Bipolar 2 From Inside and Out

Posts tagged ‘mental health’

The Overwhelming Problem

screaming (Uma painting)It’s been said that time is nature’s way of keeping one damn thing after another from being every damn thing all at once. I know that taking things one at a time—eating the elephant one bite at a time—is a sound idea.

However, every now and then the damn things gang up on you. The elephant is starting to go bad and you have to eat all you can right away – to use a disgusting metaphor that I will not take any further. (You’re welcome.)

Last month was one of those months. They happen every so often. But if they happen very often, I tend to get overwhelmed. And when I get overwhelmed for too long, my brain breaks. I have a meltdown, or I decompensate, or whatever the proper psychiatric term is. In practical terms, it means that I’m severely depressed and non-functional, for longer than usual. Days. Weeks. Months. Even years.

The things that overwhelm me are quite predictable – financial difficulties, health problems, relationship glitches, and free-floating anxiety of all sorts, either my own or my loved one’s. I know that these are situations that cause difficulty for everyone, but to a person with bipolar disorder, they can seem—or even be—insurmountable. Especially when they cluster and refuse to go away.

Over the years I have become good (or at least better) at recognizing when I am about to be overwhelmed. I know the symptoms—the whirling thoughts, the jumping-out-of-my-skin feeling, the insomnia, the inability to concentrate, and the feeling that doom or disaster is impending.

There is little I can do to stave off these feelings. But I know I have to. I have to keep functioning at some level, higher or lower, to maintain the things that I want to have – productive work, a loving relationship, a nice house, caring friends, and so forth. At the time of my last major breakdown, I came uncomfortably close to losing much of that.

I try my usual remedies for anxiety, of course. I distract myself. I color. I watch mindless TV. I play stupid clicky games on the computer. I turn off my phone. But if the anxiety builds up too much, if the feared disaster is real and really is impending, none of these works. The anxiety shreds my last nerve, and the depression starts to settle in. I isolate. I stay in bed. One task at a time, I stop being able to function.

I have taken one step that has helped, however. An anti-anxiety pill is one of my daily medications—one in the morning and one at night. A few years ago, as the stress was building and approaching overwhelming, I asked my psychiatrist if I could have permission to take one more a day if I needed it.

He agreed.

I have not needed to take the extra pill every day. Sometimes I take one in the mid-afternoon if I start feeling jumpy, twitchy, or panicky. Sometimes I take one at night if I haven’t gotten to sleep within 2 – 3 hours after taking my regular nighttime pills. I know it sounds strange that a depressant helps me stave off depression, but my diagnosis is actually bipolar disorder and anxiety disorder. The med catches me at the point where the one starts to turn into the other.

I’m glad my psychiatrist trusted me not to abuse what I consider a privilege as well as a necessity. By the time I made this request, of course, we had been working together for a number of years and had built up a certain trust. I think there have been only a couple of times when I have had to take two extra pills in a day—one in the afternoon and an additional one at night. And both times, I felt guilty about it and made sure I didn’t make it a habit.

I don’t want to start gobbling pills at the least sign of difficulty. All I want is to be able to eat my elephant in peace and in pieces.

Category:

Mental Health

Tagged with:

Side Effects: TD and Stevens-Johnson

We all hate side effects. They go from bad to worse to horrible. (A popular meme says that people wish they had side effects like multiple orgasms. Alas, no one’s invented a drug with that side effect yet.)

In my journey through the process of settling on reasonably effective medications, I’ve experienced a number of side effects, including violent nightmares, paranoia, and feeling numb all over. I switched to other meds, but really, those weren’t so bad.

Two of the worst side effects are Tardive Dyskinesia (TD) and Stevens-Johnson Syndrome.

TD, according to Penn Medicine, is “stereotypical involuntary movements of the tongue, neck, and facial muscles, truncal musculature, and limbs.” These movements “can range from slight tremor to uncontrollable movement of the entire body,” explains NIH. Basically, these movements often consist of facial movements like grimacing, sucking, sticking out the tongue, rapid blinking, and chewing motions. The bodily movements can include ones of the arms, legs, and pelvis, from tapping your feet or fingers to rocking the pelvis, swaying, and uncontrolled movements while walking.” (One description of it was “waddling.”)

