Category Archives: Anxiety

DBT; Subscribing to the System

I’ve now been through three quarters of the DBT (Dialectical Behavioral Therapy) program and I have started my final chapter; Interpersonal Effectiveness.

That means I’ve been through Emotion Regulation, Distress Tolerance, and Mindfulness. I’d say I entered this program feeling rather skeptical (I hated CBT – Cognitive Behavioral Therapy, and generally disagreed with several of their claims about how the brain works) and while I didn’t know anything about DBT before, I quickly found myself sinking into a system of techniques that only added to my current ones without taking anything (useful) away.

As it turns out, I’ve been “practicing” several DBT techniques for a long time, things like distracting myself through immediately unsolvable emotional crises, or using changes in body temperature to calm myself or bring myself out of a slow depressive stupor. For the most part, I would say at least three quarters of what I’ve learned has been useful in some way -including new ideas, like working not to suppress negative emotions but to sooth myself through them instead. Overall I would say the subject matter has been presented in a very organized way which I really appreciate, and now, 75% of the way through the program, I feel a bit like this system is something I can really subscribe to.

I am really slow to jump on bandwagons, I tend to be too curious about what makes them tick to be able to adapt to them well. I like when I can see results quickly and know why they are happening, I like efficiency, and organization, and have a hard time putting all my chips into something I don’t understand.

So… what’s the problem, right? Up to this point, things with DBT have gone swimmingly! The trouble is that last week we started on Interpersonal Effectiveness. Communication and relationships with others are by far my Achilles heel, so at first I was really excited to get to this section.

The group was instructed to go through a series of statements and pick out which ones were myths and which were facts. I wasn’t born yesterday, the page was clearly headed, “Myths in the Way of Relationship and Self-Respect Effectiveness” and “Myths in the Way of Objectives Effectiveness” (fancy talk for convoluted thinking that keeps people from asking for what they want, saying no, and generally maintaining healthy relationships). So they’re all myths (you tricky teachers you!). I sat feeling quite superior at this realization.

But then, then I started to read them. Confusion began to rise as I chewed on my lip and skimmed through both blocks of text. I admit, I glanced over at the papers of my peers who had checked two or three of the boxes as things that rang true to them, but after everything was said and done I’d checked off at least half of the entirety.

“These are myths,” said my brain. “So why do we (brain and I) believe they are true?”

I sat there, confounded, rationalizing some of the statements.

“Well, I mean ‘everybody lies’ may not be an absolute truth, because… well… maybe some people don’t. I find that hard to believe, but in 6 billion people there might be a few who never lie, so I can accept that as a myth that feels true.”

“How about number 21? ‘Revenge will feel so good it will be worth any negative consequences.’ Well… that one usually feels true but having some experience in the revenge arena I can tell you it doesn’t always feel spectacular, so I can accept that as a myth that feels true.”

When the teacher called on me I joked my way through my response, did a small song and dance, and handed the imaginary baton to someone else. I was still quite disturbed at the discrepancy between the sort of general beliefs that had got me to that point and the fact that they were labeled myths on the page in front of me. It was like someone had told me my green shirt was actually called “orange” and I’d been wrong all along in believing “green” existed.

More seriously than the ones I described were others I could not seem to contradict. Statements like:

“I shouldn’t have to ask (or say no), other people should know what I want (and do it).”

“They should have known that their behavior would hurt my feelings; I shouldn’t have to tell them.”

“Other people should like and approve of me.”

“I should be willing to sacrifice my own needs for others.”

These were all things I could hold in one hand and look at saying, “perhaps this isn’t true,” but in general, when I got down to it, they were all ideas that have shaped the way I interact with others.

I left class last week thoroughly wigged out. My first reaction was to throw DBT under the bus and conclude it didn’t know what it was talking about. I couldn’t understand it, and so I had little ability to trust in it. At the same time (as I mentioned), Interpersonal Effectiveness is definitely the thing I struggle with the most so it seemed more reasonable to assume I am the issue in this situation.

I brought it up in therapy at the beginning of this week and my therapist (one of the teachers of the DBT group) told me to “think of it as an opportunity”. There have been so many areas of my life that I have been willing to experiment on, trying over a dozen new psychiatric medications, trying new techniques to help with mood swings, or falling asleep, or my general health. However, with all of this kind of experimentation I only lost a day, a week, my mental or physical stability for a brief period.

