Bipolar 2 From Inside and Out

Posts tagged ‘being overwhelmed’

How I Learned a Few Social Skills

I thought my social skills were bad until I encountered a woman who asked me, “Do you have mental problems?” (She recognized me from our mutual psychiatrist’s waiting room, but still….)

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With practice, however, I have been able to improve my casual conversation skills, at least enough to get by in some situations, as long as they don’t last more than an hour. Here are my secrets. They do take practice. I have been fortunate to have had people to practice with – friends, coworkers, and of course my husband.

Introductions. Actually, I taught this one to my husband. Often when we met someone that he knew, he would fail to introduce me, leaving me standing there like the proverbial bump on a log. He claimed that the problem was that usually he couldn’t remember the person’s name. “Just point to me and say, ‘This is my wife, Janet.'” Then I will stick out my hand to shake and say, “And you are?” That way we both learn the person’s name. It works like a charm, every time.

Very Brief Conversations. Conversation with strangers – just a sentence or two – is also relatively easy to learn. The trick is the innocuous comment and there are two ways to go about it. The first is to make the comment yourself – “Those are great shoes! They make your feet look really small.” “What a lovely handbag. My mother had one that was similar.” Make an observation and then a related remark, usually complimentary. They don’t even have to be true technically. If you can’t think of anything else to say, a comment on the color of an outfit is usually good. There’s hardly any way someone can take offense at “That’s a great shade of blue on you.”

The other side of the equation is to get someone else to make a comment to you. This requires a prop most of the time. I used to carry a purse shaped like an armadillo, and that proved a great conversation starter. I memorized several responses that I could use when the other person said, “Oh, what an unusual purse!” I could say, “My mother gave it to me for Christmas one year” or “A friend found it in some catalog.” The purse went over  big, especially if there were children present.

Longer Conversations. These require more practice. Luckily at one of the jobs I had, there were a couple of people that I could invite out to lunch and practice conversation with. (I suspect that they knew what I was doing, but they never mentioned it. In effect, they played along.) Mary, for example, had two adopted children, and questions about them we’re always good for a few minutes of interesting listening. They also had a cat and a snake. Pets and children make good topics.

Sometimes it’s best to steer clear of work-related subjects, but if the person is really understanding, you may be able to vent. You should also be able to listen to the other person too. The secret to that is not to try to fix the problem. Simply listen and validate the person’s feelings. “That sounds awful! Does she do that all the time?”

Formal Settings. Mary also provided me with the opportunity to learn about a sometimes-necessary but difficult situation – funerals. Mary and a few other people invited me to go with them to the viewing of a person that I knew only slightly in a work context, so the stakes were low. From watching Mary and her friends, I learned that the proper procedure is to stand briefly at the coffin looking solemn, then go to the bereaved, shake hands or hug (depending on whether they proffer a hand or two arms), and say, “I’m sorry for your loss” or “My deepest sympathy” and at least one remark about the departed. It can be as simple as “He was a pleasure to work with” or “Everyone at work is going to miss her.”

Not Melting Down. Another important social skill is not having a major meltdown in front of other people. When I first visited my husband’s family, I became very uncomfortable quite often because everyone seemed to be yelling at each other. Loud, angry voices tend to upset me, especially if they continue for any length of time. The technique I developed was to go into the other room and make a cup of tea. Making tea is socially acceptable. (If you’re in the kitchen, go to the bathroom or step outside for fresh air.)

Much later I learned that my husband didn’t realize that his family reacted to even minor questions with argumentative responses in loud voices. To him, and to them, this was simply the normal style of conversation. It wasn’t what was normal in my family, and it triggered my aversion to confrontation. I guess whatever you grow with grow up with seems normal to you.

One other piece of advice: Don’t attempt flirting unless you have a coach. It’s really tricky and possibly dangerous. Not for the novice (especially not the kind of novice who wears a habit).

 

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Mental Health, Uncategorized

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The Week of Living Alone

Sometimes, when I get tired of my complicated life, I imagine what it would be like to start over someplace new, or what it might have been like if I had made different choices. I envision myself, living alone (well, with one cat), in a small town like Benson, AZ. I would have a small used book store or secondhand shop and live in a small apartment over it or behind it. I would have a couple of friends I met in my shop and go out to lunch or dinner once in a while, but mostly spend my free time listening to music, watching TV, or on the Internet.

Sounds simple and peaceful, doesn’t it?

Portrait of a young woman drowning, shark fin on the backgroundThis past week has convinced me that even such a stripped-down existence would not be possible for me. My husband was out of town for nine days, and I could barely manage.

Those of you who follow this blog know that my husband is my rock and my support. I often say I could not get through without him, and my recent experiences only reinforce that.

I didn’t begrudge his leaving, though I wish he had not been gone quite that long. His mother needed him to help her get ready to sell her house and move, and nine days was barely enough time to start on all that needed to be done. There are times she needs him as much as I do.

But coping on my own was difficult. I have paid work I have to do. It matches perfectly with my skill-set and I’m grateful to have it, but sometimes it’s just plain hard to do and hard to make myself do. And I have two blogs (the other is at janetcobur.wordpress.com) that I have made a commitment to posting in once a week, each. Plus, I have started writing a novel.

We have four cats, two of them ancient, and one dog, also ancient. I was afraid that one of them might die while my husband was away. (None did.)

As scary as the idea of coping with a dying or dead animal on my own was, just caring for them was difficult. They keep demanding food several times a day, you see, and they have no thumbs to open cans with. Then there’s the water bowls and the litter boxes. I used to live alone with one cat and manage okay, but that was many years and many meltdowns ago.

Then there was feeding me. Dan had stocked up on things I like before he left, but after the French bread pizzas were gone, I lived largely on salami sandwiches, cheese and crackers, and cereal. (I did eat vegetables. I had a small tray of sliced veggies and dip.) Once I made a couple of baked (frozen) fish sandwiches early in the week, but later I had devolved to the extent that my evening meal was peanut butter on a bagel. Another night I had mashed potatoes and a glass of red wine. Other meals I simply skipped.

Then there was Dealing With Stuff. Life Stuff. You know. The Stuff that happens to everyone sometimes piled up on me. I had to talk to (argue with) the utility company and the IRS. I had to pay bills. Life stuff leaves me exhausted.

Plus, I kept having to Go Out. Deposit my check. See the doctor. Pick up prescriptions. Buy cat food when I ran out. I wore pants more days last week than I had in the previous month. (Dan wanted me to water his butterfly garden daily, but it rained every day or night, so I didn’t have to put on pants and go out for that.) I treated myself to lunch twice when I had to go out to do those errands, but it was nearly impossible to decide where to eat.

Now Dan is back. I had to put on pants again so we could return his rental car.

But you see what I’m getting at here.

My fantasy of retreating to a simpler life is not feasible. It simply wouldn’t work. The everyday tasks and trials of managing a shop, caring for myself and a pet, negotiating all the stuff of life would overwhelm me. Oh, when I’m hypomanic and can sometimes focus, I might do all right for a while, but life – even a very basic one – would eventually overwhelm me. There are so many things I can no longer do, at least not without serious amounts of help and support.

I can muddle through for a while mostly on my own. I am getting better. But not better enough to live independently, at least not right now.

 

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Mental Health

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Senses and Sensitivity

When I was a child, I was often told that I was “too sensitive” – meaning that I took things too much to heart, especially criticism and the taunts and bullying of other children. It was something that I assumed was innately wrong with me, and that I didn’t know how to fix.Sensory Overload in Children

These days, however, I’m too sensitive to sensory input.

I used to be able to write or read or edit with music on (instrumental music, at least). I used to be able to hold a conversation while the television was on. I used to be able to drive a car and look at the scenery around me.

Not anymore.

A fan is about all the sound I can handle while I write, and sometimes quiet is the only thing that will calm my nerves. I can barely process remarks anyone makes about the TV show we’re watching. And if I’m driving, I never even notice a deer in a field off to the side of the road. I doubt that I would notice a hippopotamus.

I’ve written before about my brain being overwhelmed with too much input, meaning too many thoughts, anxieties, and fears. But over the years – at least since my last major meltdown – I have trouble processing more than one sensory signal at a time.

It’s not just a matter of focusing in too completely on just one thing. (I have in the past entered into some movies so thoroughly that I’ve nearly killed my husband when he has asked questions like, “Will you look at this pimple on my back?” or whispered to me, “I think I know what makes that spaceship fly.”)

My ability to focus – to concentrate intensely – has been a casualty of my mental disorder. At my lowest point, I couldn’t even read a book, which is something I’ve been doing since I was three or four. I still can read only one chapter or one magazine article in a sitting

Now that I’m recovering (thank God and Drs. R. and B.), I can concentrate enough to read, and write, and edit. What I can’t do is separate out multiple sources of information on the way from my senses to my brain. If my husband talks while a TV show is on, it’s not just that I can’t make sense of what he’s saying, I can’t process either signal – the TV or him. It’s all a jumble.

If I went to cocktail parties (I don’t), I would be unlikely to have an intelligible conversation because of all the ambient noise and clashing voices. I recently went to a workshop that held a mix-and-mingle event on the first day. Having people chatting all around me was not just distracting, but almost painful and immobilizing. Focusing on one person at a time was the only way I could get through it.

And forget about Chuck E. Cheese or Cici’s Pizza! No. Just no. Video arcades – are you kidding? It’s a good thing I have no reason to frequent places like that. When I go to a regular restaurant, I have to ask not to be seated near any birthday parties or office functions. I wish they had a “no screaming” section.

I understand that sensory processing difficulties sometimes occur in persons with autism spectrum disorders (ASD) and/or ADHD. I have never been diagnosed with ASD, though I may have manifested Asperger-like traits in my youth (well, OK, in my adulthood too). And I have been told by doctors that I have hyper-sensitive nerves. Is that the same as what I experience? I don’t know.

Most of the research and discussion of sensory processing and bipolar disorder occurs in the context of children, though I never noticed such difficulties when I was a child. But just as articles about autistic adults are rare (except, of course, for the high-functioning) and learning disabilities are forgotten about as soon as a person leaves school, it seems that sensory processing problems in adults also get little attention.

I can’t be the only one dealing with this.

As I learn more about my own difficulties and conditions that affect others, there is one conclusion I’m rapidly approaching:

Neurodivergent is neurodivergent. We may have different diagnoses, but there is much we share.

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Mental Health

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Who’s a Spoonie?

With all the talk about cultural appropriation lately, I’m hesitant to wear Kokopelli earrings or eat at the Chinese buffet. I understand that some people object to Canadians playing Englishmen who are pretending to be Japanese for a production of The Mikado is offensive or racist. I don’t always agree, but I understand the principle involved. Even I, a WASP, find Mickey Rooney’s character in Breakfast at Tiffany’s to be egregious, appalling, and insulting to everyone involved, including the audience.

Hand XrayBut recently there’s come the claim that those who are not entitled to it are appropriating Spoon Theory language. And in this case, “entitled to it” means someone with an “invisible illness” – chronic pain, chronic fatigue, and other conditions that do not announce themselves to the public with visible cues such as wheelchairs, crutches, missing limbs, or guide dogs.

If you don’t already know Spoon Theory, you should. You can find the explanation here: http://www.butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/. Basically, “spoonies” have only a limited amount of energy units per day, represented by spoons. Spoonies must use a ridiculous amount of spoons to get through tasks that others accomplish normally in the course of life – showering, driving to work, driving home, fixing dinner, et endless cetera.

In fact, on any given day a Spoonie may not have enough spoons to get out of bed and get showered and dressed. It’s not that Spoonies are lazy; they may have only three metaphoric spoons that day, compared to a non-Spoonie’s typical, oh, I don’t know, 20? 30?

A few weeks ago, I wrote about whether bipolar disorder and other mental disorders are invisible illnesses: https://bipolarjan.wordpress.com/2016/03/06/is-bipolar-disorder-an-invisible-illness/. (I said they mostly are.) As far as I’m concerned, we’re Spoonies and “entitled” to Spoonie language. Most of us have had the experience of not having enough spoons to spend on a morning shower, having to choose between hygiene and, say, eating breakfast.

So now, apparently, the general public is picking up Spoonie language – saying “I’m out of spoons” when they simply mean “I’m tired” or “That was an exhausting day. I’m done.” And some Spoonies resent that. See http://m.dailylife.com.au/news-and-views/dl-culture/stop-appropriating-the-language-that-explains-my-condition-20160113-gm4whc.html

I have two things to say about it. The first is that language is always growing and changing. But it does it on its own, without our control. (Unless we’re France. France at least tries.) We may wish to eradicate the “n-word,” but we can’t. It’s less socially acceptable to use in polite company, but you know people still use it. Read the comments section on any social media post about President Obama if you don’t believe me.

The second thing is that at least Spoon Theory and language are entering the mainstream. People without invisible illnesses are at least getting a clue of what it means. They may not have the details right, but at least now when we explain it to them, they won’t be starting from scratch.

And after all, isn’t that how Spoon language started – as a way to begin a conversation on what invisible illnesses are and how they affect our lives? Not a secret language that only those who know the password and handshake can use.

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Mental Health

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I May Have Miscounted My Spoons

This week I actually got out of the house, going for lunch and a little shopping with an old friend. (Another friend of mine calls these “pants days” because they obviously require putting on pants, for going out farther than the mailbox.)

After less than three hours I went home, did some work, and promptly collapsed. All told, I think I was either active, sociable, or some combination thereof for at most five hours – most likely more like four. That for me is an exceptional day of fortitude, stamina, spoons, and hypomania.

However, I have gotten myself into a situation that will require much more than that. I am going to a writer’s conference – three days of thrill-packed seminars, lunches and dinners, and other business and social-type events. I’ve done half-day business meetings lately, but nothing so extended, crowded, or spoon-depleting. It will hit a lot of my anxiety triggers – crowds, noise, small talk, social events, and more. I know that by the time we gather for dinner in the evening, I’ll already be extra crispy.

The three days of the conference will not allow for much of any downtime – although I have fantasized about asking someone who’s staying in the hotel if I can borrow a room for an afternoon nap. (The conference is local so I don’t have a room of my own or it wouldn’t be a problem. Less of one, anyway. All I’d have to do would be pick which seminars to skip. But the idea of asking a relative stranger for the use of a room or the idea of a relative stranger letting me use a room is pretty ludicrous.) Fortunately, I have to get the car home by 10:00 so my husband can go to work. That means I can’t stay for the after-hours socializing, even though that’s said to be one of the highlights. But it does mean I get a few more hours in pjs instead of pants.

Back before I had my most recent major meltdown, I was able to attend business conventions and do at least most of the requisite functions. I could and did give little talks at power breakfasts or afternoon cocktail parties – even opened with a joke. I could meet and greet the public at our booth – “howdy and shake,” as my father would have called it. I could have lunch with potential writers. I could almost interact with our sales force.

Those days are long past. So now I ask myself, how can I build up my stamina for the writers conference? Maybe it’s time for me to try to reclaim some of those parts of myself.

It feels like I’m going to be training for a marathon – or maybe the Normandy invasion. I know that in order to get through it, I will have to prepare in advance: writing my Sunday blog posts before the conference starts, assembling my wardrobe, checking out the parking situation, stocking up on business cards, and all the other little details that make me so frantic at the last minute.

Perhaps during the next two months I can keep track of how many pants days I’m able to have and gradually increase them. Perhaps I can arrange more lunches and shoppings. Perhaps I can improve my usual record of doing only one major thing per day. Perhaps I can try to work up to three pants days in a row.

The conference itself is certainly a massive and major incentive. Plus I’ve already paid for it – yet another reason to get myself in shape to take advantage of it.

Right now the conference looks like rather an ordeal, but I hope that by the time it rolls around I’ll be in good enough shape to both enjoy it and benefit from it. At least it’ll be a group of writers, and humor writers at that. They’re known for being at least a little odd. Maybe I’ll fit right in. I’ll be the one napping on a couch in the hotel lobby in fuzzy slippers. And pants.

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Mental Health

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Trigger Warning: Trigger Warnings

What is a trigger warning?

Let’s start with a more basic question. What is a trigger?

Just as a literal trigger activates a gun, a figurative trigger activates your mental disorder. It’s a stimulus that sets off either a manic or depressive phase, or a bout of PTSD.

Triggers are usually unique to the individual. What sets you off may not affect me at all.

Over the years I’ve learned what my triggers are, and so do most bipolar or PTSD sufferers. Loud noises and large crowds trigger my anxiety, which is why I could never work at a Chuck E. Cheese. My depressive phases don’t often have triggers except for bad dreams about an ex-boyfriend. Most of my depressive episodes just happen without a trigger.

Generally, one avoids triggers, because who needs more manic or depressive phases in addition to those that occur naturally, with no prompting?

A trigger warning is something else. It is a notice that someone puts at the beginning of a piece of writing to warn readers that the subject matter may be intense. Ordinarily, trigger warnings are given for major life events that have caused trauma and may cause flashbacks, severe stress  or other extreme reactions.

Some of the most common trigger warnings are for graphic depictions of rape, suicide, self harm, or physical or sexual abuse. The trigger warning says to a potential reader: If you don’t want to encounter this material, if you think it will make your illness worse, or cause you undue stress, don’t read any further.

Although we call relatively minor stimuli triggers, they usually do not require trigger warnings. If you’re going to write about having a fight with your mother, you probably don’t need to put a trigger warning on it. If your mother hit you in the face with a frying pan and sent you to the ER, you might need to place a trigger warning on your post about it.

Online, the standard form for trigger warnings is first to state, often in all caps, TRIGGER WARNING and state the type of trigger it is – TRIGGER WARNING: SELF-HARM, TRIGGER WARNING: SUICIDAL THOUGHTS, etc. To be extra sensitive, the writer leaves a number of blank spaces or a few dots before beginning to write the difficult material. This gives the reader the choice of whether to scroll down and read it or not.

Trigger warnings have become controversial, particularly in schools and colleges. Many pieces of literature and even textbooks on history or sociology discuss difficult topics that may be triggering. For example, a novel might feature a rape as a plot point, or a history text might discuss slavery.

Some people believe that a trigger warning will help a prospective reader know whether reading further will provoke a strong reaction. Other people believe that trigger warnings are a way of coddling the weak and letting students avoid challenging material that is necessary for the class.

My own opinion is that a trigger warning is like chicken soup: It won’t hurt and might help. It may mean that a student asks for an alternative reading or assignment, but it also may mean that the student simply wants to be in a safe space – not surrounded by strangers, for example – before reading the material.

People that believe trigger warnings should not be given have usually not experienced the kind of emotional breakdown that can result from unexpectedly confronting a traumatic topic. Very likely they have never even been in the presence of someone who has had such an extreme reaction.

I suppose that ideally, we could all read any material and simply brush it off if we found it troubling. Unfortunately, for those of us with mental disorders such as bipolar illness, PTSD, and anxiety disorders, this is simply not possible. A trigger warning may prevent someone from having a public meltdown and others from having to witness one.

I don’t know why that should be controversial. It seems like simple courtesy to me.

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Mental Health

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Am I Ready to Stop Therapy?

I got my first hint that I might be ready to stop therapy when I realized how little I was going. Over the years I have scaled down from weekly sessions to biweekly.

Then I noticed that, effectively, I’ve been going only once a month. I’ve been forgetting appointments, showing up on the wrong day, oversleeping, feeling poorly physically, or having too much freelance work to do.

Of course, those could be signs that I’m in denial, that I’m resisting therapy, that we’ve hit a bad patch of difficult issues and I just don’t want to deal with them.

But I don’t think that’s what’s happening. Here’s why.

I’m stabilized on my medications and they’re effective. When my psychiatrist moved away a few months ago, he left me with enough refills to last until this month and a list of other psychiatrists. My PCP agreed to prescribe my psychotropics if I lined up another psychiatrist for emergencies. I’ve done that, though I couldn’t get an appointment before March.

And that doesn’t alarm me. I don’t have the oh-my-god-what-if-my-brain-breaks-again panics. I don’t have the feeling that my brain is about to break again. I’ve thought about it, and I’m comfortable with letting my involvement with the psychiatric profession fade into the background of my life.

As long as I keep getting my meds.

I have more good days and I’m beginning to trust them. Oh, I still question whether I’m genuinely feeling good, happy, and productive or whether I’m merely riding the slight high of hypomania. But really? It doesn’t seem to matter very much. A few days ago I reflected on a string of particularly good days – when I accomplished things, enjoyed my hobbies, and generally felt content. And I simply allowed myself to bask in those feelings.

That’s not to say I don’t still have bad days. After a few days of hypomania, I hit the wall, look around for spoons and don’t find any, and require mega-naps to restore me. (I’m intensely grateful that I work at home and can do that. Most offices don’t appreciate finding an employee snoring underneath her desk. And my cat-filled bed is much more comfy-cozy.)

I still get low days too, but they are noticeably dysthymic rather than full-out, sobbing-for-no-reason, Pit-of-Despair-type lows that last seemingly forever. I know – really know, deep within me – that they will last a day or two at the most. And just that knowledge makes me feel a little bit better.

My creativity, concentration, and output are improving. I can work longer, read longer, write longer, take on new projects, think past today or even next week. I can trust my muse and my energy, if not immediately when I call on them, at least within a reasonable time.

I have trouble remembering how bad it used to be. Recently I’ve made connections with several on-line support groups for bipolar and mental health. I find I’m astonished at the crises, the outpourings of misery, the questioning of every feeling and circumstance, the desperate drama of even the most mundane interactions. They are overwhelming. But I realized that it’s been a long time since they’ve overwhelmed me. I recognize that I could some day be in that place again – that’s the nature of this disease. But I have a good support system that I trust to help me not fall too far without a net.

I don’t have much to talk about when I go to therapy. There are issues I need to work on – getting older, getting out of the house more, reclaiming my sexuality. But most of those I feel competent to work out on my own.  My sessions are mostly an update on what’s going on in my life at the moment, plus a recap of my recurring problems. But those problems are ones I’ve faced before and know how to cope with. I already have the tools I need and use them without needing a reminder.

So I’ve talked it over with my psychotherapist and I’m not completely quitting therapy, but I am cutting back officially to the once a month I seem to be going anyway. I know that if and when the bipolar starts giving me major trouble again, I can always call for an appointment or a telephone therapy session.

I’m not going to stop writing these posts. I still have a lot to say about where I’ve been, how I’ve got to where I am now, how things will go in the future, and all the many ways that mental illness affects society and vice versa.

You’re not getting rid of me that easily. I’m sticking around.

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Mental Health

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Dental Health and Mental Health

I still remember one of my earliest episodes of panic, which happened in a dentist’s waiting room. As I said in the uncomfortable chair, surrounded by Highlights for Children magazines that I had already read, I felt dread moving up my body from my toes. It crept up my legs into my hips and on into my abdomen. I was convinced that when the feeling of terror reached my heart, I would die. I was called into the doctor’s office before that happened.

This is a memory I have shared with only one other person before now. Just thinking about it still brings back a visceral body memory of fear.

It really bothers me that some people think that good teeth are a sign of moral superiority. Some other people, like me, are simply born with bad teeth, or at least weak, cavity-prone little tooth buds embedded in our infantile gums. Brush as diligently as we might, we are never going to have pristine white teeth like the people on TV.

While my dental phobia can possibly be attributed to the general pool of my anxiety triggers, there were also some outside factors that contributed to it.

My parents were never good role models for dental health, as my mother had gotten dentures at age 16 and my father chewed tobacco.

There were also bad experiences with blame-and-shame dentists and hygienists, one of whom scraped a bit of tartar off my teeth, stuck it in my face, and asked, “If I put that on a piece of bread, would you eat it?”

I used to loathe the public school practice of making us chew little purple tablets to see how clean our teeth really were. My teeth were – and still are – considerably crooked, so it was difficult for me to brush in a manner that wouldn’t leave glaring purple spots all over my mouth.

My teeth have only gotten crookeder, since my parents were not able to afford orthodontia for me. When and where they grew up, braces were a luxury for the well-to-do; rural children like they were simply did without. By the time my sister and I came along we lived in the suburbs, but braces had never become a priority for my parents compared, say, to eyeglasses, which were deemed essential.

My last and most recent experience with a dentist was a number of years ago. I don’t remember what prompted me to go, but I did tell the dentist about my phobia and he was very considerate. (I always look for a dentist whose advertising says, “We Cater to Cowards.”)

He did my exam and treatment in the kiddy room with the bright, nonthreatening murals of cowboys and western scenes on the walls. Just the x-rays and routine cleaning proved alarming enough to trigger one of my worst stress reactions – diarrhea. When it came time for the actual procedures the dentist brought in a traveling anesthesiologist so that I could be knocked out rather than conscious and terrified. My husband was there for driving, moral support, and decisions that needed to be made while I was out cold.

I have not been back to the dentist since. However, it’s becoming increasingly obvious that I need to. My teeth ache. My fillings have fallen out. One tooth is broken. Because of that, my teeth are moving in directions they were never supposed to. And that makes my dental bridge (acquired at the aforementioned last experience) fit poorly. I look like the stereotypical Willie Nelson fan. (I am a Willie Nelson fan, but I don’t care to reinforce the popular image.)

This week I was trying to convince myself to call a dentist just for a consultation. I still haven’t managed to do that. Just saying the word “dentist” gave me a spasm in my chest. Maybe I’ll be able to make the call during this coming week.

The only person in the world who is a worst dental-phobe than I am is my sister. She too had childhood dental issues. Once she even bit a dentist and he slapped her. Needless to say, that experience did not improve her attitude toward dental care.

She is also ultra sensitive to (or afraid of) pain and quite terrified of needles. Even as an adult, she has been known to scream so loudly and lengthily that she has cleared an entire dentist’s waiting room. (She then sent the dentist a Halloween card that screamed when you opened it.)

Still, I am a grown up. I need to do this. I cannot convincingly tell myself that waiting will improve the situation. I just have to pick a day for my appointment when my husband is available to take me and I have had my prescription for Ativan recently refilled. And some Immodium on hand.

Wish me luck.

 

ETA: I now have an appointment with a dentist for some serious work, and with a traveling anesthesiologist for IV sedation. I tried to get the doc to prescribe roofies, but some guys have no sense of humor…

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Mental Health

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Self-Harm Revisited

If that title isn’t enough of a TRIGGER WARNING for you, I don’t know what is.

Not long ago I saw on the web a video with the title “Is scratching self-harm?” Well, of course it is, I thought. The video agreed with me.

It seems like the low end of the spectrum, not as extreme as as what most people think of as self-harm, but a form of it nonetheless. Scratching, pinching, hair pulling, and the like are probably considered subclinical next to cutting and burning. But they are still problems. They can escalate into worse self-harm.

In another article (http://www.upworthy.com/this-researcher-who-studies-self-injury-explains-why-people-do-it-and-why-he-did-it?c=ufb1) I saw this definition for self-harm:

“Self-injury is intentional damage to body tissue (that doesn’t include body modifications like piercings, tattoos, and scarification) without suicidal intent.”

So, yes, scratching is self-harm. It is intentional. It is damage to body tissue. and it does not indicate suicidal intent.

Scratching sounds so minor. We scratch ourselves all the time when we have an itch or an insect bite. We scratch ourselves accidentally on protruding nails. Occasionally we draw blood. We wash it off, slap on a band-aid, and that’s that.

But when scratching escalates to self-harm, it can indeed be serious. For one thing, scratches have a tendency to become infected, infection of the sort can lead to further tissue damage – and if untreated, to more serious complications.

There is also the potential for further harm because the scratching will scab over. Then the desire to scratch off the scabs kicks in. When this happens, the scratches never heal. And yes, that’s both a fact and a metaphor.

My own experience with scratching came when I was working at a job that required me to monitor burglar alarms. The alarms tended to go off – whether there was a burglary or not – during thunderstorms. When a storm hit, a dozen or more alarms could go off simultaneously, or at least in rapid succession. I had to call the owners of the businesses, or emergency services as required.

One night during a particularly bad storm, I missed one of the alarms. I did not call the owners until I looked back at the record. When I called, it was 45 minutes since the alarm. I knew I had made a mistake, and a bad one. The owners of the business would not be happy. My boss would not be happy. I was not happy.

I sat alone by the monitors and imagined the trouble I was in. I started scratching my right arm – long slow strokes from nearly the wrist to nearly the elbow. Repetitively. Obsessively. Painfully. I believe I was punishing myself for making a bad mistake. Perhaps there was some thought that if I inflicted the pain, I would escape further consequences of my mistake.

Of course that makes no sense. It’s an example of the irrational thinking that goes with self-harm.

I don’t cut anymore, as I discussed in a previous post (http://wp.me/s4e9Hv-cutters). I also don’t scratch the way I did that night. I still have a tendency to pick scabs. Occasionally if I have an insect bite, I will scratch it to blood and then pick the scabs on that. I try not to. My husband helps me by reminding me not to pick at scabs or to put band-aids on them. I try to rub instead of scratch, or use lotion.

Jenny Lawson (aka the Bloggess) has admitted in her most recent book, Furiously Happy, that she scratches past the point of bleeding and pulls her hair enough to create bald spots. It’s clear that she considers this self-harm. Her husband tries to help her with it too.

But self-harm is basically a private thing – something we do and hide from the world. Some people are able to hide it even from their most intimate family and loved ones. I know I wore long sleeves to cover the dreadful scratch on my right arm. It healed from a scratch to a pink scar and then to a white scar. Now I can’t even see it anymore through the freckles.

But I don’t need the visible reminder. I remember how it felt to do it, how it felt after I did it, and how I felt as I watch the scars slowly fade. its nothing I’m proud of, except for the fact that I survived it and no longer do it.

As most cutters and other people who self-harm do, I feel shame in recalling the act, and almost never speak of it. The reason I’m sharing the story in such a public forum is to let people know that not all self-harm consists of big dramatic gestures. It can start with a tiny scratch. But it is not something to be ignored. We need to talk about self-harm, educate about it, bring it out in the open, and let others know that it doesn’t have to continue.

And that it can start with something as small as a scratch.

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Mental Health

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Does “Natural” Treatment Work for Depression?

Not for everyone. Not all of the time.

Angel Chang recently posted on LittleThings.com “The 10 best natural ways to treat depression.” (See http://www.aol.com/article/2015/11/06/the-10-best-natural-ways-to-treat-depression/21260290/?ncid=txtlnkusaolp00001357) While she does acknowledge that “clinical depression is triggered from within, and very often need[s] medical attention” and “it’s imperative to consult your physician if you notice an abrupt change in your mood, feelings, or sense of well-being,” her article is about “easy” ways to treat depression yourself.

Unfortunately, her tips are not very helpful for me and many others who suffer from clinical bipolar or unipolar depression. Here’s how I respond to them.

Meditate. This is both nearly impossible when you have racing thoughts and a way to sink even lower if you can’t clear your mind of negative thoughts, which is one of the hallmarks of depression. And if you’re manic, even sitting still in one place for any length of time can be a challenge. After you’re stabilized on medication – go for it.

Eat Foods With Vitamin B. It may be true that vitamin B has been linked to neurotransmitters that we need more of, but preparing them is not realistic when I’m in the Pit of Despair. I try to imagine myself preparing a meal of fish, Swiss cheese, spinach, and eggs, and I just can’t. Or shopping for them, for that matter. I might be able to scramble an egg in the microwave, but that’s about it. (I wrote about food and depression recently: http://wp.me/p4e9Hv-db.) I do take a multivitamin along with my bedtime psychotropics, so I guess I can follow this advice a bit.

Set goals. Chang recommends starting with “small, daily goals.” When in full-blown depression, mine are about as small as you can get. Get out of bed. Make it through the day without crying. Take my meds. Poof! Out of spoons! The expert Chang quotes gives an example of a goal to work up to as washing the dishes every other day. To me, that implies a series of goals: Gather up dishes. Find soap. Fill sink. Wash a dish. Put in drainer. Repeat. My tip: Wash the spoons first!

Sleep on a schedule. Going to bed at the same time every night may be do-able, but getting up at the same time isn’t possible for me, which is one of the reasons I can’t hold a regular job. An alarm clock awakening me before my body is ready leaves me groggy and unfit to work. And there’s no guarantee that I’ll actually sleep during those scheduled hours, even with Ambien. Chang advises not taking naps, but I seldom make it through the day without one, even if I have slept eight (or nine or ten) hours. In fact, I love naps and consider them therapeutic, for me at least. Naps are my friends.

Get out of your rut. Structure is the only thing that keeps some of us going. And if we could find joy in a painting class, a museum, or making a new friend, as Chang suggests, we probably wouldn’t be depressed in the first place. J. K. Rowling described the Dementors in the Harry Potter books: “Get too near a Dementor and every good feeling, every happy memory will be sucked out of you. … You will be left with nothing but the worst experiences of your life.” She has stated that they are metaphors for depression. With every good feeling sucked out of you, you can’t see anything but the rut. I am told that for some people, Cognitive Behavioral Therapy (CBT) lessens the tendency to keep traveling in the rut. But “easy” and “natural”? I don’t know.

Talk. Chang is advocating talking with trusted loved ones, which is good as far as it goes. What it ignores is that friends and loved ones are not universally understanding of depression or supportive in dealing with it. She never suggests talking with a therapist or doctor. I don’t know why that’s less “natural” than talking with someone who has no training. Except you have to pay them (or your insurance does), but painting or language classes or art supplies aren’t free either.

Exercise. This is a classic antidote for depression, and I understand that it works for many people some of the time. But I would put this under the same heading as setting goals. I know it would be good for me, but motivation is hard to come by and immobilization thwarts me. But I wish I could take this advice. I looked into water aerobics, but there’s not a feasible program in my area.

Responsibilities. “Because you might feel down,” the article states, “you may also want to withdraw from your daily activities in life and your responsibilities at home or at work.” Yepper. “Try staying involved as much as possible in the causes you care deeply about, and take on new daily responsibilities. These can be as simple as volunteering at your local food pantry, or going back to work part-time.” Big nope. See getting out of your rut, above. For the clinically depressed, working even part-time is unimaginable, with responsibilities of the crushing sort.

Unwind and relax. If your depression comes with anxiety like mine, this idea is a non-starter. Unless you count drinking as relaxation, though it isn’t the best idea if you’re on meds.

Stay off caffeine. Okay, I can pretty much do this one, except for one cup of coffee or a caffeinated soda to get me started in the morning.

“Did you learn something new about how to naturally treat symptoms of depression?” the article ends. Not really. Well, except for the B vitamins. We’ve all heard these kinds of advice before. They’re good tips for situational or reactive depression, but largely not feasible for the chronically, clinically, biochemically depressed. In a way they add up to the much-hated “Just stop it. You must want to be depressed or else you’d be doing all these great things.”

But try them if you can, perhaps in addition to medical treatments. Maybe some of the ones that won’t work for me will for you. In the meantime, get help. See your therapist and/or psychiatrist. Keep taking those meds. Those may not be “easy, natural” ways to treat depression, but if they work, isn’t that the larger point?

P.S. Do NOT Google “CBT.” Spell out “Cognitive Behavioral Therapy.” Trust me on this one.

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