The medications that can bring on TD include antipsychotics such as Haldol, Risperdal, Abilify, and Seroquel; antidepressants including (but not limited to) Sinequan, Elavil, and Prozac; antiseizure medications such as Lamictal and Dilantin; and, of course, lithium, particularly if taken along with other medications. (I’m currently taking meds in three of these categories and have in the past taken others, though never lithium. I’ve never experienced TD.)

You may have seen commercials on TV with information on treatments for TD. Although they’re designed to prevent a particularly troubling side-effect, they have side effects of their own. A list of these includes depression, suicidal thoughts, mood symptoms, heart abnormalities, allergic reactions, dizziness, weight gain, loss of balance or falls, stomach pains, frequent urination, and constipation. Oh, and there’s one more—uncontrollable body movements that may become permanent. That’s right. The anti-TD meds can cause exactly the symptom they’re supposed to alleviate. Sounds like a good deal to me. Admittedly, the incidence of these side effects is likely less than the incidence of TD from lithium, but would you be willing to roll the dice? Maybe you would, if there’s a chance it could protect you from TD. It’s up to the individual. Me? I’m not sure.

Another undesirable side effect is Stevens-Johnson Syndrome. It’s a condition that at first causes a skin rash that isn’t really itchy and often first appears around the nose and mouth or other mucous membranes. Unless you get immediate treatment, the rash can spread and turn into blisters and painful sores. It can develop into toxic epidermal necrolysis (TEN), a condition in which skin all over the body peels off. It’s potentially fatal. In 80% of cases, a psychotropic medication is the cause. (My psychiatrist prescribed me an antipsychotic particularly associated with the disorder and told me, “Don’t look it up on the internet. It’s gross.” Of course, I did look it up, and he was right. It is gross.)

I’ve had my bouts with side effects over the years. In every case, my doctor listened to me, weaned me off the drug that was causing the problem and titrated me up on a different one until we finally found a regimen that works. I’m fortunate that none of the side effects have been TD, Stevens-Johnson, or TEN. And I’m profoundly thankful.

The only advice I can give is to be mindful of the potential side effects of the drugs you take. On TV commercials, they run through them so rapidly and print them in such small type that they’re difficult to notice. But they matter. It’s your physical health as well as your mental health that’s at stake. If that means you need to do research on the internet, do it. I know there’s a danger that you’ll expect the side effects you read about but, in my opinion, it’s a trade-off worth making, especially with all the new drugs on the market and the potential severity of the side effects you’re facing.

Category:

Mental Health

Tagged with:

Self-Care and Social Care

We hear a lot about self-care these days. Much of the mainstream media seems to think that it means “shopping therapy,” indulgent desserts, spa days, and mani-pedis. Expensive things. Ones that you need to be able to leave the house to do. (Except for online shopping, of course.)

Businesses are also quick to suggest self-care for their workers who are experiencing stress. What they mean by self-care is to take up yoga or meditation—on your own time and your dime.

Real self-care may include yoga and meditation and even the judicious use of ice cream, but it’s much more than that, of course. Self-care begins with the things that we all know are good for both body and mind—exercise, healthful food, good sleep, and stress reduction. Other good habits often mentioned are a digital detox, mindfulness, journaling, gratitude, affirmations, prayer, fresh air and sunshine, and hobbies.

Those are good things, of course, but they are primarily solo things, or at least were while the pandemic had us cooped up. Now we can get out and about more easily, go jogging or hiking with a friend, invite people over for dinner, and generally add human companionship to our list of self-care techniques.

But maybe what we need is social care (also known as community care). It’s hard to define social care. One source I looked for mentioned advocacy. But that’s pretty much something we have to do for ourselves. There are organizations like NAMI, and they do a great job at advocacy, but there’s only so much they can do. There aren’t brain illness support groups the way there are for alcoholism, narcotics addiction, and other kinds of afflictions that require outside support. There aren’t Meals on Wheels-type services for people who can’t leave their homes because of crippling anxiety. (Of course, grocery stores deliver now, but it gets expensive.)

