Thursday, April 30, 2020

A Final Note -- And the future of this blog

Well, this is it, my last day writing this blog. What next? I want to turn this information into a book or a guide of some kind, hopefully with some professional influence. I want all of you out there to know that you're not alone. And that it's hard when you feel like you're losing your mind, but you can get better, that you can get help.

There are so many resources out there! Seek and you will find! 

And my best wishes and luck to you while you do that. 

It's not an easy journey, but it's worth it.

You will come out the other side.

I promise.

~ Emery 

How to create a crisis plan

Crisis plans -- Easy to make, hard to follow. There are many versions of this that I am currently working with.

There's the official crisis plan (for an extended look at this I suggest Susan Rose Blauner's book), there's what I call a crisis journal, and there's a crisis, or happiness box.

For the happiness box, I can't speak much on that, but I love the idea. Here is a sample https://youmatter.suicidepreventionlifeline.org/self-care-box/ of what that could look like.

I have actually used my crisis journal a few times. It's a non linear thing that reminds me of ways I can support myself, or ways in which the world sucks.

A crisis plan is the most official of these, and it's hard to use in the moment to my experience. What I have found helps is keeping it simple. If it's too elaborate, it simply doesn't work.

What your crisis plan absolutely needs to have: a progression of events -- if you're mildly suicidal, you don't need to jump right to calling 911. See if you can calm yourself down first. The best way I've found for this is distractions. If you want to add meditation or music to this, go right ahead.

You can journal, play a game, take some deep breaths, and take stock of what's going on. Try writing down your feelings, sleeping if you need to sleep, eating if you need to eat, etc. You can do these things for as long as they feel helpful.

If you're still feeling awful the next step is to call someone. Call your mom, call your therapist, call a friend. Repeat if you want.

Then, you need to call a crisis hotline or text line. This step is crucial for me, and if I feel VERY suicidal, I'll often go straight to this step.

If you still don't feel better, that's where you want to call 911 or have someone take you to the hospital. Don't be alone if you are actively suicidal during any of these steps, but especially the last one. Call over a neighbor or a friend. Your dad.

The last step of any suicidal crisis plan is this -- put down any weapons, get to a safe place, and keep both hands on your phone.

On a crisis plan you can also write what it's for -- mine says for when I feel: Worthless, depressed, afraid, sad, numb, and hopeless.

It has a list of activities, such as reading, candy crush, video games, knitting, drawing, etc.

It also has a remember list, such as: You are a fighter, you will get better, all feelings change, etc.

I also have a call list, of people I need in emergencies. It's good to have this where you can see it.

My crisis journal (I also call it a lighthouse book), has the following sections, all illustrated.

*Reasons to Live
*People to Call
*Beautiful Things in Life
*Things I want to do
*Things to Distract
*Things that might help that you haven't tried yet
*Compliments
*Rules e.g No Suicide for 48 hours.
*Happy Memories
*Acts of Self Care
*Things to Remember e.g Your mood drops at night so be gentle with yourself.
*Coping Tools
*What to do when depressed

It helps a lot in a bind and I can slip it in a bag pretty easily.

In future, I would like to do a whole, more detailed post on both subjects, but I think that is all for now. Coping and getting better is all about developing a tool kit for the bad times. It is yours, and yours alone, and you have to experiment and find out what works for you. It's a process, but you will get there, I promise.

~ Emery

Psychiatry and what it entails

First off, you should know that the line, "psychiatry kills," is false. There is nothing more infuriating to me than people who insist you don't need meds when you clearly do. The truth is psychiatry saves countless lives and it certainly saved mine.

But it is also a dangerous game and you need to find the right person. I have worked with three psychiatrists. Two were good, one I am still angry at.

The first psychiatrist I met with was highly recommended, because she didn't overdose people. This is important, but in the end, I found her to be highly uninformed and she gave me some drugs that were awful, though to be fair, as I've mentioned before, each person and each drug will interact differently.

Things I was put on that did not work for ME.

Valium
Wellbutrin
Abilify

Hydroxyzine.

This combination of drugs was what landed me in the hospital.
Let's take a look shall we - Valium is in an addictive class of drugs. It should not have been used as a first choice. What would happen for me with valium, was I would use it (as needed) when I was suicidal, it would take me up a few notches . . . and then I would crash, and wind up worse than before. It was incredibly dangerous for me and those crashes could have killed me.

Wellbutrin -- I have never felt so drugged out as I did on this one. I felt like half of my brain was missing. I couldn't think, I was sluggish and slow, and when I came off the drug, the room spun and I couldn't stand up.

Abilify -- I felt as if everything had sped up. It made me jittery and inpatient.


Hydroxyzine -- was given to be in too high a dose, so instead of slowing down my anxiety, it made me fall asleep, a very quick, very drugged sleep.

In addition, despite after talking to me and giving me an extensive questionaire, I was diagnosed, incorrectly with bipolar two disorder, which took me 3 months to rectify.

Finally, she never bothered to tell me that meds take a long time to work. I was expecting an overnight success. That I would take these meds and two days later, the suicidal thoughts would be gone. That's not how meds work. At all. But they do work. But they're not miracles.

So, enough about this woman. This is to show you that meds can be dangerous, and harmful in the wrong hands. This is not to frighten you, but so you know what to look for. If a med feels "wrong" it probably is. You should just feel like a better version of yourself, and the side effects should be mild, not strong.

The second woman I worked with is also my current psychiatrist. We'll call her K. There are also nurse practitioners, like the woman above, and my other psychiatrist, C, who we'll talk about in a moment, but this woman is an official one.

Either way, they all know their stuff. They have med school backgrounds, and are doctors first.

