Tag Archives: Mental health

How to deal with emotional overwhelm

‘Tell me one last thing,’ said Harry {to Dumbledore}.  ‘Is this real?  Or has this been happening inside my head?’ Of course it is happening inside your head,  Harry,  but why on earth should that mean it is not real?’

Quote from “Harry Potter and the Deathly Hallows,” Part 7; p 579 by J.K. Rowling
Photo credit:  Wikia 

What is real?

As I have been reading the Harry Potter series,  I came across the above quote near the end.  It is a question that swirls through my head on a regular basis.  Recently many memories are coming to the surface.  Neither real bad,  nor very pleasant.  They just are.

Just like Dumbledore I know that my thoughts, feelings,  understanding etc. from those memories are real.  And as such they are part of my truth.  It is my perception of that event when it happened.  Even though my parents perception of that same event completely differs,  my experience is still valid ánd real.

Then,  something occurs,  that emotionally overwhelms us,  we overreact and don’t understand what is going on.  To make life more complicated,  we can overreact because of two reasons:  because of how our bipolar mind works,  and/or because of past traumatic events.

What we have to realize,  is that an occurrence today will also tap into our emotions from the past and emotions trump.  It means that the two merge and cause our emotions to intensify and overwhelm us which in turn causes our response to be much stronger than the present situation warrants.

The challenge is this:  to respond to todays event with the appropriate action without being able to trust our emotions.   In other words,  to be aware that an event is a trigger to past events,  check ourselves and keep a reign on our emotions.

how to dealw with emotional overwhelm

How do we achieve that?

I find I have to step back sometimes when I feel overwhelmed.

Being aware of our bipolar and trauma triggers.  I can never stress it enough:  we need to be(come) students of our own life!!!

Once we know what is triggered,  it is important to attribute our feelings.  If it is the bipolar disorder brain or if it is an overreaction because of,  for instance, a certain trauma,  we label it accordingly.  Then we give it value:  do we want it or not?  Is it in our best interest?  Maybe we have to take note and work on it with a counselor or talk it over with a friend or support group.

The next step is to focus on the here and now and practise mindfulness.  Why the here and now?  Because a bipolar mood as well as unprocessed trauma will always drag us to the past or the future.  The past might be full of memories that trip us,  the future is full of ‘might-be’ and ‘ifs’ causing anxiety and fear.  It all feeds into our emotional system and as a result we get easily overwhelmed or hijacked by what we feel.

Real life example

As far as I can I have made peace with the total abandonment my mother subjected me to.  I am in a much better place than I have ever been.  Yet,  if something happens that triggers those feelings of abandonement… it is still a hard nut to crack!

Recently I met an old friend,  we used to have a deep friendship that stopped quite a number of years ago.  We made an appointment for coffee later that week.  

Afterwards,  my emotions were out of whack and I wondered what was going on.  I figured (amongst some other things that were happening) that the old emotions were surfacing of the time our friendship shipwrecked.  I was really angry.  More than the situation warranted.  

So I thought some more and realized I felt abandoned by her… and that triggers the abandonment issue with my mom which is very strong powerful stuff.  

I decided to use my anger in the here and now to keep a safe distance between her and me.  I also figured out what I wanted to say if the issue came up.  

When we met for coffee I was calm and I had a strategy in place to end the time together early if I felt I needed or wanted that.  It worked out fine – in that the issue came up,  I calmly explained my side and we will see what happens next.  

Afterwards I talked the situation over with my counselor. 

When we apply these steps,  like in my example above,  it is possible to deal with triggers and the emotional overwhelm it causes.

Step back, take stock, be mindful and live in the here and now!

Photo credit:  dvs

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Are bipolars by definition Highly Sensitive People?

Photo credit:  Renett Stowe

Highly Sensitive People
According to the dictionary,  highly sensitive means:  readily affected by various agents.

Wikipedia says that a highly sensitive person (HSP) is someone having the innate trait of high psychological sensitivity (or innate sensitiveness as Carl Jung originally coined it). According to Elaine N. Aron and colleagues as well as other researchers, highly sensitive people, who comprise about a fifth of the population, may process sensory data much more deeply and thoroughly due to a biological difference in their nervous systems.

