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Tag Archives: Mental Health

Losing Control

I am seeing a couple of clients whose lives revolve around not losing control of their emotions. They both have a parent who is very out of control–addictions, emotional outbursts, marginally functional–the kind of people who seem beyond hope. “Black hole people,” as my client calls them. These clients fear that if they let their emotions out, they will get lost in them like their parents.

This is a common fear. Most people think that having feelings makes you needy. Weak. Crazy. It’s better to do whatever you can to avoid feelings altogether. Ironically, it is the things that people do to control their feelings that brings them to therapy.

Eating disorders are a good example of this. Every client says that their eating disorder began as a way to have control. They can’t control any other aspect of their lives, but they can control what goes into and comes out of their bodies. Stuff down their feelings with food. Numb themselves by restricting and exercising. Get rid of feelings by purging.

At some point they lose control over this strategy. They think about food, exercise, bodies, and weight all day long, every day. They eat in isolation. They lose friends because they are constantly lying and hiding. When it gets really bad, a dean forces them to come to the counseling center. But no one can help them until they are willing to let go. Until they are willing to feel, to be vulnerable.

We all have ways that we try to control our emotions. Mine is to help other people. I don’t have problems. I don’t need anyone. I’ve got all the answers; I don’t need help.

A client recently asked if I had any flaws. I told her that I have all kinds of flaws. She seemed relieved. I almost told her about my blog–but I’m not ready to go that far.

So what do we do with all of these feelings if we don’t suppress them, deny them, or push them away? How do we keep from falling into the black hole?

One of my favorite movies is “The Matrix.” By the end of the movie, Neo realizes that all of his fears are an illusion. He has to die first to realize this, but once he is outside of the matrix, his fears no longer control him. Feelings are the same way. Your feelings are a part of you, and you are larger than any of your parts.

Sometimes you have to let go before you can discover that you have control.

2014 Blog for Mental Health Project

“I pledge my commitment to the Blog for Mental Health 2014 Project. I will blog about mental health topics not only for myself, but for others. By displaying this badge, I show my pride, dedication, and acceptance for mental health. I use this to promote mental health education in the struggle to erase stigma.”  
A Canvas of the Minds

Sometimes we make the most important decisions in our lives without consciously knowing why we made them at the time.I knew that I wanted to become a psychologist since I was in high school. At the time I wasn’t fully aware of being depressed in the clinical sense. Being anxious was so much a part of my personality that I didn’t think I had an anxiety disorder. And I definitely wasn’t aware of any mental illness in my family. I had no idea at the time that depression, bipolar disorder, and anxiety would impact every aspect of my life–in both positive and negative ways.

It’s probably not surprising that I have been negatively affected by mental illness. But as I write this post, I realize that there have been positive things about it, too. I have learned the most important lessons in life through suffering and loss.

Even as a therapist, when I heard clients make comments about how they had a bad week, it didn’t fully register how horrible that week was for them. In part because clients don’t elaborate unless you ask them to. Unless they are certain that you really want to know. And because they are embarrassed about it. Ashamed, even. But after going through my worst depression 5 years ago, I have much more compassion when clients make these offhanded comments.

I admit, during that period there were times when suicide would cross my mind. But there were two things that kept me from seriously entertaining it. One is that my dad would be devastated, and I feared he would never recover if I went through with it.

The other reason is that if I took my own life, it would undermine everything I ever said to my clients about how pain passes. That one day when they look back they will realize how strong they were at the time. That they will learn lessons from their suffering that it takes some people a lifetime to learn. How can you believe anything your therapist said if she committed suicide? That would be the ultimate betrayal.

So I spent months willing myself to get better. I went back to therapy, started meds again, meditated and prayed, and forced myself to play tennis and spend time with friends. And I did get better. And everything I said about realizing my strength, becoming more compassionate, and acquiring wisdom were all true. I would have never chosen depression, but we usually don’t choose the experiences that teach us the most about life.

People often ask me how I can listen to client’s problems all day long. In all honesty, I can’t imagine what else I would do for a living. It feels more like psychology chose me. And when I hear a client’s story, I always have hope that together we can change the plot for the better. After all, I always root for the underdog. I am the eternal optimist. And I never back down from a challenge.

There was a time when I would never have told this story about my struggles with depression and anxiety to my students or clients. Or even friends and family. But now I want to share it with the world, because every act of courage benefits someone else. My blog is proof of that.

Obsessiveness

I don’t know if you’ve noticed, but I’m kind of obsessive. I can’t blame people for being annoyed with me. Sometimes I annoy myself.

I’m an excessive planner.  For example, because of my GERD and exercise-induced asthma, I’m constantly obsessing about what and when to eat. Last night I made rice at 1 a.m. while I worked on this post because it will save time and decrease the likelihood that I will throw up on the court tonight.

Sometimes obsessing is a memory device. Like I’ll repeat a sentence that I want to say over and over until I see the person. Writing it down helps, but I can’t always do that–like when I’m driving. Lots of obsessing while I’m driving.