It takes an extraordinary amount of effort on my end to maintain an even vague sort of relationship with another person, so these relationships are extremely precious to me. Frankly, in many ways I am terrified of experimenting with them, it seems that the risk of losing a friend by suddenly behaving differently is more significant to me than losing a day to depression, or a week to hugely swollen lymph nodes. This notion that only bars my better judgement; I know I need to improve at communicating.

I took a French class at a local college in high school and almost failed the class. I had been a straight A student up to that point, but for some reason the very act of having to speak aloud, speak strange sounds and arrangements of words I didn’t fully understand, well it freaked me out. Being able to communicate in a way other than I’m used to is something I aim to learn, but, like French, don’t be too surprised if there is a lot of hacking and gagging involved before I get it right.

 

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Supported as Supporter

The last two weeks has been a whirlwind as my boyfriend and I were faced with a family member who was in a near-death situation. I found myself sitting in one of the biggest role reversals our relationship has seen so far; stepping down as the supported and stepping up as the supporter.

I knew that this was a situation I would find myself in eventually, and it is something that has happened a few times on a much smaller scale before. Still, being in a position where my spotty depression brain this month was the more stable of the two of us (legit) made for a very stressful and confusing time.

While it has been many years since I stepped in the role of supporter for any prolonged period I have a lot of experience doing it. I grew up around a lot of instability which lent me to put most of my effort into being the rock for the people around me. I didn’t allow myself time or room to express my own emotions because I didn’t want to further upset the people I was trying to support.

Beyond that, my supporter resume remained equally as mentally and emotionally unhealthy when I found myself in a relationship with a guy whose instabilities often overshadowed my own in frequency. By the time this started taking place my bipolar symptoms were starting to make more and more of an appearance, eventually exploding through the seemingly supportive facade I had built up. As I expected as a child, my emotions + his emotions = a horror story.

I had forgotten most of this until two weeks ago when I put on my supporter hat, strapped on my supporter boots, and waited, poised, to be told how I could help in the situation. Before long I found myself settling into old patterns, completely overburdening myself with things, giving my self little leeway in terms of completing tasks when I thought they should be finished, and providing no outlet for my own emotional responses to the situation. Within days I could feel myself starting to crack under the pressure, my depression got seriously worse. I was having psychosis on and off. My DBT binder sat under a pile of clothes as I did my best to prepare meals and clean up and take care of our dog without sleeping.

I knew it wasn’t working. Within the first day I knew I couldn’t keep it up for very long. My emotions could not be contained under such a thin shroud of good intentions.

But… sometimes, when I am under a lot of stress or facing intense emotions (like mania or depression) all the framework for strategy falls away. An all-consuming fog makes it extremely difficult to know what to do next, or what I should do, or even what my options are. Even though I knew what I was doing wasn’t working, I was having the damndest time trying to figure out if there was something I could do different.

Luckily I have a scheduled weekly time I spend around a couple understanding friends. Pulling myself away from the apartment after 5 days of turmoil, they made me laugh just enough to help the fog lift.

Right. Taking care of Corey was helpful, but futile if I wasn’t able to also take care of myself. Frankly, at this point in my life I spend almost every waking moment working at taking care of myself, smoothing out the rough emotional corners  with routines, self-soothing or distracting myself when I need it, going to therapy and DBT group and seeing my friends each week to help take some of that ever-growing internal pressure off. I hadn’t been doing any of those things, and it wasn’t until I’d stumbled back into part of my routine that I realized how much I missed it.

At times I can be very single minded, if I start on a task it consumes me. Supporting Corey was no different, and while my therapist praised me for even noticing that I had fallen into that single minded place (from one of trying to take care of my own needs) I didn’t want to hear it. It didn’t feel like enough. It didn’t answer my question of how to be a supporter of both my boyfriend and myself at the same time.

This week things are finally starting to cool down. I got through things by grappling my way from one familiar point (like dinner with my friends) to another, despite how sparse those instances felt. I did my best to try to ask for help when I needed it (even though I have a hard time with it), and I cancelled several plans as well which was difficult (I hate feeling like a flake) but totally necessary in this situation.

Even though I don’t feel like I had any moments of clarity, any real understanding of how to position the elements in my life to enable me to be more fully a supporter and supported simultaneously I would like to think that down the road this situation will have taught me something, even if it is something I don’t fully recognize yet.

I’m sure it might sound greedy to yearn for immediate full understanding (yes please!) but as I get older I find I appreciate the sort of understanding that comes with time more and more. Since this situation didn’t lend itself to the former, I’m hoping for the latter.