There are very few group homes for people with SMI who need to transition between the hospital and living alone. There are group homes (sober houses) for those with alcohol or other addictions and even prisoners on parole. Many people with psychological or psychiatric needs rely on family members as long as they are able. I know a woman who lives with her father because of her assorted diagnoses. We’re all worried about what will happen to her when her father, who’s not in good health, dies. Her mother, when she was alive, tried to get her into a group home, with no success.

For those who are able to leave the house on occasion, social networks are recommended as a form of self-care. And even for people who can’t go out, there are social media, email, and video chats, which can fill some of the gaps.

But social services are thin on the ground, at least near me. I live in a suburb near two medium-sized cities. Most of the services available are for the mentally disabled, physically disabled, seniors, and some respite care for caregivers. People with SMI get a list of the crisis numbers. And, of course, psychiatric beds are limited and even psychiatrists have months-long waiting lists.

I know funds are limited and that the other groups need care, too. But social care is needed for those with SMI, too. We’re dependent on tax dollars, which are hard to come by.

It’s worth noting that the National Health Service in the UK has many more programs accessible to those with SMI at little or no cost. Of course, those are functions of socialized medicine, which is not likely to be enacted in the US anytime soon.

Category:

Mental Health

Tagged with:

Everything in Moderation

Support systems are important for good mental health. There’s just something about sharing difficulties and successes with people who truly understand because they’re in the same place, facing the same issues. You get to say how you’re doing and what has helped you. You get to listen to what has helped others and incorporate their insights into your own journey. You get a chance to bitch and moan if that’s what you need to do. And after you’ve vented to people who share your pain, you feel better.

During the pandemic, we learned the value of connecting without physical presence. In many ways, it was ideal. We didn’t have to get dressed and venture out into the people-y world. We didn’t have to risk getting or spreading illness. Most of our therapy sessions went virtual. Mine did—and stayed that way even after pandemic restrictions were lifted.

Social media has also provided many virtual gathering spaces for people with brain illnesses. For example, there are many Facebook groups that create communities of mental health advocates and sufferers alike. These groups vary in what they offer. Some are chat groups. Others specialize in various diagnoses. Still others provide access to resources so people who need them can find them in one place.

I moderate one of these Facebook groups. It’s called Hope for Troubled Minds, and it addresses people with brain illnesses and their families and caregivers, with an underlying focus on faith. (You can find it at https://www.facebook.com/groups/654965125046006.)

I don’t have an awful lot to moderate, so I curate, instead. Every day, except when I’m out of town, I hunt for articles of interest to our group members. I get them from The Mighty, The New York Times, The Washington Post, CNN Science, blogs, and other Facebook groups. (I subscribed to NYT and WaPo mainly to be able to share articles they print without having members run into a paywall.)

My goal is to post four to six articles or connections a day, and most days I make my quota. The stories I find include first-person articles written by those with psychiatric conditions and their relatives, scientific articles such as those on brain science, and news stories about political and legal aspects of the topic. I also cross-post my own blog posts to the group. I try to keep a balance of different diagnoses so that it doesn’t run too much to bipolar, which is my own disorder and primary interest.

I comment on most of the posts I make to point out interesting quotes or opinions on the issues presented. The group members also make comments and start discussions, though not as many as I would like. Sometimes I post questions that I hope will prompt those discussions.

Recently, I’ve posted links to articles on hospitalization, “high functioning” anxiety, depression and creativity, the difficulty of reaching out, working, eating disorders, ruminating, OCD, DBT, schizophrenia, medication, self-care, co-occurring conditions, suicide, and more.

My goals for the group (and my moderating of it) are to improve member engagement, to seek out some guest bloggers, and to continue to share a diversity of articles.

I’d like to invite you to go with me on that journey. Join our group or tell me what would make it better. Put me in touch with other groups so we can cross-post information. Point me toward blogs I need to be reading and posts I need to be sharing. Volunteer to write for the group and its members.

Help me make Hope for Troubled Minds the best resource it can be.