While the concept clearly isn’t new,  the interpretation and it’s consequences for daily life have been studied by Eileen Aron Ph.D. since 1991. She has written several books on the subject and continues to do research together with her husband Arthur Aron.  She calls it Sensory-Processing Sensitivity (SPS) as that is the trait’s scientific term.

Some of the characteristics of SPS :

  1. You tend to be easily startled, and often overwhelmed by loud sensory inputs.
  2. You tend to be cautious and highly conscientious.
  3. You are easily shaken up and distressed by changes, and don’t do well in “multitasking” situations.
  4. You are often negatively affected by loud noises, strong scents and smells, or bright lights.
  5. You tend to be “cooperative,” rather than “competitive.”
  6. You get easily rattled in stressful situations.
  7. You are often deeply empathic and frequently “pick up moods” from other people.
  8. Even when extraverted, you tend to be introspective, have a rich inner life, and need a lot of time alone.
  9. You are disproportionately drawn to the arts and music, and tend to be very easily moved to tears by expressions of beauty and intensity, as well as images of horror and violence. (Source)

To find out if you are a HSP you take a self-test which is based on empirical research,  by answering questions related to characteristics such as above.  At a certain score you are considered a HSP.  Congratulations! 😉

Causes
While I have no question that HSPs exist since I know quite a number of people,  (including myself),  being highly sensitive in different ways,  I do wonder what exactly the cause is for experiencing these traits.

  • Are you born that way?  SPS is a ‘biological difference in the nervous system’,  what does that mean?  There is no medical test to prove it…  (and yes,  in some ways I have the same questions about bipolar – but that is for another post.)
  • Have circumstances made you that way?  For example your upbringing,  social position,  education,  job,  etc.  But while I know a friend of mine is a HSP,  his brother is not. So what is the deal with that?
  • What about the consequences of sustained trauma acting as highly sensitive traits?  Such as hyper-vigilance (having to protect yourself from further trauma),  or being sensitive to what others feel (because you have learned to take care of your parents’ needs or else there were consequences).
  • Can SPS be part of an illness?  Of course my first thoughts go to bipolar disorder!  Since I have both,  I really don’t know,  but I do wonder…

So,  help me out please?  Any thoughts,  experiences,  opinions?

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Cure or no cure?!

All right,  even though it has taken much longer than I expected,  let’s get back to the post Can bipolar disorder be cured? and the question I finished with:

Would you allow me to suggest that there is a possibility to get your disorder ‘in order’?

Today I like to begin answering the question with offering the following musings.

There is more
My ‘problem’ is that I am a fighter.  I simply can’t accept a diminished life because somebody else tells me so.  Nor can I accept that I will be on meds the rest of my life because a pdoc says so. Even so I am realistic.  Of course bipolar in its disordered form has cost me much.  And most likely there will be times where it will cost me still.  But I don’t want to dwell there.

Because I believe there is so much more to my and your life.  So.much.more.

Real stability

cure for bipolar disorder

Flickr credit: horiavarlan/4273913966

You see,  to reach real stability is not to be ‘in remission of symptoms’ , or be afraid when the next episode will roar its ugly head.  It is not avoiding any stressor,  trigger,  or situation that might possibly set off an episode.  It is not responding on autopilot to whatever happens.

I want you to look further than these types of statements and challenge your view of yourself and the way you function:

Simply living with this illness is a major achievement, so give yourself credit.

Stress is toxic to anyone with a mood disorder, so every effort needs to be made to reduce stressful situations.

Since bipolar disorder is a brain malfunction,  there is not much you can do about it.

For me,  I much rather put all my energy in living my life,  than trying to avoid stress,  avoid possible triggers or being afraid for the other shoe to drop.  Because be not mistaken:  to avoid all these things takes a lot of energy that can be used differently in a way that builds you up and makes you stronger.

Don’t get me wrong: I do know first hand how debilitating the illness can be.  I do not take it lightly.  I can’t.  It has cost me way too much.  In months and years spent in deep depression.  In being suicidal.  In my hypomania getting out of control.  I totally recognize the seriousness of those times.  But I don’t wanna get stuck there.  I want to move on.

Which requires study.