 K worked in the locked facility, That is where I first met her. She is kind and compassionate, but not to be crossed. She knows her stuff inside and out.

She put me on Latuda and Lamictal, which both help bring any suicidal thoughts down from a 10 to a 3, and help to keep them off overall.

These are bipolar drugs, and she agreed with the other woman that I had bipolar. Still, they didn't hurt, and I have no adverse effects to them to this day.

I did however, have to mess greatly with the dose. It turns out that too high of a med dose makes the suicidal thoughts worse for me, so they had to make sure the dose was correctly adjusted.

I was then given someone more permanently, as K was very, very, busy.

That's where C came in. She had me take the genesight test, and in the end, suggested Lithium for me, as I continued to struggle daily. She also finally listened and took the bipolar label off, replacing it with MDD, with mixed episodes. Lithium is still a bipolar drug, but it worked very well for me, though it took a long time to really make a difference.

She helped me through this transition saying how the drug worked was like a puppy transforming into a dog. It would be bit by bit and I'd barely notice it, but before I knew it, I'd have a full grown dog.

She was right.

She also did, at my absolute pleading, try me on an antidepressant, and that went as well as she thought it would. Which, was terribly. It had an adverse effect that took me months to notice.

But the Lithium saved me, even though like before when she tried to up the dose, it nearly landed me back in the hospital, and we had to reduce it again.

She also suggested I add Deplin in, a high vitamin B complex. That helped.

Finally though, I felt like I was stuck and like she was out of ideas.

I switched back to K, to get a new look at things. K suggested Fish Oil (UGH) but it helped. I've been pretty stable since then.


A standard psychiatry appointment isn't especially scary either. It's like a less personal version of therapy. You're asked how you are, what's been going on, what's going well, what's not, and of course, how the meds are doing. They should get a sense of you, but it's not therapy. They care, but they are also trying to make sure you're stable.

My appointments have lasted 20 minutes to 60 minutes, though initial appointments for me have been up to 90 minutes.

You should look for in a psychiatrist what you look for in a therapist. Someone kind, knowledgeable, who is a good listener, and likes you and wants to and can help.

Psychiatry appointments are typically once a month, though when you begin they may be every 2 weeks, and once you are established, they may be farther apart, like every 2 months, or 3 months.

Finally, take all this advice with a grain of salt. I am not a doctor, I just speak from personal experience and your experience may differ vastly from mine.

And of course, the takeaway:

Everyone is different. All meds work differently, even on different people, in the same or different doses. Meds are all about trial and error. Trust your doctor, but if you feel worse for an extended period of time or something seems wrong, don't hesitate to switch doctors.

All on this subject for now.

~ Emery

Monday, April 27, 2020

Option two -- unlocked facilities

So, there is apparently an option for voluntary hospitalization, but I have never encountered that, so I will not be speaking on it, but know that it does exist.

An unlocked facility is one that is a step down from a locked facility. I just have experience with mine, but I will explain how it worked.

It was considered a crisis residential, which meant you could stay up to two weeks (sometimes longer with exceptions) and it was similar to the PUFF in that all your needs were met and you had a roommate.

The difference in these two facilities couldn't have been more different, however.

Instead of being staffed by nurses, it was staffed by students. You could leave the building for outings either with staff or with permission. Dinners were homemade. There was mandatory meetings twice a day that ranged from art sessions to discussions of boundaries.

Like before, I had a roommate. Like before they didn't allow us to take our own meds and did "Mouth checks" to make sure we swallowed.

You met with a psychiatrist (nurse practitioner in my case) twice weekly.

There was still no therapy, but you could talk to staff at any time, and they tried to make some of the groups therapeutic.

Overall, it was a nice place with a homey atmosphere and (mostly) caring staff. 

The biggest difference for me though was that the space was not psychically safe. They came and did hourly checks, but the space itself was dangerous. I, again, refuse to mention how as per rule one, but there were plenty of ways for someone to get ideas and to harm themselves. And even though I later found out there were cameras (duh, but I wish someone would have told me) I didn't know at the time and I felt like it would be very easy to carry out a plan.

For that reason, I did not feel as if it were doing the one thing a facility ought to do -- keep me safe.

Now, for many people, this could be a very valid option, but for me, I would not do it again. If I wanted to be hospitalized, no matter how traumatic, I'd take the locked hospital option.

BUT I don't suspect that would be true for most people.

If you are on the edge and you don't want to be put on a 5150, but you consider yourself to be in a psychiatric emergency (the criteria for entering such a place) this may be a great option for you. Talk with your team of people to discuss unlocked options. They are less severe than a 5150 and may really help.

However, in the case of my facility, they made an exception by taking a suicidal patient, because they had assessed me and felt I would be ok. The rules may vary wildly for each place. Check. If you are very suicidal, my first choice is still a locked facility, but that is my two cents. You need to figure out what works best for you.   

~ Emery

Energy and the human condition

With depression, you only have so much energy. The more the depression lifts, the more energy you'll have. But until then, know that you have a select amount of energy, and it's probably less than you need to get through your day. On a good day, I have about 6 hours of energy. But on a bad day, I have maybe 1-2 hours. What you decide to do with that energy is up to you (see other posts for ideas). But the important to realize is that sometimes you don't have the energy or will power and that's ok. When we are depressed, we are drawn to low focus things, like our phones or tv shows. This is okay. It's a part of the process of depression.

I was really hard on myself about being on my phone. I tried very hard to control it. And if that's what you need to do, then that's what you need to do. But I found that being gentle with myself helped a lot. This period in your life is going to suck a lot. But you'll get through it. You have to just keep moving. Easier said than done, of course.

