Checking in for Wednesday, September 14, 2016

I haven't been sleeping well since this depressive episode started.  I am having what's called "middle insomnia."  I fall asleep at my usual bedtime, but then I wake up around 1 or 2, and am up until about 5.  Then I want to sleep the rest of the day.  Sleep wise, last night was rough.  I do have good news for you...mood wise, today was better!  I got some news last night that could have been quite a setback for me, professionally.  My Depression tried really hard to take it and run with it.  Seriously, A for effort.  It tried to tell me to give up on this particular goal, and what do I think I'm doing?  I'm going to fail at it anyway.  I really should just quit.  I knew that it was my Depression talking, and that my Depression lies to me.  A lot.  About EVERYTHING.  I also knew that this depressive cycle is going to end, hopefully within the next week or two.  When it does, my life will go on.  Any decisions I make now will affect my future.  This is not the time for any major changes, like giving up on a goal.  So even though I didn't want to, I got moving.  I reached out.  I sent emails, brainstormed, researched, begged (yep), and stomped my feet, but I got moving.  By the end of the day today, I have things worked out for that particular situation.  Actually, it turned out even better than I was hoping!  I love proving my Depression wrong.

Something else I did today is that I saw my therapist.  We talked a lot about what I am doing right: seeking help as soon as symptoms started, accepting a change in my medications, talking about what's going on, getting outside time, making myself get out of bed, writing, etc.  It's hard.  I don't feel like doing any of it.  But I also know what happens if I don't: I always feel worse.  

Tonight, I am tired.  I am ready to go to bed, but not because I am depressed.  I feel fulfilled.  I am proud of the work I am doing.  I am even having moments when I feel like myself.  

Be well

Checking in for Tuesday, September 13, 2016

One thing that I agreed to yesterday during my appointment with my psychiatrist is that I will get outside 15 minutes per day. At the time, I thought it would be easy. But today, I just flat did not want to. I don't feel as sad today, or as hopeless. But my energy has not returned. I texted a friend that I didn't feel like starting my outside assignment today. My friend answered, "Good you ate lunch. Now do outside." Okay, fine. 

So, friends, I am writing this article outside. I'm actually dictating it on my phone. I have to say, the sun feels nice. There is a little bit of a breeze, and it certainly feels like fall is just around the corner.

I start today on higher doses of two of my medications.  Tomorrow, I also seeing my therapist. I am doing all the right things to take care of myself, and I am starting to feel the results.

One thing that's bothering me right now is I feel like I'm not writing very well. My thoughts are kind of all over the place, and I have trouble thinking of words. I went back and read what I posted yesterday, and was mortified. I don't know if anyone else sees it, but I do. I could have done so much better. I'm leaving it there, and leaving it the way it is because it's all part of my depression. It's all part of staying honest. My depression hates it when it doesn't have complete control. I'm okay with that. 

Be well. 

Checking in for Monday, September 12, 2016

Today has been challenging, but I have done some good things for myself, and made some good decisions.  First of all, I had a terrible time sleeping last night.  I went to bed at 11, and was awake by 1.  I was supposed to get up at 5 to drive my spouse to work so I could take the car for the day.  I knew that I hadn't had enough sleep to be safe on the road.  I let my spouse take the car, and I used Uber to get where I needed to go.  
I had my appointment with my psychiatrist.  I feel extremely fortunate to have this particular person as part of my team.  She and I went over the past couple days, and things that I am doing right to take care of myself.  Some of these are making and keeping appointments, letting her know I was having symptoms even though I would see her today anyway, and reaching out to my support team.  She is increasing the doses on a couple of my medications, and I will see her again sooner than I normally would, were I not having a depressive episode.  I continue to struggle with eating enough.  I finally got some sleep from about 5 am until around noon.  I always eat breakfast, but today I just couldn't.  I didn't feel like eating lunch, but I made myself eat a sandwich anyway.  I am also very sleepy.  All I want to do is go to bed.  My goal is to stay up until 9:00 tonight.  I really need to try to get my sleep on a somewhat normal schedule. 
None of this is coming easily.  I am fighting hard not to go get in bed and stay there until this passes.  I know from experience, however, that doing so makes me feel worse.  
One thing that is helping me immensely is blogging.  I feel responsible to you, my readers.  It's so important to me that I am honest about what is going on with me.  I look forward to feeling better and getting back to topics we've been discussing.  I also have some topics planned that, before this, had me really excited.  I want that back.  I want the challenge of getting an article written.  I want the sense of accomplishment for publishing something I know is well-researched and accurate.  I want the drive and the passion I feel to help others.  It's all in here, it's just taking a breather.  Depression, you have met your match.  Your eviction notice looms...to everyone else, however,

