no matter how small, can provoke an ear-piercing shriek and a huge bump in my heart rate. And because I have chronic pelvic pain that’s partially caused by trigger points, the instinctive tensing makes the pain multiply, which makes me more miserable, and it becomes this whole endless cycle that’s really hard to break.

I’m also hopeful that some new treatments that help with sleep but don’t leave me a groggy mess the next day will pop up. I sleep very lightly now and have a hard time falling asleep. I usually use either lorazepam (if the insomnia’s not too bad, though I need at least two milligrams to get a good night’s rest) or quetiapine/Seroquel if I’m really sleep-deprived. However, even though those drugs work in the short-term, I end up sleeping way longer than intended and am basically a zombie the next day.

Readers, what do you think of this drug, given what limited information we have so far? Would you try it? What do you use to cope, either medically or psychologically?

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The illusion of control.

Last night was, admittedly, a little rough for me. I’m getting over a nasty cold, which always plays hell with my moods, but the day as a whole went pretty well. But around bedtime, I sort of…crumbled. Those old feelings of guilt and worry and nonspecific “bad” began to surface and I lost it for a while.

It should come as no surprise, especially to long-time readers of this blog, that I tend to be a worrier. But here’s the kicker–I don’t worry about bad things happening to me; rather, I worry incessantly about bad things happening to the people I care about.

So, after allowing myself an hour or so to cry and attempt to calm down on my own (I’m finding that the Cross Stitch World app on Facebook is particularly calming) to no avail, I took some lorazepam and settled in for some good old-fashioned Googling. It took a while to find what I was looking for, mostly because I was too jittery and anxious to think clearly enough to come up with the proper search terms, but once I did (“anxiety about bad things happening to loved ones” was particularly fruitful), I stumbled upon a treasure trove of forum posts written by people just like me. And they all had one thing in common: early loss of a loved one, usually a parent, very early in life.

Without revealing too much out of respect for her privacy, my mother was absent from my life from the time I was six years old until I was nineteen. We had contact through letters and the occasional phone call, but the sense of loss I felt was intense. Instead, I was raised by one aunt, my grandmother, and my grandmother’s sister.

I was particularly close to my great-aunt, Muriel (whose name I took as my middle name during my recent name change), and she passed away in 2010 after a long struggle with dementia and congestive heart failure. She moved in with us when I was fourteen after she had a valve replacement and her mental state began to decline; therefore, I witnessed the brutality of dementia over the next six years, when she was moved into a nursing home following my grandmother’s stroke.

I had never lost anyone so close to me in such a final way before. And because of the PTSD, I have an extremely hard time getting close to others on a meaningful, truly intimate level. I’ve discovered that this is the root of my excessive worry.

After giving myself ample time to process what I had read on the forums, comforted by the knowledge that I’m not alone in my struggle, I checked out a few Buddhist-oriented websites that also came up during my search. Most of what I read dealt with giving up the “illusion of control,” something that didn’t particularly make me feel better but did provide some good food for thought. As someone living with C-PTSD, I don’t do well with the unknown because the main reason I’ve survived as long as I have is because I am constantly planning five, six, seven steps in advance. I need to have a plan. I need to know what is going to happen and if I don’t, extreme discomfort sets in. If this discomfort is ignored, it builds into outright anxiety and, well, I end up in situations like the one I was in last night.

The good news about all of this is that I’ve made a note to myself to be more mindful and to really try to stay “in the moment” and enjoy the present instead of worrying so much about the future. I have also identified one of the main things I need to address in therapy–I’m currently in-between therapists since I’m moving in about a month and a half, but plan on finding one as soon as we’re in the Baltimore area.

Readers, can any of you relate? What has worked for you, either in terms of distraction or realizations?