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Tag Archives: Depression

Hanging in the Balance

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You know what it’s like having a mental illness? It’s like being Homer Simpson in that episode where he ate that Fugu puffer fish prepared by a rookie chef. That’s the fish that, if not prepared correctly, can kill you. He had to wait 24 hours to find out. Great episode, if you haven’t seen it.

Or it’s like hydroplaning on the highway, trying to figure out which way you need to turn the wheel so you don’t crash. That actually happened to me. I don’t think I turned the wheel the right way. I ended up going backwards in the median, wondering what was going to happen to me when the car finally stopped. Thankfully, miraculously, nothing happened. Except to my car. Which I got rid of.

I found out in the book “The Art of Racing in the Rain”–which is a fantastic book, if you’re looking for something to read–that when you’re hydroplaning, you actually need to accelerate to engage the wheels. It’s a fictional account, but that makes sense to me. So now I drive really slowly in the rain so that I can speed up if I start to skid.

But I digress. The reason why having a mental illness is like the Fugu puffer fish and racing in the rain is that there are so many things you have to do to maintain your balance, and it takes so little to throw it off.

Take sleep, for example. I am a night owl, but I’m not supposed to stay up late, because reversing my sleep cycle triggers a depressive episode. But when I try to go to bed earlier, I can’t fall asleep because my obsessive brain is wide awake, chatting up a storm. I am also supposed to wake up early, but I’m usually too freaking tired. And because I need more sleep than the average person, I still have to take a 3 hour nap.

I have similar difficulties regarding eating that is equally complicated because of my inability to wake up early, restrictions in what and when to eat because of my GERD, my tennis schedule, my inability to tell whether or not I’m hungry, and that I hate planning meals, grocery shopping, and cooking.

I also have to manage my anxiety by avoiding almost everything, lately–Facebook, the news, conversations about Trump, certain family members, relationships, looking at my schedule for the week so that I don’t get overwhelmed (which has gotten me into trouble with my colleagues).

Despite all of this effort I put into maintaining my mental health, I frequently wake up feeling anxious or depressed or both. Because it’s impossible to keep all of this stuff in balance. Which really frustrates me. Sometimes I’m mad at God. Sometimes I wonder if it’s all worth it, all this work to be mentally stable given that I am inherently unstable. Sometimes I feel alone in it, because despite having my brother and friends to talk to, in those moments when you’re lying in bed trying to find a reason to face the day, there’s no one who can really be there for you.

Thankfully, those moments usually pass, often some time later that day. Or at least they fluctuate throughout the day. Or I’ll go play tennis.

On a moment to moment basis, practicing mindfulness and self-compassion are the most helpful tools to make the pain bearable, but it still hurts like hell. I remind myself that it’s OK to be in pain. That this moment will pass. That although my thinking may be irrational but convincing right now, at some point I will be able to see things more clearly. That it’s not my fault. I’m doing the best that I can. And then I try to think of things I can do to make myself feel better. Like watching “Trolls.” Really cute movie, if you haven’t seen it.

The other thing that has helped is reading Richard Rohr’s books. The one I’m reading currently, Eager to Love: The Alternative Way of Francis of Assisi, is a much tougher read, but he says some thought-provoking things. Like, he says that the best healers are people who have suffered greatly themselves. I know for sure that my own experiences have made me better able to sit with and relate to other people’s pain, and I know how much better it feels to talk to someone who really gets it because they, too, have suffered greatly.

We all have roles that we have to take on that will involve pain and suffering–being a parent, a firefighter, a soldier, Wonder Woman (I loved that movie, too), just to name a few. Any role entails pain and suffering, really. I guess the difference is whether you’re going to rail against it or accept it–choose it, even–because there’s something that you care about that makes it worthwhile. And because not choosing it just magnifies your suffering.

I know for sure that I was meant to be a healer. Sometimes I wish I could say no thank you, God, but I appreciate your confidence in me. But I can’t, because I really don’t know what else I would do. So if trying to find that balance moment to moment, day after day, helps me to be a better therapist, then so be it. I will choose it.

Appearances Can Be Deceiving

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You know what’s hard about having depression and anxiety? Having to go about your day, looking like you feel fine when you’re not. I know everyone feels this way at times, but it’s something that I have to focus on a lot. Like, perhaps people have to prepare for the possibility of a thunderstorm every now and then, but it is a daily threat for me. So I always have to carry an umbrella and think about what shoes I want to wear. Whether my outfit is appropriate. Whether or not I’m at risk of getting struck by lightning.

But then again, perhaps I underestimate how bad the weather is for everyone. Because when I listen to my clients and read my friends’ Facebook status updates, I am reminded that there are all kinds of people walking around in pain, looking normal on the outside. We all feel broken in one way or another. It’s so convincing, though, when people look like they have it all, isn’t it? So easy to believe that you are alone in your pain.