If it bothers you, try to replace the things you hate with something you like -- if you're always playing candy crush and you hate it, find another game you feel less guilty for. Watch videos on your hobbies instead of random fails. Or embrace it and find other things that make you laugh. Make your media consumption that helps you - not makes you feel guilty. Your phone or other device will seem less interesting once you're better.

So be easy on yourself. It's okay. You're ok. It's going to be ok.

~ Emery

Saturday, April 25, 2020

When it all hits the fan -- on hospitalization and what your options are -- part one, locked facilities and 5150s

There are two types of hospitals -- ones where you can leave any time you well please, and ones where you very much can't. This about the ones where you can't leave.

I think anyone who's ever felt horribly depressed and knew it has had the terrible fear that they're going to be locked up, and their life will be forever ruined.

I want to look at the hospital process and tell you my experience about it. It may differ depending on where you live and what insurance you have.

The first thing I know is that I was afraid to be hospitalized and didn't always tell the full truth because I was so scared of this. As a result, I didn't get the treatment I needed as soon as I needed. Always tell the truth. Your life is the most important thing. Don't gamble with your life.

Second, not everyone you tell that you are suicidal has the power to lock you up, nor do they want to. Hospitalization is absolutely a last resort. Even my psychiatrist who WORKS IN A MENTAL HOSPITAL admits that it is traumatic and will only use it as a last resort. But she will use it.

Your risk of being hospitalized is highest in the ER, or in a county building. Most therapists do not have that power, nor is that your go to.

You are likely to be hospitalized if

YOU HAVE NO SUPPORT SYSTEM
YOU ARE ACTIVELY SUICIDAL
YOU HAVE A PLAN
YOU HAVE A WAY TO CARRY OUT THE PLAN

You probably SHOULD be hospitalized if you are several of the above.

You should know however, they can't just be hospitalized like THAT. You have to be assessed.

The thing that they will put you on if they assess you to be a danger to yourself is a 5150. It is a three day hold by which they will assess you within the context of the ER and/or a mental hospital. They do not make this decision lightly.

After this three day hold, they will decide if you need to be continued to put on a hold. If they renew the hold, which will last for 14 days at maximum, this is called a 5250 and you will continue to be assessed. If after this you are still not judged to be stable, you will be put on a final 14 day hold, a 5260.
You cannot legally be held longer than that.

The team will reassess you daily. If they feel you are stable, they will release you. There is a team of people making this decision, and they do not make it lightly.

After a three day hold, if they decide to put you on a 5250, they will hold a trial where you will work with a patient's right advocate, the hospital, and a judge to make sure that you are not being held without good cause. The patient's rights activist is on your side. They are there to represent your expressed wishes. The hospital is there to defend their decision. The judge is there . . . well, you can guess it.

They have your files and everything can and will be used against you. I was judged for being unkept -- because I didn't brush my hair. Luckily on that day, I had chosen to take extra care with my appearance, so the judge looked at me and brushed it off.

I won't lie and say the experience can't be scary, difficult, and even traumatic. It can be. But there's also something to be said for it. It will keep you alive. And that's a pretty good reason to be hospitalized.

But keep your eyes and ears open. Every facility is different.

You will not have access to your phone, your wallet, or anything valuable. They will lock them up and give them back to you at the end of your stay. They will allow you to use their phone, however.

There are LEGAL rights that you have as a patient. I will make another post on that soon. These rights are yours and cannot be taken away without reasonable cause.

You should be hospitalized if: YOU CANNOT KEEP YOURSELF SAFE.

When I was admitted, I was having suicidal thoughts 24/7 and they were a 10/10. Mental hospitals (or psychiatric hospitals, or PHF (Puff) unit) are physically safe places, where your primary responsibility is to get through the day. The nurses are there to help you. It's a good place to get on the right meds, to meet with a psychiatrist daily, and have all your needs met.

Sometimes you'll get more out of it -- there are programs, but how good or helpful depends on the people and what you need. Where I went, there was no therapy.

Things to consider:

Pros:

You'll be physically safe
You'll be constantly monitored
Your meds will be adjusted
You can be as unstable as you want and people will understand.
You will have all your physical needs met
You will have food prepared for you.
You will be alive
It will give you time and space to process safely

Cons:

The people around you are as crazy as you are
The people who work there vary widely
You may not always feel emotionally safe
You may be bored
You will probably have a roommate
You will be constantly watched
You will lose your freedom
You will only be allowed limited visitors.

I might write more on this, but for now, that is all I have.

~ Emery




















Thursday, April 23, 2020

What a sample crisis line talk looks like

This will not be a word for word example, because I worry that that will be triggering for both myself and others. Instead, I'll use some of my conversations as an example, but I won't be going into anything that might be triggering.

First off, all you have to do to text a crisis line (at least the 741741) is text hello. That's it. From there you'll get a message that says "Resources and coping skills while we connect you:" with a link. "STOP to cancel convo"
"What's your crisis?"
They then go on to say they can't accept messages of over 160 characters.

From there, you describe your crisis. You don't have to be suicidal to text the hotline. You can just be in a bad place, depressed, or have something to talk about that you feel you can't talk about with anyone else. They don't judge.

There is a minute as they assign you someone.

The person will then reach out and introduce themselves. My person wrote, "Hi there, I'm Ashley, and I'm here to listen and support you through your crisis. I see you're in immense pain. It's courageous of your to reach out. Can you share more about what's going on?"

I explained more of what was going on. I explained a certain health care provider had made me feel like my depression was a personality thing and that I would not get better. This had spiraled me.

I got an immediate response. "That is not okay for her to tell you that. That would be devastating for sure."