 

5 Exercises for Falling Asleep

Falling asleep can be tough, even after attempts to remove all distractions. Sometimes I find myself too worried or anxious to fall asleep, other times it is like my mind just wont shut off.

Obviously living with bipolar disorder complicates things for me when it comes to sleep. In depressive phases I might feel like I can sleep for days, but there are times when I feel exhausted but can’t seem to fall asleep. Other times manic energy or a racing heartbeat makes it difficult to physically relax, not to mention hypomanic or manic flights of ideas that leave me constantly grabbing for a pen while I’m lying awake.

In these situations there are definitely times where I feel compelled to use a sleep aid and any number of attempts on my part to try to slow myself down to sleep seem to fail, however I can also have a difficult time falling asleep when I haven’t been bouncing up and down manically in my living room for 12 hours.

There have definitely been periods where I was prescribed sleep aids to take on a regular basis, and what I found was that it really screwed up my ability to fall asleep if I stopped taking them for any reason. The inevitable insomnia that followed triggered mania for me, and finding myself caught between being able to sleep but also having unwanted side effects or damaging my own ability to sleep wasn’t a fun place to end up.

These days I make the best effort I can to fall asleep before turning to a sleep aid, and over the past few years I have gathered a few exercises (some physical, some mental; all done while laying in bed) that have helped in my sleepy success.

Of course, there are many things that can be done to help increase our success rate for falling asleep like limiting screen time, increasing physical relaxation, and creating a routine around our sleep schedules. I find every little bit helps, and while it isn’t my intention to directly address these (or other) external strategies in this post it should be said that taking some time to bolster a healthy sleep routine can definitely get the ball rolling, and you may find that doing so may be all it takes to help you fall asleep.

These exercises are free, relatively easy, and can be done by anyone, not just folks with bipolar disorder, or anxiety, or depression. While I am not suggesting this can “cure” anything (and there are serious situations that require medical expertise) these five exercises have helped me become more successful at falling asleep naturally when I have been dealing with sore or stiff muscles, racing thoughts/flight of ideas, constant worry or obsessive thinking, physical symptoms of panic while in bed, and helped me relax when I generally just felt too alert to sleep. Some nights it takes a little extra energy to push myself into sleep past some of the physical side effects of my medications as well, and in those situations this list is my first line of defense.

1. Pointed Toe Exercise

This first exercise was especially helpful for me when I worked retail and spent several hours a day on my feet, but I used it just the other day when I had the flu and my legs were aching, keeping me from falling asleep and it was just as effective.

  • First I lie on my back and try to position my upper body to be as relaxed as possible.
  • Next I point my right toe down at the foot of the bed and then point it back toward myself. I repeat the pointed toe with the right foot ten times, and then do the same exercise with my left foot ten times.
  • Next I point both toes toward the foot of the bed at the same time, alternating between the pointed toe and toes pointed back up at me. I do this a total of ten times.
  • Finally (and this part is the most fun) I alternate which foot is pointed. If my right toe is pointed at the foot of the bed, my left foot is pointed up toward me, then they switch positions. Left foot pointed at the foot of the bed, right foot pointed up at me, kind of like using a paddleboat. I do this until each foot has been pointed at the foot of the bed ten times.
Usually by this time my muscles are stretched and much more relaxed, and my brain (that has been focusing on counting) is yawning and telling me, “dude, counting is boring. I’m going to sleep.” Sometimes I don’t even make it through the whole exercise before I am ready to fall asleep!
2. Clench & Relax
This is another exercise that is good for a tight/clenched/sore body, but the physical relaxation can be helpful anytime, really. I’ve seen several variations of this exercise but generally the idea is the same; systematically move through the body tightening and releasing different muscles as you go.
  • For this I lay on my back, and it doesn’t really matter how relaxed I am when I start (because end game relaxation is kind of the point here).
  • Starting with my feet, I flex my muscles in my feet and hold them rigid and count to five, taking a deep breath in as I count. When I breathe out I let go of the clenched muscles.
  • I continue up my body continuing this pattern with each area, flexing calves, hamstrings, hips, stomach, chest, shoulders, biceps, lower arms, hands, and then my neck. Finally I flex my face (I just scrunch it so the muscles are tight) and release.
One tip to maximize relaxation on this is to keep all areas of the body that have already been addressed as still as possible to maintain the relaxation. It can be eerie to feel like parts of my body have melted away to relaxation as I progress with the exercise, and that is part of the fun for me.
3. Fake it ’till You Make It
When I was a child I hated taking naps, so I devised a plan to lay perfectly still and pretend I was asleep to trick my mother into thinking I was napping. I remember laying on a couch at my grandma’s and considering what someone looks for to tell if a person is sleeping, and I tried to address every aspect I could think of. Wouldn’t you know it? I ended up falling asleep! I use this technique when I just generally feel too alert to sleep overall, as it covers some mental and physical strategies.
  • First I consider, “How do sleeping people lay?” and position myself in whatever is most comfortable for me that would recreate a deep slumber.
  • When people sleep they often appear or feel heavy and loose, not rigid, so I focus on making my body as heavy and loose as possible. I unclench my hands, sink into pillows, and let my shoulders sink downward.
  • The real trick, I find, is considering how sleeping people breathe. The breaths often aren’t too deep or too quick, but instead they are slow and moderately shallow. Focusing on trying to reproduce this kind of breathing is something that often uses all of my attention (which doesn’t make room for many other thoughts).
With this exercise I like to imagine what would happen if someone I knew came in the room and found me there. Would they think I was asleep? Typically, when the answer is yes, real sleep is right on the heels of my faux sleep.
4. Continental U.S. Map
I find this exercise the most useful if obsessive thoughts or constant worrying is getting in the way of falling asleep. Sometimes even if my regular thoughts are simply being too persistent I can use this to fall asleep as well. This exercise can be done in any position, all it takes is closing one’s eyes.
  • First I imagine there is a white line against the black background I see with my eyes closed.
  • Next I follow the line with my eyes as it creates an outline of the continental United States (moving clockwise). I allow my eyes to move as the line dips and curves around the great lakes and rises up over Maine, etc.
  • Depending on how persistent the thoughts are I might circle the country two or three times before going back to trying to sleep. If the obsessive or persistent thoughts happen again, I do the exercise again.

