Remission is Weird, part 2, or: "Oh yeah..."

As I write this I realize this might have been written a little out of order; I should have written this post first. I was just so excited about it all that I dove in head-first. Oh well...

The other day, I was folding laundry and letting my mind wander. I was stuck on a pretty toxic line of thought: things I can't do because of energy levels. If you read the last post, then you know that this is a load of bullshit (I do still have Crohn's, but that is also in remission, minus my arthritis issues).

Well, I was mid-thought: "I just don't have the energy because of the Crohn's and depression...wait a second..." when I got the idea for these couple of articles. I'm not depressed anymore. I do have the energy to do things. I no longer have an excuse to not do chores or exercise, or even have fun (this makes sense to my depressed brothers and sisters out there). So what the fuck am I waiting for?

Things I excused myself from (whether legitimately or not): chores around the house, self-improvement, eating well, personal hygiene (gross, I know), wearing at least jeans instead of sweatpants in public, breaking habits, making friends, starting hobbies, and the list goes on.

So now, I have identified my (lack of a) problem. Now I need to completely retrain myself to stop thinking I'm depressed as a way to not try to flourish in life. I am finally in a position to live. And now is where it gets terrifying. Because this is where I have to exist outside my comfort zone. I should have started earlier, but hindsight's a bitch.

This is where this blog changes, as I go out into the wilds and report back my findings to the Depressed Continent. Hmm...that would have made a much better name for this blog.

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

Weird and Wonderful News

My last psychology appointment was on Tuesday the 6th, and I was told something I had never heard before: I was at a good enough place, mentally, that we could forego making another appointment until I felt I needed another.

This is, obviously, good news. But it's strange all the same. Those of you who are depressed or have been depressed will totally understand this line of reasoning: it is very hard to admit that you are getting better.

So many people (well-intentioned or not) will be quick to point out that depression is just a "phase" or just a fleeting "bad mood" that will pass just as quickly as it came. We have to fight to be taken seriously, so it is hard to show others when we have our occasional good day. A good day is very often taken as fodder for why depression really isn't a "thing" and so we should just snap out of it because we "totally did it the other day."

None of us want to be depressed, but partaking in Behavioral Activation can be misconstrued as "bucking up." The very methods for getting better are loaded situations, and this makes for an even harder recovery. It's bad enough trying to recover with someone who understands it having your back!

So to be in a situation where I have been free to try out different methods, to get better, to celebrate the good days instead of hiding them...I have finally gotten to a good place. My wonderful, fucking amazing husband has supported me and I have had an awesome, knowledgeable doctor, too, so I am indeed extremely lucky.

To those of you who are struggling to get better, know that it is possible. Know that it may take years, and so much trial and error that it all feels like a mistake, and there will be pain and hardship and idiots that stand in your way, but it is worth it, and you are worth it. Trust me, if no one else, okay?

I started this blog long into years of therapy and drugs and research and I don't want to misrepresent what a recovery looks like. Hell, that road looks different for every person anyway. And there is something else to remember, too: I can't stop here. There is a lifetime of monitoring ahead, and when (not if) that fails, the inevitable battle to get back to where I am today. I'm also still not 100%, either, I'm just good enough right now that I don't need a therapist holding my hand.

I have taken these things into consideration and, though it wasn't required, I went ahead and made an appointment for a month from the last one, just in case. I know myself enough to know that I might slip between here and then and may need some encouragement (beyond my husband's capabilities), and if there is no appointment scheduled, I'll just put it off. And put it off. Until I'm back again, hiding under a blanket, locked in my closet, wishing I were dead.

I don't want to get to that point again. But I could. Knowing that about myself is the most important step, tied with admitting that I may be on that path again. And really, that's what mental health is all about: learning enough about yourself that you can take every step possible to make sure you stay okay or are working to get there. Even those who have never had problems need to keep tabs on their stress levels.

So everyone who is reading this right now, do yourself a favor: pay attention to how you feel. What your moods are telling you, what your body is telling you, what your friends are telling you...it could literally save your life. Or at least save you a hell of a lot of money and misery!

Happy New Year!

Hey everyone! (or at least the one other person who reads this blog)

How have things been? Have you made any resolutions?

Personally, I have vowed to make this an awesome year--depression be damned, Crohn's be damned...I'm hopefully going to do things right this year. I know there is a HUGE chance this is just a silly little energy boost with another new beginning that will wane in just a few more days, so if I fail, I won't be too terribly shocked. But I do have a little bit of hope I'm drumming up for myself.

Ah, who am I kidding?? This year is going to suck just as much as the last one, and the two or so decades before that...but what I CAN do--what even YOU can do--is make sure this bout of hope and energy is put to good use, not toward worrying about what's around the corner, or how everything is going to catch up and you/I'll start feeling like absolute shit again. We know our pattern, so let's use it to our advantage, eh guys?

So what are your 2015 resolutions? What plan do you have in place for once your soul gets sucked out again? What's your contingency plan for in case this doesn't actually happen and you are back to being a normal human being again? TRICK QUESTION--there's no such thing. So far as I can tell, there's no such thing as normal, healthy, happy human beings. We all have something wrong with us whether mental or physical or both, it's just how we present ourselves to the world that makes the difference. It's how we put this knowledge or ourselves and others to use that makes us successful or "surviving," and slowly I'm starting to realize that each of us is actually capable of the whole "success" thing, so long as we are completely willing to change from the bottom of our souls, no matter how painful looking into those depths may be.

So hold out hope for yourself, you beautiful son of a bitch, because I have hope for you, and I'm kind of a cynical little douche.

~ML

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.

PIOP

Psychiatric Intensive Out-patient Program, or PIOP, was something I got put into by one of the good doctors I saw while in the military. It was basically a two-week long, seven to eight hour therapy group. The "curriculum" used several different techniques such as art therapy, psychodrama, CBT (cognitive behavioral therapy), and just regular talk/group therapy. I think there were six of us.

PIOP was the first time I ever did any kind of group therapy, and I was nervous as all hell. I don't particularly like speaking even one-on-one with someone I know, but this was in front of a group of strangers. Needless to say, Clonazepam was my best friend those two weeks.

The schedule differed a little everyday, and certain things like art and drama were only used a few times, but everyday we started with saying how last night went and then with a kind of warm-up. The warm-up was fairly simple--a family-friendly mash-up of musical chairs and "Never Have I Ever," or a race-type game involving CBT trivia--just to make us a little more apt to talk later.

This was a few years ago, so I can't remember all of it. I do, however, remember getting caught up in other people's therapy. This was after I decided I needed to be a therapist, so I was fascinated by the process.
Basically, one person would be convinced to talk about why they were there and about their past, and the rest of us were encouraged to comment, ask questions, and challenge that person's inconsistencies and distortions. I, being the weird, awkward fuck I am, really enjoyed this part. Listening to their stories and then giving them feedback.

Then it was my turn.

One of them expressed some solidarity when it came to my past abuse, but when it came to my biggest problem, no one--not even the facilitators--know what to say. I was struggling with the concept of self-worth. Not self-esteem, but worth. You can't have self-esteem unless you also agree that you are not simply taking up space and resources with your existence. It was a kind of existential crises that I was dealing with everyday, that no one there had even considered. They took their right to exist for granted. I'm sure it is probably an evolutionary thing. I did eventually figure this out, but that's another post. Basically they told me I "think too much."

Art therapy was fun, but not really helpful at the time. Psychodrama was lame except for a quick moment where I actually believed myself when I said that "I'm not worthless," and CBT and learning the drama triangle were enlightening, but I wouldn't use that until later.

All in all, it was a great experience. Most hospitals don't call it PIOP, but I'm willing to bet a lot have something similar; so if you need it, I'd totally recommend it.

Friday is another check-in, and Monday I'll write more on the whole "self-worth" thing.

Be well!
~ML