Then, "If you feel comfortable sharing, what is your name," they will often ask this, but you don't have to tell them. If you say no, they will say something like "that's ok," and then go on.

In my case, I didn't care, so I told her.

She continued. "Thank you for sharing this with me Emery, it's great that you're reaching out for help when you notice that things are getting worse. That's really hurtful that your (redacted health care provider) is saying that your personality is what is causing you to struggle. I highly doubt this is the case."

We go on with more sympathy on her end.

She continues by asking if I have suicidal thoughts. I tell her no, but the night is still young. I have told them yes before. They are compassionate either way.

I tell her no but she asks if I have a plan for ending my life.

I tell her no again. She says she understands and just wants to make sure I'm safe.

We talk about my situation some more, then she asks what has worked for me in the past, and I tell her that distractions are very effective.

She asks me to specify.

I tell her that texting and games are most helpful.

She also suggests mindfulness and links me with a website.

I tell her thank you and we close the chat.

I feel a bit better.

Something to keep in mind -- each counselor is different. Some are more helpful for you than others. The goal of crisis lines are to take a client from a "hot place" to a "cool place" they do this by asking questions, listening, being kind, and offering resources.

If you are suffering, I highly recommend reaching out.

I may do a second post on this, but I am not sure. I think it's nice to know it's a resource that is good in a pinch and that it can really help calm you down.

It has saved my life many times, and I think it will likely do the same for you.

~ Emery




What a sample therapy session looks like/my therapy through the years.

Therapists first off, vary quite a lot, and what they do can vary quite a lot. But here is what some of my sessions have looked like.

Pre College: I was 11 and my parents were constantly fighting and my grandmother had just died. I talked to a therapist about how sad my Grandmother's death was making me. She literally fell asleep.

Takeaway: If your therapist isn't listening to you, dump them. This goes double if they sleep.

College: I had six sessions, and either nothing was discussed, or I bawled about the same idiot who I talked about in my last post. He had just dumped me for the 1st (out of 3? 4? Times? I lost count). time.

Takeaway: If you don't feel like you're getting anything out of a session, you probably aren't. Drop them and go somewhere else. Give it 3-6 times then get out of there.

Post College: I had my first "real" therapy, where I was going because I felt like something was wrong with me (spoiler, there was, I had very severe depression) instead of because someone told me to. She was really sweet. She listened as I ranted and cried about THE SAME BOY. She never made me feel stupid. She asked if I just wanted to talk or if I wanted an official diagnosis. I said I just wanted to talk. She never made me feel pressured.

Takeaway: Your therapist should always listen to what you want and need. They should adapt their style to what works for you. They should ask questions and let you do the talking. They should interject occasionally with a tool -- this therapist talk me the 5,4,3,2,1 technique.

AFTER THE BREAK (After we moved and I became suicidal).

There were more therapists that I am probably remembering here, and I am omitting at least 1 here, by virtue of only seeing her once.


The one with the puppets.

Easily one of the best therapists I've ever had, her methods were unconventional. She worked with little puppets, brought her dog once, and had water in her room. She listened well, brought up issues that mattered, and seemed to see beneath the surface. She was also the only person I've ever met that could talk me down from a ledge. I used to call her Mary Poppins, because she was honestly magical. She used a combination of conventional wisdom -- she insisted I needed meds -- and unconventional wisdom, like her puppets. Why did I stop going? She was incredibly expensive!! And didn't take insurance!

Takeaway: Even if someone is unconventional doesn't mean they're not right. Techniques that were super weird that worked. Puppets: She used it to explain why and how my suicidal thoughts were arising, including the idea that they were tied to my self esteem (they were) and a defense mechanism (they are). She also talk me to picture the suicidal thoughts on a dimmer switch. I used it a few times, and it actually worked better than you'd think. The mind is a powerful thing. Don't disregard weird techniques if they work for you.

The one with the candle

Highly recommended, I found this woman lacking. It just wasn't a good chemistry. Her technique seemed basic to me -- she did not do anything that the other therapists didn't, but came across as much more wary and judgmental. I was always concerned to tell her when I had suicidal thoughts and she was appalled when she learned that I had more than one therapist (I was trying to work with someone more than once a week and no one did. I was also interested in having different opinions and finding the perfect match.) The last thing she did was after every session was make me make a wish. Yeah. Corny.

Takeaway: If you are afraid to confide in your therapist, that's a big red flag. If you feel like they're judging you, or they clearly are, that's another red flag. In the end I made my excuses -- and left. One major point though, to be fair, she is correct, most therapists will not be cool with you cheating on them. However, she failed to realize that I was struggling so badly I needed to see two therapists at that time. I could not get through the week otherwise. She failed to see the severity of the situation or to adapt to it. She tried (offered to text me any time, which was very generous and I would love that now) but it wasn't enough at the time. Not a huge diss on her, but in the end it wasn't a good match.

The one who hated Grass Valley.

This woman was clearly out of her comfort zone when she met me (she instantly knew I needed meds, and bless her for that). She was clearly used to clients who she could help heal organically through things like meditation and running. But she knew I was different. She was very adamant about what I needed to do and she was wonderful at talking with my parents. But she did not have many tools. She let me talk quite a lot, told me I needed to get the hell out of the area, as it was stiffing for someone my age (not wrong, but not helpful either), but her main issue was she would lose focus mid session and start looking at her phone if it rang or just space out. I think she may have been going through a hard time of her own, but in the end, considering how far I was driving, it just wasn't working out.

Takeaway: You want a therapist who listens, so if they look at their phone at all, that's a huge flag. You also want a therapist who lets you talk, but you also want one who helps you -- without being phony or controlling -- looks at the positive. It should be a balance, and they should always help you leave in a better place than when you come in. If they're harping on something you can't change, that's a big no-no.