You know how I said that blogging is my new boyfriend? Well, I’m kind of a stalker girlfriend.  I will check my blog stats repeatedly–hundreds of times on the first day I publish a post. Thank goodness it can’t break up with me.

Sometimes I obsess like it’s a hobby. I might obsess about my next blog topic.  Or what my strategy will be in my tennis match. Or when I can schedule my next haircut and if I want to try something different, like get bangs.

Obsessing is the most painful when it is fueled by the inner critic or drill sergeant or perfectionism. Then it’s this relentless voice pointing out all my flaws (Your arms look fat in that picture!). Or when I’m not being productive (Get out of bed and do something!). Or how stupid I am for making a mistake (You shouldn’t have dated that loser!).

There are things that help. I take antidepressants, which also help with anxiety. And when the obsessing gets out of control, I take Ativan. I used to obsess for days rather than take the Ativan, but my psychiatrist reframed taking it as a way to have control over my anxiety. And I’m all about having control.

I also practice mindfulness meditation.  You’re not supposed to judge how well you meditate, so I will just say that I obsess about random things for 95% of the time while I’m doing it. But it seems to work, nevertheless.

I tell myself the same things I tell my clients. I remind myself that I don’t know what will happen and I can’t prepare for every possible scenario. To take one worry at a time. That no matter what happens, I will be able to cope with it. And that I have an excellent memory and won’t forget.

Most importantly, I try to accept that this is a part of who I am. Some people may not have to deal with obsessive thoughts, but everyone has to deal with something. This is my thing.

Since blogging has helped me accept other aspects of my personality, I thought I would try blogging about my obsessions. Sometimes it helps just to say them out loud. And it’s an added bonus when readers say they can relate.

I still obsessed all the way home about what to eat before and after tennis tonight and how to end this post, though. Oh well. I guess practice makes perfect.

Let it Go

I love Disney movies. And Disney’s latest, Frozen, is one of my favorites, not only because the music is awesome, but also because it is a story about self-acceptance and love between two sisters.

Elsa is the heir to the throne in the kingdom of Arendale. She has spent her life locked in her room, afraid of her power to create ice and snow, because she accidentally injured her sister Anna when they were children. At her coronation, Elsa’s powers are revealed when she sets off an eternal winter. When she sings the theme song, she is exhilarated that she no longer has to hide her secret. She creates her own palace of ice and snow on an isolated mountain top.

Although Elsa is free from her secret, she still doesn’t want to let her sister into her life. And ironically, in her effort to protect her sister, she accidentally freezes Anna’s heart, which almost kills her. But even then, she still tries to push Anna away, for fear that her powers will do even more damage.

It is not until the end of the movie, when Anna sacrifices her life to save her sister, that Elsa understands that surrendering to love is the answer to controlling her power. She is then able to unfreeze the kingdom and open the doors to the palace.

Tonight my brother called me because he has been depressed and struggling to make it to work. For the first time I shared with him how I had gone through the same thing 5 years ago in an effort to convince him to get on meds and to reassure him that this is not a sign of weakness. He was surprised that I had suffered as he had and that he had not known about it. But it wasn’t his fault, because I didn’t tell any of my brothers about it.

Although I had been on and off meds for several years, this episode forced me to accept that they would have to be a permanent part of my life. As humbling as this was to acknowledge, it was also freeing. But even after I felt better, I still remained in my kingdom of isolation, afraid to let people know.

Writing this blog is the first time I have been completely honest about how dark my depression was. And perhaps sharing my story will save someone else. But in this moment, the most important thing to me is that it saves my brother’s life.

We all have the power to create barriers to keep our loved ones away from the darkness inside us. Yet the real answer is to let go and to bring that darkness into the light.

Meds

The first time I started anti-depressants I was 30. By this time I had been depressed for at least 15 years on and off and anxious non-stop for about 30 years.

Obviously, it would have made more sense to start them sooner, and people told me that, but I was anti-meds up until this time. I was in a research program that strongly favored psychological interventions. Meds were just a product of the money-making pharmaceutical industry and were over-prescribed. People were more likely to relapse when they stopped taking meds. Blah blah blah.

Most of my resistance was really because I was stubborn. No one could have talked me into taking them any sooner.

I finally decided to try them after my husband and I had moved again after a year. Before we finished unpacking, he was already obsessing about buying a house. I knew at some level that we weren’t going to make it, which triggered a depressive episode.

I started on Paxil and sure enough, I felt better immediately. So much better that I wondered why I had allowed myself to suffer for decades when I could have just put myself out of my misery by taking the freaking pill.

Still, after being on them for a year and a half, I stopped taking them–with my doctor’s approval. And I was OK for awhile. But then we bought a house and my husband wanted to find another one a year later. My marriage was moving closer to its sad conclusion.

This time I took Lexapro and stayed on it for much longer. When my life finally seemed stable, I tried going off them again. As soon as the meds were completely out of my system, I felt the depression slowly creeping back. I was a little more irritable. It was a little harder to tolerate stress. My thoughts were a little more negative. Occasionally I was emotionally explosive. And finally, I was barely able to get out of bed.

