Tag Archives: therapy

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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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.

Looking Back, Looking Forward

With the new year fast approaching I am excited to say that I will be starting 2016 with a new therapist and a new psychiatrist. I will also be continuing the DBT group I have been participating in for a couple months now which is great because so far I would say it has been helping me make a difference in my reactivity and emotional rumination.

Of course, it helps that Emotional Regulation was the first thing we covered because that is one of the more challenging things I have been facing. The funny thing is that now that I’ve got a few skills to help me see the big picture (instead of a pure emotional reaction) in situations it has been made clear that my other biggest challenge is communication and Interpersonal Relationships. That module of the group definitely can’t come soon enough!

That doesn’t mean I am miraculously cured, or that I am not continuing to lose my shit on a semi-regular basis. But… I may lose it for a shorter period of time, or only two or three times (instead of 12-16). Frankly I am willing to consider any and all progress progress.

Ultimately the way my perspective has been shifting around because of this class highlights an issue that I’ve known for a while but may not have given enough credit to. Stress makes a huge difference, in terms of the timing and magnitude of a lot of my emotional episodes. Stress is like… my death star. I might think it is a friendly moon at first but really it is a fully operational space station of mass destruction.

What does that mean, exactly? I am not sure, but I know I need to be addressing stress more aggressively (eh, not me being aggressive but more seriously) and not fail to recognize it or deal with it before all the firing sequences have been completed and it becomes a giant laser heading straight for me.

I can’t control the stress, but I am hoping that if I can recognize it early enough there will be time for me to react before the laser hits the fan.

Anyway, even with the intense illness and surgeries of 2015, spending summer in bed, and most of my plans being totally pulled out from under me this was somehow a better year than 2014. While 2014 was almost a year of being comical because of how many things could go wrong, 2015 was great because “at least it isn’t 2014.”

I don’t know if it was because I spent 2014 operating on a totally empty tank but this year it was like I could feel parts of my brain beginning to operate that hadn’t been used in ages. I can’t make a final word as to if I should be chalking that up to hypomania or simply 2014 acting as a hard-reset of my brain but it leaves me hopeful that in 2016 I might be able to dust off a few more parts and put them to good use again. We’ll see.

Ultimately, this year I learned that there is still a lot of improvement to be had in terms of the treatment of people with mental illness and mental health crisis. It bewildered me that so many people were willing to reach out and to respect my space when I was having surgery (for a physical problem), but the treatment I have received both just having a mental health problem or during a mental health crisis is wildly different. I am hoping that going forward I can learn and discern new or better ways to communicate this problem and what we can all do to help solve it.

In the mean time, however, I will wish you all a happy new year! Thanks for reading!

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.

Comforting the Inner Critic

It was hard for me as a kid growing up to celebrate the successes in my life. There has always been a voice in my head telling me that I could have done things a little better. A little faster. A little smarter.

For whatever reason this was translated into a situation where people believed it was easy for me to achieve the things I did. People mused to me about how effortless my life must be, and that I shouldn’t bother celebrating getting straight A’s because there was no effort involved.

I didn’t tell anyone that the biggest drive in my life was fear. That voice in my head told me that if I didn’t succeed I would have no future. That I would die at any moment. That somebody close to me would get hurt. That really, I was just a failure anyway so I ought to just give up now.

In that sense, yes, it was easy to succeed. To succeed or believe that terrible things would befall you… succeeding seemed like the only option.

When I got older the voice took on a more intense role, and as my interest in school waned and was replaced with relationships the voice began to mimic all of my most awkward and heart breaking moments back to me. According to the voice, failure in a relationship meant failure at life, and I did all manner of things (and withstood all manner of things) to try to keep things together.

I tried many things to deal with these intrusive thoughts, first I tried to please them. For many years I did whatever I could to try to prove them wrong in a desperate effort to make them stop. They didn’t.

I tried to have a relationship where my intrusive thoughts became part of the dialogue. A third person in the relationship. My attempt to be open about the intense negativity and explain my odd behavior backfired and only upset my partner, ending things in an emotional explosion.

After that I tried to ignore the thoughts. I figured they must be bad after how my ex had responded and I didn’t want anything to do with them anymore. Unfortunately, it didn’t make them go away, and every subsequent “failure” or fear was repeated back to me on a loop. Something my emotional stability didn’t take too kindly to.

After 25 years of intrusive thoughts I became hostile toward them. I had a therapist who suggested contradicting these thoughts aloud to prove they had no basis in reality, but my thoughts were too cunning. When they wouldn’t stop or they would agitate me to the point of being unable to see reason I’d start arguing with them (not a pretty sight I’m afraid).

Much like the parrot (Marvin) my family had when I was growing up the noise from these intrusive thoughts in my head can be relentless. Also much like when I was dealing with a squawking Marvin it has not been uncommon for someone to walk into the room just as I am screaming, “shut up! Shut up! Shut up!”

(Although Marvin began telling random people to “shut up,” I am lucky that my intrusive thoughts have not caught on to mimicking these moments.)

Needless to say, both myself and everyone involved in my life were kind of in a tight spot. I didn’t know what to do, and constantly fighting these thoughts one at a time was both draining and time consuming.

