Choosing a Psychiatrist

A psychiatrist assists you with your mental health needs. You usually see them less often than a therapist and they are legally permitted to write prescriptions. If you’re fairly new to the mental health world, things can be quite confusing.  Suddenly you have a to be concerned about a therapist, a psychiatrist and, possibly, medications.  This post is designed to help you choose a psychiatrist that meets your needs.

The first thing you need to do is contact your insurance provider and see which caregivers are covered under your policy.  Under the Medical Parity laws, mental health professionals are supposed to be reimbursed at the same rate as doctor’s for physical ailments.  It’s also helpful to ask your primary care physician for referrals.  Your insurance company will likely have a list of caregivers for you to choose from.

Next, research the psychiatrists that are covered by your plan.  You can do this by going online.  Make sure the doctors you are considering are board certified.  You can also see a doctor’s medical school, training hospital, certifications, malpractice suits and disciplinary history.  You can find all this information on www.healthgrades.com.  You can also Google the psychiatrist’s name and find additional information that way.

Set up an appointment with a psychiatrist that sounds like a good fit.  This will probably be an hour long appointment.  This is your time to get a feel for how the psychiatrist operates and, in general, what their personality is like.  Be sure to ask questions like: “What is your philosophy on the use of medication?”  “Do you do any therapy?”  “What is your philosophy on Electroconvulsive Therapy (ECT)?” “How long have you been practicing?”  “What is your process for recovery?”  Often, while you are asking questions, you will already know that the doctor isn’t a good fit for you.  I once had an initial appointment with the grumpiest psychiatrist in the world.  He didn’t crack a smile the entire visit.  He talked in a monotone and, in short, I could tell he wasn’t that in to his clients.  I did end up seeing him for a few months because there was no one else to see.  But don’t be afraid if your first (or second) choice of doctors doesn’t meet your needs.

You are not stuck with the first psychiatrist you see.  If it isn’t a good match, move on to the next doctor on your list.  I went through three psychiatrists before I found the right one for me.

These psychiatrist visits can be difficult because it requires that you tell your full story a few times and that can be exhausting.  Plan for some down time after your appointment to process things and let your mind rest.

Some key areas that you need a good match for are: medication usage, seeing a therapist, how often you will see the psychiatrist, treatment philosophy, what is expected of you as the patient, empathy and compassion.  Those last two can be hard to find, but those doctors are definitely out there.

Are you at a point that you need to find a psychiatrist?  Tell me about it in the comments below.

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Wilford Brimley is My Spirit Animal

 

Wilford Brimley is my spirit animal. You know Wilford Brimley. He does those commercials for diabetic supplies. Lest you think I’m being disrespectful of the illness, I will confide in you that I have Type II Diabetes.

The way Mr. Brimley says the word “diabetes” is enough to send me over the edge with laughter. Its truly magical (and somewhat hypnotic) to watch that word come out of his magnificently mustachioed face.

He is my spirit animal because he represents diabetes to me but also because he is unfailingly Wilford Brimley. If you’ve seen him once, you’ve seen him a thousand times. The man does not change. And that is reassuring to me.

But this post isn’t all about Wilford Brimley.

It’s about juggling multiple chronic illnesses (AKA multimorbidity) while maintaining an acceptable level of sanity. The Universe thought it would be a hoot to give me the following:

Bipolar Disorder II

Generalized Anxiety Disorder

Obsessive Compulsive Disorder

Post Traumatic Stress Disorder

Diabetes Type II

Obstructive Sleep Apnea (yup, I get to sleep hooked up to a Darth Vader mask)

Growing up, I was terrified of needles. When I was 5, I crouched in the corner of my Pediatrician’s office, refusing to come out because I had to have a vaccination. Imagine my delight when, pregnant with my son, I learned I had Gestational Diabetes. It would only require that I check my blood via finger prick seven….yes, seven….times a day and give myself three insulin shots per day.

Women who have Gestational Diabetes have a 20 to 50 percent chance of developing Diabetes within 10 years of giving birth. Did I mention that my Grandma and Great Grandpa also had Diabetes? I was screwed. Nearly five years after giving birth, I developed Diabetes Type II.

So I added Endocrinologist to my list of specialists. My endocrinologist oversees the care and taming of my diabetes.

The rub is that a couple of my psychotropic medications can make diabetes worse. So I stay on the lowest dose possible.

There is also a link between diabetes and depression. Women taking anti-depressants are 25% more likely to develop diabetes. Women with diabetes were 29% more likely to develop depression. And get this: women who took insulin for their diabetes were 53% more likely to develop depression.

That’s why Wilford Brimley is my spirit animal. He isn’t freaking kidding around—he understands how dangerous diabetes is.

It is a juggling act to deal with Sleep Apnea, Diabetes Type II and assorted mental issues, Bipolar Disorder II being the anchor.

I have an alarm set on my phone because I take pills morning, noon and night. And with my crappy short term memory, I would never remember the noon pills. All of my pills for the week are separated out into 63 little compartments.

Every Sunday, I haul out all my medications (12, at last count) and carefully dole out a week’s worth of doses of each medication.

I would be lost without my medication box and I highly recommend one if you’re taking multiple medications.

At the same time I’m doling out meds, I write down which medications need to be refilled and when. This process involves a lot of post it notes

If you have trouble remembering to take medications, try a phone alarm. After a while, it will have become more of a habit for you and you may not need the reminder.

Keeping track of my prescriptions and getting them filled on time is like trying to herd cats. It never fails that I am out of least one of my medications at any given time. I can’t tell you how many times I have been driven into a panic over running out of a med only to be told that I’m out of refills. I’ve had to go days without pills that I need because of such mix-ups. I have begged pharmacists to give me enough to last until I can get a refill.

Another problem I have is staying awake. I turn into Goldilocks at least once a day and have to take a nap. I bet Wilford Brimley naps too. I also go to bed by 9:00 almost every night because this shit is exhausting. I strap on my Darth Vader mask and commence to breathing deeply. I love to say to my husband, “Luke, I am your Father,” while I dramatically intake my breath. Without the mask, I stopped breathing an average of 82 times an hour during my sleep study. I flunked that baby bigtime.

Having three plus chronic illnesses is a real drag, to say the least. There are days that I wish I could wear a button stating, “Chronically ill, treat gently”. But there isn’t such a button so I’ve come up with things that work for me and I hope will work for you.

To properly wrangle your multimorbidity (getting to use that word alone should make this all worth it. J/k, but it is a good word) I suggest the following:

*Always take notes at doctor’s appointments. They throw a lot of information at you in a short time about complicated subjects and medication directions.

*Ask your provider to give you written information and care plans to ensure you’re on the same page.

*Track your illness so you can see patterns developing. (I use an app called PatientsLikeMe, but there are plenty of other tracking apps.)

*Go to bed and get up at the same time every day. Get plenty of rest. And practice good sleep hygiene by not using electronics in bed.

*Eat regular meals throughout the day. Some people feel better eating six small meals while others feel best eating three meals a day. Just make sure you’re getting protein and plenty of fruits and vegis.

*Don’t take on too much in terms of work or volunteer activities. I’m on disability and often feel pressure (most likely internal) to volunteer. But the reason I’m on disability in the first place is that I’m not that great with social situations (I get incredibly anxious).

*Get outside and get some sun and exercise. I can’t tell you how much I love the sun on my face and listening to the birds and the activity in the neighborhood.

*Use cognitive approaches (ie: reframing, compartmentalizing) to help you through rough spots. Email me at mentallyinteresting33@gmail.com if you want more information about Cognitive Behavioral Therapy

*Practice Self Care. Do nice things for yourself. Do things you enjoy. Make a list of things you like to do and DO them.

*Write down some affirmations that mean something to you and repeat them a couple of times a day. Use those affirmations to replace any negative thoughts that pop into your head.

*Practice gratitude for the good things in your life. You can just list them in your mind while doing some deep breathing. Or you can list them in a notebook. Whatever feels right to you. This can help you see the positive aspects that you hadn’t considered.

*Develop a Support Network that can provide you with company or other types of help. (See www.mentallyinteresting.com/wanted:-support-network). This is something that is built over time. I have worked on my support network over ten years, slowly gathering people that build me up including friends, family and professionals.

A study done on multimorbidity found that many patients were quite resilient and determined to persevere. The study also found that people did not complain of lack of skill to manage medical tasks such as administering insulin. Instead, they had difficulty dealing with physical and emotional symptoms and suffered from depression, pain and fatigue My takeaway is that we are brave and strong. I have met many friends with multimorbidity and I am constantly surprised by their fearlessness and ability to keep going.

We sometimes laugh about the “crazy” things we’ve done when one of our illnesses has us cornered. I talk to myself, reassuring me that its going to be ok. Often done while pacing my kitchen with stops along the way just to, you know, dissociate for a bit. I know lots of rockers, headbangers and pacers. Having a mental illness ain’t for sissies. You have probably found yourself down the rabbit hole a time or two. I’m sorry for that. I know its very difficult and you have to be brave.

I hope you found this post helpful. I would love to hear from you in the comments below.

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SOURCES: Liddy, Clare; Blazkho, Valerie and Mill, Karina. “Challenges of self-management when living with multiple chronic conditions.” Dec. 2014: 60 (12) 1123-1133

WebMD.com/depression/news/20101122/new-links-seen-between-depression-and-diabetes

I Cannot Adult Properly


Family gatherings can be full of joy, just “ok” or spectacularly awful.  Family events poke my pain points….those areas of life where I just don’t feel like I’m living up to (someone else’s) expectations.

One such area that I am woefully deficient is cooking skills.  Due to being mentally ill for a great deal of my “formative years”, there are a lot of adult skills that I didn’t/haven’t really grasped.  And cooking most definitely falls in that category.

My mom says she tried to teach me and I don’t doubt that I was an uninterested pupil on the subject of cooking.   I was too busy having an existential crisis or wishing I had someone else’s brain.

As a result, I am the One-Trick Aunt that brings the same fruit salad to every family function.”I love this salad, Lauren…what are these, grapes?”  And I put on my Suzanne Sommers sunshiny smile and say, “Yup, washed them myself.”

But I had a turning point a couple of years ago. I read Anthony Bourdain and, when I heard he had a show, I sought it out.  And so begins the story of a terrible cooking being addicted to cooking shows.

Jacque Pepin, the French chef is my favorite.  (And I loved it when he was rockin’ it with Julia Child.)  I also have a real thing for The British Baking Show, David Chang and Ugly Delicious and *gasp* Gordon Ramsay.

Sorry, got distracted talking about cooking shows.

So I find myself at the aforementioned family function, fruit salad in tow.  I greet my brother’s Mother-in-Law, my sweet Sister-in-Law, my Mom and so on.  Now I’ve gotta choose a spot to park it.  This is important, you don’t want to spend the evening with the wrong person.

I look left and see my Mom and my step-dad Ray.  Not a bad seating choice.  I can’t sit next to my Sister-in-Law because she’s working her ass off in the kitchen.  (She actually knows what she’s doing).  Well-meaning aforementioned Mother-in-Law to my brother is also in the kitchen.  She tries to send me on a guilt trip every time she gets me in her sights.  I just want to say, “Look, I know you probably don’t believe in mental illness and I probably just seem pathetic.”  And she would say, “I was just going to ask if you wanted sugar in your tea.”

I advance into the living room and hear funky, not in a good way, husband of another family member, bragging about his latest deeds or giving away the plot of a movie.  I don’t think so.

Then there is my awesome baby Brother who is Born Again.  He is a joyful soul.  I, unfortunately, don’t subscribe to any particular religion.  Everybody has to be able to worship, or not, as they see fit. My Brother has been proselytizing to me because that is part of his religion.  I try to be understanding about his need to quote Bible verses to me, but it’s one of those things I don’t have a lot of patience for.  (Yes, I know I’m going to hell).

I go back to my Mom and Ray who are sitting on the couch and sit next to my Mom.  They are in the same vein of religion as my brother.  My mom, however, has given up on directly trying to change my mind about religion.  My step-dad, Ray, is a really cool guy who has PTSD from serving a year in Vietnam.  He’s a good man and takes good care of my Mom.We chit-chatted the usual subjects: kids, vacations, what we’re doing for the next Holiday.

Then I feel nicotine pulling me outside.  (Yes, I smoke. Smoking is stupid–you’re killing yourself.  But its like getting off crack, or what I imagine it would be like as I’ve never actually smoked crack.)

My Brother smokes too.  Kinda weird, we’re the only ones in the entire family.

I slip out into the garage and I’m happily greeted by my Brother.  He is such a loving man.  He got “touched” by the family mental illness genes as well.  It runs on both my father and Mom’s side of the family.  Mainly depression, anxiety and bipolar disorder and some delusions on my father’s side.  We’re like a grocery store of mental illness.  Curious about an illness?  One of us probably has it.

My Brother moves about with a manic-like energy, doing five things at once. Every once in a while, my oldest niece or nephews comes out in the garage and we send them right back in.  We try to have a serious conversation, but the interruptions never cease.

It’s time to eat.  We gather in a circle and hold hands…I breathe deeply, this part freaks me out just a little.  Someone says a blessing.  (“Doesn’t he say the most beautiful blessings?” my Mom asks me about my Brother.)  Then we stuff our faces.

What happens next depends on the reason for the gathering.  If its bigtime, like Christmas, the kids open a massive amount of presents.  Its a total free-for-all with wrapping paper and bows flying.

The family function that flummoxes me the most are my nieces and nephew’s birthdays.  I have had a panic attack during my last two tries at attending their birthdays.  I walk in, start to hyperventilate.  The noise and amount of activity buzz around me.  I try going outside.  Not any better.  I try getting a drink.  Still not better, my body is tensed up like a cat ready to pounce.

I say a quick, “Goodbye and I’m so sorry,” to my Mom and Sister-in-Law.  I rush out to my car, get in and let out a long exhalation.

So, no, my adulting skills are not at all what they should be.  I can barely keep it together through most family events.  As a matter of fact, I am 47 and I’ve held Christmas and/or Thanksgiving at my house precisely one time, many years ago.  I can barely manage bringing a side dish…much less hosting a get together.

While family affairs can be fraught with anxiety-provoking questions, they are also full of love.  My family may be a little strange, but their mine.  And they accept me, adult-deficient and all.

 

 

Eight Quick Mood Enhancers

We all find ourselves down in the dumps at different times.  Wouldn’t it be nice if there were some easy things you could do to lift your spirits?

Well, there are and I’ve listed eight of them here.  By no means are there only eight things you can do to raise your mood, but these eight are easy-peasy.

So, without further ado, let’s get to it!

  1.  write down what you are thinking about or make a list of things that are bothering you.  Writing is a powerful tool for coalescing your thoughts as well as letting out pent up emotions;
  2. contact a member of your support group.  For more info on support groups check out: https://www.mentallyinteresting.com/wanted-support-network;
  3. napping. sometimes your brain just needs to shut down for awhile;
  4. exercise. get those endorphins pumping by taking a brisk walk or jog;
  5. write a “Grateful List”.  This, as the name implies, simply a list of all the things you are grateful for.  I think you’ll be surprised how long your list is.  A lot of people write out a Grateful List every morning;
  6. pamper yourself.  Make a list of things that you find enjoyable and choose something off the list for a pampering session.  This could be anything for a relaxing bath to a pedicure at a salon;
  7. affirmations.  These are positive statements that you say to yourself.  See the post https://www.mentallyinteresting.com/affirmations;
  8. spend some time outside.  There’s nothing like some Vitamin D to lift your spirits.  And connecting with the Earth feels good.

If your depressed mood lasts more than a few days, it’s time to call you psychiatrist.  But the above suggestions can help you get your head above water again.

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Wanted: Support Network

A support network is a group of people comprised of medical professionals, friends and family that you can turn to to help you cope with your mental illness.  Your support network can ground you, provide emotional support and coping skills.  Often, just being in the company of someone you feel safe with is enough to help you feel a bit better.   But how do you build a support network?

It can be very difficult to divulge that you have a mental illness.    But you likely have people in your life that you are pretty sure will react with compassion.  Start with those people.  Explain your illness and how it makes you feel.  Talk about the times you need encouragement and support.

The first person on your support list should be your psychiatrist. If your mood has dipped severely (or you’re manic), its time to make an appointment.  A sign of a good psychiatrist is how responsive they are to you trying to contact them.  If they get back to you within a day’s time with actionable advice you’ve likely got a good psychiatrist.  However, if your psychiatrist is very slow or doesn’t respond to you at all, it might be time to look for a new doctor.

Its also a good idea to see a therapist on a regular basis to process the events in your life. A therapist can also teach you tools to use to deal with your mood state.  Your therapist will likely teach you techniques to challenge your negative thoughts.  A good therapist can also help you learn how to diffuse anxiety.

Online support groups can also be useful.  You do have to be a little cautious…not all online support groups are created equal.  Read through some posts. Make sure there’s not a lot of drama going on or bad advice being given.

Next are friends and family that you trust. Have you told any of your friends and family that you struggle with mental illness? I know it can be very difficult to open up about this subject. There will be people that you know are safe and can handle what you’re telling them, but its still hard to talk about.  Be prepared that some people simply do not understand mental illness.  These are not your people.  Of course you can still be friends, but they probably aren’t someone that you want to make part of your support group.  So look for those friends that are compassionate, understanding and positive.

Perhaps the most difficult part of building a support network is actually talking to people about your mental illness.  Many people have never talked about their illness. You are brave to break your silence.  

Write down some bullet points and statistics to help you get the conversation started. You might start your request that they join your support network by asking your friend/family member if they’ve noticed you avoiding situations or spending a lot of time in your house. Tell them what mental illness you have, how it affects you and how they can help.  Again, having some notes with you will help.

For example, you could ask a family member if they’ve noticed differences in your personality lately.  You could explain that you have been experiencing symptoms of your illness and then tell them about your condition/mood state.

If your friend/family member shows interest in what you are sharing, ask if they would be willing to be part of your support network.  Explain that this just means that you can call on them when you’re feeling ill. 

If they agree, don’t make them guess when you’re having problems.  Tell them; ask for help when you need it.  This can be difficult, but the rewards are worth it.  It feels good to receive support when you ask for it.  To make it easier, write down what you want to say to your support network member. 

Make a list of things that friends/family members can do to help you when you need it. *calling/texting you

*going out for coffee

*coming to your house

*exercising with you

*running errands with you

*helping you with a task that you find mentally challenging

Add as many things as you can think of so that friends/family have plenty of options for helping you.

Keep in frequent touch with your support network. Call/text/email friends/family just to stay close. Just being in contact with your support network will give you strength.

I realize this is a daunting task, but the end results are so worth it.  Just take it piece by piece and be gentle with yourself.

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Mental Illness and My Life

 

Genes, Divorce and Hormones

There are three factors I consider prominent in my mental illness blossoming when it did: my parents divorce, puberty and genetics.

My parents divorced when I was 11. I considered this a positive thing because my father was a violent, narcissistic mess who couldn’t stand being around his kids and wife. Although I was glad to have him out of the house, I still yearned for him to love me and accept me for who I was. I hadn’t realized yet that this was an impossibility.

At 11, I was very close to puberty and, as I would come to understand, my hormones didn’t play nice. They stirred up my illness.

Finally, mental illness runs through both sides of my rotting family tree. I could no more escape mental illness than fly to the moon.

So, at the young age of 11, I experienced my first depression. It swallowed me, forcing great waves of tears out of me. I felt a darkness in me. My mom kept asking what was wrong and I had no answer.

Stumbling

I finally started seeing a therapist at age 15. She told me I would just have to accept that my father didn’t love me.

I lay on the floor in my bedroom many days wishing for death, silent tears rolling out of my eyes.

I should have seen a psychiatrist, but I didn’t know that and neither did my mom. This was the early 80s and there was still quite a stigma attached to mental illness.

My mom’s friends reassured her that all kids my age get blue. I told my mom that I wanted to die. I knew that wasn’t normal.

So I stumbled through my teen years, depression hitting me every few years, anxiety part of my everyday life.

Start the Pills

Finally, I saw a therapist who recognized the depression and got me in to a psychiatrist. I started Prozac and, to my amazement, it worked. My depression lifted. I felt like I was seeing life as it really was for the first time. For 12 years, I only took Prozac. I was really lucky that it worked for me so long. I have also been on it a few times in my adult life and it has been a life saver.

Game Changer

My early adult years saw me going through depressive episodes about every three years. Then, at age 30, I got pregnant and my illness turned into a whole new beast.

I was depressed throughout most of my pregnancy. The hormones surging through me were too much for my brain. I spent many days in bed, anxiety-ridden and wickedly depressed. I couldn’t tell my friends. What would they think of someone who appeared so ungrateful to be pregnant?

My son was born a week and half early by emergency C-section. For five days after he arrived I was the happiest I had ever been. Then the biggest attack of anxiety I’ve ever had struck and I was terrified. I was hearing things and seeing shadows. I saw my psychiatrist and he said that if I continued to breastfeed the only medicine he could put me on was anti-depressants. I was bound and determined to breastfeed so I tried a new anti-depressant. It did nothing.

The other bad news my psychiatrist had for me is that it appeared I had developed pregnancy-induced Bipolar Disorder II. What?!

My moods began to cycle with my menstrual period. For two weeks I would be agitated, anxious and depressed and then two weeks of relatively normalcy. This continued through three hospitalizations and ten years.

Suicidal thoughts have been a constant through all of this. I promised my husband that I would not commit suicide and this promise has been all that has stood between me and my doing myself in.

Mayo to the Rescue

I was hospitalized in my local mental health facility and it only helped a little. The next time I was down in the pit, my psychiatrist wanted to send me to the Mayo Mood Disorders Clinic in Minnesota. My husband made the seven hour drive to get me admitted and I spent a week adjusting my medications and learning coping skills. I felt so positive when I got out, yet, six months, later I found myself in the pit again and back to Mayo we went.

This time I started a medication combination of Zyprexa and Prozac. Within days I felt different. I wasn’t scared all the time and the black thoughts had receded a bit. I would only continue to get better.

Stability

I was in partial remission for four and half wonderful years. During that time I started Group Therapy which has been a lifesaver. There are nine women in the group with various physical and mental difficulties. We meet once a week with a therapist facilitator and discuss our issues.

I also started a wedding officiating business and have married over 60 couples.

My self-confidence bloomed during this period. I finally felt comfortable in my own skin and felt good interacting with others.

My personality shined and I was excited to be alive.

Stumbling a Bit

Lately things have been a little rough. I’ve been going through periods of depression mixed with restlessness, anxiety and agitation. My doctor and I have been experimenting with medications once again but haven’t found the magic combination.

I just keep pushing through. I know what if feels like to feel good and I want that again.

 

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Mental illness is an elusive foe. Changing shapes all the time. It feels like every day there is something new to cope with….some new challenge to my coping skills.

I am very lucky to have good health insurance to pay for all the doctor’s visits and medications. But there is still a huge cost associated with being chronically ill. I spend at least $300-$400 a month on mental health treatments.

But I am so glad to be alive and so grateful for all of my blessings. Despite all the troubles in my life, there are a lot of great things as well. My husband and son. My friends. My family. My dogs.

Life is good. I just have to keep fighting.

Quick Tips for Dealing With Anxiety

 

I wake up and my first thought is, “what is wrong?” Then I go through a little list in my head: appointments? Yes, crap; my husband, he seems fine; my son, he was fine the last time I saw him.

It doesn’t take long before thoughts are swirling around my mind, sweeping away rational thoughts and making me feel incapable of handling my day.

My next task, to combat the worrying, is to cajole and beg myself to get ready to be out in the world.

This is life with anxiety.

Worry Versus Anxiety

Anxiety Disorders are the most common mental illnesses in the U.S., affecting 18.1% of the populations.

What is anxiety? What is the difference between “every day” worries and the illness that is anxiety.

Anxiety and Depression Association of America (AADA) reports that only 1/3 of those suffering from anxiety disorders receive treatment. ADAA also provides a chart that helps one tell the the difference between every day anxiety and a disorder.

Everyday Anxiety

worry about paying bills, landing a job, a romantic break-up, other important life events

Anxiety Disorder

embarrassment or self -conscious in and avoiding social situations for fear of being uncomfortable social situation judged, embarrassed or humiliated

seemingly out-of-the-blue panic attacks and

test, presentation, performance or other the preoccupation or fear of having another significant event.

Realistic fear of a dangerous object Irrational fear or avoidance of an object that no longer poses a threat. 

Now you know the basic differences between every day worry and anxiety. Worry involves thinking about every day things while anxiety picks various, non-likely events to concentrate on.

I wake up and my first thought is, “what is wrong?” Then I go through a little list in my head: appointments? Yes, crap; my husband, he seems fine; my son, he was fine the last time I saw him.

It doesn’t take long before thoughts are swirling around my mind, sweeping away rational thoughts and making me feel incapable of handling my day.

My next task, to combat the worrying, is to cajole and beg myself to get ready to be out in the world.

This is life with anxiety.

Worry Versus Anxiety

Anxiety Disorders are the most common mental illnesses in the U.S., affecting 18.1% of the populations.

What is anxiety? What is the difference between “every day” worries and the illness that is anxiety.

Anxiety and Depression Association of America (AADA) reports that only 1/3 of those suffering from anxiety disorders receive treatment. ADAA also provides a chart that helps one tell the the difference between every day anxiety and a disorder.

Everyday Anxiety

worry about paying bills, landing a job, a romantic break-up, other important life events

Anxiety Disorder

embarrassment or self -conscious in and avoiding social situations for fear of being uncomfortable social situation judged, embarrassed or humiliated

seemingly out-of-the-blue panic attacks and

test, presentation, performance or other the preoccupation or fear of having another significant event.

Realistic fear of a dangerous object Irrational fear or avoidance of an object that no longer poses a threat.

Now you know the basic differences between every day worry and anxiety. Worry involves thinking about every day things while anxiety picks various, non-likely events to concentrate on.

Getting Past Anxiety

First, take a moment to pick out anxious thoughts you’re having. This may take some practice. Listen to what you’re telling yourself. For example, if you’re telling yourself you can’t go out in public because you’ll fall apart, this is a thought that needs dissecting and redirecting. In this case, you might tell yourself to take several deep breaths and focus on your five senses (taste, touch,smell, sound, and sight).

If you’re still not feeling calm. Try stepping away from the crowd to a quiet place and just sit, breathing deeply, for a few minutes.

Getting Out

Something that always helps me is getting out of the house when I feel anxious.  This is tricky because I have agoraphobia (fear of leaving the the house).  I remind myself of all the good reasons to leave the house:

  1.  I’ll feel better
  2.  I’ll get out of my head
  3. Seeing new sights excites my brain and distracts it
  4. Just being out among other people makes me feel more connected

Usually, if I can make myself grab my purse and head toward the front door, I’m golden.  Its just a matter of talking myself into it.  I’ve conquered this fear enough times that I know I’ll feel better if I just leave the house so its not terribly difficult to talk myself into going.  The key for me is to think of the reward for going (feeling better) and concentrate on that while I’m getting ready to leave the house.

Sometimes I feel anxiety over meeting with people; I worry about the flow of the conversation and wonder whether or not I should put my “fake-it-til-I-make-it” face on.  At theses time I picture the person in my head saying positive things.  I picture us laughing and talking easily.  I also think of three or four subjects I can bring up if the conversation starts to drag.  So even though seeing people can be difficult, it is almost always worth it and helps my self-esteem.

The last type of anxiety related to getting out is performance anxiety.  Perhaps, like me, you have to speak in public.  My biggest defense against this type of anxiety is to practice, practice, practice.  I also get in a zone where it just feels like me and the couple I’m marrying.  Then, truthfully, I go on auto pilot during the wedding ceremony.

So there is everyday worry and anxiety disorder. Both can be dealt with using grounding, getting out of the house and practicing to avoid performance anxiety.

The last thing I use is a reward system.  I decide before the event what would be a good reward for myself for getting through an anxious time.

Every time you are able to push anxiety aside, your confidence blooms and becomes easier to do so the next time.

 

Getting Past Anxiety

First, take a moment to pick out anxious thoughts you’re having. This may take some practice. Listen to what you’re telling yourself. For example, if you’re telling yourself you can’t go out in public because you’ll fall apart, this is a thought that needs dissecting and redirecting. In this case, you might tell yourself to take several deep breaths and focus on your five senses (taste, touch,smell, sound, and sight).

If you’re still not feeling calm. Try stepping away from the crowd to a quiet place and just sit, breathing deeply, for a few minutes.

Getting Out

Something that always helps me is getting out of the house when I feel anxious.  This is tricky because I have agoraphobia (fear of leaving the the house).  I remind myself of all the good reasons to leave the house:

  1.  I’ll feel better
  2.  I’ll get out of my head
  3. Seeing new sights excites my brain and distracts it
  4. Just being out among other people makes me feel more connected

Usually, if I can make myself grab my purse and head toward the front door, I’m golden.  Its just a matter of talking myself into it.  I’ve conquered this fear enough times that I know I’ll feel better if I just leave the house so its not terribly difficult to talk myself into going.  The key for me is to think of the reward for going (feeling better) and concentrate on that while I’m getting ready to leave the house.

Sometimes I feel anxiety over meeting with people; I worry about the flow of the conversation and wonder whether or not I should put my “fake-it-til-I-make-it” face on.  At theses time I picture the person in my head saying positive things.  I picture us laughing and talking easily.  I also think of three or four subjects I can bring up if the conversation starts to drag.  So even though seeing people can be difficult, it is almost always worth it and helps my self-esteem.

The last type of anxiety related to getting out is performance anxiety.  Perhaps, like me, you have to speak in public.  My biggest defense against this type of anxiety is to practice, practice, practice.  I also get in a zone where it just feels like me and the couple I’m marrying.  Then, truthfully, I go on auto pilot during the wedding ceremony.

So there is everyday worry and anxiety disorder. Both can be dealt with using grounding, getting out of the house and practicing to avoid performance anxiety.

The last thing I use is a reward system.  I decide before the event what would be a good reward for myself for getting through an anxious time.

Every time you are able to push anxiety aside, your confidence blooms and becomes easier to do so the next time.

 

How To Have a Good Day

No matter how you feel, there are things you can do to start your day off right.

Do some gentle stretching to wake your body up.

Take your medications.

Put together a Grateful List.  List 10-15 items that you are grateful for.  Things like having a roof over your head, the people in your life and the characteristics that you possess.

Read a list of affirmations out loud (www.mentallyinteresting.com/positive-affirmations-2).  Really commit to the affirmation.

Journal.  Write about how you’re feeling and the issues you’re tackling in your life.  Journaling often provides insight into what’s bothering you and what you need to pay attention to.

Exercise.  Whether it yoga, jogging, pilates or swimming, get your body moving.

Eat a small breakfast.  Give your body what it needs for a good start to the day.

Take a shower or get cleaned up.  It’s amazing how much better you feel when you take care of yourself.

Touch base with one or more members of your support group.  It helps so much to share with people that care about you.  Don’t just say, “Hello”.  Make plans to grab coffee or walk together.  The members of your support group are as valuable as gold.  Do your best to maintain connections with them.

Check your self-talk.  Is your head filled with negative thoughts?  Refute those false thoughts.  Write down the negative thoughts you are having and then either outright reject the false ones or change the negative to positive.  Self-talk can be very difficult to monitor.  You might want to write down some of the things you’re telling yourself and then do a reality check to see what’s really true.

Do a Google search for positive quotations and write down your favorites.  Then post your faves where you can see them.

Check in with your self-talk again.  Remove the negative, replace with positive.  Give your affirmations a look over.

If you’re having a bad day and haven’t already contacted a member of your support group (which includes your psychiatrist and therapist), do so now.  Its amazing how much it helps just to talk to someone about your struggles and your victories.

Take lots of deep breaths throughout the day.  On the intake, you can say, “Calm In” and on the outtake, “Stress Out”.

You might also want to journal later in the day if a problem arises or you’re dealing with a difficult emotion.

Sometimes, taking a nap helps snap you out of a funk.  Or just resting with a book.

Get outside.  This provides a change in perspective and the sun feels good on your face.

Go somewhere you enjoy.  Treat yourself to one of your favorite places whether it be a bookstore or a clothing store.  Getting out can be valuable in having a good day.  I think it’s partially because we connect with other people and we need those connections to feel whole.

Touch base with another member of your support team.  Ask them about their day and tell them about yours.  Sharing experiences helps bring your closer to the person you’re connecting with.

Journal about the events of the day and reflect on the positive and the not-so-positive things that happened during the day.  Note actions that help you stay in a good mood as well as things that bring you down.

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Getting Things Done While Depressed

When you’re depressed, its very difficult to get anything accomplished.  Your motivation is non-existent and you may have anxiety about things you need to do.  PsychCentral says don’t wait for motivation to come to you because is’t not likely to happen.

Depression also affects your self-esteem, so be sure to be kind to yourself.  Depression can also cause difficulty in making decisions.  So be patient with yourself.

In order to accomplish tasks when you’re depressed, it helps to write down what you need to do.  Then take each task and break it down into smaller tasks.  Set a timer for 10 minutes (or however long you desire) and work on completing those tasks until the timer goes off.  Reward yourself for what you’ve accomplished so far.  A piece of chocolate, some time outside, reading a bit of a book, working on a hobby…anything you find enjoyable.

Keep working on your tasks throughout the day.

PsychCentral.com advises behaving like something is already true.  So when you get up in the morning, behave as though it’s going to be a great day.  Get dressed or showered and, while being gentle with yourself, tackle your To Do List.

 

Be sure to mark off items that you have completed on your “To Do” list as this brings a feeling of accomplishment.

Some people have more luck with a “Done” list as opposed to a “To Do” list.  This is simply another way to mark your progress by writing down all the things you’ve done.

Depression affects our self-esteem, our energy levels and motivation.  So you are really fighting a battle to get things done.  Be proud of yourself for whatever tasks you accomplish.  Mark it off your “To Do” list, write it on your “Done” list or mark it off your schedule.  The important thing is to keep trying and keep going.

SOURCE:  psychcentral.com/blog/3-strategies-for-getting-thing-done-when-you’re-depressed, Margarita Tartkovsky

themighty.com/2018/02/depression-how-to-get-things-done

I would love to hear from you!  How do you get things done when you’re depressed?

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I’m Depressed. Now What?

I have been depressed to varying degrees for the last 5-6 months.  What started out as my “usual” winter depression has now continued into summer.  Which is very unusual.  Summer is typically my best time, mentally.  So I’m feeling some fear, ok…I’m feeling a lot of fear.

I have switched medications and dosages, dropping some meds and picking up others to no avail.  My doctor increased my Lithium dosage, but it put me in the toxic range so I had to lower it again even though it seemed to be helping.  I have tried all the other mood stabilizers on the market over the last 15 years.  I currently take eight psychotropic medications…and I’m still depressed.  Some of my friends that are in the medical field worry about the amount and effect of the medications I’m taking.  I worry too.

I have been going to group and our group facilitator has suggested I try individual therapy again.  I could see the group facilitator, but we just didn’t click individually when I tried seeing him before.  My son is seeing my previous therapist and I want to make sure he can continue to see her, which means I can’t.  My other option is to ask my psychiatrist for a recommendation and I think that’s what I’ll do.

I have tried listening to my self-talk and correcting it when it’s false.  But right now, there is a very loud, scared voice in my head that is dominating the conversation.  Reading my therapy notebook, where I keep positive quotes, affirmations and positive thinking tips helps.  It also helps when I go to group therapy.  The other big thing that can lift me up a little is getting out of the house.

So I find myself smoking a lot of cigarettes…as if the answer to my problem is somewhere in the smoke.

When I have found myself in this place before, I usually put a call into my psychiatrist letting her know that the train has run off the rails.  She is always so kind and works me in to her schedule.  She usually prescribes a larger than normal dose of Seroquel and has me take it during the day for several days.  This typically results in a lot of sleeping and, if I’m lucky, the depression gets squashed.

I guess I have to consider my partial remission null and void.  It had been five years since I had experienced lasting mood problems.  But I can’t deny it any longer.  I am depressed.

Natasha Tracy, a mental health blogger suggests the following for getting out of and or lessening a depressive episode:

*self – talk

*distraction

*deep breaths

*meditation

*rest and/or sleep

*journaling

*exercise

The problem is that when I get like this, its hard for me to access the parts of my brain that know how to get better.  It is as if they are walled off.  I find myself staring a lot (dissociating) instead of giving my self talk a new direction.

What do you do when you get depressed?  What’s your favorite trick for blowing depression away?

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SOURCE: natashatracy.com/bipolar-disorder/dealing-fear-anxiety-bipolar-disorder