The man

This was an example of where it just wasn't a good fit. I'm sure for other clients he was golden, but for me, every therapy session felt more like a gossip session. He'd gleefully rub his hands and sit back and listen. He gave me a few handouts, and he was the best therapist to get a hold of in a crisis, other than the puppet lady, but for me, it just wasn't a good match. It felt, again, like the severity of the situation wasn't understood. There was no forward moment. I was relieved when he moved his office further than I wanted to drive.

Takeaway: If you don't end every therapy appointment feeling like you've moved forward in some way, that is not a good therapy session. Once you've left an appointment, you should feel (a) uplifted (b) calm or relieved (c) thoughtful (d) worn out from dealing with your issues.
If you leave it feeling like you're wasting your time, you probably are.

The trainee

She was very into one technique, and one technique only. She believed that all things stemmed from . . . I can't believe I don't remember this. I think it was one of three primary emotions. And it seemed like her goal was to make me cry every session. To be fair, she had a lot of potential. She did a lot of really important things and got me to look at lots of things differently. But she was young and very obviously inexperienced. But the worse thing about her was she was trying to juggle two kids and a career and she would flip flop between her priorities. She would frequently cancel or reschedule on such a basis that I didn't see her more than I saw her. She also didn't like that (after she read something in one of her books) I had another therapist, despite the fact that I was lucky if I saw her twice a month. The final straw came when I was suicidal and wouldn't drive and she tried to charge ME for canceling on her. She wanted it out of pocket, even though I was paying with Medi-Cal. Not only is that illegal, but she completely didn't understand what was going on. Instead of realizing that in trouble, she was mad I canceled. Once she understood, (after calling me and giving me a piece of her mind) she tried to be more sympathetic, but what was done was done. I had had enough. I do wish her the best though!

Takeaway: Flakes aren't worth dealing with no matter how great they are. You need REGULAR therapy for it to work. For me that means weekly, sometimes twice a week, for some people that means monthly. Find out a therapist that will work with and stick to your schedule.

The pessimist

This is my current therapist (who may be reading this for all I know. She's the only person with the link) who despite the name I have grown quite fond of.

She is unconventional and she is my current therapist, so I will speak with a degree of rose colored biased, since it is currently working. No therapist is without faults but I have found her to be (mostly) reliable, a good listener, and able to accommodate what I need. Twice a week? Sure, I got you. You want multiple therapists? Sure! You need me to be more optimistic? You got it. You need me to answer my texts more? Sure.

She is clear on what she can and cannot do. (No, do not expect me to get back to you ASAP, but I will get back to you. If it is an emergency, call a hotline, I am not trained in crisis). She is funny. She is supportive. She actually reads the things I send her and asks for them (writing wise). She sees more than she lets on. (Yes, you have GAD, yes, I know you're in a toxic relationship, but I'm not judging because I've been there). She respects my wishes (No, I will not hospitalize you unless we agree that's what's best for you). She helps me to come to my own conclusions (yes, you are really hard on yourself, why do you think that is?)

She is not always straightforward in what she sees and she is not always forthcoming with tools. She makes me find them myself, but since I'm stubborn enough that I tend to not take suggestions anyway, so it might just be me she's like that with. If there was one thing I would like to change about her, I think it would be that. I think a good therapist is forthcoming with that kind of thing. But I also respect that she makes me find my own answers and when I ask if we can do something, or if she has anything about xyz, she'll always give it to me. So that's her.

TAKEAWAY: The non judgmental person always wins. The adaptive person wins. I feel like she genuinely cares about and understands me, and we've been working together for a year now. I struggled with what to think about her at first, but now quite like her. There is a lot to be said for a longer therapeutic relationship. Someone knowing your history is indispensable, provided it's the right person. Your therapist should fight to help you. But they should also let you lead. You also need to realize that at different phases you may need different people. For where I am now, she is a good match. But if I was where I was when I first became ill, would she still be the best, given that she is not good in emergencies? I am not sure. Be aware of what you need and make sure your therapist is meeting all those points.

So, what does a standard session look like? It depends, that's why I wanted to show you all these examples of therapists who were both good and bad matches (mind, I didn't say bad therapists! They were all good in their own way, but they weren't always good for me!). A good therapist should: Meet your needs, listen, offer tools, and make you feel safe and unjudged.

A sample session will look like you sitting on a chair -- sometimes a couch, but not a weird one like in the cartoons -- and facing the therapist. They'll ask you what brought you in. And then you'll talk. Depending on what you mention will take the conversation different places. You may talk about what you want for the future, you may talk about the strained relationship with your dad, you may talk about your hobbies, your eating habits, your moods, your fears. The therapist may use tools -- puppets, dogs, body movements, breathing exercises, puzzles, paints, sand trays, -- or may just listen and ask questions. You may get homework. You may not.

You do not have to tell anyone that you are in therapy or what happened unless you want to. Many people may ask. It's your choice. Sometimes you may get into fears so deep, you're not going to tell anyone ever. Sometimes, you may just talk about how great (or terrible) your boss is and what you want to do that weekend.

But I do want to tell you this. Therapy is not scary. It is just you talking with a friend* who happens to be really good at what they do. With someone who cares and is knowledgeable. That's it. Therapy is all about looking at your mind and patterns and finding ways to better deal with the problems in your life.


*I use friend here to mean someone who cares and is kind and compassionate. A therapist should never use you as a support or act in a casual way.


So that's all for now folks. Hope this was helpful.

~ Emery

Monday, April 20, 2020

No post today

I have almost finished Sunday's post but it will not be posted until Thursday because it is a very long involved post about my therapy journey and will be on what to look at in a therapist yourself.