When I brought this up to my therapist (a new one I guess, as this has clearly been an ongoing issue) she asked me to imagine I am both a child and my own mother, and to treat these intrusive thoughts the way I would treat myself as a child.

Frankly, after a few weeks I was still trying to wrap my head around what she said. A mother? A child? What does that have to do with anything? I don’t intend to have children so how do I know how a mother would act? I find children a little creepy (nothing personal) so we don’t have the best relationship. Moms either.

Should I make english muffin pizzas?

Ultimately the message I was failing to discern was that she wanted me to approach these feelings with more of a comforting and understanding point of view. Despite her terrible metaphor, I could imagine, perhaps, a puppy (way cuter and less jam-hands) as my intrusive thoughts.

Sometimes puppies bark or bite or simultaneously projectile vomit and poo on the floor (an imagine I will never be able to erase from my memory, thanks Luna) because they need attention and some nice belly scratches… maybe a bath after that poo thing too. Arguing with the puppy wont make it content, and neither will ignoring it.

I’ve taken this concept to heart, and even though this is definitely the biggest jerk of a puppy living in my brain, it is also just me hoping for reassurance, or comfort, or anything to help dispel that fear. And when I get reactive and angry sometimes I just need to say, “guess what? Your anger is totally justified right now! This is frustrating!” instead of using it to try and fight myself.

I’ve spent many years seeking justification or comfort or approval from other people, and there are genuinely some very difficult times I’ve experienced when I had reached out to every person I knew and been turned away. I find it a little amazing that I was capable of doing it myself this whole time, I just didn’t know how!

Obviously I am not cured. It is a work in progress, as always… and I can’t claim I haven’t told that puppy to shut up at least a few times in the time since then. I am simply doing the best I can trying to learn how to take care of myself and my life, and that (if nothing else) is comforting to me. As it turns out, I am in the market for more comfort, so whaddaya know?

(Snippet)

My new therapist seems to be working out. I have only seen her three times, but she has a face that closes tight like a brick wall when she is listening. Frankly, that is exactly what I wanted… I hate watching people pass judgement on me or my situation while I am talking to them.

I have been having trouble writing for a myriad of reasons, I think I may have been traversing some hypomania last week or the week before but the energy and activity associated with it has taken a toll on my body (that is still healing from surgery). This week has been the physical crash that follows, and my 13-14 hours of sleep followed by exhaustion during the day has not leant itself to much motivation or productivity whatsoever.

My optometrist suggested I have been having ocular migraines -honestly I didn’t know that was something that even existed. I am pretty tired of heaping physical health problems on top of already crippling emotional ones… but such is life I suppose. If it isn’t one thing it is another, I am just glad I can eat relatively normally again.

 

The Ongoing Journey for the “Right Fit” in Therapy

After the events of last week my goal this week was clear.

Switch therapists.

I have been seeing the current one for just under a year and while we’ve had several communication issues I’ve tried hard to come back at the next appointment, try to talk things out, and move on.

She is a nice woman and she is very easy to talk to when she is receptive. Unfortunately sometimes she just… isn’t? Her availability has not been stellar, so when I actually have a chance to see her it has been a real bummer when she isn’t listening.

Despite the obvious issues I told myself that (realistically) some of the feelings I was having about her not listening to me could be an emotional reaction, out of line, and that maybe I wasn’t communicating properly on my end. However after several of these situations I found myself sitting in front of her last week talking about this very subject. She seemed to listen, she had a sad emotional reaction in her face, and I was prepared to move past it. Again.

But then… she asked if looking up [a specific topic] as homework might help me. I replied I felt more comfortable saving the topic for later down the road because I didn’t want to be confused after getting different information from difference sources (once I get into the DBT group). In seconds she said,

“ok,” pulled out a sticky note, wrote a few words down, and gave it to me. “That way you will remember to look this up when you get home.”

For a second I honestly thought she might be screwing with me… hadn’t I just said no? Hadn’t I just said that I was terribly afraid she wasn’t listening to me?

I took the note and left.

When I told this story to my new psychiatrist later last week she implored me to call the director of the program to switch to someone else. It can be so hard to know when to cut ties with a therapist, and I have a hard time not giving someone having a hard time with their job another chance to do better. After all, it is what I would want if I needed another chance… the difference is that this pattern I fall into is no longer therapeutic for me. Sure, it might be therapeutic for my therapist that I be forgiving when something comes up, but when does that gesture dissolve the positives I might be getting out of therapy in the first place? I need to be working to resolve issues in therapy, not causing new ones.

At any rate, this is the first time I have made a big move to switch therapists. Normally they’ve just quit or left before I had a chance, so I feel proud of myself for addressing this before it went too far. I’ve already spoken to the program director and have already been assigned someone new, I just have to wait for them to call to set up our first appointment now.

I feel a little conflicted about not reaching this point with my therapist in person (I generally do enjoy her as a human being), but every time I tried to suggest we split in the last year she would reel me back in. Again with the not-listening. At any rate, I think I’ve devised a method to help me potentially predict big upcoming episodes with more accuracy (more on that in my next post) and it seems pretty clear that I am heading into one of those large depressive states I can find myself in. Finding a support system that is… well, supportive before the ball drops will be crucial, so any guilt I am feeling is largely overshadowed by a sense of self-preservation.