Late (EARLY?) Stream of Consciousness

NOTE TO START: this is a stream of consciousness post written AFTER taking PM meds mostly on the topic of my experiences with mania and supports in my life. Not a standard post at all but definitely straight from the heart. Due to the timing of the writing being after my nighttime meds, I may clean it up a bit tomorrow. Wanted to get you guys an update though. 

Since my last post, my life has been all over the place. I’ve said it before and I’ll say it again, the number one way to fight stigma is to share our stories and show that we all are indeed human, regardless of diagnosis (or diagnoses). I mentioned in my last post that I am finally employed again and, in that post, I was embracing quite the optimistic view of things. Now, I am still embracing optimism and looking to focus on the good, but a part of sharing stories is being transparent, and so this is my transparency post for the month, I suppose.

I am a firm believer that you can’t help other people with their mental health if you are neglecting your own. 

Now, I don’t meant that you need to be completely healthy or recovered to do good, I’m talking more along the lines of that age old saying that if your own glass is empty, you can’t really fill the cup of someone else. Some have suggested that perhaps I jumped into this “blogging thing” too soon. The point of this statement is not lost on me. I started this blog less than a month out of the hospital while still engaging in intensive stabilization treatment. I can see how some would consider that my own recovery may not quite be far enough along to be jumping in to help others. But I disagree.

I disagree because I am not trying to write this blog from the perspective of someone who is “better” or is an expert. I am writing this blog to share my recovery process, in all its messy glory. The successes as well as the setbacks, the victories as well as the defeats. And, I hope, to share some things that have helped me which may help someone else as well.

That said, due to the fact that my recovery is still young and I am still learning to navigate this new life of mine, the “ideal” version of this blog – developing and realizing the vision I have for this blog – has been a pretty painfully slow process. 

And I recognize that that can be frustrating to you, as a reader. I’m still in a rather persistent battle with the army of demons. Some days are better than others, some weeks are better than others, and some months are better than others. See, when I’m feeling pretty stable and good, I tend to get very “big picture” and excited about the things I want to accomplish in this space. And I remain excited about that vision on some level all the time, but if you’ve ever experienced depression or mania or PTSD symptoms on full blast, you know that these things can really get in the way of executing any excitement in a tangible way.

So, here’s the deal: I spent last night pacing my kitchen freaking out for about an hour before I finally reached out to a friend.

My thoughts were streaking through hyperspace and I couldn’t catch a single one of them. And I couldn’t sleep. And I wasn’t hungry. And I was irritable. And, worse of all, I was obsessing over the fact that I didn’t used to be like this. I never experienced manic symptoms this extreme until November, and back then, they didn’t have a name. And, in my little obnoxious, bipolar brain, I had myself pretty convinced that the fact that these symptoms only really picked up after I started the meds to treat the “lesser” bipolar symptoms (the severe depressive episodes and “milder” hypomanic episodes of Bipolar Type II) that maybe the meds were to blame and taking them would make it worse. Now, on one level, I knew that that was irrational – I knew that my brain is now accustomed to these meds and that even if there was some connection, I need to keep taking them until I talk to someone about getting off them. (Spoiler alert – I don’t really need to get off my meds. As sometimes happens with Bipolar that goes untreated for years, my symptoms worsened over time. The trigger of my husband leaving, which kicked my PTSD symptoms into full blast also kicked the Bipolar symptoms up a notch. Common triggers for mood episodes include stress, loss of a relationship, loss of a job, lack of sleep, and drinking or using drugs excessively. Between November and January literally ALL of these things were staples in my life, thus, Bipolar symptoms increased.)

Now, my manic symptoms tend to manifest as mixed. I am wired, but not “having the time of my life.” I live in full blown catastrophic and irrational thoughts. Here’s an accurate representation of my stream of thought last night before I called my friend. I’m going to become full blown manic. I’m not going to sleep for a week. I’m going to go back to the hospital. I’m going to lose my brand new job. I’m going to lose all the progress I’ve made over the past six months. I’m going to lose my friends because my “grace period” is completely worn out at this point. I mean, really, how many times can someone answer the phone and walk me through a freak out before they just don’t have it in them anymore. Before their own cup is empty and they have nothing left to give. Cause that shit happens, you know. And it’s not because they aren’t good friends, it’s because I’m a bad one and I just keep needing all the things and it’s been six freaking months so when is it exactly that I stop being “crazy” and start being “me” again? What the fuck do doctors know anyway? Maybe they did this to me with all this intensive treatment. Maybe I’m actually fine. Maybe I’m blowing this out of proportion. Maybe I’m minimizing. I don’t know. But I know a lot of shit and taking my meds might make this worse but not taking them might make them worse too. I’m completely fine. I’m going to be fine because I’m awesome. I can muscle through anything. I can’t actually do anything. What if I can never actually work a real job again? My god everyone must think I’m a complete nut job and I’m just embarrassing myself with being so open about it, no one actually sees me as “Sheila” anymore. But I’m doing amazing things by helping people. I’m rocking it. I just need to snap out of this because I know I can. I’ve white knuckled way worse. I should call someone. No, I can’t. If I call a crisis line they’re just going to show up and take my ass to a hospital because they all see me as insane anyway so why would they listen to me. Maybe I should call my friend. Its not that late in California. No. Text. I should text her. ETC. 

These are the kinds of thoughts that spin – and spin and spin and spin some more. And I obsess. Now, I’m not proud of this by any means, but that little stream of consciousness was mostly uttered aloud, in my kitchen, to myself, as I paced. Because nothing says “I’m alright” like talking to yourself in a dark kitchen in the middle of the night right? Thankfully, I DID end up reaching out to that friend and the phone call resulted in me taking my regular meds as well as my PRN sleep pills I’m meant to take when manic stuff is popping up. That combination of medicine got me a grand total of 3 hours of sleep last night. Which is another red flag. And I’ve taken it this evening as well – about two and a half hours ago. Now, this stuff usually KNOCKS ME OUT. I mean, I take it and if I’m not in bed within thirty minutes someone is going to have to help me get there. This has not been the case this evening or last evening. I am decidedly in the hypomanic range at the moment, and I’m very convinced that the only reason I’m hypo- instead of hyper-manic is my meds. And I’m honestly even concerned about writing this, or, rather, about having some of you read this, because I’m annoying myself. And I apologize if I’m annoying you, too. The thing is, recovery isn’t linear and there’s no magic button.

I’m not trying to make this post all about me complaining about where I’m at or anything like that. I’m taking all appropriate steps to minimize the impact of this current situation.

Today was a fantastic day. Truly. A very god friend of mine became a citizen of the United States and I was honored to attend the ceremony. This friend is a former coworker of mine from the group home, and so I got to see a lot of my former coworkers and even my old bosses. I was so happy to see everyone, but my anxiety and that stupid voice in my head that like to replay every single screw up I’ve ever made was putting me on constant blast. My PRN sleep med has a half life of thirty hours and I have mood stabilizers and anxiety meds I take throughout the day. The combination of these things had me pretty mellow today, if a little overwhelmed. And I felt a deep sense of loss being around my coworkers and boss and realizing that I’m now on the “outside” of that equation. It’s a very strange position when you’ve essentially spent five years spending more time with those people at work than with your own family. I’m not sure how to explain it. I did not act on this urge, but there were more than a few times that I wanted nothing more than to profusely apologize to my former colleagues and supervisors. Apologize for not being able to handle this on my own. Apologize for needing help. Apologize for not being able to work with them anymore. Apologize for the abruptness of my departure. Apologize for all of it.

The vast majority of that is internal stigma and anxiety lies, but there is something to be said for changing roles and the difficulties that poses on one’s sense of self. I was someone who viewed my work as a core component of my identity. If you asked me to briefly describe myself before having to leave work, the two answers I would consider most important would be: mother and residential instructor in a group home for dual-diagnosed young men working toward independence. (ok, that’s a mouthful, maybe not “brief” in the strictest sense of the word, but that would be my answer.) Is it healthy to have so much of your sense of self tied to your job? Probably not. I admit that. But nevertheless, it was. And it is a real loss to not do that work anymore. And, believe it or not, when you work so closely with the same people in a sometimes high-stress environment, there is a lot of guilt for leaving – at least there was for me.

So, while seeing all of these people who I truly love, and bearing witness to my friend’s naturalization ceremony was an incredible experience I will never forget, the combination of all those unresolved feelings around leaving work for mental health reasons and the simple amount of people at the courthouse, in the elevator, and at the reception afterward was incredibly overwhelming. I took some extra PRN anxiety meds, caught a short nap on the ride home, but came home wired, irritated, and anxious. I’ve heard from more than one person that nightfall can increase mood symptoms, and that has certainly been the case with me. So, once I got my daughter to bed, I again felt incredibly irritable with those same racing thoughts and obsession over whether or not I was overreacting or underreacting, increased rate of speech, and a general “intensity” that only seems to come with mania. Despite this, I DID take my meds – both normal and PRN – and I did attempt to sleep (no luck so far) and I did both without needing to use my phone a friend life line (did I date myself there?)

I’ve just been thinking a lot about what a contrast I’m feeling now compared to my last post. I said I wanted other people to take the kid gloves off, but I literally spent two hours on the phone with my friend trying to get level headed enough to take my meds and try to rest. My head is so all over the place, I don’t know if I need complete isolation from everyone trying to help me or frequent phone call check ins and reminders. And regardless of what I think I “need” now, it honestly seems for fluctuate – sometimes day by day. So, I can see how overwhelming that is for others – it’s definitely overwhelming for me. And, as is the theme of my life since December, I again find myself needing the reminder not to make sweeping generalizations of myself being “better” or “worse”. It’s an ebb and flow. One of these day, that will actually click.

So, again, I don’t want to be an obnoxious human and bother anyone, but I really want to share this with you guys and also to give myself some space to reflect. Maybe I can even take this in and show it to my therapist to give her the true inside scoop.

