Tag Archives: mental illness

No Good Reason

Posted on March 5, 2014 by Christy Barongan

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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.

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Posted in Mental Health, Psychology and tagged blame, Depression, Mental Health, mental illness, mindfulness, therapy. Bookmark the permalink.

Fear of Sadness

Posted on March 4, 2014 by Christy Barongan

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Most people find it difficult to tolerate negative feelings like sadness. This task is even more difficult when you suffer from depression, because any time your sadness feels too intense or lasts too long, you worry that the depression is coming back. And if you’ve ever been depressed, you know how terrifying the prospect is of going back to that dark place.

Your loved ones also become hypersensitive to your sadness, which just exacerbates your fears. If you’re feeling down, they ask you if you’re taking your meds, or if maybe your meds need to be adjusted. Don’t get me wrong–I’m all for meds. I’ve tried to go off them several times, and each time I got depressed again. But it’s unfortunate that once you’ve been depressed, every feeling has to be scrutinized for potential pathology.

There’s also this added sense of failure associated with relapse. Like you should have been able to prevent it this time, since you’ve been there before. And even though you recovered before, you fear that if it happens again, you won’t be so lucky the next time.

And even if you do recover, you fear that the wait will be agony. I fear depression much more than anxiety because when I’m anxious I can take an Ativan and I feel better immediately. But antidepressants don’t work that way, so there’s not much I can do to feel better right away when I’m depressed.

Whenever I am afraid I’m becoming depressed, I journal about my fears, my sense of failure, and my pain. And when I look back at these entries, I realize how strong I am. There are a lot of things that suck about depression, but I have no doubt that it has made me a stronger person, even while it tries to convince me that I’m weak.

But how do I know when I’m sad versus depressed? To be honest, I don’t always know. Sometimes I feel depressed for a day. Sometimes I feel sad for what feels like an eternity. The line is not as clear-cut as we’d like to think. But regardless of whether it’s sadness or depression, the best I can do is to control what I can control. This includes therapy, meds, stress management, and self-care.

And most importantly, for me, it means practicing self-acceptance–of my sadness, my depression, and everything else that makes me who I am, for better or worse.

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Posted in Mental Health, Self-Acceptance and tagged Anxiety, blame, Depression, free will, Mental Health, mental illness, self-care, self-compassion, self-criticism, stress management, therapy. Bookmark the permalink.

How to Save a Life

Posted on February 28, 2014 by Christy Barongan

A few years ago a client told me that I saved his life. Well, he didn’t tell me directly. He told my colleague when he was drunk at a gala. But he told her to tell me. Although I’m not sure he remembers doing so. Still, I was humbled by this. I knew therapy was important to him, but I didn’t think his life was in danger. But then again, even when clients are in therapy, they don’t always tell you the full story.

Once I had to cancel a session with this client and he stopped coming in for about a month. Apparently he got depressed because he felt like I had abandoned him. A professor contacted him because he had also stopped going to class. When he came back to therapy, he told me that his professor saved his life. That was the first time I really understood how much therapy means to some clients, even when they say they’re not sure they want to be there.

Last week I went to a threat assessment training, and the first case that the presenter discussed was a student who had to go to the police department because she told her roommate she was suicidal. While she was there, she asked for a piece of paper and a pen. She drew what appeared to be a bunch of random doodles. But later when they looked at the drawing, they saw that she had embedded the word help three times.

This, too, reminded me that people may say they don’t want help but their actions tell you otherwise.

Before I started blogging, I thought blogs were just another example of our narcissistic culture in that journaling, which is supposed to be a private experience, was turned into something that you shared with the world and everyone was free to comment. But now I realize that blogs can be a way for people who have never had a voice to connect with people like themselves.

My favorite blog is by Nelly N. She writes passionately and honestly about her struggles with obsessive-compulsive disorder, among other things. She shares her most painful experiences so that other people who suffer in silence will realize that they are not alone. And it works.

A few days ago the student group that I advise had their annual eating disorder panel. It consists of students in recovery who are brave enough to share their story. On our campus, people with eating disorders are blamed and judged more harshly than any other disorder. Not surprisingly, no one wants to admit to having one publicly.

Every year, at least one student seeks treatment after attending the panel. And the next year, those students volunteer to speak on the panel so that they can help someone else who is alone with their eating disorder. Sometimes they use the opportunity to speak as motivation to get better.

We don’t have to be able to leap tall buildings to save someone’s life. Sometimes heroes are ordinary people who take action when someone needs help.