Be well

Depression: The Opportunistic Little Bugger

What I believe makes Insight, Outside In unique from other blogs about mental health is it is run by a mental health professional who also has a diagnosis of Major Depression, and is therefore a patient.  I couldn’t write this blog with any sense of honesty or integrity without also writing about my own mental wellness and illness.  I am having a depressive episode.  It started about 24 hours ago.  I began to have negative thoughts about an event that had just happened.  I had spent the afternoon with a friend.  My friend was recovering from being sick, and had very little energy.  We didn’t spend as much time together as we would have normally, and during our visit, my friend was pretty checked out, mentally.  We’ve talked here about how mental illness can be an opportunistic little bugger.  Mine is no different.  My brain started spinning over how my friend must not want me around.  This person was obviously annoyed by my very existence, and why wouldn’t they be?  I have nothing to offer.  There’s nothing anyone could ever like about me.  Just like that, we’re off to the races!  In the past 24 hours, I have continued to struggle with negative thoughts about myself.  I also start crying just randomly, for no reason, other than the fact that I am having a depressive episode.  I want to sleep all day today.  I would probably still be in bed were in not for the same friend messaging me earlier and saying, “get up, and come over.  You need to get out of your house.”  My friend knew because of a text message I’d sent earlier with three words: “having depression symptoms.”  I sent the same text to other supportive friends and family.  I have also left a message for my therapist.  I already had an appointment on the calendar for tomorrow with my psychiatrist, just by coincidence.  

My plan is to continue blogging through this episode.  I am putting other topics on a temporary hold while I deal with this.  I believe the best way I can be credible and accountable is to be honest with my readers, my family and friends, and myself.  I don’t normally blog every day.  My goal is three entries per week.  However, I will try to post an update daily until I return to baseline  (Updates will most likely be deleted once the episode is over).  All right, I’m going to go over my self care plan.

Be well

September 11th

Friends,

Today is September 11th.  It is the 15th anniversary of the terrorist attacks on the United States of America.  Rather than write about it, I simply want to encourage each of you to take care of yourself in whatever ways are right for you.  There are posts on IOI about trauma and PTSD, media saturation, and dealing with panic attacks.  Please feel free to post here in the comments, or on IOI's Facebook page.  If you have any thoughts of self harm, PLEASE seek help.  You are loved, wanted, and needed as part of the IOI community.  Take care of yourselves and each other.

Be well

Emotional Abuse: More Than Sticks and Stones

Friends, today’s entry is about psychological abuse, also known as emotional abuse.  As with anything on IOI, I encourage you to use your best judgment and keep yourself safe.  This entry will give information about what emotional abuse is, why it is harder to identify, and suggestions of what to do about it.  