I know this exercise might sound ridiculously simple, but it has been super helpful for me. Weird, right?

5. Conjuring Observations

Ok, this one might be a little trickier but it is my favorite. I find it to be sort of emotionally soothing, beyond just helping me relax enough to sleep, and it is usually my first choice when I am experiencing physical feelings of panic in bed while trying to sleep.

  • This exercise requires me to unfocus my eyes. The best way I can describe it is that I close my eyes and first focus on an imaginary point (like the line in the US map in exercise 4), and then relax my eyes as though I am looking at a distant landscape of a mountain beyond tiny point. It can be helpful to make the distant thing I am looking at someplace familiar, a wooded trail I know, a beach I grew up by, or a room from my childhood.
  • Once my eyes are unfocused and I am looking at this “distant place” I occupy my mind by conjuring items or landmarks that I once observed of these places. Sort of like taking a big empty space and filling it with elements that I can remember. They can be as specific or general as I want. For example:
    • What were the location and types of trees in our old orchard?
    • What machines were at the arcade at the local drive in movie theater?
    • What was the floorplan of my childhood friend’s house?
    • What items could be found on the counter in my childhood home?
  • For this to be a nice experience and soothing (like soothing enough to make me fall asleep), there are some rules I employ, like:
    • I only choose places with positive or neutral associations. That doesn’t mean some places (like my beach) were never associated with anything negative, only that I have reached the point where I no longer feel a negative association with that location.
    • The details should be difficult enough to remember that it requires my entire focus (so it can’t be wandering around distracting me).
    • I never populate these spaces with living creatures, human or otherwise. I want to treat these spaces as tools and don’t want to lay around reliving memories that might produce an unexpected emotional response that might hinder my ability to sleep, not help it.

 

So what do these exercises have in common? It seems that each of them involves creating a relaxed atmosphere (physically or mentally) and occupying my mind in a challenging, but still relatively mundane task (like keeping track of how many times I’ve counted to ten). For me this is a combination that has made a recipe for success when it comes to coaxing myself to sleep.

Keep in mind that yes, like I mentioned, there are definitely still times I can’t calm my manic energy enough, or rebound from a midnight panic attack into a state of sleep, but I have been finding that with practice those moments seem to be getting farther apart. While I can’t guarantee these will work for you just because they work for me, I hope that considering what we are imagining or thinking, or how we are feeling right before bed is just as important for falling asleep as, say, having the right pillow.

There are numerous tips and tricks out there to help turn those sleepless nights into sleep-filled ones, and I encourage anyone and everyone who has had trouble falling asleep to do a little research and keep some tricks up their sleeve! There has certainly been no contest for me, more stable sleep is a constant requirement for a more stable emotional life and regaining the power to help myself fall asleep without the use of a sleep aid (at least, most of the time) has been paramount in helping me regain a feeling of control and peace in my life as well.