Become a student
You need to become a student of your own disorder.  You need to know absolutely everything about it.  What are your triggers?  What are the signs of your different types of mood?  How does sleep or lack thereof influence your mood?  How do you respond to stress?  What happens when you have a row with your partner, children,  family,  or friend?  What helps you to deflect depression?  What are the signs your hypomania is getting out of control?  What action do you need to take to come down from hypomania?  Have you build a good working relationship with your mental health professionals?  Are you an active participant in your own treatment?  Do you work hard in your talk-therapy to get the most out of your life?

In time you become an A+ student and your reward is the ability to recognize your condition,  to stand back and have the freedom to choose how you respond based on what you have learned about yourself and your bipolar disorder.  You will no longer be the victim of an illness that you feel you can’t control.  In time you will react differently to the same situation in comparison to the past.

What is the challenge?
Because really,  the challenge is not to ‘survive’ your illness,  but to function no matter what situation you get into,  no matter what stress throws at you or which triggers you encounter.

Flickr credit: katerha/5807967450

That is why I believe that it doesn’t really matter what the cause of bipolar disorder is,  as long as you change the pile of jigsaw pieces into your own beautiful picture of your life lived to the fullest.  Through your studying,  you begin to get the disordered heap sorted out.  Yes,  it is a huge pile.  Yes,  it takes a while.  Yes, frustration is part of it.  But oh,  it is so worthwhile,  especially when you see a glimpse of what is to be!

Cure
That said,  I have nothing against researchers finding the gen responsible for bipolar disorder  and consequently finding a cure.  But I,  for one,  am not going to wait and waste my time for science to catch up with my life.  Are you?

Further reading:

Are you a victim or a survivor?
Bipolar in Order by Tom Wootton, a book review

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Lurking depression

Survival kit in a soap box by Jon_Aquino

I have been busy surviving these past week or so.  A depression is lurking as a reaction to scrambled emotions caused by a difficult situation I am dealing with.

My bipolar brain struggles with the negative influence it has.  It is so much harder for us to overcome the negativity and the emotions linked with difficult situations since our brain simply functions differently.  Negative emotions linger on and on.

I hosted an Easter brunch after church and had invited a load of friends.  We had a good time chatting and playing games together.  It was fun,  but I wasn’t able to fully enjoy it.  This was my first clue.

Monday I took ‘off’,  since I know I am exhausted after such escapades.  But I kept sleeping on Tuesday as well.  That was my second clue.

I already had lost the enjoyment in most things I do.  The jigsaw is laying on the table,  looking the same as nearly a week ago.  On the computer I keep playing one of my favorite games,  thinking ‘one more game and then I will do …’ and I keep playing until it’s time for bed.  I don’t want to leave my apartment,  even though the weather has been real nice lately.

It’s vacation time for the primary schools so I don’t need to work.  Which is a pity,  cuz it forces me out of the house.  I finished my library books and couldn’t muster the strength to go and exchange my books,  even though having something to read is a must for my compulsive reading.  I simply bought a book at the super market,  glad to find an author I like for a  reasonable price.

Sigh.

But I did write a letter dealing with the difficult situation I referred to above.

I keep working on accepting myself,  even though … a host of things,  mentionable and unmentionable,  standing in the way.  I remind myself that it is still okay to be me.

I hate to be in this situation.  I am angry and hurt.  I don’t deal well with those feelings.  But that is okay too.  I am learning to use the tools of my trade.

The sunny side is that I am dealing with this situation to the best of my ability.  I am aware of what is going on with me.  I am able to let some of those feelings go (even though only with my counselor,  but still!).

A year ago that wasn’t even a remote possibility.

So,  I guess one can call that growth?

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To stress or not to stress…

This post is a follow up from Coping with stress

Photo credit:  purplemattfish

Since stress is a given in life and no one is immune to it,   we better learn to deal with it in a way that builds us up instead of tears us down.

First we need to identify where our stress is coming from.   There are two main factors:
External factors: work;  relationships;  family;  moving house;   getting married;  getting a baby.
Internal factors: nutrition;  emotional well-being;  sleep & rest;   overall health and fitness.

Some questions
We have to ask ourselves some questions where we look at our habits and attitude to life.   For instance:
How are our sleeping and eating habits working for us?
How do we approach life’s events?
Who in our opinion is responsible for dealing with the stress in our life?

Enter Bipolar Disorder
In this respect,   we as bipolars are already dealing with a lot of internal and external stress by default.  Our emotional well-being is not a given,   instead it is the biggest challenge in our lives to achieve.