For the purposes of this article, “emotional abuse” and “psychological abuse” will be used interchangeably.  Emotional abuse is characterized by exposing or subjecting someone to behavior that may cause psychological trauma.  This psychological trauma caused may result in Anxiety, Depression, and/or Post-Traumatic Stress Disorder.  Attempts to scare, control, or isolate the victim are forms of emotional abuse.  Some examples of how an abuser may do this are:

• Monitoring the victim’s activity and whereabouts all the time, or most of the time
• Accusing the victim of infidelity 
• Preventing the victim from seeing or contacting family or friends
• Attempting to prevent the victim from going to work or school
• Causing the victim to doubt their own memory, thoughts, or experience.  This is sometimes referred to as “gas lighting,” or “crazy making.”
• Getting angry in a way that frightens the victim
• Controlling how the victim accesses and spends money
• Belittling the victim, especially when the victim discusses feelings, thoughts, opinions, goals, or accomplishments 
• Humiliating the victim in front of others
• Threatening to harm the victim, loved ones, or pets
• The abuser threatening to harm themselves if the victim leaves or seeks help.
• Saying things like, “if I can’t have you, no one can,” “no one else would want you,” or otherwise insults the victim
• Making decisions for the victim that you can, should, and want to make for themselves

This list is by no means comprehensive.  Other forms of abuse are also emotional abuse.  Physical abuse and sexual abuse also harm the victim emotionally, and also scare, control, and isolate the victim.

Let’s get something straight right here and now: 1) Abuse is never the victim’s fault.  2) We don’t do victim blaming on IOI.  Ever.  3) No one has the right to harm another person EXCEPT in cases of self-defense.  

One of the more challenging things I have seen for a victim of emotional abuse is for the person to be able to acknowledge that what is happening to them is, in fact, abuse.  This is especially true if the victim no longer trusts their own thoughts, memories, or experiences.  The effects of physical abuse are harder to hide after the fact.  The victim may be injured, items may be broken, walls may have scratches, dents, or holes.  These are harder to ignore.  But when all the evidence the victim has exists between their ears, it gets tricky.  

If you believe someone is in an emotionally abusive relationship, it can be a very helpless feeling.  We never want to see someone we love and care about be harmed.  Emotional abuse is harmful.  An outside party may feel stuck watching the victim retreat inside themselves as they shut down emotionally.  The abuser has trained the victim not to be who they are.  They are belittled for having the personality traits that we love about them.  Here’s what you can do:

• Love them.  No matter what, show them that you value them.  Thank them for things they do for you.  Praise what they do well.  It doesn’t have to be huge or overt.  
• Stay in it with them.  Even as they may pull away from you, do what you can not to pull away from them.  If they cancel plans with you 20 times, schedule the 21st time anyway.  Understand that they are going to cancel, if that’s their pattern.  But their abuser is telling them that no one cares about them anymore.  Even if they stop making plans, an email or a Facebook message that says, “hey! Just thinking about you!” can plant a seed of doubt in the harmful messages they are getting. 
• Validate their worth and dignity as a human being.  They are in your life because you love them and want them.  They are being stripped down and belittled by the abuser for anything that makes them who they are.  The victim deserves love and caring.  They also need it right now more than just about any other time in their life.  You can absolutely show them that love without saying a single word against what’s happening to them.
• Listen.  It’s going to be really hard to hear sometimes.  But it’s not about you, it’s about them.
• Avoid judgmental statements, or telling them what to do.  Ask questions instead.  “What do you think?” “How do you feel about what happened?”  “How are things with (abuser’s name) now?”  
• Do not speak negatively about the abuser to the victim.  This is also a really tough one.  Remember, the victim has to go home or hang up the phone after talking to you.  If the abuser knows the victim was taking to you, they are going to ask what was said.  
• If the victim wants to leave, it’s going to take time.  It’s also very likely that the victim will return to the abuser, possibly multiple times, before they leave for good.  Even after they leave the abuser, focus conversations on moving forward, not on trashing the abuser.  If the victim goes back, there will likely be a honeymoon period, when things will be really good.  The victim may share your conversations with the abuser during this time.  
• Encourage the victim to seek outside help, if possible and safe.  
• Above all, you MUST take care of yourself.  Utilize your own self-care plan.  It’s okay not to answer the phone if you are going to end up being more distressed, and less able to help.  It’s okay to talk to your own mental health professional about your experience with the situation.  In doing so, you are actually modeling healthy boundaries.  