Stepping Stones; Stepping out of PTSD

Trigger Warning – my brand of PTSD came from situations involving sexual assault, and this post may contain loose details about that situation or other sexual topics regarding my recovery. Nothing super graphic though, don’t be gross.

Post traumatic stress disorder seemed to come into my life like a flood. One minute life seemed totally normal, and the next it began to deteriorate rapidly.

It was sort of like, if you could imagine, every time you bought a smoothy someone would walk up and take that smoothy away from you after a couple sips. After a while, you sort of just know to either avoid buying smoothies or, if you do buy one, only expect two sips. This is just the way things are, and because you haven’t known much else there are no real expectations otherwise.

Now imagine someone sits down with you and tells you that we live in a world where you could have (and you deserve) that entire effing smoothy. I mean, more than two sips. And that these people who have been taking this delicious fruity beverage away from you are a-holes who have done something profoundly inappropriate.

Well there’s shock. And anger. And definitely some horror associated with the fact that people can be so awful to one another, and that you’ve let this smoothy-snatching business go on for so long. There is guilt for not knowing things could have been different, and fear that this cycle is something that will never end.

But, maybe you feel a little empowered too. Like maybe now that you know this business about the smoothies you can buy one and enjoy the entire thing. You can break the cycle! So you go out, you buy a smoothy, and after two sips someone walks up, takes it, and walks away.

This time it feels different though, doesn’t it? This time you know you’ve been violated, that the other person is in the wrong, but maybe you just froze and didn’t know what else you could do to stop it. The anger is much bigger, much more difficult to contain. The fear becomes profound, because now you know that people seem cavalier about hurting you and that it can happen anywhere at any time. The shock leaves you frozen, bringing guilt because, somehow, you knew this would happen, didn’t you? Maybe the horror is so overwhelming you decide to pretend the whole thing never happened, just to put it all out of your mind, and ultimately blame yourself. After all, you really just can’t be trusted with a smoothy.

For me there was a series of moments like these that were like seeds being planted. I pushed the memories and my reactions down into the dirt as far as they would go, and once they were there I didn’t feel a need to address them because I thought I won. I thought I put them somewhere that was somehow equivalent to them not-existing, and if they didn’t exist I couldn’t be upset, right?

I admit, it is easy for me to look over this whole process when it is about a deliciously fruity blended beverage or something as seemingly harmless as seeds and connect the dots, but even now, years later, thinking about this process in terms of sexual assault there is a whole host of emotions that come up making it difficult for me to see through the fog that they create.

For several years I did a great job of putting the whole thing out of my mind and ignoring it. Then, after enough time had passed, those seeds that had been planted began to grow.

They broke through the soil and I suddenly began having panic attacks in crowded places. I became physically ill when someone, anyone, would touch me. I couldn’t leave the house without getting into arguments with people, so I didn’t leave the house. I felt powerless and depressed, but also angry and very afraid. Every time I closed my eyes I could sense someone standing next to me waiting for me to be vulnerable, like any moment I was happily unaware or in the shower or asleep.

The most infuriating part of this process for me was not being able to see how one person could get from the situation I was in to something better. My PTSD symptoms (mostly the anxiety and panic) were just as treatment resistant as my bipolar symptoms so I couldn’t rely on any anti-anxiety medications to help with the panic attacks and fear I was having. My doctors suggested deep breathing and reading boring case studies about PTSD, and while the deep breathing only really helped keep me from constantly screaming the reading seemed to trigger my symptoms over and over again.

Having said that, (spoiler alert) I am sitting here today really feeling like I have finally made a big dent in untangling myself from those awful PTSD plants and I found myself wondering just what I did to make it here. I thought that perhaps sharing what helped create a makeshift ladder for me might be useful to others in a similar situation, and while I am not suggesting you go out and do any of the things I am about to share I can honestly say they helped me, and all of these things were done with the consent of my healthcare team (including my therapist and psychiatrist).

For Anxiety and Panic Attacks

Basically I needed to desensitize myself to being around people and sort of re-learn that people (in general) aren’t trying to hurt me. The real trouble was that any time I was in a more crowded place (the bus, downtown, the grocery store) it would just trigger the panic attacks over and over again. Even at house parties of people I knew and loved I felt overwhelmed and would panic, so I entered into the realm of medical marijuana.