NOTE: MANIA IS NOT FUNNY OR QUIRKY, IT IS A SERIOUS MEDICAL CONDITION WHICH REQUIRES TREATMENT BY A MEDICAL PROFESSIONAL. DO NOT STOP OR START MEDICATIONS WITHOUT SPEAKING TO A DOCTOR FIRST AND RECEIVING AN RX. In addition to medication and friend support, I have a phone call in to my psychiatrist and therapist’s office to see if there are more things I can do to help manage my symptoms at the moment. I am a member of a peer support group as well. I don’t want you thinking that I’m flying solo and barreling toward the deep end. I’m managing and it will get progressively better as long as I stick to my treatment plan.

On Expectations

I hope you’ll indulge me in a bit of a personal update post. Emotion Regulation Part 4 is coming, I promise! It’s taking a bit longer to polish than its predecessors, but it’s almost complete. According to the schedule that I keep trying to implement, but almost never follow (please remember, I’m still quite new to this “blogging” thing and there’s a lot of stuff I’m still figuring out), Wednesday is meant to be some form of a personal post – usually one of my Scrawling Toward Sanity posts, or a tidbit from my personal life that has broader applications and relatability, such as When Someone You Love Dies by Suicide.

Tonight, though, I’d like to throw it back to the style of my older posts – like my very first post or On Shoveling, Fathers, and Forgiveness. Straight up reflection on something that’s been on my mind a lot lately in my own, personal life that I’d like to share with you. Maybe you’ll relate, maybe you won’t, but I really feel the need to give this line of thought some air time.

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Prior to January of this year, I was employed at a fantastic (if stressful) job: one with great pay, amazing benefits, and the absolute best co-workers a person could ever hope to have. It was meaningful work, too: supporting young men as they learned to regulate their emotions and grow life skills as they worked toward independence. I loved my job. Truly. I looked forward to every shift and left every single night immensely grateful to be where I was. On nights that featured violent escalations, I was grateful for my teammates and the support and skill we all shared in keeping the situation safe for ourselves as well as our clients. On nights that included long, thoughtful, impactful conversations with those clients, I left grateful for the opportunity to walk along side those young men in their journeys; I was grateful and humbled to have the chance to make some lasting impact in their lives, however small it may be. On nights that were not particularly eventful at all, I was grateful to work in a “home like” environment: to have a job that sometimes consisted of geeking out to a Star Wars movie or the staff and clients enjoying each others’ company over a friendly, for chips, game of poker. Regardless of the events of each shift, I was always thankful to work in such an amazing place. And I miss it every single day.

As you know if you’ve been following my blog, my life changed pretty drastically in January. A seven day stay at an inpatient psych unit, another month and some change of Partial Hospitalization and Intensive Outpatient, difficulties navigating the mental health system as a patient, and a general lack of direction have more or less consumed the past six months of my life. Finally, though, I am on all of the correct medications, I am in regular therapy, and, as of today, I am once again a member of the work force! The part time, minimum wage work force, maybe, but a member of the workforce nonetheless!

But here’s the thing: going through something like this, living in this state of limbo of med adjustments and intensive therapy; meeting with professionals of all different specialties and areas of treatment; telling my story over and over and over and over again: these things can really start to wear a person down. And the truth of the matter is this: once you’ve gotten “into the system” as “mentally ill”, people’s expectations of you change. In a really big way.

Treatment professionals, I’ve found, tend to have generally low expectations of someone “like me” – you know, bipolar, PTSD, hospital stay. These things, these labels, these events, sometimes seem to carry more weight than anything I do or say. Never mind the fact that prior to this very difficult chapter of my life, I was employed – full time. Often working much more than full time, honestly. I was a student at the University of Vermont, trying to finish my senior year and earn my Bachelor’s in Social Work (and I made straight A’s first semester despite being mid-breakdown). I was an active participant in my own life. I had a pretty vibrant social life, actually. I had a lot of things going for me. But all of that sort of fell through the cracks of crisis stabilization, psychiatrists, primary care visits, and counselors.

I get it. When one is in an acute mental health crisis, it’s not the time to push getting back to full time work and school and all of the responsibilities of life, at least not all at once. I understand that. But, looking back, I realize that somewhere in the crisis stabilization process, the expectations placed on me became less and less.

When I was in the hospital, the doctors said I would just need a few weeks to complete the PHP program and then I’d be back to my regularly scheduled life. At the PHP program, they suggested I hook up with Voc Rehab to get some support around finding a different, less stressful full time job. I was discharged from the IOP with a note saying that I could “maybe work” in a “part time, low stress environment.” When I started up with my new therapist, there was only talk of further therapy. She suggested I join the DBT group the agency runs. I LOVE DBT. If you’ve followed this blog, you know that. And I say this with absolutely no disrespect to the members of this particular DBT group or to the facilitators, but the fact of the matter is no one in that group was a “peer” to me. The pace of the group was far too slow. The facilitator would spend thirty minutes explaining a concept I understood after five. I don’t want to sound like a judgmental, arrogant jerk here, but sometimes groups are just not a good fit, you know? There was nothing wrong with any member of that group. Their lives are theirs; my life is mine. But it was very clear to me that this group would not challenge me at all, and that I would struggle even staying engaged in it. I would not be getting much from the sessions. But my therapist (who I really do like) thought it would be a good fit, and honestly, that stung a bit.

But why wouldn’t she? By the time I made it to her office, professional expectations of me were so low that no one even mentioned a job. Those of you who know me personally know that such a low bar would almost be laughable, were it not for the fact that something started to happen over these months of the medical professionals’ gradually lowered expectations of me: they became my own. The consistent explicit or implicit suggestions that I was incapable of achieving anything remotely close to the life I used to have burrowed into my subconscious and set up shop. And I sat in resigned acceptance. I thought “Maybe this is all life has for me from here on out. Maybe I am incapable.”

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And it wasn’t until I realized this, until I recognized what was happening in my own psyche, that I knew I had to put my foot down a bit and refuse to allow others’ perceptions of me to run my life. I’m taking my recovery process very seriously, and I fully intend to continue with the treatments my providers believe will be helpful, but I refuse to do it blindly anymore. I refuse to sit back and have my capabilities dictated to me. I realized that this is just an attitude that I need to adopt for my own well-being. A little self-advocacy can go a long way toward boosting self confidence, I think.

And so, I told my therapist that the DBT group was not a good fit for me. She was a little disappointed, but I think she understood. And I applied for a job. Not through Voc Rehab, not through my therapist, not through the state offices, but by myself. Because I needed to do that. I think I needed to prove to myself that I could. So, I did some good old fashion pavement pounding and filled out applications and handed them in. TJ Maxx is the only place that called me for an interview (I assume because the jump from residential instructor to unemployed for six months to looking at retail jobs is probably a little off-putting to some potential employers).

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When I was offered the job, I was understandably excited (because a part time job beats no job, and having something to get me out of the house on a regular basis is exciting, and the idea of being able to be a productive member of a team is motivating in and of itself.)

But again, those pesky expectations reared their somewhat ugly heads when I told loved ones and my therapist about it. More than one person responded with “Oh that’s awesome! You know, it’s really great that you have something to fill your days.” Other people said, “Oh, do you think you’re ready for that?” Some said, “That’s great! You know, some people make full careers out of retail.” My therapist asked, “So, what, you’ll working 4 hours a week?” Now, again, I appreciate the congratulations and I am excited about this job. Retail has always been fun to me, and I’m pretty excited about the discount, too! I enjoy helping customers and making upsales and all of that jazz – I have since I was a junior in college working at F.Y.E.

But do I see myself working part time retail for the rest of my life? HELL. NO. Could I consider making it a career if I got a managerial position? Maybe… but honestly, probably not. I enjoy retail, but I’m hard wired for a career that involves helping people beyond making sure they have a shirt in the right size and are signed up for a credit card to get savings. I’m still not sure what that looks like for me now. Will I ever work residential again? I don’t know, but I know I won’t be doing it in the foreseeable future. Right now, my job is about one thing above all else, and that’s money.

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The fact is, one cannot live in this society without cash flow. I’ve got bills. I have a lot of bills, actually, with all the doctors I’ve needed to see over the past six months. And I need to start making a dent in the stack of collections notices. I don’t meant to knock retail by any means. As I said, I enjoy retail. And I have a lot of friends who have careers in retail. But they don’t just enjoy it, they are passionate about it. And that’s the key, right? It’s building your career around your passion.

But passion can get snuffed out pretty quickly in the land of low expectations. If enough people don’t believe you’re capable of something, and they tell you so, you can start to doubt yourself pretty damn quickly, regardless of everything you thought you knew to be true.

So, that’s where I’m at. I’m setting my own expectations for myself. And I’ll be sharing them with anyone who will listen for as long as it takes until they hold those expectations of me as well. And you know what? If it turns out they are right and I am wrong, and for some reason, a sales associate job is too stressful for me at this specific time in my life, then I’ll find a job with a little less commotion and a little less social interaction. But I reserve the right to determine that for myself. And frankly, I need a couple of people in my life to take off the kids’ gloves. I need my treatment team to know that I am not satisfied being the “unemployed crazy person”, and that I am not going to be satisfied working a part time sales associate job for the long run, either. Or even a full time sales associate job. I need my treatment team to recognize that these are stepping stones right now. I need acknowledgement that, yes, I am still hiking that mountain, but there’s no way in hell I’m pitching a tent and living here.

This post is, of course, very specific to me. There are many people who are incapable of work due to their struggles. And it’s feasible that I will be in that situation again at some point in my life. I certainly was not capable of working in January or February of this year. This is in no way a “pull yourself up by your boot straps and stop making excuses” post. I hope it’s not interpreted that way. This is not meant to minimize the experiences of anyone living with a mental health diagnosis or diagnoses.

I just know that, for me, the lack of faith in me by others lead to a lack of faith in myself, which then lead to further depression. That, coupled with med adjustments, lead to me kind of dropping off the face of the earth for a few weeks there. But I’m back. And, honestly, I’m more motivated than I’ve been in the entirety of the last 6 months to continue to recover, to learn to live within and adapt to my limitations (because I do have limitations), and most importantly, to grant myself permission to have the dignity of risk and find those limits for myself, through experience, and not from some checklist on a therapist’s clip board.

