A darker time than usual.

I don't want to alarm anyone, but I'm struggling right now and I don't know why.  I post a lot of more positive things usually, however that does not mean my life is all sunshine and rainbows.  As a matter of fact, most days it is a numbing grey sensation.  Right now seems a bit darker than usual though.  I can't quite put my finger on it.  The sensation for harming myself is high, and with each passing day it gets higher.  Don't panic, I've already told people and have plans in place to ensure my safety.  I'd like to take this time to talk about these urges though.

These urges have come with an increase in nightmares and closed eye hallucinations.  What do I see when I close my eyes?  Random patterns of light at first, then flashes of images that I can't control, usually disturbing in nature.  This leads to me not getting restful sleep, which in turn leads to depression.

Currently however I am experiencing a mixed state.  Which is when I am experiencing both a high and a low all at the same time.  Which is confusing to imagine, I know, but I assure you that such a thing exists.  This makes it hard to identify what is going on with me because on the one hand I may have a lack of interest in things that I normally would, conversely I have more ambition for things that I haven't done in a while.  I also am aware that this is the time when I am most prone to actually committing suicide.  All my attempts in the past have been during mixed episodes.

I'm not sure why I'm feeling this way, or even if anything can fix it.  Maybe it is time to see about getting my medications changed.  I've thought about getting another evaluation done, because I'm thinking there's more at work that just bipolar and social anxiety disorder.  New country, new rules though, so I'm not even sure how to go about getting that done.

Or even if they will, given how long I have had this diagnosis.  Not being believed is something that bothers me.  Especially after an event that occurred about four years ago during a hospitalization.  The doctor asked me where my scars were.  If I cut, I would surely have scars.

This upset me greatly, and makes me hesitant to share my experiences honestly for fear of being judged like that again.

At any rate, I have been given the task to figure out what is wrong.  What if nothing triggered the episode and I am just chemically deprived?  I suppose that would be what is wrong.  I suppose trying to figure out how to get to a doctor is a good first step.

What do you do to help in times of darkness?  I'm looking for any suggestions you may have.  Thanks for taking the time to read.

--JJM

Dealing with general anxiety (a short introduction to my experience)

I often get stressed about things and I don't understand why.  Even better than that, I often get stressed about things and I don't know that I am even stressed about anything in particular.  This leads to many things, including fatigue, anger, and general unrest.  This often comes out in my being particularly cantankerous at times.  I fully realize that I may need to focus on this and am mostly writing to brainstorm on what I can do differently to help recognize my triggers and how to deal with them in a healthy and productive way.

Perhaps I should look at things in reverse.  Perhaps I should notice when I am being particular on edge and stop and evaluate, in more detail, why I am feeling that particular way.  In the past this has been less than ideal because I would find something external to focus on as the trigger for my current issue instead of what was really bothering me.  This led to many arguments that could only be classified as extraneous.

One thing that seems to help is to have someone understanding who is able to "check" me.  That is, ask me why I'm upset and understand that my stated reason may not be the true reason.  Though, as understanding as she is she sometimes upset that I am not more able to identify my emotions and thoughts.  She touts "mindfulness," but I try.  The issue is my mind wanders, and I mean goes out for a walk to end no others.  So many thoughts occurring simultaneously in such a way that they are like fish swimming in a school:  hard to track down and catch a single one.

This is apparent in the way I write.  More free-form I suppose.

Anyway.  The way things are going right now, I know that I'm stressed about work (I've now got two jobs), but is that all?  I know right now I think I'm struggling with things emotionally, but I'm not sure how much of that is work, and how much of that is me going so long without "professional" support.  Perhaps a mixture of both?

I just know that I am lucky that the Universe has conspired to guide my actions in such a way that I wound up with my wife.  I could have theoretically wound up with her if things had gone ideally with university and other aspects of my life, but I would not be the person I am nor have the things I do.  It is a wonderful conspiracy to be sure.

I should probably end this bit of a rant before it becomes totally derailed.  I will write again soon with regards to what I am struggling with specifically.

--JJM

My thoughts on seeking mental health treatment.

     Treatment is a funny thing.  As much as other people want to help their loved ones get the help they need it is up to the individual to seek treatment.  Even if they are forced into a hospital setting to a limited degree they can refuse treatment while in there, or even if they are medication compliant they can stop treatment at any time after they get out.  They may not think they have a problem, or even if they do admit a problem they may think they can control it on their own.  Likewise the issue of money comes into play because treatment can get quite expensive between the doctors and medication (let alone therapy if need be).

     Like quitting smoking or drinking, until a major event occurs that impacts either their safety or the safety of others, it is unlikely the individual will admit that they don’t have it as under control as they think they do.  And even if they do get treatment, things may not go exactly according to plan.

     I remember the first time I attempted to actually seek treatment for my issues.  It was not a crisis situation and I was working full time.  I had a therapist that I couldn’t stand and no one explained to me that for the first week or so most psychiatric medications cause a sense of sedation.  I felt zombified and instead of continuing to take my medication I stopped.  Instead of asking for a different therapist, I stopped going.