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Posted in Mental Health and tagged Anxiety, blame, blogging, courage, Depression, eating disorders, free will, judgment, Listening, Mental Health, mental illness, self-worth, therapy, vulnerability. Bookmark the permalink.

Free Will

Posted on February 25, 2014 by Christy Barongan

When I was in college, one of my fellow psychology majors asked me if learning about psychological theories made me question whether we had free will. It did not. Although his question did make me read through the theories again, just to make sure I understood them correctly. But I was still convinced of my free will.

In my last post I used the example of an alcoholic father to illustrate how difficult it is to sort out blame and responsibility. If alcoholism is genetic, and his parents were alcoholics, and all of his friends drink, what chance does he have of living a sober life? How much of his behavior is in his control?

What if you have someone who is depressed with no family history of depression and no apparent cause, and she can’t get out of bed to make it to class. Is her depression real? Does she deserve to fail? What about if she refused to go to therapy and start meds?

I mentioned in my last post that these problems require forgiveness. We have to forgive ourselves for having the disorder. We may have to ask for forgiveness from people whom we have harmed. And we may have to forgive people who have added to our suffering.

When I’m depressed, I think everything is my fault. In the midst of an episode, I am angry at myself for not being able to function. I don’t think I have an excuse to be depressed. In those moments, it’s hard to forgive myself for not being able to control everything.

I also mentioned that there is always some part of the problem that we can take responsibility for. It may not be the alcoholic dad’s fault that he is prone to addiction, but he can join AA. He can stay away from friends who pressure him to drink. He can see a therapist.

I believe that knowing our limitations allows us to have more freedom. In my work, clients often try to convince other people that their suffering is real. I tell them that they have limited control over what other people think about their disorder. However, they don’t have to blame themselves. They can take control of what they can control.

Some people think that going to therapy is a sign of weakness. In reality, therapy increases your degrees of freedom. And I want to make sure I capitalize on all the freedom I can get.

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Posted in Mental Health, Psychology, Self-Acceptance and tagged addiction, alcoholism, blame, Depression, free will, Mental Health, mental illness, self-compassion, self-criticism, therapy. Bookmark the permalink.

Whose Fault is It?

Posted on February 23, 2014 by Christy Barongan

I love playing games. One of my favorites is the Blame Game. Even though any couples therapist will tell you that you’re not supposed to do this, I’ll use every piece of evidence of every argument I can remember to prove that it’s not my fault. I have no doubt this has contributed in part to the demise of some of my relationships.

However, even though I don’t like being at fault, I also blame myself for everything. I’m one of those people who takes too much responsibility for problems. Maybe that’s why I am also willing to do more than half of the work to try to “fix” the relationship.

The whole blame and responsibility thing is even harder to sort out when you throw in mental illness. Lets say, for example, that you have an abusive alcoholic father. Is it his fault if he hits you while he’s black out drunk? Is it his fault that he has an addiction-prone brain and can’t just have one drink? What if he had been sober for a year but relapsed because a buddy guilt-tripped him into going to a bar to celebrate his new job? What parts of the alcoholism are his responsibility?

In my work, the Blame Game is the most problematic in a sexual assault. It is often the case that both parties were drinking. However, when friends are assigning blame, the perpetrator is seen as being less responsible because he was black out drunk. The victim is seen as being more responsible for allowing herself to get that drunk.

And when the victim comes to therapy, she also believes it was her fault because she had been drinking. The perpetrator usually doesn’t come to therapy. In rare cases, the victim will bring the sexual assault to our judicial system to get the perpetrator to take responsibility for his behavior. And the victim almost never wins.

The two most common disorders we see in the Counseling Center are depression and anxiety. These are disorders where the person takes too much responsibility for their problems. If they can’t will themselves to get out of bed and go to class, it’s their fault for being lazy. When I suggest that a client try meds for her panic attacks, she often says no. That’s a cop out. She should be able to do it on her own.

I don’t claim to know the answers for how much blame a person should assume. I do know that the split in assigning blame is rarely 100% to 0%. There is always some part of the problem that we can take responsibility for. And when we take responsibility for our part, it usually makes things better.

Sometimes no one is to blame. This one is really hard for people to accept. How can you play the Blame Game if it’s no one’s fault? But let’s say a typhoon hits the Philippines and causes mass destruction. Whose fault is it? There is power in blame because it gives us the illusion of control.

But there is also power in forgiveness. We can forgive the other person for wrongdoing, even if they haven’t accepted any responsibility. And we can forgive ourselves for our role in the problem. And forgiveness is much more freeing than blame, regardless of whose fault it is.