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And that motivation is not limited to my employment status, either. It is for this blog; for the fight against stigma and against false assumptions and expectations around someone’s abilities; for the fight for support, understanding, and access to resources to those in our community who cannot work; for the dignity of risk for everyone who wants to give it a shot; and for a more comprehensive understanding of the ways that the same diagnosis can look very different for different people. I’m motivated to continue to educate and advocate, and to share my struggles and triumphs with anyone who’ll listen. Because that’s the single most effective method to attack stigma and misinformation.

Thanks for reading.

AS ALWAYS, I’d love to hear your thoughts. Have you ever been in a situation where others’ expectations of you dictated your own? When you were first diagnosed and receiving treatment did you feel helpless? Do you agree that finding and setting our own limitations is a good idea, or do you think it might be too risky? Whatever your thoughts, I’d love to engage in a deeper conversation in this topic! Leave your two cents in the comment section below, Tweet me @paradichotomy, or hit me up on the blog’s Facebook page

ALSO, in case you missed it, I had the opportunity to be on a podcast last week – check it out here! I’ll catch you all later!

 

8 Self-Care Techniques for an Impending Mixed Features Episode

OK, it’s transparency time. Transparency is essential to fighting stigma and helping those who may not live with a mental health diagnosis (or diagnoses) understand a little bit of what we face daily. The truth is, sometimes living with Bipolar Affective Disorder is absolutely no fun. This has been the case for me these past two weeks. See, I’m trying to get in a groove with the scheduling for posts on this blog. I’m on track to do that for next week, at least. I have caught an expanded vision for this blog that really excites me, and I’m so looking forward to putting it into action! But, I missed the mark this past week and the week before, and the depression that caused me to miss that mark also tells me what a failure I am and that I will never be able to make this space line up with my vision. Then, the more manic symptoms tell me that I don’t have to. Whatever I do, everyone will love it, and everything I touch will turn to gold because I’m freaking unstoppable. (One symptom of mania is grandiosity, and in me, it tends to take the form of making ridiculous plans and just assuming that everything will come together because, hey, how could it not with how amazing I am.) I’ll be honest, even typing that makes me feel like an arrogant jerk. I hope you’ll forgive me.

I assume if you’re reading this, you’re at least a little familiar with the basics of depression and a Manic episode (links provided in case you’re not). I’d like to briefly describe my experiences with each before getting into the meat of this post. Depression is an aching in my bones. It’s the searing knowledge that nothing has ever been right and nothing will ever be right, but the simultaneous numbing of all pain receptors. It’s feeling my whole body slowly petrify. It’s being unable to get out of bed some days and also being unable to even muster the energy to care. It’s running my fingers through my hair in exhaustion and realizing only then that I’m a greasy mess who hasn’t showered in days. Then, there’s (hypo)mania. When everything is perfect and I am amazing and I can do no wrong. It’s unrestrained energy and excitement. Now, that might sound fun, and it is – at first. I’m charismatic and I can probably get you just as excited as I am about [insert Amazing, World Changing, New Idea here]. But then, things get pretty overwhelming. The best analogy I can come up with is when you go on one of those super-fast, spinny rides at the fair. At first, it’s thrilling; then it starts to make you sick and you wonder when it’s going to stop. It’s being so energized you can’t sit still. It’s having so many ideas flying through your brain that you can’t grab just one. It’s jumping between ten tabs on your browser, all on different topics, and only being able to stick with any one long enough to read a sentence or two, but trying to make sense of what you’re reading anyway. Trying to blend the sentence fragments into a coherent reading experience, then getting frustrated that you can’t make it make sense.

Then, there is the dreaded Mixed State. And it truly is a beast. It’s hard to explain, really, even for me. The technical definition is that you have symptoms of Mania and Depression at the same time or in rapid succession. Try to imagine that for a minute. It’s being depressed but energized. It’s having fantastic ideas of things I want to accomplish all while depression screams in my face that I can never accomplish anything. It’s being hyper and hopeless at the same time. It’s wanting to do nothing but sleep all day, but being unable to sleep at all. It’s pacing the kitchen at 4 AM, crawling in my skin, with quick snapshots of everything I’ve ever done wrong in my life flickering before my eyes, and being simultaneously unable to break the train of thought and unable to focus on just one event or memory. It’s sensory overload on every level. It’s just a big collection of suck.

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Well, here we go! (Resigned to the coming battle)

Were it not for my meds, I have no doubt I would have been in a full-blown Manic with Mixed Features episode these past two weeks. Meds, thankfully, muted the effects a bit. But the basic symptoms were still present, if less severe than they have been in the past.

All of that to say, today is supposed to be a post about self-care. What steps can we take to practice self-care while in the midst of a Mixed Episode? That’s the question of the week!

The first, most important part of self-care with BPAD is pre-episode, daily management. Being aware of subtle changes in your mood, following a schedule, taking a PRN sleep aid the first night you can’t sleep, within the first two hours of trying to sleep and realizing you can’t. Eating well, even when you’re not hungry. Reaching out and connecting with people, even when you don’t feel like it. Taking all of your meds as scheduled. And so on. This is the “do as I say, not as I do” part of the post, I admit. I’m still working on getting a handle on the whole “schedule” thing, I hate my PRN sleep pill because it makes me groggy all of the next day, and I’m not even going to touch the eating thing. That said, I recognize that these things are important and I am working on it!

Alright, you say, preemptive management is good, but what do you do when you’re already barreling toward a Mixed State or in one that hasn’t reached red alert crisis levels yet? Agitated depression, paranoia, no sleep, racing thoughts are here or right around the corner… what can you do?

  • Stick with your meds even though you probably have no interest in taking them. I set alarms in my phone and I know, no matter what, I have to take them when the alarm goes off. This can help minimize the impact of your symptoms on your overall day to day life and prevent the need for a hospitalization or a full-blown crisis situation.
  • Reach out to a friend/family member/treatment team person. Maybe this feels absolutely impossible. But if you’re aware that your mood is spiraling, asking someone you trust to check in every day can be the difference between a rough few weeks and a very dangerous situation. I have a really good friend who calls me four to five times a week and helps me keep track of things. Remember other people have their own lives, though, and you can’t count on them for everything because they have their own stuff going on. But even a 10 minute phone call every other day can go a long way. IMG_20170429_030324_285.jpg

Yes, I’m using a picture from Disney Land. The sword is a metaphor, though. Sometimes we need help. Friends are great at helping. Let your friends help. ❤ 

  • Keep crisis lines saved in your phone. Really. If it’s 4 AM and you’re feeling unable to handle the chaos in your brain, having a support you can call no matter the time of day can be immensely helpful, if not life saving. Keep them in your contacts and use them.
  • Make sure your friends and family know what to look out for. This article may be helpful to share with your family/ friend support system. The fact is, once the episode becomes full blown (whether traditional mania or one with mixed features), we don’t really have the ability to realize what’s going on or what we’re doing or feeling. If you live with BPAD, you know that. That’s where an extra set of eyes (or two, or ten) can really come in handy. Someone outside of you who can help keep tabs and manage things is essential.
  • Avoid alcohol and mind-altering drugs. This is essential. I understand the temptation, that need to do something, anything, to stop feeling what you’re feeling. But it’s just going to make things worse and less manageable for you in the long run. If this is a big struggle for you, take care to avoid triggers during this time. Don’t hang out with friends you drink with. If it’s a REALLY big struggle, have a friend or family member go to the store with you if you need to go so that you don’t convince yourself that buying that bottle of wine on the shelf won’t hurt. Really, it will. I promise. Drinking is going to make things much worse for you. IMG_20170429_040108_636000.png
  • What’s in your Kit Bag? “Kit Bag” is a term I learned from a friend to refer to a sort of “emergency self-care kit”. If you don’t have one, I highly recommend making one now. It doesn’t have to be an actual bag of tangible things. It can just be a list. When you’re recognizing mixed features but they are not yet full blown, it’s time for self-care central. What people, places, and things make you feel most at peace and in control? Hot showers? Mindful cooking? A favorite movie? Calling a friend? Seeing your therapist? Come up with your list and use it! Some people also do have a tangible bag with things like a DVD of said favorite movie, a bottle of favorite bubble-bath, some beloved recipes, notes of encouragement and love from family and friends, etc. Find what works for you and do it.
  • Challenge you’re thinking. If you’ve ever done Cognitive Behavior Therapy, you know that negative self talk and distorted thinking can overtake us at any time. You also know that there are ways to challenge these thoughts. My favorite method is the one that feels the least threatening – I think of one fact that suggests that my negative thoughts are not 100% true, 100% of the time. I say “least threatening” because, as backward as it may sound, my negative self-talk and distorted thoughts are pretty thoroughly ingrained in my mind, and I’m so used to them that the idea of getting rid of them is sometimes more scary than the thought of continuing to live with them. So challenging them outright is always difficult and sometimes impossible. But, I’m also a very analytical person, so finding one fact, one event, one moment in time, that demonstrates that my negative thoughts are not 100% true feels pretty manageable to me. By doing this, over time, you do start to fight against the entire thought. But it’s all about baby steps.
  • Finally, if you are truly in crisis, get to a hospital. Have a safety plan in place with your supports. Set limits. If you cross the line on those limits, it’s time to go get the next level of help. Look, no one likes hospitals. Especially not psych units. I know. I get it. But I also promise you your future self will thank you for going.

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Literally me checking into the psych unit. Taking a selfie was maybe not rational, but, honestly, I was pretty thoroughly irrational at the time. Really, though, it’s OK to need help, and sometimes we do need that “higher level” of support. There’s no shame in that! 