I look forward to sharing it with you on Thursday.

Stay tuned.

~ Emery

Saturday, April 18, 2020

Deweeding your life

This is a part of helping the depression go away in your life. It's the ying to the yang of filling your life with good things that you want. This is the clearing part. This is hard sometimes. I still work very hard on this myself. It is much harder to get rid of the things that aren't serving you then to find the things you want. But it's worth it.

There are two categories of things that are making you unhappy. This you need to get rid of and things you can change. And then there are things you just have to accept.

Examples: things that make me unhappy

My room
My relationship with my ex (it's a whirlwind of emotions)
Where I live
Not eating
My self esteem
My appearance
My very much singleness
My lack of purpose
My relationship with my dad and brother
My phone

So let's break that down

My room. Things that I hate about it. It's messy, it's blue, and it doesn't feel like me, and it's too small for me to access my books in.

Ok, so the first thing. I can fix the mess. And I have, for the most part. It's made me like my room a lot better. The blue I can also fix, though I haven't already. There's literally paint in the basement. It doesn't feel like me because my clothes are in a box on the floor. I can also fix this, which some help from my family.

I can't fix the size, so I put my books in the living room, where I could access them regularly. There's an element of acceptance. I could also work on how to make a small room look smaller.

Relationship -- yesterday, I took a close look at the relationship and decided that even though its brought me comfort and joy, it brings me more pain. So I decided to cut the person from my life. It is not a decision I take lightly, but the chance is if you're depressed, you've also found some toxic people. Doesn't need to mean they're mean, they're just toxic for you. My ex is in many ways, a really sweet person, but he's my Achilles heel. And he's toxic for ME, because of how I behave around him.

If someone is toxic for you, you need to look at the relationship really hard, and think about cutting the person from your life. This is essential to help depression. Get rid of anything that pulls you down. Ugly bed sheets, closets full of clothes, trash, toxic people -- whatever you need.

  Yeah, I hate where I live. It feels stifling to me, and something I very much want to do is leave some time in the future.

But I also thought about it. I love being with my family and I still struggle enough with my mental health that moving out isn't a good option for me right now. So, for now, it's all about the acceptance.
And hand in hand with the acceptance is finding things you like about it.

I don't like my town, but I do like some of the small cities around it. I've looked around and found things that make life bearable.

If you hate where you live and you can fix that or move, and you are able to, do it. Don't let yourself be dragged down.

When I don't eat, I get all kinds of weird. This is very very fixable. Learn to cook, learn to prep easy snacks. Just do it.

My self esteem. That's something I can change. But it requires the help of a therapist. I am currently working on this and hope it will seep over into other areas of my life.

Other than general therapy stuff I can look at what causes my self esteem issues.

First, being tall. I'm very self conscious about it. Can't fix that. But I can work towards acceptance and finding the good in it.

Second, my glasses and skin. I can fix these things. I am working with a dermatologist and thinking about switching to contacts.

Singleness. I can change that. Need to get out more, and at least make a try to be around men.

Lack of purpose -- we've talked a lot about that. That's where searching for what you want and scheduling your life comes in handy, but it's definitely something you can change. Or you can completely disregard it if that makes you happy. Maybe everything is meaningless to you and that makes you happy. Go you!

I'm not going to go too much into the last one here, but I'd like that relationship together. I'm not sure if that's an acceptance thing or what, but that's something you have to decide by yourself.

So in conclusion, always look to see what you can change, get rid of, or accept.

And if you hate your job, your weekly trips to the mall, or anything else that makes you miserable, just cut it out. Or cut it down.

Lastly, with my phone, I decided to change how I see it and instead of guilting myself for spending so much time on Instagram, I decided to use my phone for educational things and furthering my hobbies. And when I am on Instagram I accept it.

You are in charge of your life. It's yours to change as you wish. So go do it. Find your dreams.

~ Emery

Thursday, April 16, 2020

Tools for when you are two seconds away from death that aren't going to the hospital

As I reflect on Sanvello, I am reminded of what helped the most in the dark night of the soul.

1. Sanvello has a feature called a Hope Board, where you can post pictures that remind you of the parts of your life that you still love, but you can do this anywhere. The point is, when you want to give everything up, because the pain is too much, this board can sometimes remind you of what still matters to you. (Hopefully, we can talk about what makes a hope board in another post)

2. Crisis Text Line
Literally has saved my life more than I can ever count. Their goal is to get you from a hot place to a cool place. They have resources, caring people, and it sometimes just helps to say your worst thoughts aloud. Sometimes I can't even voice what is wrong, but weirdly, I can text it. If you are right at the edge, it's the best thing you can do.

3. Mathematical Questions
If you are with someone, and you are suicidal, and you have instant access to whatever it is you are thinking of doing (no examples per rule 1), have them give you simple logic questions or math questions. It requires you to think about something else, and problem solve in a very black and white way, which helps your currently black and white thinking. Sometimes we don't want to think about the good in the world when we're like that but we can think logically, and these exercises help your brain. At least, they did for me.

4. Talking to someone
This is also to get your mind on something else. You can't do two things at once, at least not well. It doesn't matter what you talk about. You'll probably forget anyway. But just talking about SOMETHING can make the suicidal thoughts ease a little while you chat.

5. Mindfulness.
I hate to admit it but this works (sometimes.) Find 5 things to see, 4 things to touch, 3 things to hear, 2 things to smell, 1 thing to taste. Sounds stupid but it works. Especially if you're having anxiety on top of it (I know I did. Being suicidal is terrifying.) 

6. Better Stop Now App
I think I used this once but it's worth a mention. Try it when you're in that space. It works.

7. Candy Crush
I will point out candy crush (or another puzzle game like gemcrafters) as being a miracle to any suicidal or anxious person. It distracts you, makes you think logically, and is soothing (no timers) all at once. If you are suicidal and need to keep your mind on something else for the time it takes for the ambulance to come get you, this is your game. Keep your hands on your phone and play.

8. Calm Harm, Clear Fear. There are two apps here, but they both help. They have a bunch of coping skills and one may very well be the right thing for you at this moment.

9. Great Big Story
A video channel that shows the light side of life on You Tube. They show far away places, amazing people, and cool animals. Similar to a hope board, this will remind you why some parts of life might be worth hanging in there a little longer for.

10. Refusing to Move
Just what it sounds like. If you are suicidal, find yourself a safe place. Mine is my bed, but yours can be anywhere that's safe. The floor is now Lava. You cannot move from your bed. Tell yourself over and over, you are safe on your bed. Don't move.

11. Medication
Not my first choice, but it is an option. I had as needed meds that knocked me out. I used them when I was suicidal to save my life. Not fun, but an option. Talk with a doctor for sure.

12. Hiking

For me, the woods were a safe place. I couldn't think of many ways to hurt myself, but I could walk and walk and walk and let me thoughts roll and roll without risk of hurting myself. I often felt better after.

13. https://www.metanoia.org/suicide/

Stopped a few attempts right in their tracks. This is definitely one to use when you're really on the edge.

(I hope to link helpful articles about suicide later.)

14. Sleeping

First choice? No. But if you're tired, and it's late and you can, sleep. You'll be surprised how much looks better in the morning.

15. Being with someone

Having someone just physically sitting with you is life saving, because for most of us, it's way too awkward to have someone watch that, and we don't want to traumatize them. Plus, we figure (rightly) that they'll try to stop us.
If you do nothing else on this list, please, at least do that. It's not huge, but it could definitely save your life.

~ Emery

The little thing called Sanvello

If we're going to get out of this thing together we're going to need you to track your moods.
I use Sanvello for this. I have tracked my moods since Dec 2018. It has been extremely helpful.
Sanvello has a scale. I've recently developed my own scale for my own therapist -- emoji hearts, adapted from the ones on instagram.
The Sanvello scale looks like this: Awful, bad, not good, okay, good, very good, great. For me, if I'm actively suicidal that's an automatic awful. If I'm flittering suicidal thoughts through my head, it's an automatic bad. If I'm horribly depressed, that's a not good. My standard is an ok. It's my baseline. I'm not actively thinking about my emotions, either good or bad. Occasionally, I get a good, meaning I feel hopeful and positive. Maybe even a little happy. But that's pretty much it.

To be fair, you can use whatever mood tracker you want. I just like Sanvello.

Tracking your moods is helpful for a couple reasons.

1. Once you've fallen down a hole you always tell yourself, it wasn't that bad. Well, now you know it was. You have proof.
2. On that note, you have PROOF. You can show your doctor, your therapist, your caseworker, your mother, whoever! They can see where you're coming from.
3. You can find patterns. Always feel suicidal right before your period? Now you can be ready. Feel the best in your life only to be followed by a crash the day after? Now you know. Always depressed at night? Now its obvious.
4. You can add notes for triggers, exact thoughts, and precise moods.
5. Sanvello also has a section where you can track your sleep, food intake, exercise, and many other things. This is also helpful in figuring out what bothers you the most.

Tracking your moods is so crucial. You really must start!

~ Emery

Resting your brain

It seems some days that I have two settings. Super high focused energy and super low horribly numb depressed energy.

The problem with this is that your brain runs through the super high energy really quickly. And once you've run out of this energy, you have nothing left, which leaves you with nothing. Also, that sense of purpose you once had? It's gone.

I have two trains of thought on this. One is that it's like breathing in and breathing out. Even though you hate it, you can't be happy all the time, you can't be down all the time. You have to have a little bit of both. You need to let the depression out when it happens or it's just going to build up inside you and explode when you least expect it. We want to avoid this. So, as long as you're not ranging into suicidal territory (and if you are, get immediate help), let it wash over you for a little bit. But keep an eye on it. Have your family and friends keep an eye on it. Mostly, if you've gotten to the point where you actually have high energy, you likely have a more moderate depression. If you don't, be very careful about letting yourself slide. But if you're anything like me, it will go away by itself. It can't stick around forever.

However, if you're in moderate depression and you wind up in a severe depression for more than 3 days, get help.

I would argue that moderate depression is the lowest level of depression that you can actually consider yourself functioning on, since you're mostly able to live your life, though it can be tough.

Moderate depression for me is feeling neutral most of the time, while feeling depressed every night or every other night, with flair ups every once in a while (usually once a month, though an episode can last as long as a week).

Anything worse than that and I would argue you are not yet stable, and this particular blog post is completely irrelevant.

But more on that later.

The other train of though, given to me by my case worker, is that there should be a medium place. Somewhere where your thoughts are low energy but stable. You are doing something, but you are not bouncing off the walls.

To achieve this, she suggested mindfulness and meditation. 

I struggle with both. So I'm turning her idea over in a different way. A medium way might be just sitting and reading, watching a movie, or a show, or listening to a podcast. Something where you're breathing in for a bit.

This is a very new idea but I hope to think about it more -- the idea of filling the well when you don't have enough energy to go out and do anything.

Anyway. That's the food for thought for today.