When people tell me they read my blog, they always say something about how vulnerable I am in it. They mean it as a compliment, but even though I’ve been doing it for over 3 years now, it always makes me feel self-conscious. Have I said too much? Did they read something that makes me look bad? Do they think less of me as a person? As a psychologist?

Still, it has been worth the risk, both because of how much I have helped other people and because of how freeing it has been. Of all of the things that I have done to battle my demons, blogging has been one of my most powerful weapons. And if there are clients who choose not to see me after reading my blog, I am learning to accept that I can’t be all things to all people.

I realized recently that choosing vulnerability is like choosing love: it’s risky, and you’re bound to get hurt, but it’s better than spending a lifetime trying to play it safe. It’s still hard to put myself out there and risk judgment and criticism, but most of the time it results in a meaningful connection with someone–perhaps even a complete stranger. Because now they know they are not alone. And I am reminded that I’m not alone, either.

Wouldn’t it be nice if more people were willing to take the risk of being vulnerable? If instead of seeming like we had it all together, we could be honest about our pain? I know it would be unrealistic to go around telling everyone about the holes in our hearts all the time. Sometimes when someone asks how you are, you just have to say fine or you won’t have time to get a coffee before your first client. But if you want to know the truth about how I’m feeling, I’ll tell you. And if you read my blog, you will definitely find out.

Eye on the Ball

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When I went to that self-compassion retreat a few years ago, one of the teachers told me that she thought I loved tennis because I love practicing mindfulness. As you know, I’m a big advocate for mindfulness, but I was pretty sure I cared more about competition, burning calories, hanging out with friends, and wearing cute outfits than I cared about practicing mindfulness. But I can see her point. Tennis is the only thing I can do that allows me to block everything else out of my mind, and I almost always feel better afterwards.

For example, last Monday I was feeling so depressed that I actually did not want to play. Which almost never happens. But I knew it would make me feel better, and I was playing with a friend, so I forced myself to do it. It was tough, though. I thew up 4 times, which is a record. I’m not that good at singles anymore, so I was losing for most of the match. For the first set and a half I felt like crying.

But then I channeled my inner warrior. I told myself I could cry when I got home. I reminded myself of all of the times I was depressed during matches and played through them. How I’ve had to lie down for several hours after matches because of heat exhaustion–which is not a great thing, I know, but it does demonstrate my mental toughness.

And It worked. I won that night. I even saved a match point. I felt better afterwards, but I still cried when I got home. Still, I was proud of myself for my ability to fight through adversity. If there’s one thing that depression teaches you, it’s how to be resilient. To play my best under pressure. It has made me a stronger person.

The most helpful strategy was to keep my eye on the ball–which is pretty much always my strategy. If you’ve ever played with me, then you know that I often publicly announce that I am going to watch the ball before every point. I told myself that in that moment, I’m just a tennis player. Not a psychologist. Not a sister taking care of her brother. Not a depressed person. It’s just me and the ball. Nothing else exists.

Thich Nhat Hanh says that when you practice mindfulness, happiness is available to you at any moment. I can’t say that I was happy after the match, but I did feel better afterwards. And there were moments when I was in flow. When I was free from all the thoughts and feelings that plague me. And that is a great feeling.

So whatever your equivalent is to keeping your eye on the ball, be sure to call upon that strategy whenever you’re feeling down to help you ground yourself in the present moment. You’re bound to feel better afterwards.

A Compassionate Take on Why Misery Loves Company

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A few years ago I had the pleasure of listening to the the President of Washington and Lee University speak to the parents of the freshman class that year, appraising them of some of the things they could expect to encounter in their child’s first year of college. A frantic call in the middle of the night about something. The transition to being a little fish in a big pond. The Turkey Drop–which happens over this very break, when some poor girlfriend or boyfriend is informed that this long-distance relationship thing just isn’t working out. Hope we can still be friends.

Students in counseling often talk about “losing the breakup.” I like that term, because it so accurately captures that feeling of being left behind with your heart broken, stalking your ex on social media as they post pictures with their new significant other. If I have to suffer, they should have to suffer, gosh darn it! I hope they get what’s coming to them.

It’s true; misery loves company. And sometimes it’s because people who are miserable want other people to be miserable so that we can all feel sucky together. But sometimes it’s not because people are mean and hateful. Sometimes it’s because we don’t want to be left alone in our pain and suffering.

In self-compassion speak, this is called common humanity. It’s one of the things that comforts us in the midst of our pain in suffering. To know that getting your heart broken is an inevitable part of experiencing love. It sucks for everyone. It did not happen to you because you are uniquely unlovable. And it’s not your fault that it hurts so much that your friends are tired of listening to you talk about your ex.