You are loved and cared for.  You do not deserve harm.  You have a right to be happy, healthy, and safe in your relationships.  

Be well. 

Tipping My Hat to You

I wear many different hats.  There's my blogger hat.  Then there are my clinician and student hats. I'm somebody's child, sibling, spouse, cousin, and friend, each with its own hat.  I've also worn mentor and employee hats. No wonder I have a headache!  Each of us assumes many different roles in our life, usually multiple roles at once.  Some of these we choose, and some we don't.  Each calls on us to use different skills and access different parts of ourselves. 

Sometimes a certain role takes priority over others.  This is both normal and necessary.  For example, the role of parent will be a higher priority than that of friend, especially when the child is very young.  Most parents feel they never truly take off the parent hat.  Any role we assume in life has potential to be fulfilling or draining.  Most are a combination of both.  So my question to each of you is this: In which of your roles do you find personal fulfillment and satisfaction?  

A particular role that gets neglected the most is that of self.  This hat gets the most use, but is often the most tarnished.  We justify and rationalize that other roles require more of our attention or that we will get to our role of self later.  Whenever I work with someone who is experiencing a great amount of stress, I always ask this question: What are you doing to take care of yourself?  Some will answer that they are engaging in self care, and be able to tell me how.  I love that.  It makes my job so much easier.  Often though, I am told that self care will just have to wait, or at least remain at an inadequate level.  My next question is, “until when?”  What has to happen to get us to that point when we will make ourselves a priority?  I know someone who will push themselves until they begin to experience flu-like symptoms, and will have to stay in bed for a couple days.  This person describes it as having a “bug.”  After about 48 hours of downtime, this person feels so much better!  I know I am not a medical doctor, but I don’t believe this person would be helped one bit by antibiotics, antivirals, or a flu shot.  I think it’s their body’s way of saying, “I’ve had enough, you’re going to rest.  Now!”  This is an example of how we can get unintended boundaries set for ourselves.  What would be better would be if we could be proactive and set boundaries with intention.

When we apply Maslow’s Hierarchy, we can see how things that we may believe are optional are actually very necessary.  When we have a physical need, the need goes away once it is met.  We feel better.  Psychological needs, however, continually need to be met.  It is only in doing so that we are able to keep growing and learning, and eventually reach self-fulfillment.

My suggestion is to find a way to balance the roles that are the most draining with roles which are fulfilling.  Can you take a class you might enjoy?  Is there a group you’re interested in joining?  What about a hobby that’s fallen by the wayside.  Make it something to really look forward to.  Get excited about it!  For me, it’s drawing.  When I need to, I make my drawing time a special reward, a treat.  I get big glass of water, open all the windows, and put my favorite music on.  I make a point to use my favorite art materials and find a subject that makes me happy to look at.  It’s all for me.  If I need to, I schedule it.  

It’s always important to continually take stock of the hats you wear.  In what condition is each one?  How are you doing at that spouse role?  What about parent?  PTA secretary?  Congregation member?  Are you getting more, or giving more in each?  Is that okay with you?  There is almost always something that can be done to change the dynamics of a relationship.  It may not be easy.  Usually the ones that are the hardest to change are the ones that need the attention the most.  The changes don’t have to be big ones in order to be helpful.  Maybe the change is just what you’ll do differently in your relationship with yourself to help you feel better about other roles.

No matter what it is, we all need to spend time working on the relationship with ourselves in order to reach self-fulfillment and self-actualization.  All relationships take work, and this one is no different.  It’s one of the most important relationships you will ever have.  It will be life-long.  Just like any relationship, it is multi-faceted.  It can be easy to deny the mind-body connection when we are in the thick of particularly draining or challenging roles.  But we cannot take care of the body and not the mind, or vice versa.  Psychological needs and self-actualization needs are just as much a part of our existence and experience as physical ones.  Your only get one "self" hat, and it has to get you through your entire life.  Give it the care it deserves.

Be well.