Tag Archives: group therapy

My Intro to DBT, Breaking the Bucking Bronco

For just about as long as I can remember, my emotions have been akin to a bucking bronco that I was plopped on top of at an early age.

For several years the best I could do was hold on, but in the last ten I have gotten to know the bronco a little bit. Every once in a while I can feed him an apple to win his favor, and I can do a better job of riding all of the ups and downs (instead of just holding on for dear life).

It always unnerved me when people would tell me to get the bronco under control, and that the task should be relatively simple. That I could harness it and use it to ride faster and further than other people. In response to most of those people I simply sat back and, though willing, rather spitefully responded by asking, “how? If you can tell me how, I can do it.”

That is when whatever adult/therapist/boss would get flustered and I would sigh unapologetically. I didn’t need someone to teach me how to ride a bucking bronco, I already knew how to do that. I needed someone to teach me to tame it enough that I could dismount and spend some time on solid ground.

Needless to say I was pretty pleasantly surprised when my first meeting with the DBT (Dialectical Behavioral Therapy) group at my local clinic (finally!) did just that. Within two hours there was discussion on how to change from a harmful emotion to a positive one, and all I could think was, where was this group ten years ago?!?

Frankly, I am really excited to have the opportunity to try strategies for managing my bipolar and anxiety symptoms as well as work on my abilities to communicate with others because those are the biggest barriers in my life. DBT might just be the horse whisperer I have been looking for… heck, it practically came with a saddle and a bit!

I am not expecting a miracle, but being desperate for ideas and answers for quite some time I am the sort of person who will not scrimp on doing legwork to get to where I am trying to go. Ultimately I think this group will help me do some great things, and I am excited to absorb as much information as I can to implement some much needed positive changes.

Normal vs. Normal

For the last week I’ve been wearing a doctor-ordered heart monitor, 24/7. Last week I casually called my doctor asking if there was any way to have my heart checked out, because I was nervous the Geodon has been having ill effects on my heart (which, heck, I don’t know, but I’ve been having some odd symptoms). They rushed me into the doctor’s office that day, and after an EKG they concluded that, at the very least, I have an arrhythmia.

Basically, that means I have an irregular heartbeat. This could be nothing at all (as many people have irregular heartbeats that don’t cause problems) but they set me up with the monitor to make sure there aren’t any larger problems at work.

This week I’ve found myself thinking back to my childhood, and even more recently, when I’ve thought to myself, “wow, it doesn’t sound like my heart is beating normally.” It sort of speeds up and slows down and pauses every once in a while, but since this is what I was used to… it seemed normal. 

After 27 years, this same activity has been deemed irregular. Abnormal, compared to most other hearts.

It makes me laugh, a little bit, about how often this sort of thing happens. Not about hearts, necessarily, but with life. Mental illness is another example of how, though I was used to the symptoms (they are my normal), I’ve been told that they are abnormal when compared to the general population.

Lots of little things raced through my mind, like growing up thinking one thing (that seemed normal) only to realize later that it was abnormal. Trying hard to avoid seeming normal through high school and college (coupling me with a group of people that had the same goal, making our actions ironically normal to us).

What is the fascination we all have with what is normal? It is a word that has its own stigma associated with it, is normal good? Is normal bad? What defines what is normal? Is it something you can quantify, or is it simply our own perception?

The thing that I don’t like about the word normal is that its being requires its opposite; abnormal. The connotation that comes with abnormal is a negative one. Nobody wants an abnormal test result at the doctor’s office, and who could forget the “abby-normal” brain Dr. Frankenstein puts in his monster in Young Frankenstein? 

So, if something isn’t normal, it is abnormal… leaving “normal” to be the option of choice.

With mental illness, it is easy to feel abnormal. What feels normal to someone with bipolar disorder might seem extremely abnormal to someone who doesn’t have the illness, and it is common to hear that our thoughts or behaviors are abnormal (when compared to the general population).