Category:

Mental Health

Tagged with:

Running Out of Meds

Isolated Empty Pill BottlesRunning out of your medications is scary.

I know. It’s happened to me several times.

Sometimes it was a matter of supply. My usual pharmacy ran out of a sleep aid and wasn’t going to get any more until after the weekend. Fortunately, they recommended a mom-and-pop pharmacy (yes, such things do still exist) just down the street and helped me transfer my prescription there.

Another time the problem was the prescription. I ran out of an anti-anxiety med, but when I called in for a refill, I was told that it wasn’t time for one. When I looked at the bottle more closely, I discovered that they had given me 60 pills, as if I were taking two a day, instead of the three a day actually prescribed. (I was changing doctors about that time and there was miscommunication.)

Yet another time, it was money. I ran out of an antipsychotic and was told that even with insurance, it would cost me $800 for a month’s supply because of the out-of-pocket required minimum. I spent a couple of days arguing with the insurance company, researching solutions online, and making sure a local pharmacy would take the coupon I found, which lowered the price to under $200. That was still a hefty chunk of our budget, but we managed to scrape it together until the drug went generic a couple of months later. (I also had to stand in line while the pharmacy called the coupon people and the insurance company to see how to enter it all in their system.)

And of course there are the everyday screw-ups. My husband forgot to pick up my scrips (one time he remembered to pick them up but left the bag in the car and drove 500 miles away), or he forgot which pharmacy they were at, or he didn’t hear me say that I was completely out, or the pharmacy didn’t open until 10:00, or they had my pills in two different bags and only gave us one. There are lots of ways it can happen.

Once I even took my entire supply on a weekend getaway and left them in a drawer at the bed-and-breakfast. I know. Stupid.

Most of the time running out of drugs isn’t a crisis. It just feels like one.

Of course, there are exceptions. It is a crisis if you run out of certain anti-anxiety drugs and you don’t get any for several days. You can have withdrawal – actual, physical as well as psychological withdrawal. I’ve heard that benzo withdrawal can be as bad as opiates. That’s one reason it’s important to replace your meds as soon as possible.

A lot of psychotropic medications build up to a therapeutic level in your bloodstream, so a day or two without them probably won’t even be noticeable. When you start taking them again, your levels will even out.

But even if the med you run out of is one that you can easily tolerate a day or two without, you may have some psychological effects. When I run out of a prescription, even for a short time, I become twitchy and agitated – my hypomania kicks in and comes out as anxiety, the way it usually does for me. I fear crashing back into that deadly unmedicated space where all is misery and despair. Intellectually, I know that likely won’t happen. But it sure feels like it will. This is one way my none-too-stable mind plays tricks on me.

It’s like the opposite of the placebo effect – believing that a sugar pill will help you and experiencing gains until you learn that the pill is fake. In my version, I believe that not taking the pill will cause relapse, even though it actually won’t.

Whatever else you feel or do, DO NOT use missing a couple of pills as an opportunity to go off your meds entirely. This is another lie your brain can tell you: “You’re doing fine without it. Why keep taking it?” It may not in the short term, but you will feel the effects of not taking your meds, and then there you are, back in the Pit of Despair or rocketing to the skies. It won’t be pretty.

For me and a lot of others like me, the key to effective medication is consistency. Once you find the right “cocktail,” stick with it. But if you run out, don’t panic. Keep Calm & Get a Refill.

Category:

Mental Health

Tagged with:

Grippy Socks and Sour Candy

My husband is a great help when I write my blogs. He keeps an eye out for news stories that deal with mental health in some fashion. So when he saw an article on new words related to the topic, he made sure I saw it. Then he asked me how I felt about it.

The story was about new language that young people were using to describe various mental health concepts.

First and foremost among them was “grippy socks vacay”—a reference to the footwear issued to people who have been committed, voluntarily or otherwise, to psych wards. But “vacay” is short for “vacation.” I can just picture a conversation using it: “Where’s Janet been?” “Oh, she’s been on a grippy socks vacay.” Or “I’m stressed. It’s time I went on a grippy socks vacay.” It seems unlikely that the people who say these things are always referring to an actual stay in a psych ward.