So, that’s my little list. The fact of the matter is self-care while heading for a mood episode of any form is a tricky proposition, and preemptive planning with your support team is the best way to manage it. But if you, like me, are living with some of the symptoms, but they are muted enough to not require hospitalization, self-care can really help you ride it out. It’s going to suck, there’s no getting around that, but having good self-care techniques and good supports can be the difference between a crappy couple of weeks and a crisis requiring hospitalization. It does require a certain awareness of mood and an understanding of what is happening, though. Which is where the friends and family come in. In the week heading into this episode, on three of my phone calls with my friend, she noticed that I sounded “in a fog”. This was a big cue to me that things were not well and that I was heading for a bad time. So, self-care kicked into overdrive.

Self -care is going to look different for everyone, of course. And I feel obligated to mention that Mixed States are often the most dangerous types of mood episodes, because being depressed but energized tends to facilitate making and carrying out a suicide plan. So, please take care of yourselves. And, not to beat a dead horse, but IT’S OK TO NEED HELP at whatever level is necessary.

If you’d like some specific techniques for getting through a particularly difficult time, check out my list: Top 5 Ways to Get Through a Bad Situation (Without Making It Worse).

What are your go-to emergency self-care techniques? Do you agree with this list? Disagree? I’d love to hear your thoughts in the comment section of this post! You can also Tweet me and find me on Facebook. Thanks for reading!

 

Mixed (Manic) Precipitation – A Poem

You all seemed to like the last poem I posted, and I hope you’ll enjoy this one, too! April is, after all, National Poetry Month. So, you may be able to expect more poetry in the coming weeks.

“Mixed (Manic) Precipitation”

I exist somewhere between
the depth of salt water
and the misty clouds in the sky –
but my mind is in both simultaneously.

So when it rains, tears tumble out,
yet fill me, all at once.
So the crushing pressure of depth
and the thin air, sharp breaths,
fog my thoughts beyond recognition.

Beautiful landscape, scattered downpours,
of words that just don’t fit, and over saturate.
I’m gathering raindrops to assemble them:
two incomplete, thousand piece jigsaw puzzles
mixed up, but I won’t stop until each one is perfect.

And you try to tell me the task is impossible.
I laugh in your face with immeasurable confidence.
But you hear the tremors of fear,
threatening to break open the ground,
in each word,
in each syllable,
in each tone.

I know the flooding will overtake eventually,
the knowledge lying in a swampy bog
in the forest of my mind. The water’s rising
and a part of me sits huddled, shivering, lost.

But I can’t listen to your sun-shine voice
guiding me back. Your words can’t quell the storm.
“I love you. And I’m here. And I’m not leaving – ever.”
But I can’t find peace and comfort from without.
My connection to the clear skies of reality is depleted;
stuck inside, and I can’t hear you through the gales.

But I see True North at night, and it calls.
So I tread lightly through the rising waters,
knowing I need blue skies –
even  if it means not dancing in the rain:

past the tangled vines of mangled thoughts,
the knotted, gnarled trees rotted with disease
and the high-water landscape
of my sopping wet, beautiful mind.
I slosh my way toward clear skies.

On My Experiences With Our Screwed Up Mental Health System

This is not a jovial or lighthearted post. This is a venting post. I may even venture into ranting territory. I would like to apologize in advance for doing all of the complaining and none of the problem solving. I recognize that that can be non-productive. But I’ve got some issues with our mental health system which have been festering for months, now, and I really just need to give voice to my lived experiences. That said, should any readers have thoughts or suggestions to improve my current situation (or, what I’m sure, is the current situation of many more like me), please share them! And if anyone knows of any resources which may be helpful, send them my way and I’ll be sure to link them so that, hopefully, others in similar situations will be able to find some useful tools here. I’m feeling pretty out of options at the moment, myself.

I’ve been struggling to come up with an adequate metaphor for our mental health support system, and I still am. I can label it – consistently inconsistent, frustrating, slow, over-complicated, etc. But a really good metaphor? Maybe a maze. Yeah. A crazy-house-mirror-maze. Only the mirrors are shattered in some areas, so you’re gingerly tiptoeing on broken glass, trying to make your way out without getting lost or injured; trying to walk the line between self-advocacy and being perceived as “overly-demanding/rude/aggressive” (because these are “behaviors” which will get you put on hold, disconnected, or asked to “calm down” in a condescending, but slightly foreboding tone that promises you’ll be in trouble if you continue to “overreact” to the situation).

If you know me, you know that I’m all about being polite and patient. Sometimes to a fault. You also know that I know many case managers personally and professionally. I am currently one semester shy of my Bachelors in Social Work. I was literally studying to become a case manager. I’ve also been on the receiving end of “self-advocating clients” who were, truly, being belligerent and unreasonable more than one time. So, I am not speaking broadly about all case managers in this post. I have also carefully considered the facts of the situation and believe that my current frustration, anxiety, and general agitation are justified and valid, which is why I am sharing my thoughts and experiences with you now.

I have absolutely no desire to be disrespectful, or to make what is already an immensely difficult job harder by being a “problem client.” But I have, over the course of 5 months, been put through the wringer on several levels, and, as the Cold War Kids said, “Hang me out to dry, you’ve wrang me out too, too, too many times”.

I am currently diagnosed with Post Traumatic Stress Disorder (PTSD) and Bipolar Affective Disorder (BPAD). I take medications to manage both diagnoses, and, in a perfect world, I would also be having sessions with a regular therapist once or twice weekly for further stabilization and management of my symptoms. But this is not a perfect world.

Here are the facts of the past five months of my life and my interactions with my primary doctor, the PHP and IOP programs I attended, the State of Vermont, and the crisis case manager I’ve been seeing at a local mental health organization until my insurance kicks in:

  • In early November, my life circumstances changed drastically, resulting in me living truly abuse free for the first time in…well… ever. And I was essentially hit in the face with 28 years of trauma and abuse. I developed severe PTSD symptoms.
  • In Mid-November, I did not sleep for 10 days straight. I did not eat. I lost 12 pounds in those 10 days. I was wired. I was having flashbacks and dissociative episodes like it was my job. I was depressed, but it was agitated depression. I could not sit still. I could not focus. I was making reckless and unhealthy choices. I was a complete and utter wreck. I went to Urgent Care on day 5 of no sleep, which happened to be a Friday. The PA I saw there was wonderful. She called the local mental health organization and was told by their crisis response that I’d be able to see the psychiatrist on Monday. She gave me a small RX of Lorazepam to help me sleep. Even with the Benzo, I did not sleep. I was doped up, but I was still wired and jittery.
  • Monday came. I was told I did not have an appointment with the psychiatrist, but the referral was in. All they could do for me was get me in to see a crisis counselor. The extent of the crisis counselor’s advice? “I get insomnia sometimes, too, and I count backward from 100 to sleep.” (I think I showed immense restraint in not yelling at her.)
  • I went back to Urgent Care that night. They told me if the Lorazepam wasn’t allowing me to sleep, there was nothing else they could do. They established an appointment with my PCP for mid-week.
  • I finally crashed on Wednesday night and slept. I crashed hard. I became very depressed, very low energy. This depression continued for a month. 
  • My PCP started me on a very low dose of Zoloft, and made another referral to the same psychiatrist.
  • I’ve been trying to get in to see this psychiatrist for 5 months, and I’m told it’s pretty much the only option available to me as psychiatrists in Vermont are difficult to come by.
  • Waiting on referrals, going to appointments only to be told I needed to wait longer, having my PCP assure me the referral was in and active while the mental health agency insisted it was not – these were all major contributing factors to me spending a week at inpatient.
  • After discharge from the inpatient unit, I spent the next month and a half in PHP and IOP. The case managers there promised me, up and down, that there was no way in hell they’d discharge me without adequate aftercare established, including therapy and psychiatry. Not only was I discharged without those appointments established, I was also discharged with no insurance and no means to maintain my medications.  
  • We only discovered that my insurance had lapsed on my second to last day of IOP. That was a Friday. I applied online for State insurance first thing Saturday morning. I called on Monday. I set up an appointment with Community Action to try to help get my application expedited. I tried so hard to be on top of my game and not be discouraged. The person I spoke to at Community Action, whose entire job is literally to help people get State Insurance, told me over the phone, “You’d be better off calling them directly. But have a book. And a phone that won’t run out of charge, because you’ll be on hold for a long time. I can’t see you in person until Friday, but I’ll set that appointment and if you don’t come, honestly, I’ll just be happy to get a break.” Verbatim. To me. Over the phone. I get burn-out, but how far past “done” do you need to be to say that to someone calling you for help? 
  • I called the State people, and I’m very pleased to report that that phone call was not nearly the hell the Community Action person made it sound like. I only read three sentences of my book before a real person answered. That real person, though, told me I was looking at an up to 30 day wait. Running out of medications with no money to get the final refills, no appointment to get further refills written, no therapy appointments set up, and nothing with the psychiatrist, either.
  • All of the back and forth and the apparent inability to communicate among my primary care doctor, the physician’s assistant I saw at Urgent Care, and the mental health agency for a referral to psychiatric services ended up costing me my career (and with it, my health insurance, which is creating the current stressors I’m facing) and my schooling, because, let’s be honest here:  if I had just been able to see someone back when all of this started, the more intensive interventions would have very likely been unnecessary and I would probably be writing this blog in my spare time between work and homework and mom-ing. (Ok, really, I probably wouldn’t have time for this blog. So, maybe that’s the silver lining.)
  • Today, the crisis coordination case manager I’ve been seeing in the interim until I can get established insurance and regular therapy sessions calmly told me I’m in serious jeopardy of not being able to maintain my medication routine until insurance kicks in, because of the out of pocket cost and because my primary doctor is unwilling to fill the types of psychiatric ‘scripts one needs to manage BPAD. In addition, insurance and all that aside, I can’t even get on the calendar to meet with the psychiatrist until I’ve met with my PCP and received a referral. A referral to the psychiatrist. You know, the very same referral that has, according to my PCP, been sent no less than three times already.
  • Today, I mentioned to my interim crisis case manager my concern that there may be a mixed-state episode in my near future based on what that’s looked like in the past (those 10 days without sleep, et. al.) and some current symptoms I’m experiencing: Screenshot_20170313-192328She responded by asking, “How did you even get a Bipolar diagnosis? That’s not Bipolar. I’ve worked with a lot of people with Bipolar and what you’re explaining isn’t Bipolar.” (How did I get diagnosed? By sitting down with a fucking psychiatrist and telling her exactly what I’m telling you, that’s how!)    
  • This interim counselor is not aware of this fact, but it took me a solid three weeks to even accept the Bipolar diagnosis. I was very resistant to it at first and did my fair share of pushing back against it before actually accepting the fact that the psychiatrist I was seeing through the PHP knew what she was talking about and was there to help me get well and stay well. So hearing the case manager (who, by the way, is NOT an MD and has spent a grand total of 75 minutes face-to-face time with me in the last 2 weeks) not only question the diagnosis, but essentially state flat out that I do not have BPAD was not only infuriating, but also incredibly invalidating of all of the work I’ve been doing toward accepting and attempting to manage the diagnosis.