As far as sleep habits go,  I know for myself that it changes as much as the direction of the wind,  as do my eating habits.   My overall health usually leaves something to be desired and my exercise is mostly lacking.

We,  as well as those around us,  are often dealing with challenges concerning relationships,  including family relationships,  because of our bipolar.   Having a job and keeping it can be a challenge in itself.   We don’t do too well with change.  Even the stupid changes of day-light-savings-time can be a disturbing factor!

What can we (as in:  all of us)  do?

Furthermore, it is important to locate the stressors and to know what we can or can’t do. Where possible, we change the situation by either avoiding or altering the stressor. If we can’t change the situation, we need to change our response by adapting or accepting the stressor.  (Quote)

Avoid the stressor
For instance,  if I am not doing well with big gatherings,  I need to make a choice in attending a family gathering,  party or other social function.   Is it absolutely necessary that I attend or is it acceptable if I don’t?

Recently,   I made the choice not to join the youth to an event where 30.000 youth will be gathered.  As a youth leader,  it is beneficial for me to be there and experience it with the youth together.  Yet,   I don’t handle big crowds very well,  let alone thát big of a crowd!

Thankfully,  there are enough other youth leaders and/or parents who will go,  so I get to stay home.  Thus I am able to avoid the stressor.

Alter a stressor
On another occasion,   our church had organized a long weekend away to spend some quality time together as a church.  I really wanted to go,   but had a lot of stressors to deal with at the time.   This meant I needed a place to be by myself,  have time to rest,  be away from the crowd.

After explaining my situation,  it then was solved by the organizers and I was to share an apartment with a small family, together with a good friend of mine.  Normally those apartments are solely for families.   The normal situation being altered,  made it possible for me to join the get-away.   And as it turned out,  I did use the apartment when I needed it.

Adapt to a stressor
For this year’s church get-away I have considered to adapt and camp instead of being housed.  This would have worked well,   since I would have my own tent.  Together with my earplugs  (a lot of the families like to camp)   it would have had my own little place.

Unfortunately,   there are other circumstances that prevent me from going this year.  We are only going from Friday night till Sunday lunch time. That is a very short time to make so many changes,   especially as I have just started a voluntary job and have to be back at work on Monday at 10 o’clock.

Accept the stressor
When my father passed away last Summer,   I had to learn to accept that nothing was going to change between us anymore.  Up till that point,   I still had hope that some day,   something might change in our relationship (which was unfortunately very dysfunctional and necessarily distant in time and place).  With his passing,  I knew that was not going to happen ever.

Even though it robbed me of my hope,  at the same time it set me free.   I didn’t have to try anymore,  I could let go and simply be.   No more (false) responsibilities to carry about our relationship.   On this side of life it is all over.  I am still doing my grieving, but accepting?  It turned out that it wasn’t so hard.  Surprisingly to me.

God, grant me the serenity to accept the things I cannot change,  courage to change the things I can,  and wisdom to know the difference.

Serenity Prayer

Good read:

Stress management ~ How to reduce,  prevent,  and cope with stress.

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How to help people with a mental illness

Do you know someone with a mental illness?  Maybe you feel unsure about what to do or say as you don’t know how your words or actions will be perceived.  Or maybe you just like to know a little more.  Then,  please keep on reading!

Photo credit: Brenda Gottsabend

What follows is a list of things you can do,  not do and say to someone with a mental illness by someone with a mental illness.  By no means is this list complete.  For that reason I have added some further reading material at the bottom.

What to do:

  1. Learn more about the illness.   You need to know what your friend or relative is dealing with.  This is so helpful for both you and us.
  2. Separate the person from the illness.  We are more than our mental illness.  Thank God!
  3. Respect us.   Even though we have a mental illness,  it doesn’t render us stupid or dumb.
  4. When we isolate ourselves,   show that you care by calling us or stopping by.
  5. Ask us what we need or how you can help during our good times,   so we can decide together what is best for both you and us when we are in an episode.
  6. Offer to go with us or drive us to appointments if we need it.
  7. Offer to help with practical chores.  Especially when we are depressed, household chores are way too hard to keep up with.   It’s such a blessing when someone steps in and does our stacked-up-week-old dishes.  Or cleans the bathroom.  Does the shopping.  Cooks a meal.  Etc.
  8. Encourage us to keep taking our meds.   When we complain about the side effects,  encourage us to go to our pdoc to talk about it.
  9. Encourage us to get professional help if we don’t have already.  Even when we are stable we need it so we stay stable.
  10. Encourage us to go to our pdoc or other mental health carer when we are not doing well.  Make sure we go when we continue to be unwell.
  11. Have humor  –  laughter lightens the soul 🙂
  12. Ensure you have contact numbers (for those who are very close to someone with MI).
  13. Ask if we are thinking of hurting ourselves (for those who are very close to someone with MI).
  14. Take care of yourself.  It’s not good for either of us if you give yourself away,  nor is it healthy.
  15. Set boundaries.  It might not be easy,  but it’s absolutely necessary to maintain a healthy relationship between us.

Don’t:

  1. Take strange behaviour personally when we are having an episode (especially mania,  delusions,  hallucinations).
  2. Change your role as a friend or relative into that of a caregiver.  You can care for us without becoming a caregiver.  But we need you as our friend or relative.
  3. Neglect yourself  –  know your boundaries of what you can give and what not.  Set your limits and discuss those with us during our good times.

Tell us:

  1. That we are strong.  MI is not a weakness,  if anything it has made us stronger in who we are by dealing with it.
  2. That we are not to blame.  No one is to blame.  We just happen to have it.
  3. That we are not guilty for having a MI.  It’s nobody’s fault.
  4. That we do not need to be ashamed of it either.
  5. That we are courageous for dealing with our illness.  Especially when confronted with the fall out our episodes can cause.  It’s so hard to deal with that,  people,  so hard…  But also necessary for us to maintain healthy relationships.
  6. That we are not alone.
  7. That you care,  no matter what mood we are in or what is happening to us due to our illness.

I welcome any and all comments and questions,  either in the comment section below the post or through the ‘Contact me’ page at the top of my blog.  Please,  share your tips!  Thanks 😉

For further reading:

Helping someone with a mental illness ~ for youth between 14 -25 years

60 Tips for Helping People who have Schizophrenia ~ very helpful for those of us with Bipolar Disorder as well

Supporting the Mentally Ill: Best Things to Say ~ Natasha Tracy

How to Help Someone With a Mental Illness ~ Natasha Tracy (We must be twins,  after I finished my post I found this recent post of hers. :))

Other interesting posts regarding bipolar disorder on this blog:

What is Bipolar Disorder?

Symptoms

Medical treatment

Peeps that are important

Why mood charting?

Mood charting revisited

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Curve balls

Photo credit: Terry Dye

It’s been a though week.  Life threw me some unexpected curve balls.  Oh wait,  maybe they are always unexpected?  I dunno a thing about baseball,  really…

Anyways.

The major one is that tomorrow night (early afternoon for USA peeps) I will be sharing about mental illness and bipolar disorder with my youth group.  That’s what a hypomanic episode might lead to…

To be honest,  I wanted to share about it either way.  For one,  to break the taboo of mental illness and two,  to disclose a little about my bipolar disorder.

It will sure be an interesting evening… truth be told I am even a little nervous,  really.

But then,  since I will share with them that Winston Churchill, Vincent van Gogh,  Mel Gibson, Jean-Claude vanDamme,  Brian Wilson,  Carrie Fisher,  Patty Duke,  Stephen Fry,  Robin Williams and some Dutch authors had or have it,  at least I can’t deny being in good company!

🙂

Update:
The evening went real well – I was composed and was able to calmly share the facts about mental illness and bipolar disorder.  Much to my relief I didn’t even remotely feel like crying,  even though it had been a very emotionally week for me.

The youth received it well.  They were respectful and understanding.  What more can one ask?  We will take it step by step,  but I belief it’s been good to have it out in the open!

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What about our care?

Photo credit:  seiuhealthcare775nw

Last week I started a discussion as a result of some news articles I read.

The first article dealt with Dr. Donald Levin who felt that he could not provide both talk-therapy and medical treatment anymore.  Dinah Miller, MD, however, maintains the view that it is essential to receive both treatments from one qualified person.  John M Grohol PsyD introduced the thought that nowadays clinical psychologists,  amongst other mental health workers,  are much better trained in the area of psychotherapy than psychiatrists.

This led me to ask two questions:

1)         What to think of the appearance of other mental health workers providing various types of (talk-)therapy?

2)         Is it really better to be treated by one doctor providing talk-therapy as well as medical treatment?

One commenter, A. Karmin, wrote:

Since there are so many approaches to psych, it’s an asset to have various providers to turn to. If one has a negative experience it does not mean they should stop all treatment, rather they need to find a new provider. Kinda like if you go to a bad restaurant, you don’t stop eating, you just find another place to dine. The bottom line is to find the kind of treatment that suits your taste.

I love how he relates it to a dining experience!  Instead of staying with a health care provider who is not to our taste,  be it a p-doc,  counselor or some other therapist,  we should find one that is.  For this to happen we first need to know what care we need and want,  before we can go looking for it.

This can be as diverse as our food taste,  as Mommylebron’s comment shows:

I have an adult friend who sees a p-doc who is on charge of both her meds and therapy. However, in our case I feel that having one doctor who could cover both areas effectively would make it easier for me to keep up with my daughter’s treatment plan.

Since she is a mom to several children,  having  to go to different doctors for treatment is simply not an option.  So,  she needs to look for a p-doc providing both med and talk therapy with whom she and her daughter feel comfortable.  Unfortunately,  this can be quite a challenge…

Melody observes the following:

I believe it is imperative to have a level of continuity of care between the medication management and the therapeutic treatment to retrain the brain.

I wholeheartedly agree with this statement.  Oftentimes,  since diagnosis tends to happen during a crisis,  the medication treatment is started first.  Once the crisis  has passed or is under control there is room to start a form of therapeutic treatment.

My own care is divided between my counselor who resides in America and my p-doc and GP who live here in the Netherlands.  This is a pretty unusual situation and something the Dutch mental health system couldn’t deal too well with.

My counselor and I were already working together for over three years when I unexpectedly ended up back in my home country.  Through telephone and mostly Skype,  we continue our sessions as I was not willing to give up what we had built up over that time.  I am very grateful that it works very well for me!

I opted out of the Dutch mental health care system and found myself a psychiatrist in private practice,  specialized in mood disorders amongst other things.  My GP happens to know him and both of them have short links with the mental health care system.  Which is a reassuring thought!

With thanks to my commentors 😉


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Depression is on my mind…

…and in my soul.  Wanting to write about depression for a week by now,  I became depressed several days ago.  Maybe that’ll help?  Nah,  guess not.

What does depression mean?
Depressed and depression are words we hear a lot nowadays.  It seems that everyone and his neighbour are depressed.

However,  the term is highly overrated.  Whenever that happens the true meaning of the word gets lost in the overuse of it.

Sure – we all have days when we feel down,  tired,  pessimistic,  inadequate and don’t want to do anything as a result.  But normally this will last a couple of hours or at most a couple of days.

The depression I am talking about here continues for several days or weeks or months (and for some of us years) when we are in a state of despondency,  dejection,  melancholy,  overriding sadness,  downheartedness,  mournfulness and anhedonia so severe as to require clinical intervention.  Anhedonia means that one loses pleasure in activities that are usually enjoyed.  I had to ask my p-doc when he first used the word :).

Note that the main issues here are the severity and the duration.  It doesn´t resolve itself,  as it would under normal circumstances,  so that is why medical treatment is needed.

Photo credit: 3Neus

How depression feels (for me)
The tiredness hangs as a dead weight around my neck.  I don´t really know what to do with myself.  Sometimes I am simply existing,  because that is all I am capable of.  My heart feels so sad and down that it seems impossible to pick it up again.  I mourn my loss of hope which turns in despair which in turn pulls me ever more downwards.  Whenever I think I can’t go further down,  it turns out the bottom of the pit never ends.

In fact,  it can get so bad and so painful that it becomes impossible in my mind and soul to live any longer with this burden.  That is when I start thinking about suicide.  (This has happened to me,  but thankfully hasn’t in the last few years.)

It is vital to understand that we do NOT want to DIE,  but that we can NOT longer live with the PAIN!

It is critical for those around truly depressed people to understand this.  The intervention is geared (or should be turned) towards relieving the pain in the first place.  Relief of the pain in turn takes away the biggest reason for wanting to commit suicide.