I was more than slightly appalled. It’s true that grippy socks evoke the image of a hospital stay. But grippy socks are a part of any stay in any department of a hospital, not just psych wards. And such a stay is hardly a vacation. It’s likely, I think, that people use this to mean something like “relaxing getaway” or “time to clear my head.” An actual stay in a psych ward, however, is not a relaxing getaway. It’s intense. It’s not supposed to be relaxing. And while it does provide time to clear one’s head, that’s still far from accurate. Medication, group therapy, and individual therapy may eventually clear one’s head or at least change one’s perspective, but it’s hardly just a time away from work and day-to-day stresses.

The article went on to discuss whether the phrase increased or decreased stigma. Some said one, some the other. I think it perpetuates stigma. It implies that someone who is in a psych ward is there to have a good time. “Grippy socks vacay” is demeaning when the hard work that mental patients must accomplish is considered.

If it’s used as a euphemism for an actual psych ward stay, it’s insensitive at the least. If it just means time off from daily cares, it’s still inaccurate and discounts the real experience. Those things can’t be good for reducing stigma.

Now, my friends and I have been known to use irreverent language to refer to our conditions. Robbin and I used to say on occasion that we needed a “check-up from the neck up.” We used it just between the two of us (well, I’ve also used it with my husband) to indicate that we needed to see our therapists. But I don’t see it as being demeaning, especially since we never used it in the context of anything but our own disorders, not a general description of someone the general populace would slangily describe as “crazy.” If we had said of any popular figure that they needed a check-up from the neck up, that would have been something else. But we didn’t.

Of course, you may disagree with this and I’d love to hear from you regarding your opinion.

The other article my husband shared with me was one that indicated that it was a trend on TikTok to use sour candy to ward off anxiety. The article even said that experts backed up the theory.

The idea is that the intense sensation of sourness distracts the brain from the cause of the anxiety. It’s a distraction technique, like snapping a rubber band on your wrist to take your mind away from unwanted thoughts. One expert interviewed for the article said, “Panic ensues when our amygdala triggers the flight or fight response. One way to dampen our amygdala’s response and mitigate panic is by turning our attention to the present moment through our senses: taste, smell, touch, sight, and hearing.” Mindfulness through candy, I guess, would be a way to describe it. The experts also advise grounding yourself with other sensations such as the scent of essential oils.

Other experts noted that sour candy is a kind of crutch and not a long-term solution. One called it “maladaptive.” Sensory distractions, they said, were most effective in conjunction with acceptance rather than avoidance.

What’s the takeaway from this? Aside from the potential boost in sales for Jolly Ranchers, I mean. I think it’s a good reminder that there are ways to short-circuit anxiety and panic. And for people who only experience occasional, momentary anxiety, it’s probably a good thing. But for someone with an actual anxiety or panic disorder, it’s likely to be only one tool they use — and a minor one, at that.

What have you been reading recently about mental health trends? I’d love for you to share that, too.

Category:

Mental Health

Tagged with:

Positivity and Acceptance

Those who follow this blog have seen me rail against toxic positivity. When it’s not absurd, it’s insulting to those of us with mood disorders. No, we can’t just cheer up. If we could look at the bright side, we wouldn’t have depression or anxiety. You may be able to choose happiness, but I can’t. I’ve needed medication and therapy just to feel meh at times. If I could turn bipolar disorder off like a light switch, don’t you think I’d do it?

Toxic positivity can be seen nearly everywhere, in a lot of different situations: the self-help movement, of course, but also business, medicine, and even religion – as well as endless memes. American society is rife with toxic positivity. It appears in motivational business conventions and TED Talks. Salespeople are advised to think positively and envision success. Breast cancer survivors are advised to keep a positive attitude, to the extent that they are encouraged to tell how the disease has had a positive effect on their lives and relationships. (Expressions of fear, anger, and other natural emotions in response to the diagnosis are downplayed or discouraged.) Religions can exhort us to count our blessings or “manifest” our wants and needs by using positive thoughts to attract them.