But I can’t say that. I can’t say any of it. I have to hold it back, because if I start to say these things, I’ll likely end up yelling them at this point and getting myself in trouble. Because when you’re meeting with or talking to these particular caseworkers, you’re not allowed to be upset. “Upset” is for Therapists. “Medication concerns” are for Psychiatrists. “Referral requests” are for Primary Doctors. Polite acceptance, it seems, is all the Case Managers with whom I’ve been working have room for. And I am so far beyond “polite acceptance”. I am frustrated. I am angry. I am saddened by the stated of things.

You’ve heard of jumping through hoops? I’m bouncing around among five different agencies/offices and perpetually being told to talk to someone at one of the other phone numbers. It’s like a line of people holding the hoops through which I must jump, but every time I jump through one, the fucking person holding that hoop just moves to the back of the line and waits for me to jump through again.

It feels, in many ways, like this system is designed to allow people to fall through the cracks. If I wasn’t a stubborn, persistent, determined, sometimes pain-in-the-ass person, I would have completely given up on this by now. As I write this, I am discouraged, yes. But I am also genuinely scared. I’m scared that I’m going to have to taper off the medications which are still not even at full theraputic value in my system yet. I’m scared about all of this waiting leading to a destabilization and possibly another hospitalization for me. I’m scared of the implications of all of this. I see the “cracks” for what they actually are: gaping holes. And I’m terrified of the fall.

And, to end, I’d like to acknowledge a few things about privilege. In some ways, yes, I am in a position of disadvantage in our society: I am a woman, I am currently a single mother with no income, I’m an abuse survivor, and I have substantial mental health diagnoses.

But, in many other ways, I am very privileged. I am white. I am a Natural Born U.S. Citizen. English is my primary (and only) language. I am perceived as a cis-gendered, straight person. I am educated. I have access the internet. I am literate. I have some knowledge of and familiarity with the system which I am attempting to navigate. I have a steady work history. I have a car and a license. Despite being unemployed, I am not at risk of homelessness. I have family and friends supporting me in many different ways.

All of these factors place me at a great advantage over others who are attempting to gain support and services through this same system, and if I’m having so much difficulty with it, please take a moment to consider how hard it must be for those who do not possess the same privileges.

Our system is broken. And with the current administration’s plans for the future state of health care in this country, it is at risk of becoming irreparable. We need to fix it. We need to fix it before it’s too late.

On Meaningful Connections

This is not what I intended to write this evening. It’s actually the emotional opposite of what I intended to write. See, I’ve had an exhausting day of phone calls, waiting rooms, and non-productive meetings in an attempt to get everything situated. Red Tape is real and my god does it get in the way of things. I planned to write a rather scathing commentary on the impact of burnt-out workers, seemingly insurmountable hurtles, and the general way the system treats you as a number and a clipboard-check-list rather than as a human being on motivation to even try to get help and support. But that’s not what I’m going to focus on tonight, because I need a little positive energy and I’m just going to cultivate it for myself.

Rather than focus on people who seem to see me as “another case file,” I’d like to talk a little about meaningful connections and their importance in recovery and maintenance of mental wellness.

First, I have family members who have really stepped up in different ways to show their love and support. My mom has been immensely helpful in many tangible ways, from financial assistance to childcare, and emotionally, too, by just generally being around if I want to talk. My Uncle calls me frequently to check in. My foster sister, who I hadn’t seen in years, came up to visit me for a weekend and it was like we never missed a beat. She helped me in a lot of tangible ways, too, and I’m seriously looking forward to the next time I get to see her.

I’ve said it before, and I’ll say it again: I have some fantastic friends. Friends who showed up for me even when I was actively trying to push them away. Friends who gave me “space” when I did push them away but were there for me the minute that I, much like the Prodigal Son, came crawling back beaten and filthy and out of options. I do not feel I deserve such unconditional love and support, but I’ve been blessed to receive it nevertheless.

I named this blog “Parallel Dichotomy” because the two words are, by definition, mutually exclusive. Carl Jung had a concept he called the “Tension of Opposites,” holding two seemingly incompatible things in balance. This has been a theme throughout my entire life. In this post, I’d like to focus on one particular example: if I’m being honest with myself, I’ve always had this internal pull toward self-destruction, but I’ve denied it’s existence and kept it mostly in check by my need to be perceived as responsible and reliable. As with any aspect of Self, though, the more you deny something, the more it tends to pop up at very inconvenient times and in very unexpected ways. “What you resist, persists,” as the saying goes.

This has been the case for most of my life, I think. Too afraid to be honest with myself about my feelings and thoughts, I avoided them at all costs. I denied my anger at others, and thus, took it out on myself through self-harm rather than expressing it in a productive way. As I got older, I tended towards drowning my sorrows in alcohol, especially when alone, rather than facing my feelings head on. I tended toward indulging my self-defeat in private while publicly projecting a persona of strength and confidence. I tended toward being resistant to medical professionals (or support of any form, really) while holding a career in mental health support. I tended toward a lot of maladaptive stuff, and masked it all with a smile. I basked in the light of others telling me how strong I was while really, I felt weak and broken. I enjoyed the pats on the back I would receive for each accomplishment, all while feeling, at my core, that I didn’t deserve any of it. And whenever anyone would get too close to seeing the “real me,” I’d pull away. Only now am I beginning to recognize these patterns and work to consciously address them.

My friends, though, saw these patterns for what they were far sooner than I did. When I was in college the first time, I very nearly had a breakdown which likely would have required hospitalization were it not for such wonderful friends. Actually, I nearly had two: one slightly less acute episode my Junior year of college, and then the spectacular, blazing fire of self-destruction that was my Senior year blow-out.

In each case, I had friends step in and intervene. Junior year, my high school friend Kim was literally available for texts and phone calls every day, any time of day. That, in conjunction with therapy, was sufficient to get me through what I thought was intense depression and insomnia. (Interesting aside, around age 20 tends to be when the Bipolar switch gets flipped, and looking back on that month and a half or so and discussing it with a psychiatrist, it’s now clear to me that that was my first real mixed-state manic episode.)

Senior year, I was in a state of complete willfulness. I was just going to do my thing, get through the year no matter what life threw at me, because I was stronger than my depression and anxiety and trauma and dammit, nothing was going to stop me from graduating! I’d just act like everything was good, “fake it ’til I made it,” and self-harm and drink as stress relief. As I am now 28 years old and still do not have my bachelor’s degree, you, astute reader, have probably deduced that this approach was unsuccessful. See, there was no way in hell I could juggle everything life was throwing at me. Thankfully, I had these wonderful people called “friends,” you see, and one of them in particular realized I was on a very slippery slope, took away anything I could possibly use to hurt myself, and essentially dragged my ass to therapy (*cough* Paige *cough*). She also refused to leave me alone until everyone was sure I’d be OK. (There was a whole fiasco with anti-depressants making me hallucinate and a Halloween ER visit in which literally all of my closest college friends showed up, piled into the car, and hung out in the ER waiting room while Paige sat with me in the actual exam room. Again, friendship at a level I did not deserve. And another aside, such a reaction to an SSRI should have been a red-flag for Bipolar, but the doctors missed it.)

Many of these people are still around today, despite me really falling off the face of the earth after I found out I was pregnant, burying myself in work and my marriage and parenting, and generally being a shitty and unreliable friend.

As I gingerly claw my way out of the pit of self-hatred and self-destruction once again, this time actually learning ways to avoid the pit all together next time (a foreign concept to me), many of these friends have come back into my life in full force and demonstrated that even though I suck at picking up the phone, they are always there for me.

My friend Paige (the same Paige from Senior Year), who literally lives across the country now, supported me by listening to me vent, cry, get mad, and sometimes, just bitch and whine from October (when things were just starting to slip) on. She came to my house for almost a whole week right before Christmas and dealt with me and my flashbacks and panic attacks and dissociation which, at that point, were so bad they disrupted just about everything we tried to accomplish. I talked to her on the phone leading up to me going to the hospital and she gently encouraged it. And she talked to me every day I was in the hospital and in the ensuing weeks and months. She’s one of those good friends I’m not sure I deserve. (Ok, she’s one of the best friends possible.)

And then, there’s Cassie. Now, Cassie has known me for over 15 years. She’s younger than me, but she’s always kind of played “big sister” in a way. In 90’s kid terms, she’s always been the Cory to my Shawn. That self-destructive tendency I mentioned earlier? If Cassie wasn’t in my life in middle and high school, I’m honestly not sure where I’d be today. I’m quite sure, though, that I wouldn’t be taking positive steps to improve my well-being and over all quality of life. Because Cassie has always possessed the ability to steer me away from the stupid choices and toward the right ones. Gently, with compassion, without being forceful. She’s the person who is always on the other end of the phone if I call. I spent the weekend prior to my hospitalization at Cassie’s house, and she spent the weekend making phone calls, doing research, letting me sob on her lap, holding me while I rode out panic attacks and flash backs, comforting me after nightmares, and, ultimately, convincing me (with the help of Paige and Kelly – another fantastic friend I have) that the hospital was the way to go because things needed to change and I needed help and, despite my Irish stubbornness, I couldn’t do it on my own, or even with friend support and once-a-week therapy.