     If someone had been there to say such things as “You are allowed to change therapists,” “stick with your medication, it should get better,” or “if you don’t like the way your medicine makes you feel, you can explore other options” things would have turned out differently.  You may not have many options, but there is almost always more than a single option.

     Many people think help can be cost prohibitive.  While it can be costly, many areas offer programs that work on sliding scales to make treatment affordable to anyone.  Likewise, even if you don’t have insurance and your medication is expensive many pharmaceutical companies offer assistance programs.  I save over $600 a month via prescription assistance programs and my therapy is on a sliding income scale.

     Perhaps my situation may be considered “lucky” but I know many people in the same boat as I am.  There are more options out there than most people realize.  For many people, knowing where to start in the whole process can be overwhelming and that may also contribute to some people’s resistance to treatment.

     So what can people do to help?  Be patient.  I know you are scared for us, but we are scared, too, and need to come to terms with what is going on.  Be there for us.  Be willing to tell us that you do worry about us, but don’t pressure us unduly.  Be proactive.  We may not know where to turn to help and may be so frazzled by the whole thing that we are emotionally unable to deal with trying to get help.  I don’t mean for you to have the local hospital on speed dial, I mean help us do the research, or do it on your own so that when we say “I just don’t know what to do” you have some concrete help to give us.

     I’m not saying advice isn’t a good thing, but be mindful of the advice you are giving.  Telling us to cheer up?  That is not exactly helpful.  Telling us everything is going to be okay may sound like a great idea, but depending on what the person is going through, they may think only “easy for you to say.”  Avoid “you” statements and instead use “I” statements.  “I think, I feel.”    But don’t be a pushover either.  If some behavior is unacceptable, say so.  If we are being a jerk, tell us “That really hurt my feelings.”  It will help solidify that we are hurting others and we don’t have the level of control we think we do.

     Helping someone seek treatment is no easy task.  I do not envy those who support people through the entire process; it must be a hard thing to do.    But for those of you with the strength, thank you.  You may not hear that enough at first, but once your friend/loved one is in a better position you will often hear it.

--JJM

Asking for, and receiving, help.

     Two very difficult things to do, for anyone, are to say no or ask for help.  For someone with social anxiety disorder I assume both are even harder.  I know they are for me.  I think there is a relationship between the two concepts that needs to be explored first.  If someone says no firmly they are confident and know what they are capable of handling at any given moment, and the same can be said for someone who asks for help.  Does this mean that if someone has problems with no they automatically have problems with asking for help?  You can be confident in knowing what you can handle but ashamed that you can’t handle more.  I think that would lend more to an ability to say no but not ask for help.  Likewise, someone who wishes to please everyone would have a hard time saying no, but generally an easier time with asking for help.

     

     So someone with social anxiety disorder would fall where?  I know for me, I want to please everyone but am afraid that I will be unable to do what is required of me and therefore tend not to take on more than is needed.  Rather than risk the grand show of failure I rather avoid participation at all.  Asking for help is a little more straightforward.

      

     First there is this sense of shame for needing to even ask for help in the first place.  There is also a sense of judgment that we fear for how we got into a position to need the help in the first place.   I know that I feel as though I am a bad person for perhaps not being good enough to succeed from the get go.  There are more self judgmental thoughts that race through the head, such as why would anyone want to help, that people have problems of their own they need to deal with and that their problems are greater than my own.  Put basically you don’t want to be a bother or drain on people.

      

     This is all on top of “normal” social anxiety stuff such as not even knowing how to broach the subject of asking for help.  As a classic example, I was in college and just recently out of the hospital for the first time.  A good friend of mine said to call any time day or night if I needed anything.  I was feeling especially raw one night and was thinking of cutting again.  I called up my friend who was too busy to talk.

    
     It took everything I had to convince myself to pick up the phone and call, I was shaking, pacing, going over what I would say and how he would react, my heart was racing, mouth dry, stomach churning.  All to be told that even after he said he would be there, he wasn’t.  This reinforced the depressive thoughts I was having anyway, but also led me to never want to ask another human for help again.  All of that worry, and in the end, I was right.  So why put myself through the worry again?

      

     Saying “Call me if you ever need anything” is such a common statement people make that it is meaningless and quite frankly unrealistic.  What should someone do instead, especially when dealing with someone prone to depression or anxiety?  Prove that you are there for them and willing to help.  Tell them, when you sense something is up, that you are coming over for tea.  When there, ask them how they are doing, if they need anything.  Be somewhat assertive with this; reiterate that you are there to help and what you are willing and capable of doing.  Set up another visit before leaving, if you are sincere about helping, realize that we may need help in getting help.  By and large we are too timid to stop you from helping once you start.

      

     Once we see your sincerity and see that you do actually want to help (and perhaps indeed you are capable of performing the help we need) we will be less afraid of you.  If you feel the need say “call me if you ever need anything” be a bit more specific.  “I’m around most days in the evening if you ever want to chat.”  “If you need a ride somewhere, give me a call ahead of time and I will see what I can work out for you.”     

     Once we have very clear rules for what and when we can ask it makes it easier to ask, because we are told what to expect, and it is the unknown we fear the most.

--JJM