Positivity becomes toxic when it is seen as the only method of coping with problems in life, even ones that have other solutions or none. Toxic positivity presents relentless cheer as the only acceptable reaction and a panacea for every difficulty. And toxic positivity leads people to demand that others take up the mindset and apply it to every situation, even devastating ones. As such, it denies the reality of human suffering and normal emotional responses. It’s a form of non-acceptance.

So, what is the alternative? What is a more natural – but still effective – technique for dealing with difficulties? How can those of us who have mood disorders or any other brain illness find ways to navigate through life without slapping on a smile and coercing our emotions to fit a certain mold?

Radical acceptance is one answer. Radical acceptance means that you accept your inner feelings and your outward circumstances as they are, especially if they are not under your control. You acknowledge reality without trying to impose a set of emotional mandates on it. Your acceptance and acknowledgment may involve pain or discomfort, but those are understandable, normal human conditions. They are natural conditions that evoke a natural response.

Rooted in Buddhist teachings and given a name by Marsha Linehan, the psychologist who developed dialectical behavior therapy (DBT), radical acceptance uses mindfulness to help people learn to face and regulate their emotions. Interestingly, one 2018 study found that accepting your negative emotions without judgment is a factor in psychological health.

With radical acceptance, when you encounter difficult situations and emotions, you note their presence without trying to suppress them. You accept them, as the name implies. This attitude can address – and reduce – feelings of shame and distress that you may feel, especially when you are not able to simply shut off those feelings and replace them with positivity. That doesn’t mean that you wallow in unpleasant feelings or allow unfortunate circumstances to stunt your responses.

Instead, you note the feelings – accept that they exist – and “hold space” for them within you. You appreciate that your emotions can lead you to new understandings of and reactions to your circumstances. For example, instead of adhering to the unattainable maxim that “Failure is not an option,” you can recognize when you have indeed failed and accept it as a natural part of life. You can then move on to a mindset of growth where you use that failure to inform your future actions. You develop a more accurate picture of the world and can begin implementing real solutions.

Of course, there are situations where radical acceptance is not appropriate. Abusive situations, for one, shouldn’t simply be accepted without being addressed. But neither will positive thinking resolve them. They require action, from seeking help from a trusted individual to leaving the situation to contacting law enforcement or an organization that can help.

But in other circumstances, radical acceptance may be an answer for some. For myself, I’ll just be satisfied if radical acceptance helps drive out toxic positivity. I don’t think it will, but a person can dream.

Category:

Mental Health

Tagged with:

Beating Bad Thoughts

I saw a meme today. It said:

“Just do what you can today, okay? It will be enough.”

Instantly my brain said, “No, it won’t.”

My brain, uncooperative at all but the very best times, has a habit of telling me bad things when I’m in a depressive episode: “You’re useless.” “You’re pathetic.” “Everything you do fails.”

For some reason, positive thinking memes and slogans bring out the worst in my brain. If a pass-along or a bumper sticker tells me that tomorrow will be brighter, my brain says, “No, it won’t.” If a meme says, ” I hope the situation you worry about favors you in the end,” it says, “Yeah, like that’s gonna happen.”

Is my brain simply cranky and uncooperative? Well, yes. But these intrusive thoughts reinforce and deepen my depression, chip away at what self-esteem I still have, deny my progress in healing, and make me resent the whole happy, smiley world that apparently everyone but me can see.

Is there anything I can do to make my brain shut up, or at least pipe down with all the negativity?

I’ll tell you what doesn’t work for me: daily affirmations. My brain tells me these are lies and that I shouldn’t believe them. I can’t look into a mirror and repeat five times, “I am a good, worthwhile person” or “I deserve happiness” or “I will overcome my problems.” It’s like the problem of seeing cheery, encouraging memes on the internet, only having to inflict them on myself. If anything, they make me feel worse.

If these sorts of things work for you, fine. I’ve no objection. I won’t make fun of you. I’m truly glad you’ve found something that helps you.

They just don’t work for me.

So what can I do?

I have gleaned two helpful hints from my therapist. Both are visualizations, and both are metaphors. And both involve animals. (They are variations on a technique called “thought stopping,” which is simpler and more direct. But I find visualizations easier to remember and do. I love metaphors.)