Once at the hospital, I had five different people who called me almost every day to check-in, and I learned about another very meaningful connection – peer support and the importance of spending time with people on a similar journey. It might sound weird at first, but I made some fantastic friends while on the psych unit and at the partial hospitalization program. And I plan to maintain those relationships, because spending time with people who “get it” is essential to success, I think.

And, as of today, I’m beginning to connect with other mental health advocates as well. Bloggers, YouTubers, and Twitter Kings and Queens. I’m feeling a little more confident about putting myself “out there” as a vehicle for impacting change and shifting perceptions about mental health struggles and successes. I’ve mentioned before that I have a drive to be a force for good in this world and a desire to have a positive impact. This has not diminished, I’m simply shifting it toward a more healthy (for me) platform.

The scathing post about some of the reactions I got today from “support” people will come at some point, but it felt important, tonight, to focus on the good people in my life, and I dedicate this post to all of you.

On Loopholes, Jumping Through Hoops, and Silly Holidays.

In which Sheila returns to the use of footnotes in hopes of being perceived as somewhat funny. 

Ok, here’s the situation*: Vermont is a silly place. I say that with the utmost respect for the Green Mountain State. I’ve lived here most of my life, and, if you’re not from Vermont, it really is as amazing as Bernie Sanders said.**  One of the really amazing things Vermont does is declare “Town Meeting Day” a holiday so that everyone*** can go to their respective Town Meetings and vote on things like school budgets. Literally, every state office is closed on Town Meeting Day, and, to my knowledge, Vermont is the only place to engage in this strange custom. Now, don’t get me wrong, it’s a wonderful thing to encourage people to participate in local politics and in forming the budgets of the local schools and such, however (and it’s a big however) it is incredibly inconvenient should you find yourself in the situation in which I found myself this morning.

Quick little personal note – I am currently unemployed and, according to all the doctors I’ve spoken to, am to remain unemployed with the exception of “possibly being able to work a part time, low stress job which is conducive to a consistent schedule to successfully prevent any intensified PTSD or BPAD symptoms.” Saying that this is a massive pain in the ass is an understatement. There’s something else you may not know about me: I’m kind of a work-a-holic. If I had my way, I would consistently work a minimum of 50 hours a week. It keeps me busy . All this “down” time is driving me nuts.**** So, I’d like to be working, but the powers that be, it would seem, have a different idea. With not working comes the loss of the benefits I had while working, the most pressing one being health insurance. To be absolutely clear, no one knew that my health insurance had lapsed until Friday afternoon. I filled out the application online for state insurance on Saturday. So I have been as on top of this as possible. But it doesn’t happen overnight, and you really need health insurance if you are hoping to manage a chronic medical condition, especially one requiring expensive mood stabilizers.*****

Back to this morning: I realized yesterday that I had less than a day’s worth of one of my medications and no means with which to get more until the insurance stuff cleared. This stressful epiphany came as I was having a late afternoon meeting with a counselor at a local mental health organization. Like I said, the application is in, and I’ve been told, based on my application, I’m approved. But it’s not “official” until the paperwork goes through all the way. State offices close at 4 PM on weekdays, and I did not finish my appointment until 4:10 yesterday. Then, I couldn’t make the phone call to get that magic number that will allow me to fill my prescriptions today due to Town Meeting Day.

So, there I was, with less than enough of this medication I’ve been told I cannot go without to get through the day and apparently no recourse. I called my Primary Care office and explained the situation. They said they were not sure they could help, but “someone will get back to you.” I then called the local mental health organization. I got voicemail. The waiting game began as my anxiety steadily increased.

My PCP office called me back at around 2 PM. I calmly explained that I do not have insurance currently (but I will, and it will be retroactive to the end date of my prior insurance), that I was dangerously low on this medication that every keeps telling me I absolutely cannot stop taking, and I have no money to pay out-of-pocket for a partial RX refill. The lady on the other end of the phone seemed genuinely concerned and interested in helping me, and I could hear the attempt at a reassuring smile in her voice****** as she said that she could call my pharmacy, have them fill the prescription and bill the hospital for now, so my retroactive insurance could handle it when it kicks in.

Fantastic! Problem solved! That was surprisingly simple, I thought. ******* She said she’d call me back once it was cleared it with the pharmacy.

About 15 minutes later, my phone rings and it’s the same very helpful nurse. Her opening line, though, is far less helpful and reassuring than I anticipated. It certainly wasn’t “You’re all set! Just head to the pharmacy.”

“So, Sheila,” she opened with a tone of hesitation. Uh-oh. “Your dosage on this medication has substantially increased since the last time you saw your primary care physician.”

“Um… yeah. Last time I saw him I was fresh out of Dartmouth and not diagnosed Bipolar, so it was being used in a very low dose to manage anxiety. Now it’s being used for mood stabilization.”

“Ok, well, your primary doctor isn’t really comfortable writing prescriptions of psychiatric meds in such high doses. Do you have an appointment with a psychiatrist lined up?”

“Yes, but we’re not sure exactly how far out that appointment will be. I am working with [mental health agency], though, and will have access to psychiatric services through them. The idea with discharge from the IOP, though, was that my PCP could write the prescriptions in the interim. They were supposed to communicate with you guys about that.”

“Well, they haven’t, and your doctor is not comfortable writing scripts at these dosages. So you’ll need to talk with the people at [mental health organization] to set something else up. Also, with your recent hospitalization, I need to clarify that you haven’t had any thoughts of suicide. That’s another reason your doctor is hesitant to write such large dose ‘scripts. We don’t want you trying to overdose on them.”

And there’s the real problem. “I haven’t, and I won’t. These meds are the things that are preventing both manic and depressive episodes. If I stop taking them, then I might be in trouble. But I don’t see how getting the prescriptions I’ve been taking for the last month and half to get stabilized is considered more dangerous than stopping them and risking being unstable just because a doctor is nervous I’ll suddenly try to kill myself with the meds that are literally preventing me from hitting that point.”

“Well, it’s an issue of liability.” Ah, yes. Liability. In our litigation filled society, it’s a legitimate concern for medical professionals. But I briefly wonder what the lawsuit would look like if I was forced to stop taking this medication and then ended up hospitalized again or worse. 

“Ok, so what am I supposed to do?” My anxiety and irritation are pushing code red levels at this point. 

“Well, he’s willing to write a prescription for one day’s worth. That will get you through until tomorrow when you can call about your insurance and also connect with your interim counselor to establish interim psychiatric care until you’re established with consistent care.”******** She tells me to come pick up the one day’s worth of this currently essential medication, which she gives me at no cost due to this loophole she’s found.

This fiasco took me just about all day. It was stressful. It prevented me from doing several other things I was hoping to accomplish today, and I spent a good chunk of the day honestly concerned I would not be getting this medication and missing it for a day would send me into a tailspin and land me back in the hospital, because it’s been drilled into my head over and over again how essential it is that I maintain consistency with my medications.

Maybe it’s my inner cynic, but I can’t help but wonder if the reaction to this situation would have been different were this medicine for a “physical” health problem verses a “mental” health problem. I suspect the answer to that question is a resounding “Yes”. Fear and stigma, it would seem, extend even into the medical world. Which is pretty silly when you think about it. BPAD and PTSD are medical conditions. The chemicals in and physical structure of my brain are messed up. Medication and therapy are essential to correct those issues and maintain “normal” functionality, much like a person with diabetes needs insulin to stay healthy. But “mental” health is still viewed as being very separate from physical health, and mental health patients without an established psychiatrist tend to fall through the cracks of misunderstanding and legal concerns.

So, I’m moving into tomorrow completely unsure of how much of this can be resolved in the next 24 hours. I’m worried that my Primary will flat out refuse to fill the prescriptions I’m now acclimated to and dependent upon; I’m worried I won’t be able to get in with the psychiatrist for over a month (psychiatric appointments in Vermont are very hard to come by, it seems). I’m stuck in this system that simultaneously fears destabilized mental health patients and hesitates to write prescriptions for mental health medications to keep people stabilized.

I was discharged from IOP with no insurance, no way to refill prescriptions, and no established, on going psychiatry appointments. Yes, I’ve learned the skills I needed from that program, and mentally, I was stabilized and prepared to move on. But, when you think about going from two months of wrap around services to seeing a temporary mobile crisis counselor because they don’t require insurance or payments upfront (another loophole I’m currently utilizing) and having a primary care doctor completely unaware of your medication changes and, it seems, unwilling to maintain those changes short term, you can start to see how fucked up this system of ours really is.

I’d be lying if I said I’m not more than a little frustrated. “One day at a time” is fantastic advice, but I’m not sure it’s comfortably applied to prescriptions. I certainly don’t want to be moving through the next however-long-it-takes-to-get-insurance-and-a-psychiatrist one dose or one day at a time.

One thing is for sure, I will feel so much better once my on-going maintenance care is established and I have insurance. I’ll feel better once I can work again, and I don’t just mean working at a “low stress, consistent part time job,” I mean working. Full time, with benefits, in some capacity that feels meaningful. Because I’m not built for a “job”, I’m built for making an impact. I don’t mean that in a “savior complex” kind of way, I just mean that I am someone who needs to feel like somehow, someway, I am making a positive impact in the world.

But for now, I’m literally being forced to live moment to moment. And maybe this is where that DBT idea of Radical Acceptance comes into play. But make no mistake, tomorrow morning this girl’s coming out the gate (politely) swinging, with self advocacy and assertive communication skills cranked all the way up to 11.

*my parents are NOT away on a week’s vacation – an obscure reference, perhaps. OLD Will Smith – like before the acting gigs old.

** Unless you live in the NEK (I grew up in St. J and Danville, I’m allowed to say that.)

*** State and Bank employees

**** Too soon?

*****Seriously, these things are, like, $5 a pill and I am supposed to take 18 of them a day.

******Medical professionals have a “special” voice for mental health patients, I’ve discovered. Quiet and gentle, intentional, like verbally attempting to defuse a bomb, all the while sweating bullets and terrified of an accidental detonation.

*******Famous last words. Right up there with “Hold my beer.”

******** I think I’ve mentioned more than once on this blog how very much I dislike “interim” and “short term” care.

On Moving On and Bumper Sticker Wisdom (That Actually Helped Me)

(Photo – I wanted a selfie while admitting myself to the psych unit… because that made sense. My wonderful friend humored me. This picture is denial incarnate, I think.)

Today was my final day of Intensive Out Patient treatment. This is a massive transition for me, as my life for the past 2 months has consisted of some form of group therapy almost every weekday. In January, when I admitted myself to the psych unit at Dartmouth, I was not anticipating the length of the journey upon which I was embarking.

In Dialectal Behavioral Therapy (DBT), there is a concept called Radical Acceptance. The basic idea is that you have to accept reality for what it is. If you accept reality, while there may be pain, you will not suffer. If you refuse to accept reality for what it is, then you will suffer. Another way of putting it is “willingness verses willfulness”. Willingness is the ability to accept where you’re at and do what it takes to get better. Willfulness is rebelling against or refusing treatment.

I struggled with willfulness at the beginning of my treatment. Though I voluntarily admitted myself to Dartmouth, I spent the first two or three days I was there insisting that I could not learn anything from the group therapy because I had a strong  professional understanding of the topics being taught.

** A slight aside on my professional identity: I have spent the past four and a half years of my life as a residential instructor in a group home. My job was teaching emotional regulation and life skills to dual diagnosed individuals (think Autistic/Schizophrenic; Bipolar/Fetal Alcohol Syndrome, etc.) . In that capacity, I was very familiar with the concept of DBT as it is a resource offered to many of the clients with whom I have worked.

Back to the Dartmouth Psych Unit, sitting in a DBT group as a patient felt pretty unnecessary to me. On my third day on the unit, I had a good conversation with my nurse for the day. She told me that I needed to shut off the professional part of my brain, the part that “knew” DBT skills intellectually, and I needed to have “beginner’s mind” when approaching the material and consider how those skills could be applied to my current situation. This perspective helped me overcome my willfulness on the unit; but I was still willfully in denial of the scope and impact of the struggles I was facing. I was convinced I would return to work and school in a matter of days and that this little detour to the hospital would have no long-lasting impact on my life.

This, as it turns out, was a completely irrational belief. You can’t qualify for admittance to a psych unit one week and be back to business as usual the next. There’s all this follow-up care shit you have to do. (It’s not really shit. But that’s my angry, willful Bostonian coming out.) For me, aftercare was a month of Partial Hospitalization and two and a half weeks of Intensive Out Patient (IOP). Finishing up IOP, though, is also not the end of my journey to wellness. Now, I’ll be working closely with my PCP, therapist, a psychiatrist, and Voc Rehab to try to really get things evened out and get my life back on track. And I’m very excited to continue to learn and grow. Right now, though, I’d like to take a few minutes to reflect a little, if you’ll indulge me.

In the past two months, I’ve learned a lot about myself. I’ve learned that I have Bipolar Affective Disorder. I’ve learned that my PTSD symptoms don’t have some magic cure, and that I’ll have them, to some extent, for the rest of my life. I’ve learned that I have an unhealthy tendency toward numbing my feelings with alcohol. I’ve learned that the way to manage many of my symptoms is to set and follow a schedule (something I despise). I’ve learned that medications are essential for the foreseeable future at the least, and possibly for the rest of my life. Prior to each moment of learning were several moments of willful denial.

“Fuck off, I’m not Bipolar!”

“The PTSD isn’t a big deal. It will pass.”

“I’m not taking any meds heavier than Tylenol.”

“Schedules are boring.”

“I’m a night person. I’m not going to start being in bed and working on sleep by midnight.”

“I don’t even need this program.”

“Drinking with friends isn’t a fucking issue. I can drink whenever I want. Who are you to take away my social life?”

The above are all actual things I’ve said out loud to my friends and/or treatment team over the past two months. Honestly, there have been moments that I’ve been truly insufferable, I’m sure. But, one by one, I’ve moved away from my denial and toward acceptance. And you know? Accepting things as they are instead of getting angry about how they “should be” has truly helped me stabilize and engage fully in treatment, and I have come a long way.

Treatment isn’t over yet, though. And there are some immediate hurtles for me to try to jump over. I’m hoping I’ve got enough momentum to clear them. My insurance lapsed mid-February, which is making follow-up care tricky to coordinate and getting prescriptions refilled impossible at the moment. (I’m working on that, though, with both my PCP and a local mental health organization, and should hopefully have that resolved in the next few days.) But, it’s definitely a stressful note on which to leave the intensive, wrap around support of the IOP program. (There will, in the future, be a separate blog post all about the ridiculous struggles of finding and maintaining affordable, quality mental health care.)

For right now, though, I just wanted to take a few minutes to share with you some bits of what I like to call “bumper sticker wisdom” that I’ve learned in the last two months that I’ll carry with me for the rest of my life:

“Sometimes good is good enough” (for your inner perfectionist)

“Yeah but your yeah buts” (For the moments your self talk is not helping you.)

“Check your lens” (Also for the moments your self talk sucks and your inner critic is dictating your perception of yourself and others.)

“Your shit; my shit.” (For the moments you may struggle with being able to differentiate between your responsibilities and other people’s problems)

“There is no bad mindfulness practice, there is only practice or no practice.” (Even if you’re REALLY distracted, and being mindful is hard, as long as you practice bringing it back to the present, you are succeeding in practicing mindfulness.)

“Act Opposite” (This one is from Cognitive Behavioral Therapy – you feel like staying in bed all day because you’re depressed? Do the opposite, even if you only make it to the kitchen and do 10 minutes worth of something before going back to bed.)

“Use the 10 Minute Rule” (This is maybe exactly what it sounds like, you do something you are avoiding for 10 minutes at a time. Got an inbox full of emails you’re avoiding replying to? Set a timer for 10 minutes and start reading and responding. Wherever you’re at at the end of that 10 minutes, you can choose to stop or continue based on how you’re feeling, but at least you made a small dent.)

“Action Precedes Motivation / If You Wait Until You Feel Like It, You’ll be Waiting a Long Time.” (Mood dependent behaviors are going to keep you stuck in your cycle of suck. You’ve got to do something to break the cycle. 10 Minute Rule is great here.)

“It’s Simple, but not easy.” (All of these things seem simple enough, maybe even like oversimplifications of the struggles you’re facing. But no one is saying it’s “easy.” Doing this work is fucking work. But it will help improve your situation over time.)

“Distress Tolerance: Getting Through a Bad Situation Without Making it Worse.” (I literally have a card of go-to healthy coping methods I can use when things really suck. I also have a list of favorite activities – I call it my “kit-bag”)

“G.L.A.D. / What’s Not Wrong? Journal” – One thing you are Grateful for today, one thing you Learned today, one thing you Accomplished today, one thing you took Delight in today, and two or three things that are NOT wrong in this moment. Write it out every day. Keep track. Over all, it will help challenge those deeply entrenched thoughts of “My life sucks”, “Nothing good ever happens to me”, “Why bother?”, “Fuck it”, etc.

And finally, remember that we are all working as hard as we can, and we have been working as hard as we can, but recovery is based on finding a way to work better, not harder.

So, I’m onto the next step. Wish my luck in this insurance fiasco. I’m told going off my meds due to not being able to refill them at this specific point may undo all the work I’ve done in the last two months, and I’m really not trying to have that happen.   I have several meetings tomorrow, so I anticipate a more technical/ resource filled post at some point.

Movin’ onward and upward, as they say.

On the “Moments of Suck”

This post directly contradicts a rule with which I was raised – an implicit rule, a common rule, I think, in Irish American households (and maybe in other household, too.) “Don’t air your dirty laundry.” Well, I’m tossing that rule out the window tonight along with my “dirty laundry,” wheeling out the clothes line full of shirts and pants and underwear, stained and smelly, for all to see. I want to make a little note that if mentions of domestic violence trigger you, you may not want to read this.