I have a few final thoughts on this matter…

First, lets consider replacing “normal” with the word average. An average can be measured with mathematics, it isn’t something that is based on our perception of ourselves and those around us. “Average” also doesn’t have a negative word associated with its antonym, so there is no particular pull  or shame involved with being average or not-average. Personally, just thinking back on my life, I can feel an extreme desire in my youth wanting to be “normal” (the same way kids want to be well-liked by peers), but if you replace “normal” with the word “average”, I have never felt inclined to be average (beyond wanting to stay within the realistic realm of human behavior, and not be so not-average I become a menace)!. The switch in words makes me feel more confident in myself, instead of making me feel ashamed.

Second, lets take a second to consider how the perception of what is “normal” is formed. When we are used to something, a set of symptoms, for example, if they are all we’ve ever known, we don’t have anything else to compare them to. How could we have another perspective, or even know that symptoms or actions aren’t average?

At the same time, there is the perception of “normal” that is formed in the community, basically social norms and standards set by the actions of the people within it. People’s personal versions of what is normal can be wildly different, and not fit into the community’s expectations of “normal” at all… and people can live their entire lives without realizing they are acting in a way that is considered socially unacceptable (because it is the only way they know how to act).

Personally, I believe that we are capable of creating our own personal “normal”. By going to therapy (to get another perspective of my normal) and having expectations for myself beyond what what been my normal in the past, I’m changing the way I manage my symptoms, and interact with others. Though I may be pretty far outside the realm of social normalcy (having pretty active bipolar disorder), I’ve found ways to connect with others and make that social normalcy more accessible.

And finally, if you don’t like not fitting in with the social norms around you, why not change the people around you? If you have recently been diagnosed with bipolar disorder, lets say, and you have been told you are now abnormal compared to your friends and family, you can switch things up by comparing yourself to the population of people with bipolar disorder. In other words, head to a support group. Surround yourself with people who share the same “normal” as you! Putting yourself where you are considered average, and the change in perspective can really help in the acceptance process!

Normalcy is a funny concept. I can’t say that I fully understand it, and what it means to the vast majority of people in our society. But, with bipolar disorder, I am in a constant state of change… which means I often feel free to change the things around me that others wouldn’t generally consider. My sense of normalcy, how I view myself, and how others view me are all things I have spent many years contemplating and trying to understand, but every day I still learn something new.

Maybe my normal and your normal are cousins. Maybe they’re familiar, or maybe they’re total opposites. The point, I think, is that they’re always changing too…

The Buddy System

I am stubborn.

No, it’s alright. I know I am. I often feel like, why get help with something that I could ultimately fix myself? 

Because fixing something myself means feeling good. For me anyway. I can give myself a teeny little pat on the back, maybe dance around for a minute, but then all of my hard work has been traded for a fleeting few moments of joy before it dissipates out into the cosmos.

Is it worth it? 

This is something I’ve been considering a lot lately… and I think this is a big factor for a lot of people who aren’t willing to seek help for treatment. There is a lot of fear around the idea of asking someone for help.

Fear of rejection
Fear of abandonment
Fear of looking weak
Fear of confrontation upon disagreement

And the list goes on.

I went to 6 12 step meetings a few months ago. Though I am not technically an addict, my life has been greatly affected by addicts on more than one occasion. They request that you attend 6 meetings before making a final decision about moving on with the program.

Ultimately, my decision was to stop after 6. There were things I disagreed with, but things I really loved as well, but the final decision was made when I couldn’t seem to focus on anything long enough to be of benefit because bipolar disorder kept rearing its ugly head and distracting me. As I mentioned in my recent post, I have a genuinely hard time taking my focus off of bipolar disorder and putting it on something else without the bipolar element rearing its ugly head and bringing the whole thing down. Without any help from medication, wrestling with bipolar disorder consumes me.

Anyway, the thing I liked the most about these 12 step programs is the idea of having a sponsor.

A sponsor is someone you like and get along with who has been through a similar struggle as you, and is able to help guide someone through the process of recovery.

Well, I’m the sort of person who loves patterns, and I quickly identified that in the grand scheme of things or in another setting, a sponsor might be a mentor if they were helping with your career or non-profit work, this person might be your therapist if you are seeking professional help for various reasons, this person might simply be a friend who has already had two kids when you’re having your first one.

What do they all have in common? This person is someone you go to when you have questions about a specific part of your life. When you want to bounce ideas off of someone. Someone that allows you to talk about specific things because they have a genuine interest in something similar.

What I’m suggesting here is the buddy system. 

I know I said earlier that it is difficult for me to ask for help. I have gotten better at it, but what has changed is knowing who to talk to. It is difficult for me to talk to someone about my feelings if I don’t know how they’re going to react, there are times when that fear can be extremely overwhelming.

When I started going to a local support group, I found the overall experience helpful, but like the 12 step program I attended, I didn’t have anyone to bounce the ideas I got from the group off of. Luckily, one of the attendees who was in my age range latched onto me about as quickly as I latched onto her, and I discovered the secret, amazing world of having a bipolar buddy.

We’re not just buddies anymore, we’re really good friends too. When I was hospitalized last year for a big episode of depression, I was terrified to tell anyone where I was. I knew, though, that she would understand. She did, and brought me an assortment of rockin’ magazines and art supplies.

Therapists also make good buddies, and though you’re very unlikely to go out for drinks with them afterwards, if you are buddy-less and can afford to see one on a regular basis, I think therapists can be amazing when it comes to supporting people in their search of knowledge and understanding.

You can meet other bipolar people at support groups, you can start a social group for bipolar people in your area on meetup.com (or there might already be one!). You can have a bipolar pen-pal, which is a great type of buddy because you can email them any time, 24 hours a day.

We’re all on the same team here, so I think it is a wonderful idea to watch each other’s backs. Some people don’t have a willing ear to listen, and I don’t know about you but I have two ears so I try to listen whenever I can. In the process, I almost always learn something about myself, too!

Before you run out and grab yourself a bipolar buddy, here are a few things you may want to think about first:

  1. It is probably best to have a buddy who is actively seeking treatment, and interested in learning more about themselves and what they experience. Obviously, if your buddy is a therapist you are safe on that end, but it can be dangerous to take on buddies who are in a current self-destructive mode. That self-destruction could potentially launch us into “saving mode”, and the point is not to save others. If you are a licensed mental health professional, by all means have at it, but otherwise it would be safer all around to have a buddy who is in the realm of at least stable-ish.
  2. Some people don’t mesh well, and that is natural. There are certain people I “click” with right away, and others I’ve tried to be friends with but just can’t seem to get in the groove. I would suggest not forcing it, when you find the right person, you will probably know it right away. Also, if the other person is of the opposite gender, you may want to ask their intentions (platonic? romantic?) before moving forward to make sure they align with your own intentions.
  3. Think about what level of commitment you feel comfortable with. Just email? Talking on the phone? Meeting in person? Sometimes that level of commitment is flexible depending on how comfortable you feel with the other person, and that is ok too.
  4. Know your buddy’s emergency plan. In the event that your buddy has a big episode, have a plan made ahead of time so you will know what to do. It is unfortunate, but a realistic possibility that emergencies pop up, but if your buddy also knows your emergency plan they can be equally as helpful in the event that you experience a big episode as well.
  5. Put the mask on yourself before putting it on someone else. I know this is a recurring theme in this blog, but it is important to remember that as a bipolar individual, you have specific needs in order to help keep yourself stable. Sometimes that means taking a day or two to respond to an email, or saying no when plans are requested, but that is ok. It is extremely important to take care of yourself first (because you’re the only one who is going to do it!) and it is very likely that your buddy will know exactly where you’re coming from (because they’ve probably been there too!).

Buddies come in all shapes and sizes, and they might share similar backgrounds, similar mindsets, similar ages, or similar symptoms as you. Having someone to bounce ideas off of, or even just talk with periodically can be extremely helpful -especially if you are between therapists.

So shake off the isolation! Spend some time with someone who’s communication barriers are down. Practice talking about what you experience in an open way, because a little practice can open the door to talking openly in other areas of your life as well!

Exploration of New Territory

Today I am trying something new.

If you’ve been reading for a while, you probably know that in addition to bipolar disorder, I have a number of other diagnoses (these are usually referred to as co-morbid diagnoses since they exist in addition to one another). Generalized Anxiety Disorder is one of the flowers in my bouquet of mental illness, I was diagnosed with it a year ago.

Just the fact that even the name has the word generalized in it makes the whole thing seem a little vague (hey, I’m a little ignorant about this world, ok?) but I know for sure that anxiety is something I struggle with on almost (if not on) a daily basis, and it is something that has been a part of my life since childhood.

I’ve been to a sizable smattering of support groups that focus on bipolar disorder, and led some, but as much as I address bipolar disorder, I am not addressing the other components. Anxiety. PTSD. OCD.

It is like being in the ocean in a small boat in the middle of an oil spill.

My boat springs a leak, and I start sinking.

My initial reaction, though, is shit. Oil is getting all over everything! 

I’ve been trying to clean up this oil, cleaning and cleaning and making a tiny dent… but underneath that oil is water, and that water may seem less threatening but it is still collecting together and threatening to sink my boat.

The trouble has been that since I do not have a series of medications to help stabilize my bipolar disorder, I spend an exceptional amount of energy and attention wrestling with it myself to keep it from wreaking too much havoc. It is time consuming, it is exhausting, but the tools I’ve compiled are making a difference. I still feel like hell a lot of the time, but I can control myself enough to keep from having a huge meltdown 9 times out of 10.

Unfortunately, it is incredibly difficult to address anything else even remotely emotional or thought provoking because I am trying to listen to a story or look at a different part of myself while wrestling a bull. The bipolar bull. Sometimes it gives you wings, sometimes it just stomps on you with its sharp, pointy hooves.

I feel pretty confident in saying this is probably why many therapists wont work with a bipolar patient who isn’t medicated. I’ve stumbled upon the explanation by accident. I have to keep 75-85% of my brain subduing a bull, and the remaining 15% can’t absorb the information fast enough to really make a huge difference.

Of course, therapy is entirely helpful for bipolar-related stuff at this moment, and to have someone act as a non-biased level-headed advice person (always good) as described in the last post. But, if I take a minute to let go of the bull to try and focus on something else, there’s a stampede and I wind up getting trampled.

It is quite frustrating.

Anyway, the new thing that I am going to do today is go to an anxiety support group.

I love support groups of all kinds, and even with my 15% attention span I almost always find some portion helpful, and relatable, and thought-provoking.

I do, however, get anxiety (ha!) when going to a group where I know the majority of the people -well, I don’t know that they’re more sane but they generally have a lot fewer issues than I have going on. Does that make sense?

I feel like I have become accustomed to bipolar, and even schizophrenic folks in my support groups. I find solace in the idea that the people there have generally had as many, if not more struggles than I have had… and I can walk away knowing that if others can survive with more difficult problems than I have, I can do what I need to do.

I have been to a group or two in passing where I am clearly the black sheep in the room, and I don’t think it is bad, I just don’t really know how to handle myself in those situations.

My therapist wants me to practice “filtering” myself in different situations so what I say is appropriate, but I have trouble discerning where “filtering” ends sometimes and straight up lying begins… which is why I’ve avoided doing it up to this point, really. I’d rather just say nothing at all than something that isn’t true.

In any case, I think I ought to go into this as optimistically as possible. I am excited, to some degree, though a little nervous, and I’m sure if I take the time to think before I speak it should be fine.

Plus, maybe I can act as that banner for someone else.

Hell, if that odd, bipolar girl can deal with her anxiety, so can I!

Finding the Right Therapist

It seems like last week’s post Is Therapy Pointless for the Unmedicated Bipolar Patient? caused a bit of a stir. In the last week I’ve received quite a lot of responses with many different opinions on the matter, which have led me to the following conclusion:

people’s expectations of what having a relationship with a therapist means varies WIDELY, and there is no single answer when it comes to what folks expect their therapists to do for them. 

On top of that, I would say at least 50% of the people I’ve talked to are unhappy with their relationship with their therapist and weren’t sure what to do about it.

Most responses I heard were very clear that the effectiveness relies, in large part, to having a patient/therapist relationship that works for you. Is therapy pointless? That depends on what you are trying to get out of it, and what your therapist is able to provide.

So I thought I would spend a little time today on finding the right therapist.

I definitely agree that getting what you want out of therapy can not only be tricky, but finding a therapist who is on the same page can be a grueling process as well. Should you pick one and just give them a go? Try out a few and then decide who you feel most comfortable with? There are a lot of different ways to go about this process.

Never had a therapist before? That’s ok. Here’s a quick rundown of how this process normally works.

If you are going to a clinic, there is usually someone who does an intake appointment, and the person usually is not going to be your therapist. You may or may not be charged for this initial evaluation, where you will be asked about your history and current situation. After a brief evaluation period you may get a call letting you know whether you have been accepted or denied into the clinic, at which point you will be scheduled with a therapist.

Clinics can be great because if you don’t mesh with your initial therapist, there are often many more in the same office you can switch to. On the downside, you don’t always have as much of a say in who you will be seeing specifically (at least initially), and having an intake appointment with someone who wont be your final therapist can mean telling the same story twice.

If you are seeking someone in private practice, you can often read people’s bios on the internet or get information through your psychiatrist or general physician. This can be nice if you already know that you are looking for something specific, like art therapy, for example. Generally I’ve found that private therapists will give you one free session to get a feel for how things fit between you, and do not require a next appointment right away.

Private therapists can be great if you are looking for something specific, and having a free session means you could potentially try out several before making a final decision about who you like best. On the downside, some will ask for a specific commitment period (which would mean agreeing to something like weekly sessions for a 6 month period), and they tend to be a little more expensive overall.

If you are short on funds there are a few options. Sometimes local schools have programs for those getting advanced degrees to become therapists which can offer free or low-cost therapy if you are willing to see a student. Sometimes this can mean being recorded or videotaped in your sessions so their instructor can review how they’re working, but this is something that can be helpful in a pinch if you can’t afford any other options.

On the plus side, potentially free! On the downside, these folks are much more inexperienced so it is possible that having a diagnosis such as bipolar disorder may not qualify you for therapy at their level.

In addition to where the person is practicing and what the cost is, there is more you’ll want to consider.  I know, shocker right? Some people don’t take the time to read any further into what they’ll be getting out of this relationship though, and those tend to be the ones that are frustrated or disappointed with what they get. It is ok to be picky. Granted, some people have limitations based on the population of the area they live in, which is something I’ve had to deal with in the past, but there is a big difference between compromising and just saying yes to the first person you meet.

Here are the three things I would consider, to get a better understanding of what I’m looking for:

  1. Values
  2. Perspective
  3. Expectations

1. What kind of values are you looking for in your therapist?

At the same time you can ask yourself, what kind of values do you have? Is natural or alternative medicine something that appeals to you? Are you interested in an artistic or spiritual approach to whatever you’re dealing with? Should the person be LGBT friendly?

My own therapist is really big on reinforcing that she doesn’t look at anyone as a label or specific disorder, she considers everyone she sees to just be people, all on a level playing field. That is a value that is important to our relationship.

Some people aren’t particular about the values of their therapist, which leads me to the second consideration,

2. What kind of perspective are you hoping to gain?

Do you want a therapist with the same values as you, or are you hoping to gain an “outside” perspective? Some people chose their therapist based on what perspective they hope to gain. Personally, I feel more comfortable with a woman therapist, and it isn’t that a man’s perspective isn’t valuable to me, it just isn’t as helpful with my own personal situation. Are you potentially interested in a therapist who is much older than you, or one around the same age? It all depends on what kind of perspective you’re interested in and who you feel comfortable with.

And finally,

3. What do you expect your therapist to do for you?

When you enter into the initially awkward, yet sacred bond between patient and therapist, what are you hoping to get out of it?

I’ve seen a lot of therapists, and they almost exclusively start the relationship by asking what goals I wish to achieve by participating in therapy. My mind always goes blank and I never feel like I have a good answer, or at least the right answer, as if there is one. The word goals is what usually puts me into a stupor, I’m quickly sent back to school in my mind trying to figure out what my goal is, in regard to how quickly I want to be able to run a mile in class. Since this word makes me like a deer in the headlights, I’ve tried to go about this a different way. What is at the core of the very reason I’ve agreed to see a complete stranger in the first place, what services am I expecting this therapist to provide?

I think this is the part where debate about whether therapy for unmedicated patients is pointless or not becomes murky. Most responses I heard were very clear that the effectiveness relies, in large part, to having a patient/therapist relationship that works for you. Is therapy pointless? That depends on what you are trying to get out of it, and if you’re therapist can realistically give it to you.

If the point is to cure one of bipolar disorder, it’s pretty easy to argue therapy will fail, and is therefore pointless.

There are a ton of other, more realistic reasons for seeing a therapist though, some of which may have gone unconsidered. Here are a few of the big reasons people seek out therapy:

  • A Mentor

Many perfectly “mentally healthy” people see a therapist as a mentor-type figure. Someone who can help weigh the pros and cons of potential big decisions, or give advice on how to conduct onseself in particular situations.

  • Career Therapy

Some people, especially those unemployed, can seek out therapy to help figure out their career goals. If you’re switching industries or want to make a change to another career path, there are therapists who can help with that specifically.

  • A Spiritual Guide

Some people seek out therapy with the intention of finding someone with similar spiritual beliefs that can help guide them. When folks don’t exactly agree with the modern forms of treatment, this is a common alternative, and I’ve seen that there are therapists available in a number of religious and spiritual concentrations.

  • Releasing Steam

Some people have friends or relatives that they talk to on a regular basis about their lives to release steam and let off some pressure, but some people don’t -or don’t feel comfortable talking about specific topics with the people they know. Therapy can be a great way to release steam and decompress when something particularly aggravating is going on.

  • A Support Person

Sometimes we just need a supportive force in our lives, right? For anyone who has been around a lot of negativity, having time around someone who is supportive and can praise our accomplishments can be a big mood-booster. Having that extra support can also mean the difference between succeeding in overcoming a problem, and not.

  • Friend With an Outside Perspective

Many of us surround ourselves with friends with similar values to our own, so some people really find it helpful to have another “friend” who can look at situations from another point of view. Maybe you’re not religious, but your therapist is -can you work together to find common ground to feel good about each other? This is great for people looking to get a more “well-rounded” perspective on things.

  • Learning Coping Skills

This is a common theme among many therapists, they usually want to teach “tools” on how to cope with various situations. This can be helpful for things like anxiety and stress, as well as bipolar disorder, PTSD, & more.

  • Gain an Understanding of Mental Health

For many people, therapists act as a sort of “mental health 101” in regard to informing people about the ins and outs. If you’ve just been diagnosed for the first time, chances are that a therapist might be able to give a little more insight into the world of mental health.

  • Heal From Trauma or Loss

It is common for people to grieve the loss of their “easy” life after being diagnosed with bipolar disorder. This process can take years and a form of acceptance can be difficult to reach, but therapy could potentially help. It could also be helpful in grieving any kind of loss, or  grieving and healing from past trauma. This is something that can be very uncomfortable, so building a stable foundation with your therapist before starting on this process is considerably helpful.

  • Build Stronger Relationships

It is said that our relationships are based on the ones we grew up around, so therapy is important to a lot of people for either building a new, healthy relationship or learning ways to make a current relationship stronger. These could be relationships with anyone from co-workers, friends, family, or partners.

  • Change Thought Patterns

Low self-esteem from negative thoughts about your self, or negative/unruly thoughts in general? Some people find therapy helpful in alleviating these, as well as obsessive or other harmful thought patterns. Keep in mind, this is not something that will change overnight, but with time changing thought patterns can be exceptionally helpful for changing one’s life for the better.

  • Change Behaviors

Some people want to change certain behaviors but don’t know where to start. Things like addiction can be particularly daunting, so having someone who can guide you through the process can be very helpful.

  • Relating to Others (group therapy)

Many folks facing big issues in their lives feel isolated, group therapy is awesome for getting a chance to relate to others facing similar issues. This can add a lot of perspective and give some the inspiration to persevere in situations where they may not have otherwise.

  • Understanding the Self

Sometimes I ask myself, “why do I do what I do?” and nothing has been more helpful in answering those questions than therapy. We are all such complicated beings that there is usually more going on than meets the eye, and my general thought is that I might as well get to know myself as best I can -we’re going to be stuck together for a while!

  • Improve Communication Skills

Is there a topic in your life that you have trouble talking about with others? Or are there situations where you feel your ability to communicate is hampered? Maybe to your boss, or to strangers, or your family? Therapy can be a great way to learn new methods of communication and improve what you’ve already got!

 

There are certainly plenty more reasons to see a therapist, but I’ll stop there. I really just wanted to give you some idea of the scope of what is available, and what some people find helpful.

Once you figure out what you’re looking for, it is important to discuss what you’re looking for in the relationship and what you’re trying to achieve with your [potential] therapist. It is possible that they may not be able to provide something you are looking for, and if that is the case, that’s ok. You can keep looking, or make a compromise, but the point is that the choice is up to you.

The idea is that by figuring out what we want out of therapy and what we’re looking for in a therapist, we can avoid having those “pointless” therapy/patient relationships. After all, why keep paying for/doing something that isn’t helpful?

Saying It Out Loud

So I’m a little nervous, I’m going to be hosting a group this afternoon.

The first one was actually supposed to be last week, but I had to cancel because of both my health and the snow.

It’s sort of a bipolar peer support group (so there are no medical professionals) and I’ve been going to a Monday night version on and off for a couple years now.

Obviously, these sorts of groups can be difficult, both to attend and to host -I do believe I mentioned something about it here.

Most people are afraid to share anything about mental illness to anyone, thanks to our old friend stigma. I’m a firm believer, though, that learning to talk about it out loud can be both a huge tool and help lift a lot of the burden we carry from being silent.

The biggest trouble seems to be: where do I begin? Believe it or not, most folks with a diagnosis would rather chew off a limb than willingly talk about mental illness, so it is ok to take baby steps with this process.

  • The first step I took (or was forced to take, rather, as a teenager) was to talk to a therapist. I think this is the simplest and least frightening step one can take for many reasons. Your privacy must be respected by law, so unlike talking with a friend or relative you know for certain anything you say will be confidential (though keep in mind there are one or two exceptions to the rule). Many therapists are also trained specifically in the realm of mental health, so they are people who can usually readily identify what you’re trying to say, even if you don’t really know how to say it. Practicing talking with this type of professional can begin building the skills to talk to other types of people. You know, the ones you aren’t paying to listen.

After a time, I was encouraged by my therapist to join a support group. This was (and can be) a terrifying prospect for many reasons. You may not be someone who is comfortable talking to strangers in general, or you might have an anxiety or panic disorder. Then, of course, there is also the fact that you will likely be talking about that big, scary topic again: mental health.

  • The second step was to reach out to others with mental illness. This could be talking one-on-one (my usual preference) with someone with a similar diagnosis, attending a group run by a medical professional, or attending a peer-run group. I was really lucky as a teenager because there was even a summer camp in my area for creative teens struggling with many of the same things I was. The platform here doesn’t really matter, as long as you can begin a conversation with someone else with a mental illness. Many of us have very similar experiences, so we find very quickly that we almost “speak the same language” if you will. Even though some people consider strangers to be scary, I don’t! They’re people I have no relationship with yet, so really I can say whatever I want and I might never see that person again. Just try it once, I promise it is incredibly freeing!

I would say about a year ago I reached the point where I began to feel a little stagnant in regards to the pool of people I usually talked with about my mental health. I really began to feel tension between the times I could be open with a group of people and when I seemingly “couldn’t”. I wanted to bridge the gap a little bit so I could feel like I was able to just “be myself” around a larger group of people.

  • The third step was to open up this topic with close friends that may not have been wholly aware of it before. At first I was a little scared to go there, but these were all people that I’ve known for a long time and who I have great relationships with. I couldn’t imagine any of them suddenly “dumping” me for talking about my mental health, and they didn’t. When you finally feel comfortable and are able to explain your diagnosis to a fair degree (and to someone who might not know what any of that medical jargon even means), it might be time to talk to some close friends of family about it. With my own experience I have tried to add this topic to conversation casually (while stable), instead of building it up as this huge, “deep dark secret,” I need to tell someone (even if it often feels that way). If I spew what I want to say out in a big awkward lump, yes, it’ll be awkward. But, if I act casual about it, it is more likely that the person I’m talking to will act casually about it too. After all, stigma might say that this topic is a “big deal” but it doesn’t have to be if we don’t make it!

After the ball got rolling and I was triumphant with talking to my friends, I had a lot more confidence in myself when it came to my ability to explain bipolar disorder, what it is, and how it affects me.

  • The fourth step, in a perfect world, would be to be open with everyone about mental health. There have been one or two moments in the last few months, I admit, where I’ve really stumbled on this one, but for the most part I’ve been very open. For me, this is the step where some resistance occurs, and I don’t think it is because people are hateful or malicious, just that they are ignorant. Obviously the more open and casual people can be in normal conversation about mental health, the more ignorance we can eradicate.

Some people reach this last step somewhere in the middle, and are comfortable with that. Personally, I wasn’t. I needed to feel empowered enough to get there.

  • The final step is advocacy. Representing those who aren’t feeling strong enough to speak up yet, representing the community in which we are a part of, and helping out our peers. This is what I’m going to do today, and I am nervous, but very excited. It took a little pushing for me to get here, but that’s ok, I must’ve needed it.

I realize, too, that just because I’m hosting this group today doesn’t mean I’ve finished learning how to talk about mental illness and I can move on to something else. On the contrary, I’m constantly learning about how to express what I’m feeling out loud, and it is something I have to work at on a regular basis.

Pen-Pal Hostage

So I am working on a new External Variables post on stress, but I think I’ll be posting that tomorrow.

I’ve been in a very stressed place the last few days, what with the snowstorm and being sick and the power flickering on and off and all. The snow is still coming down, and I’ve had to cancel both my appointment with my therapist this week and two group sessions I was planning on attending. Obviously that doesn’t help with the stress level!

My prescription is also almost needing a refill, but the bus I need to take isn’t running due to the weather. I’m really hoping things begin to melt by tomorrow.

I’ve been very good and didn’t go sledding yesterday, despite the overwhelming temptation.

This year I am trying to be extremely careful, because at this same time last year I got sick, went though four rounds of antibiotics for what they thought was a sinus infection, then had all the nonsense with the CT Scans and everything because I ended up with an intense migraine (though they still aren’t sure that’s what it was) that all left me incapacitated for six weeks.

When it finally all went away, my neurologist told me we would just have to wait and see if it happened again.

So here I am, sick, same scenario, but I’m not going out. I’m not doing a darn thing, short of walking between the living room and the bedroom. I can’t risk that happening again, especially since the stress the pain caused greatly contributed to my hospitalization last year.

The anxiety I have the most is that this will become a self-fulfilling prophecy. Like many panic disorders, where the anxiety of having a panic attack causes one to have panic attacks. Could the anxiety about being sick cause enough stress for me to become more sick? Probably, so I’m walking a very thin line. And trying to keep busy with projects.

The hypomania has apparently passed, I finally got to sleep last night. I’m hoping the forced isolation of being sick and the snow wont trigger an episode of depression, sooooo if you feel so inclined, shoot me an email! I am trapped in my apartment, so feel free to make me your pen-pal hostage for the day.