The first comes from a mindfulness meditation that Dr. B. asked me to try. I’m not much good at meditation, because of both my intrusive thoughts and my anxiety. Sitting still for that long is difficult, and so is emptying my mind of thoughts to concentrate on my breathing, for example.

The narration that guided the meditation had a solution for this. When your mind wanders and your thoughts drift off to somewhere else, think of them as puppies that wander away when you’re trying to teach them something. Gently corral them and nudge them back in the right direction. You don’t have to panic and shout, “There they go!” and run off after them. You just give them a little push toward where you want them to go. If they wander again, do the same thing. “What about the mortgage payment? Come back, little puppy. Over here.”

The other technique is for the kind of bad thoughts that I often get: anti-affirmations or negatives that deny any suggestion of peace or happiness or accomplishment. For these, Dr. B passed along an idea that another client had given her. Imagine that your bad thoughts are naughty cats, who jump on the kitchen table or try to go fishing in your aquarium. Then imagine spraying the bad thought (cat) with a bottle of water to make it stop what it’s doing and scram. “I never do anything right. Psssst! Psssst!”

When I’m profoundly depressed, I doubt even these clever dodges will work, though I’m certainly going to try them. But when I’m just starting on the slide down, I predict they’ll be just the thing to trick my brain into submission.

Take that, brain! Psssst! Psssst!

Category:

Mental Health

Tagged with:

The Therapeutic Hug

The common wisdom is that a person needs four hugs a day for survival, eight for maintenance, and twelve for growth. I doubt that this is confirmed by any scientific studies and I doubt that it is true. If it were, there would be millions of people on Earth who would not survive. I would be one of them. Despite being married to one of the two truly world-class huggers I’ve met in my life, I do not get my four-a-day. And certainly not twelve. Assuming eight hours a day for sleep and eight hours a day for work, that would leave eight hours to work in twelve hugs. That’s one and a half hugs per hour, and I suspect half a hug just won’t do. In fact, I know it won’t. Scientific research has been done on the 20-second hug. It releases oxytocin, a pleasure and bonding chemical in the brain. Half a hug would need to be 40 seconds long to do the proper amount of good, and young lovers and newlyweds tend to be the only people who give hugs of that duration. Then there’s the question of what constitutes a hug. For greatest oxytocin effect, I would recommend the full body hug – toe to toe, torso to torso, heads on shoulders, arms tightly squeezing. But you probably can’t give that particular hug when you run into an acquaintance in the supermarket, especially not 20 seconds worth, without blocking the aisles. Other variations of hugs that may be less effective are the side-by-side one-shoulder squeeze (and the multi-person variant, the Big Group Hug), the manly back-thumping, and the A-frame hug (standing a distance apart and leaning in for a hug from the shoulders up). Then there are the virtual hug, often written ((hug)), with the number of parens indicating the length/intensity of the hug, and the proxy hug, in which you delegate a person to pass along a hug when you’re not able to be there. None of these seem really conducive to the 20-second, made-for-thriving hug. But, on some level, we know that hugs are therapeutic. Oxytocin or whatever, they make us feel better. Lots of hugging goes on at support and 12-step groups, and people who go to those daily might indeed make their recommended quota. I go to private psychotherapy, however. I’ve never hugged my therapist, and am not even sure whether it’s appropriate for therapist and client to hug. It would be awkward to ask, “Can I have a hug?” only to hear, “No. That’s unethical.” But I suppose it depends on the therapist and the client and how each feels about the subject. I know sex between therapists and clients is unethical, but hugs may be a gray area. Perhaps someone can enlighten me. Of course, there are people who do not like to – or are afraid to – touch other people. People who are aware of and skilled in responding to others’ body language may be able to see the little (or, let’s face it, large) cringe when one person sees another moving forward with open arms. If the non-hugger is quick enough, he or she can quickly stick out a hand for a hearty handshake, or the potential hugger will abort the hug and retreat to a friendly tap on the shoulder. But there are people who will swoop in and envelop you in an unwanted embrace and maybe even air kisses with smacking noises. I suspect these would be more likely to shut down oxytocin entirely, and possibly release adrenaline instead in a fight-or-flight response. As with sex, the safest route is to ask for consent – “Can I have a hug?” – and take no – “I’d rather not” – for an answer, without taking offense or pressuring – “Aw, c’mon” – and making things even more awkward. Still, the best advice I can give is to be proactive about hugging. Say, “I need a hug” when you do. Ask “Do you need/want a hug?” when a person you know seems to be in distress. Avoid hugging strangers, though. That hardly ever helps. At least wait until you’ve been properly introduced.