I have had a lot of shitty moments in my life. The moment when I was a child and found out my father wasn’t in my life because he was struggling with heroin addiction and in and out of jail. The moment my mom divorced my first step father. The moment I decided not to go on the every-other-weekend visits with my first step father because I felt out of place knowing that my brother was his biological kid and I wasn’t. The moment right after my mom married my second stepfather and he went outside on the porch for a cigarette and I followed him out and said, “So, you’re married to my mom now. Do I call you dad? Or do we stick with Tom?” and he replied, “I think Tom is good.” The moment I first realized I needed to take care of my younger brothers. The moments (and there were many) that I saw my mother sobbing in the kitchen and tried to comfort her. The moment I had a friend spend the night and I spent time before we were picked up from school explaining that my parents fought sometimes (every weekend, really) and that sometimes it was really intense, and she replied “I get it, my parents fight too.” The moment the relief from hearing that vanished as we sat playing up in my room and they screamed downstairs and her face turned white and she couldn’t even look at me as she said, “My parents don’t fight like that.” The moments that I sneaked into the kitchen when my mom and Tom were fighting to grab the knife block to make sure he couldn’t stab her if he got too mad. The moment I watched Tom tackle my mother to a sidewalk and beat her while holding my toddler brother and trying to prevent him from seeing what was happening. The moments right after that happened when we went to our church. The moments and days following that. (That event is a whole separate post, probably, we’ll leave it there for now.) The moments I sat in my room listening to every crash of dishes and every word screamed to figure out whether or not the police needed to be called. The moments I gave my brothers headphones and videos so that they didn’t have to listen to those fights. The moments neighbors did call the police and I heard my mom and Tom both insist that everything was fine. The moment my pediatrician pulled a social worker into my physical to ask me if I ever felt afraid or threatened in my home or if I ever saw anyone else afraid or threatened, and the ensuing moment in which I made a conscious decision to lie because I didn’t want to be taken away. The moment my lie didn’t matter and DCF said Tom needed to leave the house or else we would be taken away. The moment I angrily paced my living room telling my mom “They can’t break up our family. I’m 16. They can’t take me anywhere. I won’t let them. I’ll get emancipated if I need to.” The moments in time where my mom would decide to leave Tom and it would be my job to help get things packed up and keep the secret until we moved out. The moments they would reconcile and I would finally feel like “everything is good, we have a stable family” and almost immediately, it would seem, a huge fight would erupt and a separation would ensue again. The moment I returned from a weekend long Ultimate tournament in my senior year of high school to find a broken clothes rack and  a few shattered plates and I asked my little brother what had happened and he said, “Dad got mad.” The moment I told my Ultimate coach that I had to quit the team because it was too much to do weekend tournaments with all my senior year homework load, when really, it was because I knew I couldn’t leave my brothers alone to deal with Tom each weekend if he got pissed off. The moment I went to my paternal grandfather’s funeral having just recently connected with my father and his side of the family and the cruelty of only getting to meet Papa Tom when he was already in the late stages of Alzheimer’s and MS . The moment I realized I had an older brother who had known me as his baby sister for 3 years until I just disappeared when he was eight. The moment I realized I had a younger brother who didn’t even know I existed until he was much older.  The moment my mom truly decided, once and for all, to end her marriage and was on the phone asking me to support my brothers through the divorce and telling me all her fears and concerns and how she thought he was stalking her while I was at college 2 hours away and completely helpless and, honestly, dealing with my own conflicting feelings on the topic. The moment my husband intentionally slammed frying pans off the kitchen counter because he knew it would trigger me and then stood over me, a sobbing blob on the floor, screaming at me for being a weak bitch. The moment my husband shoved me against a wall and then told me I was “too sensitive” because of the environment in which I grew up and I “didn’t know what abuse was” due to that “over-sensitivity.” The moment I found out my Nana and Papa died. The moment I learned it was a murder-suicide and that my Papa, the man I loved and admired more than anyone on this entire planet had put a gun to my Nana’s head while she was eating a muffin and killed her before sitting down and turning the gun on himself and leaving it to my Uncle to find the bodies the next morning. The day I told my husband to leave. The moment I admitted myself to Dartmouth. The moment I was diagnosed Bipolar. The moment I learned I couldn’t keep my job…

That’s a snap-shot. There are more events, but I think I’ve successfully established that I’ve had my fair share of “Moments of Suck.” That’s what I like to call them. I’m not sure how else to classify them. They suck. They all suck. Plain and simple. Why list them out like this? Because I have been taught implicitly, and occasionally told explicitly, my entire life, to keep them to myself, and because of that, I have felt immense shame. I’ve been ashamed of myself and of my family. I’ve felt, inherently, that I am broken and worthless. I convinced myself very early on that all of this was a part of God’s plan and that I had no right to question it or to be angry about it. I’d been taught in school and church that God either allows things to happen to teach us a lesson or as a punishment for sin, and therefore, as a child, naturally assumed that that meant I deserved each and every one of these moments and had absolutely no right to complain about any of them: fertile ground for shame to grow.

These “Moments of Suck” are where developmental trauma comes from, my friend. It’s not a singular event. It’s not a moment in time. It’s a compilation of moments. Some scarier than others, but all, decidedly, Moments of SUCK. What do you do with these Moments of Suck? I’ve tried to do quite a bit  with them – I’ve tried to ignore them, I’ve tried to minimize them (“lots of people have endured much worse”), I’ve tried to trivialize them (“hey, shit happens, right?”), I’ve tried to numb them with alcohol (many, many nights with many, many bottles), I’ve tried to say, “Hey! I can use this shit to help other people! And if I can help enough of them, then maybe I can be ‘good’ enough to warrant an end to my own suffering.” I’ve rationalized it. I’ve written shitty poems about it thinking maybe I’d be the next Bukowski. I’ve justified it – remember the Barenaked Ladies song “The Old Apartment” and that one line “Why did you plaster over the hole I punched in the door?” That line was a lifesaver for me when I was a kid, because it normalized people getting angry and putting holes in the things and that made me feel a little less alone.

The only thing I haven’t truly done is felt it. In truth, I’ve spent my whole life pushing it all away, shoving it so deep down that any anger I feel is automatically labeled “bad” and “dangerous” because, in my experience, anger is dangerous. Hell, mild irritation is dangerous because it can lead to anger at the flip of a switch and anger and violence are synonyms in my fucked up brain. Any sadness I felt was automatically pathetic and unjustified – evidence of what a “weak bitch” I really was. I’ve overcompensated, taking a job in a difficult group home with clients prone to violent outbursts to prove to myself that I was not weak, to prove to everyone else that I could handle threats without breaking, and because it was familiar to me. I was feeding that inner child that needed to be around dangerous situations so that she could make them safe. Abuse is, and has been, my comfort zone. For as long as I can remember, managing a crisis has been my strength. Detach, be cool, do what needs to be done. That’s been my MO my entire life. But no more.

Now, I’m in a situation where I literally am incapable of detaching. I get hit with flashbacks and panic attacks almost daily. (This is improving slowly, but it’s still a fairly frequent issue.) I still have nightmares almost every night. My brain is screaming at me “We have to deal with this. You have to feel this. It’s eating you alive and we have to get ahead of it!” 

And that’s a huge part of what I’m working on now. What do you do with the Moments of Suck? You’ve got to dig in deep. Because they fester. They get infected. And that infection spreads and contaminates every aspect of your life. Until you cut away the rotten flesh and flush the wound and let the air hit it, it can’t even begin to heal. But I’ll tell you what, that surgery is a painful one. There’s no anesthetic; there’s no quick fix. And sometimes, it’s just you staring at the gauze trying to build up the courage to take the bandage off, and re-flush, and re-tape this gaping hole in your body. And you have to take careful steps not to get it infected again. This can mean pulling away from some people that you really care about, it can mean setting boundaries you’ve never set in your life, it can mean doing things that make you feel like a terrible human being. But it has to be done if you ever want to heal – no, really, if you want to survive. Because one way or another, that infection will kill you if you don’t get it take care of it.  But you can get it take care of it. You can heal. It’s work – it’s a lot of hard work. But it can happen. This is what I am learning, and slowly but surely, I am healing. If you’ve endured trauma, I hope that there is a little kernel of something resembling encouragement and hope in this post. I know that sometimes the Moments of Suck can seem to pile so high you can’t see past them, but there is something beyond them. I promise.

On the Good Days

Today was a really good day. Sweatshirt weather, sunshine, Vitamin D, time spent with a friend (who I actually met while at inpatient treatment), and connecting to a lot of really cool resources in my area! I spent a good chunk of the day exploring Burlington with my friend and taking pictures. As I’ve mentioned before in this blog, photography is my absolute favorite form of non-traditional mindfulness.

In the type of treatment I am receiving, mindfulness is considered a necessary component to successful application of the tools I’m learning, but it’s a big struggle for me. I’m working now on getting more comfortable with traditional mindfulness practice (focusing on my breath, doing progressive muscle relaxation, guided meditations, etc.) but it’s definitely difficult. This is a PTSD thing. See, the idea of closing my eyes in a room full of people and blocking out external stimuli is in direct conflict with the hyper-vigilance that comes in the PTSD gift basket. Focusing on my body and breath actually tends to cause me to panic and dissociate, because, physically, it reminds me of trying to stop crying in dangerous situations. When I was a kid, my stepfather would say that often-uttered phrase “Stop crying or I’ll give you something to cry about.” Except, he meant it. If things didn’t turn around quickly, someone was getting hurt. So, I’d focus really hard on calming my breathing to stop the tears. That’s what deep-breathing has traditionally been for me. Combine that with closed eyes in a crowded room, and there’s just no way in hell I’m able to participate. So, I’ve needed to be creative in my mindfulness practice, and photography is, by far, my preferred method.

You have to look at the things around you – really look. You have to consider the angle and lighting and how to best convey the feeling or message you’re hoping to put out there. You have to pause to take the actual photo. It’s being completely present in that specific moment. It’s expression. It’s everything I love about mindfulness practice and nothing that trips me up.

So, I spent all afternoon today soaking up the unseasonably warm weather with a friend who provided great company, laughs, and meaningful discussion, taking pictures, and exchanging resources and book titles and apps that we have both found helpful in our respective journeys so far.

There is something to be said – a lot to be said, actually – on the importance of peer connection and support in recovery. Now, my friends and family have all been fantastic supports, and I do not, by any means, want to minimize that. But, unless you’ve been inpatient, you can’t truly understand inpatient. You create inside jokes based on the group facilitators at the hospital, you have a sort of slang built from the bumper-sticker phrases you learned to go along with your therapy, a sort of short-hand you can just toss out at each other when one of you is having a rough time. I’m very happy to say that I’ve kept in touch with three people I met while at Dartmouth, and those relationships have been very helpful in keeping me on-track in my own journey to wellness. Those relationships, though, due to distance,  are mostly limited to on-line interactions (Facebook). Having one of those peers in this area and spending actual face-to-face time connecting with someone who “gets it” is a rare gift, I think. And I’m very grateful to have the opportunity to stay connected with him!

So, today marks the first day since I started this intensive treatment that I’ve honestly hit every box on the little “Wellness Goals” check-list: social connection, group support (acupressure treatment at Turning Point), mindfulness, exercise (we literally walked all over Burlington – close to 5 miles for me, according to my phone), sunshine and fresh-air, completion of some wellness tasks (I was energized from the day out and was therefore able to get some serious cleaning done around my house, I worked some more on my discharge paperwork, and I am writing this blog post), ate a healthy meal (sort of – that was actually a bit of struggle for me, I suppose, but I had a shake and a banana and some peanuts, so that’s something anyway), took all prescribed medications on time, and am on track to head to bed at a reasonable hour and hopefully get some good sleep tonight!

I write a lot about the idea of balance. When you focus on the good days, they kind of help balance out the bad days. It’s just a mater of maintaining that balance. And that’s the task on which I intend to keep working!

***If you’d like to see the pictures I took today, feel free to hop over to my Instagram account at https://www.instagram.com/sheilajay47/?hl=en