It turned out to be the most severe episode I had ever experienced. It seemed out of the blue at the time, but now I know that it was because my dad was also experiencing his most severe depressive episode. Even though I didn’t talk to him much, I felt it. That whole super-empath thing. Damn empathy. So annoying sometimes.

I can honestly say that this time the meds saved my life. The depression and anxiety were so debilitating that I spent most of my time lying on the couch, willing myself to keep living, counting the days until the drugs kicked in.  And when they did, I was immensely grateful for the pharmaceutical companies that came up with drugs that allowed me to be myself again.

All clients want to try therapy without drugs, and we always do.  And sometimes that’s enough.  But sometimes it’s not.  And the process of going on and staying on meds for as long as necessary–which might not be for life–is long and arduous.  But when they finally take them, they are thankful that they did and wonder why it took them so long.

But they still want to go off them.

I don’t criticize them for this, because my path to acceptance was longer than theirs.  I used to beat myself up over my stubbornness, but the reality is, you can’t be ready until you’re ready.

It takes a long time before we are willing to give up suffering.

 

Self-Disclosure

I started this blog as a way to put Brene Brown’s claim that vulnerability leads to connection to the test. I believed it in theory but now I have empirical evidence that it works. But self-disclosure is still scary.

It’s still a challenge to write about myself in a way that doesn’t out all of the people in my life who have not chosen to be vulnerable. So I try to talk about myself without blaming anyone else for my problems–in public, at least. Which is a good approach to life in general, I think.

It’s still hard to be open about my weaknesses, although people’s responses have been positive. I freak out a little when people remark on how honest a post was, because that means I said something that they probably wouldn’t have shared about themselves. But mostly I take it as a compliment.

There are still some posts that I have the urge to take down.  I haven’t done so yet, because then it will take me longer to get to 100 posts. Luckily I have enough posts that only the most dedicated readers will find them. And if they like my blog that much, they probably won’t judge me for them.

I still haven’t told clients about my blog. Partly because I’m not brave enough, but also because therapy needs to be about them. Usually they come to see me because they don’t have anyone else who will give them their undivided attention. If I were to say, Hey you know what? I wrote a blog on that very same problem. Here’s the address, that seems a little self-serving.

It’s hard to draw the line between unburdening yourself and burdening someone else. The best part about blogging is that I don’t have to feel guilty about unburdening myself because if you’re reading this, you have chosen to give me your undivided attention.

And for that, I am thankful.

No Good Reason

Most people who come to therapy for depression berate themselves for not having an excuse for their feelings.  Even when they can identify the stressors that led to their depression, they claim that these aren’t good enough reasons to be depressed.

Sometimes people try to make them feel better with the “count your blessings” approach.  This usually makes them feel worse, because now they don’t deserve to be depressed since they have so much going for them.

In cognitive-behavior therapy (CBT), therapists challenge irrational beliefs as a way to help clients see that their depression isn’t logical.  Sometimes this works.  But sometimes they know their depression isn’t logical, and pointing this out makes them feel even more ashamed for not being able to control their feelings.

For clients with the “no good reason” problem, I have found that the most useful strategy is to debunk their myths about feelings.  Since you probably believe these myths, too, I thought I would go through my whole therapy spiel.

1.  Feelings don’t have to be rational.  That’s why philosophers make such a big deal about distinguishing reason from emotion.  Sometimes they coincide, and it feels better when they do.  It feels better when we can say I’m sad because I’m sick of winter versus I’m sad and I have no idea why.  But we don’t have to know the reason why for our feelings to be valid.

2.  There is no right or wrong way to feel.  We have a lot of implicit rules for what we should be feeling in a given situation.  Take my Ph.D. example in my post on self-worth.  I thought I would feel ecstatic after defending my dissertation.  Instead I got depressed.  Positive events don’t always lead to positive feelings.

3.  We can experience positive and negative feelings at once.  Researchers say that we can’t do this, but I think they’re wrong for reasons that are too complex to explain in this blog.  But I’ll give you an example to prove that I’m right.  People cry at weddings because they are both happy and sad at the same time.

4.  Your feelings aren’t your fault.  We like to believe that we have more control over our feelings than we actually do because…well, because it makes us feel more in control.  But this illusion comes at a cost.  Which is why I wrote the posts on blame and free will.  You didn’t choose to be depressed, and it’s not your fault that you can’t stop the depression.

5.  If you try to make yourself stop feeling, you’ll just make things worse.  Because this will involve some level of deception, like denying or suppressing or minimizing your feelings.  And at some point, this will blow up in your face when you least expect it.  Plus it will make you less empathic when other people tell you how they feel, which will lead to relationship problems.

Although I can write logically about these myths, I still fall prey to them, because feelings aren’t always logical.  Knowing isn’t enough to solve the problem; you still have to practice.  Which is why I practice mindfulness and self-acceptance.  And I encourage you to do the same.

So the next time you catch yourself saying that you have no good reason for your feelings, remind yourself that you don’t need one.