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Posted in Mental Health, Psychology and tagged addiction, alcoholism, blame, Depression, divorce, forgiveness, judgment, Mental Health, mental illness, sexual assault. Bookmark the permalink.

Wants and Needs

Posted on February 20, 2014 by Christy Barongan

The other day I had a session where I was talking to a client about wants and needs. She said that she knows that she needs to allow herself to be taken care of, but she doesn’t want to do it. I thought that was interesting. How can you not want what you need? But then after I thought about it some more, I realized that there are all kinds of things that people don’t want to need. They are usually the things that bring people to therapy.

Most people don’t want to need other people. That would make them dependent, and dependency is bad. It’s a sign of weakness. There is even a diagnosis called dependent personality disorder. Excessive independence, however, is not considered a problem. In our culture, you can never be too self-reliant.

While I have certainly seen clients who depend too much on others, more frequently I see people who are afraid to rely on anyone, like this client. Which is strange, because in the animal kingdom, humans have the longest period of dependence on their parents. And even as independent adults, we still need other people to have babies, to have jobs, and to survive. Even hunters and gatherers relied on one another. I don’t think anyone would consider them weak.

Despite this knowledge, I have to admit, I don’t like to rely on other people, either. I don’t ask for help unless absolutely necessary. And the flaw that I am most of ashamed of is my need to be in a relationship. That’s why I’m so proud of myself right now for being alone. But the truth is, while I’m not in a romantic relationship, I’m not really alone.

The other thing that people don’t want is to feel. Usually they come to therapy with the hope that I can help them stop feeling. This includes the feelings that accompany disorders like anxiety and depression, as well as normal feelings like sadness after a breakup or loneliness–because that makes you weak.

Like dependency, feelings are also necessary for survival. Without feelings, we would have no signal to figure out what is causing us pain. Without feelings, we aren’t able to empathize with other people. Without feelings, we would be classified as reptiles in the animal kingdom.

I don’t want to be a reptile, but I do get frustrated with the intensity of my feelings. Sometimes they reach the level of depression and anxiety. And then I feel other people’s feelings, too. That’s a lot of feeling for one person to tolerate. And some people do find my feelings overwhelming. I’m too needy. Too sensitive. Too much.

Or maybe they were too reptilian to be able to empathize with me.

I often have to tell clients up front that if what they want is to stop needing and feeling, I can’t help them. Sometimes they transfer to other therapists, which I understand. Who wants to be told that they have to accept being human? But most people stay. When I point out that only robots have the luxury of not needing or feeling, they acknowledge that they don’t want to be a robot.

But it’s surprisingly hard work, this being human stuff. It requires a lot of self-compassion, self-acceptance.

Which is why I started this blog.

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Posted in Mental Health, Relationships, Self-Acceptance and tagged Anxiety, blogging, codependence, Depression, Mental Health, mental illness, needy, self-compassion, therapy. Bookmark the permalink.

Judgment

Posted on February 10, 2014 by Christy Barongan

There are certain personality types that are sensitive to being judged, and I have one of them. It takes very little criticism for me to feel ashamed that I have done something wrong. Sometimes I interpret neutral comments as criticism. And in some cases, I’ve even interpreted positive feedback as criticism.

Once my first husband was talking about a picture of Alicia Keys and commented on how she had big hips. I replied with, Are you calling me fat? Which really annoyed him. I kind of thought it was funny but true. Even if I get what is intended to be a compliment about having an athletic build, I take this to mean that I look fat. This is why it’s better to refrain from comments about women’s bodies in general.

Although I have never had an eating disorder, I can relate to being obsessed about my body. I also have a similar personality to the types of people who develop anorexia. I am prone to anxiety and depression. I am perfectionistic. I am highly motivated to avoid harming others, even if it means hurting myself. And I am so sensitive to criticism that I never forget a mistake.

This is why I am drawn to Buddhism–especially the practices of mindfulness and compassion. I find comfort in the idea of letting go of what I “should” be thinking, feeling, and doing. That I can accept whatever is true of myself at this point in time, without judgment or criticism–even if it’s something that I hope to change.

I often point out to clients when they are using judgment words to describe their feelings. For example, if you say I feel pathetic, the word pathetic is not a feeling. There is no emoticon for pathetic. Sometimes it’s actually hard to come up with a feeling word. Usually when you can’t think of one, you’re probably feeling ashamed.

Even when we’re successful in describing our feelings, we often get judged for them. For example, if I say I feel depressed, someone might say You shouldn’t feel that way. You should be happy because you have so much going for you. This is meant to make me feel better about myself, and perhaps it works for some people, but it never works for me.

Sometimes I have tried to point out to the person that they are judging me, but people who judge others are often sensitive to being judged. So they usually get defensive and say they were just trying to be helpful–that I’m being too sensitive. So then I judge myself for being too sensitive.

But I am all about controlling what I can control. Today, I realized that I can’t control whether someone else chooses to practice nonjudgmental acceptance of my feelings. I can only control what I say to myself.

I can also choose not to share my feelings with people who judge me. I think I’m going to start doing that, too.

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Posted in Mental Health, Self-Acceptance, Spirituality and tagged body image, Buddhism, eating disorders, judgment, Mental Health, mental illness, mindfulness, self-compassion, self-criticism, therapy. Bookmark the permalink.

Addiction

Posted on February 6, 2014 by Christy Barongan

I’ve been thinking a lot about addictions lately. Even before Phillip Seymour Hoffman’s death. I have never been the addictive type. My history is so clean I would have made a great political candidate, if I didn’t dislike politics so much. But Richard Rohr, my spiritual guru, says that everyone is addicted to something. So I’m trying to be honest with myself about what that might be.

At times my hobbies have been like addictions. When I first started knitting, I would crank out so much stuff that I made all my Christmas gifts in a month and still had scarves to give away. Same thing with making jewelry. I sold a lot of what I made, but all my profits went towards buying more beads. And I can sing Karaoke for hours. I hosted a small Karaoke party over the summer and we sang for 6 hours straight.

But knitters tend to be fanatical bunch. Jewelry makers can be, too. And for a Filipino, my Karaoke usage is average, at best. Plus these hobbies tend to go in phases. I’m in a knitting phase now. I would describe my interest in these activities as obsessive rather than addictive.

The next addiction candidates would be tennis and sugar. These two things are a consistent presence in my day-to-day life, and I cannot imagine living without either of them indefinitely. Giving them up would require some kind of intensive inpatient treatment program, and even then the probability of relapse would be high.

But playing tennis and consuming desserts has not significantly impaired my functioning, and I’ve been able to cut back. I am only playing 3-4 times a week to prevent injury. And I don’t eat 3-4 desserts a day any more. So I would classify myself as a heavy user but not an addict.

As I was thinking about this post, one of my FB friends messaged me and asked me to write something about codependence. And that’s when it hit me: I am addicted to unhealthy relationships. Ostensibly because I want to help people, but needing to be needed is a form of addiction, too. In the post on solitude I talked about how ashamed I feel for tolerating so much crappiness to avoid being alone.

Based on my experience as a therapist, I know that many people have the same problem. Often clients come in for a relationship addiction. Their friends and family are sick of listening to them. They know they should break it off, but they can’t. They live in secrecy because they’re still in contact with the other person. If someone came up with a detox program for unhealthy relationships, they could probably make a fortune.

I guess in a way I have completed my own self-imposed detox program. And for the first time in 30 years, I did not use another relationship to ease the pain. I rank this accomplishment right up there with defending my dissertation. Maybe even higher. Because after my dissertation I got depressed because there was nothing left for me to accomplish. But as far as relationships are concerned, it’s all up from here.

Interestingly, I started this blog right before the breakup. It wasn’t conscious, but I guess at some level I decided that the energy I was investing in my relationship would be better spent writing. And blogging helped me tremendously during the breakup process. I don’t think I could have made it this far without it.

So until someone comes up with a detox program for unhealthy relationships, I would highly recommend intensive blogging as a treatment strategy.

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Posted in Mental Health, Relationships and tagged addiction, blogging, body image, codependence, Depression, Filipino., jewelry, Karaoke, knitting, Mental Health, mental illness, Tennis, writing. Bookmark the permalink.

Listen Carefully

Posted on February 5, 2014 by Christy Barongan

Last night I gave a presentation to some students about how to provide support to those who have been affected by the accident last November. My advice is simple yet difficult to do: listen carefully.

Most of the time we’re too focused on ourselves to listen to what others are saying. We’re thinking about what we want to say, what we don’t want to say, whether the other person is listening to what we’re saying, what we’re going to do once this conversation ends. You get the idea.

As I got better at listening, I noticed that people put out feelers about important aspects of themselves, just to test the waters–to see if anyone notices.

Once I was watching my ex play in a basketball tournament, and I had to sit with a bunch of wives I didn’t know who were also watching their spouses play. I was having the usual conversation when I meet someone new. What do you do for a living? I’m a psychologist. Oh, I bet you’re psychoanalyzing me right now! Yup. I’ve got you all figured out.

This was not the response she expected. But she still asked more questions. Do you specialize in anything? Eating disorders, multicultural identity, positive psychology. Interesting! I had an eating disorder once.

Of course this got my attention. It was my turn to ask questions. At first I worried that she would be offended by my prying into her mental health history, but it was the exact opposite. She had never told her story to anyone. Back then no one talked about eating disorders. Bulimia wasn’t even a diagnosis. She wanted someone to hear what she went through.

This is always the response I get when I follow up on those feelers that people throw out there.

There’s nothing magical about being a good listener. Anyone can do it. The best way to get better at it is to pay closer attention to yourself. We spend so much time trying to will ourselves to think, feel, and do what we think we should think, feel, and do that we don’t really know ourselves. This is often what I do therapy: teach people how to observe themselves without judgment.

It’s not easy to do. It takes practice. This blog is one of the ways that I practice listening to myself, and you can see how hard it is for me to do so in a nonjudgmental way. But I am trying to treat myself the way I would treat anyone who I care about deeply, and I suggest that you do the same.

Because hopefully you are someone who you care about deeply.

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Posted in Mental Health and tagged blogging, body image, eating disorders, Listening, mental illness, self-care, self-compassion, self-criticism, self-worth, therapy. Bookmark the permalink.

Winter

Posted on January 31, 2014 by Christy Barongan

Today the temperature is supposed to be in the 50’s, and many people are happy about this. A lot of people don’t like winter–particularly this winter, since it’s been unseasonably cold. But I don’t mind it.

I’m not that good at small talk, so it’s nice to have something to say if I’m forced to talk to someone I don’t know that well. I know this is true for a lot of those winter haters, too, even if they don’t admit it. And I’ve worn all the sweaters that I bought while I lived in Ohio and Pennsylvania, so I’ve had more wardrobe options.

Winter is usually a time when people feel more depressed because of the cold and lack of sunlight. Even though I was depressed in December, I’ve been surprisingly cheerful since the beginning of the year. I really like living alone. I like sleeping alone. So much so that I wonder if I will ever invite someone over again. I like knitting, making jewelry, watching sports, or writing a blog post without distractions.

Adapting to changes in the weather is a good example of how we can get used to just about anything. Before the first cold spell, I thought I was going to freeze to death when the temperature dropped to 24 degrees. Now it takes single digits before I think it’s unbearably cold. The other day one of my friends commented on how last week, when we had a day in the 40’s, it felt so warm she could have played tennis outside.

The same is true about living alone. When you live with someone, they may annoy you, but it seems like it would be worse if you had to come home to an empty house every day. That’s what I said not too long ago in my post on solitude. And when you’re used to living alone, you think it would be unbearable to have to deal with all the annoying things about another person, which is how I feel now. But I’m sure if I started dating again, I’d get used to having someone in my space and it would seem worth it. Hopefully.

In therapy, I often use the weather as a metaphor for feelings. I tell them to observe what they’re feeling at any particular moment, like Weather on the 8’s. Sadness with a chance of happiness later in the late afternoon. Fifty percent chance of an anger outburst tomorrow. Maybe we don’t like the weather when it’s 7 degrees outside, but it will change eventually. Maybe even later that day.

Ordinarily this is not the way we think about feelings. We dread when the other shoe will drop and our good mood will be ripped away from us unceremoniously. But when we’re in a bad mood, we fear that we will be stuck in depression or anxiety for the rest of our lives. The reality is, you can count on your mood changing, positive or negative, just like the weather.

We can also look at the weather in a more impersonal manner. We don’t blame ourselves if the weather is cold; we didn’t do anything wrong. And we don’t really have to understand the reason why it is unseasonably cold. I don’t particularly care about understanding the polar vortex. But if we feel sad for no reason and we can’t make it go away, we must be weak. Irrational. Crazy.

The other message I give to clients is that even when we feel sad or anxious, there is still something positive about that moment. And I don’t mean this in a think happy thoughts kind of way. When I feel depressed and can’t motivate myself to do anything, I have more compassion when a client says they spent the whole weekend in bed, feeling crappy about themselves. I have a better understanding of how much pain they are in. And it helps me to be a better therapist.

There is beauty in everything, even in the things we don’t like, but sometimes we have to look for it.