I realize this might not be a popular idea, but totally legal here in Washington State. Also, like many of the medications I have tried, it turned out there are some forms of cannabis that actually made my anxiety and panic symptoms worse, so the process of narrowing things down was a little frustrating. Thankfully, as someone with treatment resistant symptoms I have a lot of experience trying treatments that either aren’t effective or have some rough side effects so I already had a system for taking detailed notes on the effects I was experiencing.

I wont lie, I felt pretty weird about this idea at first. Growing up in a time where I was led to believe that the slightest proximity to any and every “drug” out there (D.A.R.E!!) would immediately make me an addict or banish me to hell or make me lose everything I loved made me initially totally recoil from the idea.  The legalization of medical cannabis only dampened this mindset slightly, but after speaking with three different psychiatrists and four separate therapists, all of whom who told me [given the nature of my treatment-resistant symptoms] I should proceed with anything I found that was helping, I felt a little more comfortable. Even so, it took some time for me to feel ok when other people were being judgmental about it but the fact that my doctors had my back (and heck, even my grandmother agreed) made me feel less squeamish about the whole thing.

Once I was able to pinpoint a couple strains that helped alleviate the anxiety and panic I was feeling (without sabotaging something else, like my mood for example) it was a matter of using it strategically (not all the time) to introduce me into settings where I might normally totally freak out, but because the cannabis removed the elements of anxiety and panic I was able to experience triggering situations in what felt like a non-threatening way.

Basically, cannabis allowed me to remember what it was like to be around people and feel safe, or at-ease, and after long enough it became the default setting for my brain again.

For Regaining a Sex Life

This has been very tricky, and while the cannabis was helpful enough to get me to the point of being able to be touched in general (like a back rub or foot massage) I had a big blinking red stop light in my brain around sex for a long time. Not super helpful, considering my PTSD symptoms didn’t actively show up until several years into a committed and safe relationship! Even though it had been years since I was in a place where I was in danger, once those seeds sprouted it didn’t matter.

I am sure it will sound a little funny, but the most helpful thing to removing fear and panic around sex for me was when I had surgery and my doctor told us we weren’t allowed to have sex. That’s right! Having even the possibility of having sex taken off the table made me feel more comfortable because then it wasn’t this awkward thing (or an obligation) I felt compelled to dodge constantly because I felt uncomfortable. Effectively we had to almost start our physical relationship over at square one (I recognize I am really lucky my boyfriend is the most patient person I’ve ever met) and in doing so we re-built the trust that I knew was there, but couldn’t feel because of my anxiety and panic.

For Fear and Paranoia

First I would say going to therapy and spending a lot of time talking about being assertive about boundaries helped me feel a bit more confident, but I was still really afraid that if something happened again I would freeze up and be unable to assert myself.

Something that really helped solidify a confidence in my ability to protect myself was taking a self-defense class with a friend at Fighting Chance Seattle. The staff was really knowledgeable and our male instructor made me feel very much at ease and did not require us to practice defensive moves with him, instead with anyone we felt comfortable with. Being able to connect a physical action to a feeling or desire to protect myself made me believe that if there was ever another situation I knew what to do and would be less likely to freeze in the moment. The class was only one day, but it really helped me feel like I was moving forward.

Another milestone was getting a tattoo that would act as a reminder that the fear I was feeling was coming from me, not from threats around me.

Over the last few years I have tried to keep my apartment feeling like a safe space for me. At first that meant coming home and looking behind every curtain and in every closet to be certain it was safe, but now that I have made some progress with my fear and paranoia I try to talk myself through the fear and visualize every detail of the apartment when it is dark to remind myself it is empty and safe. It is funny to me sometimes to think that my brain wants to imagine all kinds of horrors waiting for me when I close my eyes, but I spend a lot of time actively un-imagining them!

***

While I can’t sit here and say, “and that’s how I kicked PTSD in the face! It is gone forever!” Things have gotten significantly better.

I still get triggered from time to time, but I’ve got enough tools to keep myself from replanting that same seed over and over again. After taking that self-defense class I felt quite empowered when I was faced with a situation on a city bus, a creepy dude next to me put his hand on my leg.

Initially I started to freeze. I could feel myself starting to shut down as I had in the past, but somehow I managed to turn things around and do the total opposite of the cowering I felt like doing.

“Excuse me?!?” I yelled in his face and then stood abruptly, pushing past him to sit in another seat. He looked over at me and I scowled, shaking my finger at him. Even though my hands were shaking and my heart was racing I turned away to look out the window and my scowl turned into a faint smile.

I was free.