As I mentioned in my last post, it’s that time of year when my inner demon of depression rears its ugly head. It’s better this year. I’ve made it to work every day so far. I have not fallen into a pit of despair. But it’s still painful.

One of the best and most unexpected benefits of having a mental health blog is that, in the midst of my lows, some reader will reach out to me and thank me for sharing my pain because they have known that pain, too, and it’s comforting to know that they are not alone. It is as therapeutic to me as it is to them to know that there are people in the darkness with me, reaching out to me so that I know that they’re there.

Last week, as I was describing to one of my clients the types of obsessive thoughts that often go through people’s heads, she asked me if I knew what this inner dialogue was like because I studied it or from first-hand experience. I was a little taken aback. I’d never had a client ask me directly if I had an anxiety disorder. But I told her the truth. It’s both. I know her pain because I studied it, and I feel her pain because I, too, struggle with it.

I know what it’s like to suffer alone. So I became a therapist. Because misery loves company.

If Only…

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It’s that time of year again–after Daylight Savings Time, shortly before Thanksgiving–when I am the most at risk for a depressive episode. But this year I am determined not to have one. Or at least to control whatever is in my control to prevent one. I mean, that is always my goal, but I do have an added incentive this year: I have to be able to take care of my brother, which means I have to take care of myself.

I am happy to say that I have been much better about setting boundaries as a result of this added motivation. I can only help so many people. I can only worry about so many things at once. I can only take on so many responsibilities.

The biggest problem is that, despite all of the blog posts I’ve written about letting go of those illusions of happiness that people cling to– money, beauty, the perfect relationship, extra hours in the day–I still cling to my illusions of happiness. I feel this restlessness that can’t be soothed. I long for something that will take the edge off. I turn to something that will only provide fleeting moments of relief, at best.

Lately I’ve been turning to shopping. I know it’s compulsive. I know that the relief will be temporary. I repeat this to myself as I fill my cart, put in my credit card information, and hover over the order button.

Sometimes I can talk myself out of it for a few days. But during those days I still obsess over it. Would it really be so bad if I bought another pair of boots? Don’t I deserve some indulgence, given the crappiness of my life?

So I give in and hit order. But a few days later, I have the itch to shop again. And then I have to take money out of savings to pay my credit card bill. And then I obsess about not having any money. And then I feel deprived, so I want to buy more stuff.

The problem is, I need something to think about. And if I’m not going to fill my head with all of these illusions of happiness, then what, exactly, am I supposed to think about?  So then I try to remember what all of those mindfulness books say about happiness.

I list all of the things that I can be thankful for. This is tricky, though, because if I see an accident on the side of the road, I think, I’m glad I haven’t gotten injured in a car accident. But then my obsessive brain will be like, oh my God! What if I get in a car accident?!

So then I have to switch to practicing self-compassion and tell myself that we’re not going to focus on car accidents because that stresses you out. We’re trying to focus on things that will make you feel more content. Like, how nice the weather is today, given that it’s the middle of November.

Or I’ll try to be fully present by focusing on whatever it is I’m supposed to be doing in that moment. Like driving. Or listening to my client. Or watching UVA get killed in football. Or I’ll do something that I enjoy, like knit, or read, or write.

But eventually I give in and shop some more. So then I have to switch to practicing self-compassion again and remind myself that I’m doing the best that I can.

It’s a lot of work, quite honestly. But it does occupy my mind with something other than illusions of happiness. So I’ll keep practicing and see if it keeps me from getting depressed.

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Do you think I bought too many shoes?

Being Present, Part 2

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Yesterday I met with a client whose grandmother is coming to the end of her battle with cancer and Alzheimer’s. Of all of the scenarios I can imagine, practicing mindfulness when your loved one has a degenerative disease seems the most challenging. Every day you try to be in the moment, grateful for good days, for what they are still able to do, knowing that eventually they will have fewer good days, fewer things they are able to do. But I guess there is always something to be thankful for–that their suffering is over, the pleasure of having known them, memories that you treasure.

This past month and a half has been tough. Practicing mindfulness and gratitude have become survival mechanisms rather than a choice. Sometimes I think about what my life was like in August, when my primary stressor was going back to work after being off for the summer, and it seems like a luxury. Now, in addition to the usual stressors of work and family crises, I have become a parent.

Ironically, the hardest part is the stuff that “normal” people do every day–meal planning, cooking, grocery shopping. Domestic tasks in general. I hate all of them. Even if I were married, I wouldn’t be as domestic as I am now. But I have no choice while my brother recovers from heart surgery.

In moments of weakness, I think about what my life used to be like. I never thought I’d say this, but I miss my solitude. I miss boredom. I miss the freedom of not having to go to the grocery store and eating a bowl of cereal for dinner instead. Of spending hours reading and writing in my journal, even if it was because I had no one else to talk to.

Likewise, I feel even more saddened by my single state. Before, although I didn’t love it, being single felt more like a choice–even though that was an illusion, since I hadn’t met anyone. Now dating isn’t an option. I barely have time to get ready for bed.

I know that I am not clairvoyant. I don’t know what the future holds. Things won’t be like this forever. Still, my current situation is a loss of freedom similar to what I experienced when I got divorced. Although I would have never quit my job while I was married, we could survive if I lost my job. Knowing that I had to work after I was divorced made keeping my job a necessity that caused me anxiety.

But as soon as I become aware of these thoughts about my past and future, I have to focus on the present. Not because I am trying to push myself to a higher state of happiness or enlightenment, but because it’s all I can do to get through each day. I would not have chosen my current situation, but hardship is an inevitable part of life, and my life is no exception to the rule. I cannot think about what my future holds because there are so many things to come that are overwhelming. I can only focus on this thing, in this moment.

This week that thing is returning to work full time, in the midst of the period in the semester with the highest volume of clients. Which is often the beginning of my descent into depression. Except this time, I can’t get depressed, because I have to take care of my brother. But since I can’t control whether or not I get depressed, I’m scared.

But I can’t worry about that today. Today I am not depressed. Today I will focus on getting through the day, and that will have to be enough.

One could argue that my life is worse than it was before, but I cannot afford the luxury of entertaining that thought, either. Nor do I feel that way. I just focus on the things that I can be thankful for now. Although they are different things, they are as plentiful as they were before. My brother is alive. He is getting better every day. He is able to help with more domestic tasks as he gets stronger. He is happy and appreciative. He is a football expert.

In fact, he recently informed me that Aaron Rodgers is not a fake State Farm agent. He is actually a really good quarterback. It makes pro football more interesting because now when Green Bay is playing I can cheer for the State Farm guy.

See? I can still find happiness in the little things.

Strength and Weakness

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In a previous post, I wrote about how using post-apocalyptic strategies to motivate yourself by turning everything into a crisis is not an effective way to manage your psychological resources. If you use shame and fear to motivate yourself–Get up and go to work, you loser! You’re just being weak and lazy!–it may work, but there’s a high price to pay.

Last week my 40 year old brother, the one who struggles with depression and anxiety, had a mild heart attack and had to undergo quadruple bypass heart surgery. They said it was amazing he was walking around at all, given that his arteries were 99% clogged. The only reason he saw a doctor is because he felt guilty for being too weak to go to work and wanted medical evidence to verify that he wasn’t just being lazy.

In fact, because he thought he was just being weak, he tried to overcome his fatigue by drinking Red Bull and forcing himself to do rigorous cardio workouts.Willing himself to commute 2 hours to and from work, to override his anxiety about his job with drill sergeant self-talk. And it almost killed him.

I’m beginning to think that reincarnation isn’t just about life after death. It’s about the opportunities for rebirth, here on earth. That’s why we celebrate the new year. Birthdays and anniversaries. That’s why people who go through personal tragedies often say that the experience saved their life.

Before the surgery my brother felt like his life wasn’t valuable because his depression and anxiety made it hard for him to hold a job. He’s not married and doesn’t have kids. He hasn’t done anything heroic. The thing that he was the most proud of was his physical strength. But right now plugging in the charger to his phone is challenging and leaves him out of breath.

Apparently it’s common to feel depressed after heart surgery, and given that he’s already prone to depression, I was worried about what his mental state would be. Surprisingly, this is the most at peace I’ve seen him. His goals are different now–to give up stressing about the little things, drill sergeant strategies, and other people’s definitions of success. He is more appreciative of the small things, like being able to sit without being in pain. And, perhaps most importantly, he finally understands how strong he is.

This ordeal has been helpful to me, as well. I still struggle with feeling weak and pathetic because I can’t do the things that other people do. My colleagues are able to handle their case load and responsibilities without becoming depressed and suicidal at the end of the term. Our services are in high demand, which is good for job security but not good for setting limits. I feel pressure to push myself beyond what I know I can handle, and I berate myself when I crash and burn.

But to see the undeniable evidence that my brother was insanely mentally and physically tough when he felt weak and irresponsible reminds me that I am strong, too. I don’t need to prove it by pushing myself to my breaking point. Trying to live up to other people’s expectations isn’t worth dying over. I’m going to accept my limits without being ashamed. I’m going to start standing up for myself. I’m going to say no when I know it’s too much.

One of the most valuable lessons that my brother learned from this experience is that you don’t have to train yourself for every possible crisis to prove that you’re strong. You can just have faith that when you need it, you will have the strength to face whatever comes your way. That you already have everything you need to survive.