Category:

Mental Health

Tagged with:

I Want to Go Home to Bed With My Kitties

Kittens. Jumping. I want to go home to bed with my kitties. These are my mantras. Or something. I repeat these phrases, under my breath if anyone is around who doesn’t know I do this. At least I think it’s under my breath. I have at times walked out of a restroom stall to see people looking at me strangely. My husband says they are “grounding statements,” though I understand proper grounding statements are usually more like affirmations – “I am safe.” “I can handle this.” “I am a good person.” How I ended up with mine I don’t quite know. I do know that I mutter or say them when I am anxious. “Kittens” indicates a general level of anxiety, while “jumping” is reserved for increased levels. “I want to go home to bed with my kitties” is an all-encompassing statement of stress or dissatisfaction and the only one that I can say nearly out loud around people with only mild looks of incomprehension. A very few people who know me well are used to this phenomenon and even have responses. When I say, “kittens,” my friend Leslie says, “puppies,” and my husband says, “Do you like them?” When I say, “jumping,” he says, “up and down?” and my friend Robbin said, “You must really be nervous.” My husband occasionally joins me in a chorus of “I want to go home to bed with my kitties.” (The extended version is “I want to go home. I want to go to bed. I want my kitties.” The short form is “Home. Bed. Kitties.”) I know that I use these vocalizations a lot when I have anticipatory anxiety or after a protracted spell of having to be competent, social, and appropriate. I say them a lot in my car or after coming home from braving the outside world. In a crowded, noisy space like a restaurant, I say them in a very matter-of-fact manner, as if I’m having a conversation with my husband. I assume the background noise covers them up. The National Mental Health Association says, “People with obsessive-compulsive disorder try to cope with anxiety by repeating words or phrases.” Fair enough. I do have a few OCD-like traits, though no diagnosis. (That’s all I need – another diagnosis!) But to me, the grounding statements explanation makes the most sense. I would argue that for me, home, bed, and kitties are all things that remind me of safety and bring me comfort. How jumping fits in, I’m not sure, except that I have hyperactive nerves and do a fair amount of it. But it certainly isn’t associated with safety or comfort. Quite the opposite, in fact. The New York Times called it “kitten therapy” in a personal story of how a kitten helped lessen a man’s depression. I can testify to that effect. Cats or kittens have stayed up with me through bouts of insomnia, snuggled when I needed touch, purred gently when I needed quiet, demanded attention when I needed distraction, and yes, even jumped on me when I needed amusement. Home is a touchstone for me. My parents’ house was home to me, but after I moved out, nothing ever seemed like home again. Not the dorm, of course. Not the sorority house. Not the basement apartment. Not the house I shared. Not the apartment. Not the second floor. Not the half-double. Not even the rent-to-own house. (That one came close.) But the house that I found, looking like it grew up out of the ground, has felt like home, has been home. Even when it was destroyed by a tornado and had to be rebuilt, it was home. While we moved among motel, hotel, rented home, and crummy apartment, home was just waiting around the temporal corner for us to come back to. Bed is wonderful. I can stay in it all day – and have, when depression hits hard. It’s sturdy Amish furniture that made it through the tornado. In fact, I was lying on it when the tornado took the roof off and all I could do was put a pillow over my head and hope for the best. I love its solidity. I love the cozy quilts that I can wrap myself up in like a burrito. And yes, I love it especially when the kitties come and join me. Is it any wonder that “home, bed, kitties” is my mantra?

Category:

Mental Health

Tagged with: