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.

Some thoughts.

abuse, ptsd, rapid-cycle bipolar disorder, suicidal ideation, therapy

It is physically painful for me when people thank me for writing, or helping them, or tell me I’m brave or a role model. I’m not a role model. I wake up most days hoping to die. I don’t know how or why I’m still alive. D.’s theory is “sheer dumb luck,” and I think he’s right.

I am a junkie. I cold-turkeyed it over a year ago, but not for noble reasons. I stopped because it was no longer taking away the physical and emotional pain in one fell swoop. It simply stopped working, so I quit. That’s all. I still think about it every day and I think I always will. This is one thing I’m proud of, however—that I was able to stop and stay clean despite all the awful things that have happened in the last year.

My therapist told me last night that I’m the toughest woman she’s ever met. She’s in her 60s, so I’m guessing she’s met quite a few people. I’m not tough because I want to be or try to be. I’m tough because of my animalistic survival instinct–in other words, I’m tough because I’ve had to be, not because I want to be.

I vacillate between strong feelings of self-loathing and guilt and equally strong moments of self-esteem where I actually feel good. But those feelings are always tempered by the fear that my meds have stopped working, that I am manic again, that I am going to ruin things and use people up like I have countless times in the past.

Right now, my pride is wounded and I feel terribly alone. I know I have good people in my life who care about me, but none of them can relate to being raped innumerable times and having people blame you for it because you were too afraid to actually say “no,” to trusting someone completely for the first time in your life and having it unravel all at once, to visiting your mother in prison as a child.

On top of it, I’ve been having horrible nightmares again and the partial memory that strongly suggests I was molested by one of my mother’s boyfriends when I was five is beginning to come into focus at a time in my life when rehashing sexual abuse is the last thing I need.

My therapist referred me to a clinic that specializes in sexual abuse and PTSD. I didn’t take it personally—as an aspiring counselor myself, I understood where she was coming from when she said that she didn’t want to risk making things worse because she doesn’t have much experience in sexual abuse or trauma. I’ve been through enough therapists to know that I wasn’t being “fired” as a patient. Therapists, it seems, are the easiest group of people for me to trust. Their motives always seem to be pure, and the confidentiality helps, I think.

I’m thankful for all the support I’ve been getting, both for the blog and in my personal life. Words cannot express how much I appreciate each message and each person who reaches out, whether it’s to reassure me or tell me how I’ve helped them. That’s what keeps me going—fighting the good fight. I want to feel strong. I want to beat this thing. I want to help people. If I can make things even a little lbetter for everyone living with a mental, I’ve accomplished more than I could have ever hoped for or imagined. If you’d told me what I’d be doing now when I was a motherless, lonely child being bullied and dealing with the prodromal phase of bipolar, I wouldn’t have believed you for a second.

My family, for all their dysfunctions and refusal to discuss the dark side (the way bipolar disorder has spread like wildfire down through the generations), has been immensely supportive. While there was a rough period when I first started my column in my hometown’s newspaper at age 19, they quickly warmed to it and realized that I was doing something most nineteen-year-olds wouldn’t be capable of and that I was taking all the pain and trying to turn it into something positive.

Some of my earliest memories are of my grandmother and beloved great-aunt and other aunts telling me that I was talented, that I had something special that I needed to hold onto. It’s difficult to believe some days—as we all know, knowing something and believing it to be true are two entirely different things.

But I’m trying. I do what I need to do in order to get through the day. Some days are easier than others. Some feel impossible. I’m a big believer in the “fake it ’til you make it” mindset; while it doesn’t work for everyone, it’s served me well over the years. At the very least, it allows me to save face and present as “normal,” even if I’m completely falling apart on the inside.

It’s another bad weather day in my head, which I guess is my reason for writing this. I also wanted to reach out to all of you and say that I’m here for you, too. I’ll always listen if you need to talk—all you need to do is reach out and I’ll be there. It’s the least I can do.

Return of the Dark Core

major depression, ptsd, rapid-cycle bipolar disorder, self-harm

About ten minutes ago, I was standing in the kitchen trying to eat a bowl of strawberry ice cream. My hands were shaking so badly, I could barely even hold the spoon, and then the dark core started its shit again. I’ve been feeling anxious, guilty, and extremely depressed lately—I shouldn’t have to add this qualifier, but I feel sad for no reason. Or rather, no reason that others can see; my brain chemistry has decided to take a dive again and I think I’m in the beginning stages of a major depressive episode.