The reason depression happens to me is because my brain is wired differently,  my brain chemistry works differently,  I respond to life events differently.  Bipolar (disorder) depression is a complex and serious illness.

What not to say
I hope that those who stand by a loved one or friend with depression start to understand that:

  • We cannot “Pull ourselves up on our boot straps”;
  • We can not “Cheer up!” or “Think positive!”
  • We can not “Just get over it!” or “Just snap out of it!” either;
  • To say that we “have nothing to be depressed about” doesn’t quite cut it;
  • We are not “feeling sorry for ourselves”,  so it’s no use to tell us to stop doing that;
  • To say to us that “lots of others are worse off”,  falls flat on its face.

Well,  I could go on,  but I am sure I’ve made my point…

What to do?
When someone has pneumonia,  we don’t say to that person: “Hey,  you’re not really sick,  get out of bed and go have some fun.  I am sure you’ll feel better!”  Nor do we say to a diabetic that (s)he is better of without her/his medication.  We accept that it is a chronic illness that needs to be treated and that it has consequences for someone’s lifestyle.  A diabetic can not decide not to be ill and expect by choice to be cured of the illness.  We all understand that it doesn’t work that way, right?

We might ask what we can do for the sick person.  Maybe we do some household chores,  shopping or something else practical.  Maybe we make tea,  sit by their bed,  show compassion and give comfort.

In short,  we accept the person with his/her sickness and take care of the person in a way that is beneficial to him/her.  We respect the boundaries of the illness the person has and do our best to  make the person more comfortable and at ease.

So why would it be any different with a mental illness?

To be continued

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DISCLAIMER:
Please,  note that I am not trying to be critical of anyone trying to lend a hand to a truly depressed friend or family member.  But I think it is important to understand what this friend or family member is going through in order to give or decide to get adequate help.  I am trying to show what depression means,  what it does and what can be done.  By no means is this post complete,  there is a whole lot more to be shared in future posts.

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A heated discussion?

A heated discussion

Photo credit: ktylerconk

About a week ago,  while catching up on my reading,  I came across an interview of Dr Donald Levin by Gardiner Harris.  This extensive interview appeared in the  New York Times on March 5.  The title stated that talk-therapy doesn’t pay  (as in,  insurance doesn’t cover those costs),  so psychiatrists (have to) turn to drug treatment instead.

The title is somewhat misleading as the article mainly revolves around Dr. Donald Levin’s working life.  He started private practice back in 1972, but worked in hospitals from 1985 till 2000,  before starting his private practice again.

As to be expected with the relapse of time, the practice of psychiatry had changed.  For Dr. Donald Levin it meant that where he previously provided medical ánd talk therapy,  he slowly turned solely to dealing with drug treatment.  It appears to me that he blames the system for this situation.

However,  there are still many psychiatrists offering both treatments.  One of them is Dinah Millar M.D.,  who wrote a response to this interview in Psychology Today (March 7),  that psychotherapy and psychiatry are still the best of partners.  She maintains the view that patients get the best of care when only one doctor is involved providing both treatments.

So,  maybe it is more about doing what you believe in,  without letting the amount of earnings stand in the way?

It is unfortunate for all medical doctors that the world of insurance has so much to say about which treatment receives coverage.  I consider it worse though,  for us,  as it greatly influences the choices we can make while  ‘shopping’  for the care we need.

John M Grohol PsyD,  the CEO and founder of the Psych Central website,  expresses in his blog that nowadays clinical psychologists,  amongst other mental health workers,  are much better trained in the area of psychotherapy than psychiatrists.

It is a given that time brings change.  It can be debated,  however,  if all changes are good changes.

Perhaps one of the biggest changes within psychiatry is the appearance of other mental health givers providing different varieties of (talk-)therapy.  Thus the ‘old’ idea that (psycho)therapy is only connected with psychiatrists is – well,  old!

What we should ask ourselves,  is what the consequences of this change are for us and how it influences the care we need and receive.

The question is,  in my opinion,  twofold:

*   What to think of the appearance of other mental health workers providing various types of (talk-)therapy?

*   Is it really better to be treated by one doctor providing talk-therapy as well as medical treatment?

I really like to know what you think!

Please,  share in the comment section or via the  ‘contact me’  page in the left hand top corner.  Thank you!

This post has been followed up with What about our care?

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