Psychiatric Philosophy

One of the things you hear said a lot from those who have depression is that it is a "disease." You usually only get the two opposing views of it; either it's a disease or "it doesn't exist." You are either crippled or you are just lazy, and neither of these views are particularly helpful.

If you are in the mindset I discussed in the previous post, then the disease model sounds the most accurate: it is crippling, you're not faking, and for many people, it feels like a "forever" thing.

Before I go any further, I just wanted to let you all know that I'm not suddenly going against the disease model just because of what my therapist told me on Tuesday. This is a question I've been struggling with since I was coached in Behavioral Activation: if depression is a disease with real, biological causes, how is it that something like getting out of the house more often can be "prescribed" by real doctors--isn't this just the medical equivalent of "just get over yourself?"

Well...the answer is a resounding kinda.

Depression, as far as we understand it, is caused by a combination of bio-psycho-social influences. This means that there is a physical (biological) component, a social component (where the people around us as well as the environment itself have influence), and a psychological component (our thinking habits, to put it simply). 

It is these three things that combine to make us depressed. Once one or all of these become a little too strong or a little too "depressive" in nature, then we start to spiral down. This can happen slowly or all at once, but it is something that snowballs, meaning the individual components stack up against you if you let them.

Obviously, we can't change our genetics. If depression runs in our family, then there is a good chance we're going to become depressed. It's not set in stone exactly, but the possibility still remains. For the other components, however, we have some control.

In a perfect world, we have loving, supportive families that accept us no matter what and always have our back. We have many close friends that help us to better ourselves and see the good in the world. We have a loving significant other who it is always a joy to be around. How many of you are laughing cynically right now? Yeah, that's what I thought.

BUT we can make sure that toxic relationships (SOs who abuse us, friends who degrade us, and family who uses us) are cut out of our lives. We can also take the lead when it comes to finding new friends. This is one area where behavioral activation comes in.

This is obviously easier said than done, especially when in the middle of a depressive episode. Also, depending on how deep you've gotten, this may very well be impossible for the time being. So then, aside from getting psychotropic drugs (which I really do recommend if you need them), you have your thought patterns left.

This is where CBT, or cognitive behavioral therapy, comes in. This is where you take every thought you have and analyze it until it is no longer harmful in nature. I won't go too in depth about it right now, but basically you try to get yourself to stop thinking distortedly. 

So how does this get you better?

Imagine for a second that your brain is a lump of clay and your thoughts are pressurized water streams. Right now, as a depressed individual, you have certain ways of thinking (depressed thinking) that are the easiest to you. These thoughts run a specific course (hypothetically) in your clay-brain, and this course is the path of least resistance, pre-carved for you by a lifetime (or whatever) of those pressurized water streams blasting away at specific spots.

Now think about if you try to get yourself to think differently, more positively. It's still a stream of water, and even at the same pressure as the depressed thinking, but it's trying to go through a pathway that's either not there at all, or at least very narrow and unused. But the more you keep at it, the more you are going to carve yourself a new way of thinking. These ways will be just as easy to use as the old, depressive ways. 

This process will be made a lot easier if you make other changes: to your environment, to your physical chemistry (through drugs), to your social circle, and to your physical health (through proper diet and exercise, sun exposure, etc.). It takes a lot of work, but depression doesn't have to be the end of your life. It doesn't have to control you. 

And don't think for one goddamned second that this post invalidates your suffering: this shit is real and harmful and it sucks. But just like having to relearn how to walk after an injury, you can relearn how to be happy again (or even for the first time), it just takes a shit load of practice.

I hope this helps you understand depression a little better, and maybe helps a couple of you get the help you need and set you on a path to recovery...

~ <3

What's been going on lately...

So I have been handling my realization that I'll never get a degree a little harder than I originally thought. I was surprised at my ability to handle it, but it turns out I was just suppressing my feelings about it.

I am disappointed in myself and angry at the system. I feel like psychological community is missing out on someone who could have helped out a lot, and this makes me sad. And then, of course, the inevitable embarrassment at not being able to function like a normal human being...

Needless to say, it's hitting kinda hard.

I had tried to use the military as my "one last chance to not be a failure," and then once I got medically retired and emotionally worked through that train wreck, just jumped headlong into this one...I don't know what the hell I'm going to do with myself now. I had plans of writing and just working where I can for now--which I'm still planning on--but it just feels so...hollow. Pointless. It isn't, but my emotional state at the moment is making it seem that way.

So today's lesson, I guess, is that just because something seems hopeless or worthless or even good and worthwhile, doesn't mean it is--it just means that that's how we are viewing it at the given moment. Everything is in flux. This line of thinking can be humbling or uplifting, depending on how we see ourselves at the moment, knowing that--given some time--it'll change, but either way it's okay because this just means we're human. That we are alive. Things that don't change, that remain in stagnation, wither and die. So even thought that's kinda what I want to do right now I know that I'll feel differently soon because I'm still alive.

It's easy to forget how you felt when you were depressed while in remission, or the other way around, but it's important that you don't. While your head is above the waters of despair you can gather information and insight to cling to once the current inevitably pulls you back under, and that insight can help sustain you. The more you practice, the better you'll get, and maybe--just maybe--you'll break free of the cycle.

I'm mainly just rambling now and I need to get ready for work, so I'll just stop here.
Stay well, guys.

Journaling Hows and Whys

Okay, so after having my terrible Wednesday and taking Thursday to chill (and work, admittedly), I feel like it's officially okay to attempt this again.

When it comes to the internet (and official literature that didn't have a paywall), so many people say that journaling is a good idea. It is a good idea for psychoanalysis, CBT, treating PTSD, behavioral activation, migraines, and just regular life among a million other applications as well, I'm sure. However, it's not necessarily something one is apt to do naturally. It feel silly, if I'm honest, at least until you get used to it. I only got really into it in the past year or so and even then it took awhile to get somewhat consistent about it.

I guess, technically, it was always "journaling," but it didn't feel that way. I had read somewhere that you can improve your working memory if you always write everything down. Supposedly this allows your brain to stop trying to hold on to a bunch of unnecessary information so you can focus better on what matters. So I wrote everything down. Grocery lists, schedules, room numbers, directions, idle thoughts, story ideas, complaints--everything. It was mostly on loose leaf paper in my school binder, but eventually I got little notebooks that I could carry around. This might be the beginning of my "pretty journals" obsession...Anyway, this note-taking led to journaling. Kinda. I didn't notice an increase in my mental powers, so I tapered off fairly quickly. When I switched over to journaling about my day, I completely stopped. Eventually I stopped carrying a notebook with me. I didn't really start back up until a couple years ago, and it didn't really get serious until last year, I think, when my depression bottomed-out again.

So what do I journal about now? Anything. Everything. I write about my day, my thoughts, I bitch about people/classes, I record my physical as well as mental health (though not as much as my doctors would like). I evaluate how I handled different problems and why, I make plans for Christmas decorations...

Do you want to start? Find a notebook that you like, or bind some loose leaf together in a folder. Then...well...start. There are a bunch of different techniques you can try, but research has shown (if you read any of the six links up top) that the most beneficial way to do this is to write about potential gains from problems you face. Basically just re-evaluating shitty situations and trying to find anything you could learn or grow from. This keeps you focused on more reflexive topics while not just dwelling on the negative.

If this deeper writing isn't for you, you can try more surface things like the route I took, writing everything down. There is also even more subtle things where you simply record the weather for each day. You can even take the more CBT-focused route and just record thoughts and feelings that you have.

If you are more creatively inclined (you don't have to be good at this, just enjoy it), you can start something called an art journal, too! Basically you take a topic and you draw/paint/photograph/sculpt/modge podge/collage it. It can be something really emotional such as a break up, or it could be fairly simple like taking a concept ("freedom") and making an entry representing that. To get the most out of this, I would suggest writing something alongside these entries so you can have something more concrete to look back on.

And for the most benefit, make sure you do look back! You can compare and see how you've grown or find patterns that are destructive. And if you have a therapist, then I would suggest bringing up your journal with them and seeing if they want to go over certain things with you. Having a trained second set of eyes can help eliminate some bias that may blind you to certain defenses or faults.

I think I might start posting journal topics for you guys either on a separate page or on the side bar, I don't know.
There is now a journaling topics page! Last update to it was on 11/25 at 1:26 am.

Have you had any experience with journaling you'd like to share? Maybe pictures of your journals themselves (I'm a sucker for a nice notebook)? Please comment below!

Little Slips

Last post I wrote about the anxiety that's always there, just waiting for myself to slip back into months-long depression and hopelessness. Well, I'm still waiting for "the big one" but little ones have been cropping up here and there.

I don't even know where the last one came from, just that it happened and it was annoying (after I got over bawling my eyes out). But really, it was survivable. I wonder if that's what my life has in store for me from now on: little bouts of mini-breakdowns every once in a while for no reason whatsoever. I hope not, but if so, then I guess it is what it is...

I just have to try to remind myself that it is happening now, yes. And it sucks ass, yes. But just because I am spontaneously depressed today doesn't mean it is going to be months of a downward spiral until I want to shoot myself in the face. It could just be for tonight, and even if it isn't, I'll deal with it like I have for 20ish years prior. Just to wait it out until tomorrow and try not to get too existential about my suffering until then.

And breathe. As much as I hate admitting it (it sounds like a tree-hugging, new-age, hippie thing), breathing exercises really, really help. Just concentrate on the fact that you are breathing in, then out and all the sounds and physical sensations in between...when you start to think about anything else (good, bad, or not), just go, "nope," and breathe in again. Breathe out again. It won't fix anything necessarily, and it takes a lot of strength and practice to bring yourself back to it, but it certainly doesn't hurt.

Anyway, that's been my week.

Panicking--what do?!

The other day, I had a panic-filled hour or two. It wasn't a traditional panic attack--with the sweating and the heart palpitations and the feeling like I'm going crazy or going to die--this was a much more mild panic. That lasted forever. Ugh.

So how did I pull through this? Well, I'm not quite an expert at this whole thing yet, but I do have some tricks.

1. Realize that this is just a feeling. I'm not dying, I'm not in danger, I'm just overreacting to something (probably having been cooped up in the house for a couple weeks too long and not having much to show for it).
2. Fat lot of good that did. What's next?
3. Take long, slow, deep breaths.
4. Oh crap, that didn't work. Now what?
5. What do the experts say? Some say exercise...ugh, that sounds awful. Others say to distract yourself...okay...god this is uncomfortable...let's try to...I don't know...edit more of my book! That sounds like a good idea. 
6. Oh god, this still isn't working. I can't even concentrate, I'm so panicked. And finally, the (somewhat terrible) solution to many problems (that surprisingly works):
7. Take a nap.

Yeah, I took a nap. It took some time for my adrenaline to stop pumping, but there just is something about laying down in a really comfy bed with a fan blasting cool air in my face while petting my fluffy Pomeranian that calms me down from a 6 to a nap. 

I don't know why it works, and it really is only a temporary solution until I can finally master myself, but when I'm in a pinch, I take a nap. It's much better than, say, running around screaming until I throw myself into a full-fledged panic attack. I just wish I still had a prescription to Klonopin. Oh well.

Anyway, I hope you guys have a better week than I've been having.

~ML

Check-In and Behavioral Activation

I'm a little late in posting this, but here it is! *dun-dundun-duuuuun*

Yeah, so my daily goals were not really reached this past week. I did, however, get the rest of the transcription done for my book (basically just typing up what had been hand-written by me a million years ago), so I was able to print that section and start editing. This is something that you already knew if you follow me on Twitter. You don't--not yet--but that's okay!

I have the same goals as before, including trying to find a place to volunteer, and another place to get a job. Other than that, I also want to squeeze in a little more drawing in my "art therapy journal" thing (technical terms, you see), just for the hell of it. It beats watching TV. Although that seems to be the only way my husband and I spend time on the weekdays because he's so exhausted after work, so it might just have to be drawing while watching TV, but I can handle that.

Mood-wise I've been pretty even-keel. A little guilt has sprouted up here and there, and I was depressed as shit for a little bit at the VA (who doesn't get that way there, though?), but nothing too out of the ordinary.

Also, just a comment on the Behavioral Activation thing I've been doing recently; it's been neat. While I haven't completely overhauled my schedule, it has made some genuine improvements since I've been writing down what I've actually done while keeping in mind what I need/want to do. I have been trying to schedule my days by the hour for months now, but never really got to the point of following said schedule. With the daily activity log, I am able to reevaluate how I spent my time, and how I could rearrange everything to fit the important stuff into my day. This is a lot smoother than just trying to shoehorn and guilt certain activities in; it's almost more natural feeling. "Okay, I wanted to take long walks with the dog everyday, but yesterday I decided to play video games because it was too damn hot and by the time I thought about it again, it was too late. So let's adjust the time I go out and maybe set an alarm," and then, gradually, it changes.
And it's so easy that I'm mad at myself for not having thought of it! Here's a quick, simplified guide for you.

1. Think about what you value, what your goals are. 
2. Think about little steps you could make every day to advance (move toward) those goals.
3. Write 1 & 2 down, then plan out your week. Add in school/work/other obligations and then fill in just a few of those steps. Don't overwhelm yourself, obviously. Just one little thing will do. Have every day planned (not necessarily every hour, and remember to remain flexible as life constants shifts).
4. Write down next to what you planned, what you actually did, how much you enjoyed it (1-10) and then how much you feel you achieved doing each of those things (1-10). This way, you can assess how those activities fit in with either your goals or even just relaxing/self-care. Because you don't have to always be doing something crazy-goal-oriented. 
5. When (not if) you fuck up, forgive yourself. No one's perfect, you included. You are going to have a day where everything is planned, and you spend it (especially if you are depressed) lying in bed eating Cheetos. It happens. Shrug it off, and evaluate why you did it. If you were just too overwhelmed, cut back in your schedule. If you just wanted a day to eat Cheetos, fuck it. You did it. Now start back up tomorrow and don't worry too much about "making up" for today. 

What might also help is starting off by just recording what you do to get a realistic view of it all. One week, write down what you do hour by hour. At the end of the week, just take a look and use that as a jumping off point for the rest of your schedule. This way, you can be a little more subtle with adding activities and it feels even less forced.

All of this was done in collaboration with my current therapist, Dr. S. She's pretty fucking legit and very realistic, so I'm hoping I get to work with her long-term. *crosses fingers*

So anyway, enough about me; how has your week been?