Travel; Mental Health Hurdles

This year my Grandma turned 80 years old, and to celebrate my family wants to host a camping trip in her honor. The reality of the situation though is that traveling anywhere (whether it is just heading downtown, upstate, across country, or across the globe) while living with a mental illness involves taking a bit more into consideration than the “where” and “when”.

Things got panicky last week when some crossed communication left me under the belief that my boyfriend and I would not be able to bring our own vehicle to the camp because of it’s affiliation with the military.

For anyone else, carpooling seems like the obvious answer, right? Well for me, living with bipolar disorder means knowing my triggers, and anytime I start to feel trapped in a strange place without an exit strategy (oh, say, like on a beautifully landscaped but guarded-by-armed-men sort of military recreation site – I have no affiliation with the military personally) I melt down. And I mean total manic/psychotic, you’ll-find-me-in-the-woods-later melt down. It is almost like a guarantee, and knowing myself well enough to know this would be an issue (after kicking countless ‘vacation’ situations in the balls while psychotic and trying to escape) left me in a bit of an odd position.

Of course, it isn’t unusual for me to try to push myself through things like this. Tell myself, “well, those other times are a fluke, and you will be totally fine this time.” I start to feel like I am making a big deal over nothing, and when friends or family who don’t have to make these kinds of considerations for themselves agree, I have a bad habit of walking into the same situation over and over again and reacting poorly on ‘repeat’.

Last week’s situation was a little more special because I went in to see both my therapist and my psychiatrist, and both immediately sided with the rational, more cautious part of me.

“Absolutely not,” they both said. “You’ve been triggered this way several times before, and you know that walking into a situation like this will be more of a strain than you are likely to handle.”

Keep in mind, my situation is really pretty singular in that my symptoms are not regulated by medication. My symptoms of bipolar disorder and anxiety are treatment resistant (they have not responded to any medications), so I am largely in a position to have to cope with them on my own. That is another big reason why it is important that I am familiar with my own triggers, because knowing what could put me in a dangerous position and either preparing myself for the outcome or avoiding the situation altogether are the best strategies I have for dealing with my symptoms on a regular basis.

I have found one of the biggest strategies that helps me when traveling or heading into a potentially stressful situation is knowing I can leave at any time. If I have an exit strategy, if I can leave the stressful environment before my irritability or mania becomes psychosis things are much more likely to go smoothly.

Even though my therapist and psychiatrist both agreed this trip would be detrimental for me, I couldn’t help but feel bad about needing to cancel. I mean, my granny is 80, and you can believe she has been talking about this for a month already.

The final decision I made was to go back and double check the policy that would keep me from having my escape route. I scoured websites and even eventually called the navy to help clarify their policies on bringing in civilian vehicles to their recreational sites. And -wouldn’t you know it? The entire situation was a communication error. We should be able to bring a vehicle to the site without a problem (so long as we have the proper documentation, yada yada yada).

Ultimately, the problem is no problem at all, but I am proud of myself for taking the steps I did (talking with my boyfriend, my therapist, my psychiatrist, and looking for a solution) before responding emotionally or making a final decision about going, or not, to this event.

Sometimes living with my current mental health situation can feel like I have to live in a small bubble to survive, and while the bubble feels safe it also shields me from many of the life experiences I want to have. That bubble doesn’t guarantee I wont become depressed, or manic, or psychotic, so I don’t feel like forgoing all manner of travel and personal growth that comes with it should be kept from me because doing so does not mean I will be able to live peacefully. I will have bipolar and anxiety outside the bubble, but I have it inside the bubble as well. For me, the trick is knowing what my absolute deal breakers are (like transportation) to keep me from moving from a “moody” travel situation to an emergency travel situation.

Of course, there is a lot that goes into it beyond that to prepare, things like

  • having my doctor’s information handy and with me at all times
  • bringing all medications, and extra in case of emergencies
  • making sure I will be in a position where I can eat regularly
  • making sure I will be in a position to have the best chance of sleeping fairly regularly
  • using coping skills to help counteract instabilities
  • maintaining an awareness of my current state
  • informing my fellow travelers how to best help in an emergency situation
  • and knowing when to pull the plug on the trip

to name a few.

Even though I have gotten over the transportation hurdle regarding this short trip, it is still a few months away. I have plenty of time to worry (heh) as more things come up, but I hope to smooth over as many of the rough edges as I can before I get there.

Revenge

Over the weekend I went to see The Revenant, and though I am not typically interested in dramas or anything relatively violent I am interested in stories about mountain men and stories about revenge.

I’ve been thinking a lot about revenge and why it is so interesting and even consuming, at times, to me. True that in a heightened state of emotion revenge can seem that much more gratifying, but most of these stories about revenge (or my experiences with revenge) well… they never quite end well.

The thing that interests me the most about revenge is how my own mental health has been able to completely warp this concept in different situations. For example, I started having my first full-on panic attacks in elementary school in P.E. when our teacher had us running around the track. He told us that we were not allowed to stop for any reason, not even to get a drink of water. When I asked him if I could stop to tie my shoe (which had become untied) he said no. I was supposed to keep running.

Now, this might seem totally mundane in terms of “personal threats”, but I have always been a somewhat awkward being who is able to trip on a line in the road. Having my shoe untied was a serious invitation to biff it on the track, and I was both pissed off and terrified. However, my fear quickly turned into something else as I found myself desperately wanting to trip on that shoelace, fall, and get hurt enough for some kind of punishment to befall my P.E. teacher.

It didn’t happen, but there have been many situations where my apparent inability to do anything about a perceived injustice has left me believing that the best form of revenge would be to take that revenge out on myself and subsequently whoever I meant to get revenge on would be forced to watch me withering away… potentially causing them inexplicable amounts of pain. At times I have thought that my younger self may have wandered into believing herself some kind of witch-doctor, capable of performing voo-doo. Of course, that almost never, ever worked out the way I expected it to, and while I admit the idea of hurting oneself to exact revenge on someone else seems totally ludacris there have been times where the act of revenge seems to completely outweigh the act of living. Watching any number of “revenge” themed movies will typically suggest the same.

I fought this notion a lot via the church. The act of forgiveness being the total opposite of revenge, I figured that might help me shy away from a lot of the odd, convoluted notions I had about punishing others or using myself to do so. Unfortunately, I found myself living in the opposite extreme, constantly in a state where the people around me were taking advantage of me and I would be ushering out forgiveness in a never ending revolving door of pain.

As it turns out, forgiveness without any sort of boundaries can be just as detrimental as revenge.

The road since then has been awash with many different theories and attempts to live a healthy life. I would say I have made significant progress on that front, but as a profoundly emotional individual it still swells up, from time to time, and revenge becomes something shiny and wisp-like begging me to chase after it. Even if I can withstand chasing it, it isn’t hard for my imagination to take the bait and for days, weeks, or even months I become trapped, seeking this thing out -if even only in my mind.

I am hoping that one day I will have replaced that inexplicable pull with something as simple, but as important, as acceptance. While it is something that seems distant to me now, I hope that little by little, inch by inch, it will become a more central part of my life and my future.

One day I will be able to sit with my life as it is as opposed to being haunted by the notion of what it should be.

Depression Under the Radar

Like most people, when you hear the word depression you probably associate it with emotion. Sadness, perhaps, if you’ve never had it yourself. Despair, even, if that is something you’ve come face to face with. I know when I hear the word depression it is easy for my mind to make an association jumping straight to utter and complete hopelessness, or going a week without leaving the house, or even suicidality.

However, the truth of the matter is that depression has many symptoms associated with it that may not directly involve feeling sad or hopeless at all, and it is this odd grey area that I’ve found myself in lately.

Though I haven’t been having feelings of despair (profound or otherwise) I am definitely feeling exhausted all the time. I am more anxious than usual and having a hard time being in public places. I am less motivated and less interested in things, and I keep bouncing back and forth between wanting to eat everything I can get my hands on and not having an appetite at all.

But, despite all of these things, my first reaction when I saw my therapist last was to say things were going well. It wasn’t until she asked about my appetite and sleeping that I started noticing all of the other (emotionless?) symptoms of depression have been stacking up, but without that emotional sort of sinking feeling they’ve all latched onto me under the radar.

Once I noticed it I felt a little silly for not noticing it before. After all, I consider myself pretty experienced with depression’s escapades at this point and beyond that, there are plenty of times I have had symptoms of mania come on without the bliss or agitation I normally associate with it. Things like increased energy, impulsivity, lack of appetite and sleep, have been pretty easy for me to notice, but something like decreased energy could be any number of things from my immune system to stress to the weather. It isn’t until I can see all of those symptoms together that I am willing to start labeling them.

I guess I am hoping that since my stress level should (that’s the key word) be letting up in the next couple weeks I can simply play hostess and seat these other symptoms at a table while they wait for their friend emotion to arrive. If I’m lucky it’ll get stuck in traffic or be too sad to come to the party, and if not I will have my wait staff ready to do what needs to be done to keep things afloat.