We’re struggling financially right now and I’m still feeling a lot of guilt and self-loathing for not being able to work; I know those things don’t help. My meds aren’t quite right but I can’t go see my psychiatrist until I get my lithium checked. He fucked up the lab sheet again and the clinic I go to won’t take it without a time written on it along with the date, so I’m not sure when I can have those levels done. I’ve stopped going to therapy for the forseeable future because our deductible just reset and we can’t afford it.

In short, things are not going that well these days.

My cycles have been getting longer, which I was told is a sign that I’m getting better. But while it’s okay to have a two-week-long hypomanic, or even manic, episode, the major depressive ones frighten me, not because I don’t know what I might do but because I know exactly the sort of things I’m capable of doing.

I’ve been feeling out-of-sorts for several days, but things started their usual downward slide this afternoon. I put myself to bed for a few hours in hopes that I could sleep it off, and I did feel a little better when I woke up…but it’s back. The worst part is feeling helpless to stop it. Oh, I know some ableist scum would argue that I could do all sorts of things to “cure” it, but the fact is, it’s a simple matter of brain chemistry that’s not quite right. And unfortunately, type I bipolar tends to be very tricky to treat even if it’s not rapid-cycle (mine is).

I’m counting the time until D. gets home so we can talk about a safety plan. It’s important to discuss that before things get really bad up in my head. For now, I think I’ll indulge in my usual anti-self-harm strategy of hugging a cat and listening to music. If I fall asleep again, so much the better. Anything to get away from these thoughts.

Capturing moods.

major depression, medication, ptsd, rapid-cycle bipolar disorder, self-harm, suicidal ideation

My psychiatrist is teaching me how to handle my episodes. Lamictal twice a day, 200 in the morning and 250 at night. Seroquel for mixed episodes; never, never take lorazepam for a mixed, because it’ll do nothing but heighten the sense of detachment. The only problem is, I find it difficult, if not impossible, to differentiate between anxiety and a mixed episode. Both make me feel jittery, anxious, prone to sobbing uncontrollably and fighting so hard to hold back the urge to self-injure or finally do myself in that it takes all of my energy. I guess the solution is to take a benzo when I feel it coming on, and if that doesn’t work, the antipsychotics might. He’s instructed me to take the Seroquel 50 mg at a time, and I can take up to 200 mg a day if necessary.

I am trying very hard to stay off the Seroquel. I’ve read terrible things about antipsychotics—uncontrollable weight gain, tardive dyskinesia—and I am terrified of having them happen to me. I know it’s just my hypochondria kicking into overdrive, but I’m so unlucky, so prone to having bad things happen to me, that my fears about the worst coming to fruition actually don’t seem that silly or off-base.

And my memory is getting worse. I’ll tell the same story three times and not remember any of it. We went to Teslacon this weekend and had a lovely time, but by the time we left on Friday night I was unable to remember any of the panels we’d gone to that morning. I can’t focus on anything for longer than perhaps 20 minutes, which is disturbing because I used to be able to read or write or play the piano for hours on end. My psychiatrist thinks it’s ADD brought on by the concussion I suffered in July, but he can’t prescribe anything to help until my cycling stops and my moods are finally under control. Considering 450 is a higher than usual dose of lamotrigine (so high that I now have to undergo blood tests periodically), it seems like the manic depression is fighting hard to keep its grip on me, just as hard as I’m fighting to get rid of it.

Relief is always just within reach, but miles away.

*

I feel guilty and hate myself every single day. My husband works 40 hours a week as the shift lead at a drug store and is taking six credits at a local community college. He hopes to transfer to a large state university within five years. My inability to work full-time so he can go to school full-time upsets me so much that sometimes I wonder if he wouldn’t be better off without me. I feel as if I’m holding him back from his dreams—having to care for an invalid wife surely isn’t what he set out to do with his life.

Meanwhile, I stay home every day, reading books and watching movies and trying not to give in to the nasty little voices that whisper to me: I’m useless, I’m a drain on everyone’s energy and resources, I’ll never amount to anything because I am so sick and seemingly unable to recover.

I’m afraid to go back to work until this is under control because I’ve lost two jobs this year; I can’t handle getting fired again. D. agrees that a break from it all, time off so I can rest and work on my memoir, is the best plan. I made a budget; we can easily afford it if we cut out all luxuries. But I want to spoil him, want to give him everything he wants because I feel so awful and guilty, and then I feel bad because the money’s gone faster than we expected, and the whole cycle starts all over again.

We’ve applied for food stamps. I’ve applied for disability. Each day, I commit myself to two hours of research (reading books on dissociation, manic depression, PTSD, and anything else I feel might be applicable), jotting down quotes on note cards with obsessive precision—a purple heading for dissociation, green for bipolar. Most of the time, these quotes help me remember anecdotes, pieces of the puzzle that I can use when I actually begin to write this thing. I am determined to be as organized as humanly possible, despite all the things that are going on inside my head, because I want to finish this book. I want to keep going on this project and not give up; I’ve tried to write a memoir three times before and got stuck after the first chapter. How can I not know what happened to me? I’ve realized the failures were probably because I didn’t have everything laid out just-so: and then, and then, and then.

I know the cycles will make things difficult. I need to make the most of the mania and hypomania and try not to hate myself too much when I crash and can’t do anything but lie in bed and sob.

Jesus Christ, I just want to be okay and make something of myself, be able to provide for our little family again. I want to be good and successful and not feel like I’m wasting my life, like I’m already useless and dead at 24.

I want to make it to 25, and then 30…

*

I feel like I need to give myself some credit for staying out of the hospital through all the years of misery. Two suicide attempts, eight months of intense cutting, and that’s just this year. 2013 has sucked, and I’m ready for it to be over. I want a fresh start. I want someone to turn me off and fix me.

I want to not be me. I want to feel like it’s okay to be me.

I want my husband to always see me as interesting and pretty, not as a sad, pathetic mess.

I want my family to stop seeing me as a disappointment (they probably don’t, but I worry that they do) : If only I tried harder, I could go back to work. Mind over matter, J.

I’m seeing my therapist on Thursday, and I feel like that’s a very good thing. What I need most right now is for a neutral third party to reassure me, to comfort me and tell me I’m doing exactly what I need to be doing, that I’m right where I’m supposed to be at this point in my life.

I hope I’m going to be okay.

Trigger words.

explanations, ptsd

From what I understand, it’s not at all uncommon to have trigger words— if you spend a few seconds on Tumblr, you’re likely to see tags such as “tw: rape” or “tw: abuse.”

I feel what makes my trigger words unusual is that words with negative associations don’t set me off at all; rather, words generally associated with positive things trigger the hell out of me, provoking a wave of despair and guilt so strong that it’s sometimes hard to withstand.

For years, I wondered why certain words and objects/occurrences made me feel so horrible. The sound of an ice cream truck, for example, never fails to bring on the bad feelings. Seeing an ad in a crossword book for a personalized name poem–”A special gift for a beloved child,” the ad proclaimed–made me wish I were dead so I wouldn’t have to feel so sad and guilty. I recently had to take Wite-Out to the back of a bag of milano cookies after seeing the phrase “You deserve” printed on the packaging.

It wasn’t until just a few weeks ago that I realized what all these happy, terrible things had in common, and I’m pretty sure it stems back to my inappropriate and often overwhelming feelings of guilt. From what I understand, it’s pretty common for people with PTSD to suffer from these emotions; unfortunately, it’s not something that the mentally healthy can really understand, much like my friends who aren’t depressed can’t comprehend my indifference to my own existence.

The guilt–the “dark core,” as my therapist calls it–tells me that I am unworthy of happiness, undeserving of good things—that it’s so far beyond my grasp at this point that yearning for it is pointless, not to mention pathetic.

Love, happiness, deserve, special, beloved—all of these trigger the hell out of me. Even things like ice cream can set me off because even though I know the “dark core” is, frankly, full of shit, there’s a part of me that still believes I don’t deserve good things. Years of abuse and trauma have all but ruined innocent pleasures for me, and while I’m trying very hard to correct the negative automatic thoughts, it’s a slow process and is often frustrating. Since I haven’t nailed down every single trigger (and I doubt I ever will—there are far too many of them), it’s difficult to avoid everything that triggers me, and when I’m triggered, the rush of negative emotions is strong enough to set me back and nearly undo all the progress I’ve made.

PTSD is such a bitch. Trauma is a bitch. Feeling “out of it” all the time because my defense mechanisms are operating on high-alert 24/7 is incredibly frustrating, eclipsed only by the terrible feelings that come from being triggered. I seem to be unable to handle happiness—take a moment to imagine what that must be like. But as terrible as it is, it motivates me to fight even harder to get better. I know there are so many things I’m missing out on because years of trauma have conditioned me to shy away from happiness and positive experiences (probably because I’ve experienced time and time again how fleeting happiness is). It’s easier, my brain tells me, to avoid good things than to experience them for just a moment, only to have them snatched away and replaced with heaps of horrible shit.

Can anyone relate? I hope this makes sense—it’s surprisingly difficult to articulate what it’s like to be triggered, what it’s like to live in my reality. But my hope is, as always, that writing about it (even if the writing comes out abstract and difficult to follow) will help people understand what it’s like to have PTSD, to fight against crippling depression every day.

I am trying to stay alive. That takes up most of my energy on a day-to-day basis, and trying to overcome the triggers and seek out happiness and positivity in my life is sometimes exhausting. But I’ve never been one to shy away from a challenge or give up on something just because it’s hard.

Even though I’ve never thought I’d live a particularly long time (another thing that’s pretty common among PTSD sufferers), statistics say I’m going to be here for a while—I might as well try to make my world a brighter, better place. I don’t want to be miserable forever.

Is happiness a struggle for you? Please let me know I’m not alone.

Snap.

ptsd, self-harm, therapy

I hook my middle finger, the nail decorated with a colorful paisley design, beneath the thick rubber band on my left wrist and take a moment to relish the way the thin oval distorts. Then, I let go. Snap. It hurts like hell but it feels like penance and for a moment, my head is quiet again.

*

Tuesday night, I get  pretty low and confess to D. that I’m feeling like self-harming. He pats my knee comfortingly, then runs upstairs and returns a few minutes later with a thick rubber band in his hand.

“Use this,” he says. “I don’t want you hurting yourself.” At this point, I’ve made it two and a half weeks since my last cutting incident. I sit obediently beside him on the couch, fuzzy red blanket draped over my knees, and stare blankly out into space. This thousand-yard stare is one of the signs my husband has learned to watch for–an indication that the disconnect between my mind and my body has become so severe that my own physical well-being has not only taken a backseat to the noise in my head, it has actually fallen out of the hatchback and was abandoned on the dusty road several miles back.

Snap. Snap. Snap. I pull at the rubber band, my mouth set in a grim line, gaze fixed at an indeterminate point somewhere in front of me. D. sighs and returned to his video game, wisely deciding to give me some time to be alone with my thoughts.

*

For as long as I can remember, strong negative emotions such as shame, guilt, or fear have caused some indescribable darkness to rise up inside of me. I become fidgety, unable to concentrate because my mind is overwhelmed with the urge to punish myself for my perceived wrongdoing. The emotions can be prompted by anything–even something as innocuous as awkwardly phrasing a remark to a coworker that results in a millisecond of confusion is enough to make me long for the blade some days. The fact that I carry around a fair amount of emotional baggage and anxiety from the PTSD doesn’t help; in fact, it’s likely the cause. My therapist is aware of my self-punitive nature and plans to work with me to correct it. In the treatment plan we created together during our first meeting, we decided on self-love as one of my goals. I mentioned “self-forgiveness” as another.

“Forgive yourself for what?” she asked, incredulous. I shrugged.

Even when I consciously try to pin down where this self-loathing came from, I feel as though I’m only scratching the surface. However, my mother is the proverbial black sheep of the family, and I remember thinking from a very young age that I had to be excellent, make something of myself to atone for any damage she might have done. This attitude was not forced upon me by the rest of my family, though they were, naturally, pleased whenever I accomplished something. I’ve always been a very driven person, though that drive comes with a high price: a heavy heart and lots of anxiety. I don’t consider myself a perfectionist, but for every achievement there is a myriad of tiny sins–stupid, insignificant things that most people would feel foolish over for a moment and then promptly dismiss–that never seem to go away.

Instead of beating myself up for hours over an email that could have been worded better or a text that was sent to the wrong person (it shouldn’t come as any surprise that most of the shame-inducing thoughts that lead to the urge to punish myself involve communication with others), I snap myself once or twice with the rubber band and it’s done–I’ve atoned, in my own small way, for these shortcomings and can move on. And if the thoughts come back…well, you know. Snap.

I don’t see a problem with it as a short-term solution for grounding myself and derailing the endless barrage of negative thoughts. Being snapped with a rubber band hurts, and much like a spanking will shock an errant child into listening to his or her parents, the snap of the band against the tender skin of my wrist forces me to come to, to be in the moment and face actual reality instead of the nonstop shit-show my brain concocts for me. I’m on the lookout, of course, for signs that it could become a compulsive self-harming behavior, but in the meantime, I’m willing to just go with it. The song “Whatever Gets You Through the Night” comes to mind, though my end goal is achieving a default mental state where I can look at an embarrassing moment and pass it off as an innocuous gaffe–nothing more, nothing less.