~ Emery

Sunday, April 12, 2020

Dealing with bad days - A thought

One of the best pieces of advice I got was from a DBSA meeting. They said, sometimes you're just going to have a bad day. You're going to wake up and think, "fuck." And you're not going to want to get out of bed. In fact, even having opened your eyes seems like it was a bad idea.
In that case, don't fight it. Say, this is a bad day. I'm not doing shit. And let it be. Know that it's a bad day, and you can't do anything about it but accept it. That way, anything you accomplish is going to be a bloody miracle. You can use any coping skill you want, but having said, this day sucks, somehow makes it seem a bit more manageable.

~ Emery

Extending your support system

One of the few things that helps in a very deep depression, is the right words from the right person. Human connection in a depression is the most important thing. Even if it's the last thing on earth you want to do, you need it. Trust me.

But it's hard. Not everyone is understanding. But there are people who are, and if you keep finding shitty people, keep trying. You'll find someone who can help and who cares. There are more of us than you might think.

Some places to look over than existing friends and family (hopefully a post at some point on how to talk to them).

Crisis hotlines.

When you're at your lowest, these are the places to go. They are trained to help you and they care. My favorite is 741741, the crisis text line, but that's just a personal preference. The crisis hotline is helpful too, or so I've heard (phone phobia, remember?). There are also crisis chats (which I have not tried because I like the text so much). I think they're'll be a post on that sometimes soon too.

Case worker or therapist

See if they will work with you in crisis. Most will, but some won't, or can't. Ask. If you can work with them, they're great in a pinch, plus they know your history.

Support group

If you've been going regularly, you've now got some pretty great pals who understand what you're going through.

Walk in Centers or mental health classes

You may get some contacts there

If you do any kind of advocacy, you may also find understanding people there as well.

Basically the easiest way to start conversation about mental illness is when you have common ground and you're both dealing with the same thing.

But also remember that waaaaaay more people deal with depression than you think. You may surprised when you open up that people look at you and say with wide eyes, me too . . .

Good luck!
~ Emery

Part Four, Five, and Six

I probably could have included this part three, but it's worth noting on its own.

Get some light! Even if it's only one window, open your damn blinds! You need the light. Being in a dark room is suffocating!

Trust me. Open the damn blinds.

Air. You should get out at least once a day. Why? You need the air. And the light. And the exercise, and frankly, you need an excuse to get dressed and move from the spot you're sitting in. When you sit in the same spot for too long, you get stagnant. When you are stagnant you get all murky and depressed, like a dull pond or a spiderweb than just keeps on growing. MOVE!

I go to the mail every day. It's at the end of our street, so it's quite a while. About a block, maybe two, away. It's not much, but it helps. I think the walking helps too, though I'm not a big walker (I have a bad foot with arthritis).

But moving after being in my little bubble all day is huge. I get dressed, I sometimes chat with the neighbors (though if you hate this, use headphones), I get a little out of breath. I remember that there is more to the world -- and that the world isn't all bad -- than my little room. Taking that fresh breath is crucial, even if it seems pointless, it will catch up with you.

Breaking up the monotony -- can be small or big. Small: you've been on youtube for 3 hours? Change to reddit. Been on social media for 4 hours? Switch to a new website or watch a movie. Couch potato? Switch to Khan Academy and learn something. You'll still be on the couch, but you'll be smarter. Hate the world? Go to Zen Pencils or Great Big Story. It won't fix it, but you might feel something for two seconds and that's something. It builds, you know. It comes back slowly, but it does come back, and every little bit counts.

Now let's talk about the bigger moments.

Move from your bed to the couch. Seriously. Move from the couch to the kitchen. Switch your location every once in a while. It helps more than you know. If you don't live alone, talk it up with your housemates for as long as you can stand. You're building your world outside your depression, bit by bit. It doesn't feel like much now, but it will add up.

Lastly, plan things you want to do and do them, things you are excited about. Maybe you want to try that new taco truck, or go to your local theater. Or maybe you want to save up and do Burning Man. Do it. It gives you something to look forward to, and even if you only enjoy it half as much as you normally would due to depression, you're still enjoying it. And it's super important not to deprive yourself of experiences you would like, just because you won't enjoy them as much as you should. Who cares. Do it anyway. Again, it builds. Maybe this time you enjoyed yourself for only 5 minutes, but next time maybe it will be 30. It builds.

Keep going.

~ Emery

Part three

I know it may seem a bit silly to have a post on hygiene here, but trust me, it's important. It's tied to your self esteem. And your self esteem feeds your depression.

I am also including hygiene to mean getting out of your bed and getting dressed. There is nothing that makes you feel sadder than just sitting in your bed and feeling horribly uncouth. If you look terrible, you feel terrible.

So here's my argument for you. Try to do at least one thing. If you can't do anything on yourself, do something to the room you're in, or vice versa.

Things you can do -- try for at least one, but the more you can do, the more human you'll feel.

Brush your teeth.
Take a bath or shower
Brush your hair
Put on contacts if you wear them.
Wash your hair
Shave
Put on makeup if you wear it
Get dressed
Get dressed in something nice.

You'll feel more human I promise.

If you can't bring yourself to pamper yourself, look around your room.

What can you do?

When I really feel like shit, I'll play the ten things game.

I grab 10 things, no matter how large or small, and put them or throw them away.

Then I consider it done for the day.

If I am ambitious, I combine it with bribery.

10 things -- 1 episode of Ducktales
10 things -- 1 episode of Totally Spies (yes, cartoon dork)
etc.

Other things you can do.

A load of laundry
Fold some laundry
Make your bed

Or other chores around the house (I'm sure you can think of some).

It is amazing how much it can help! Good luck!

~ Emery

The Anxiety Piece

Depression is not always alone. For many people, including myself, there is an anxiety component. For some people, it's mild, for some people its severe. There aren't any definite answers as to why anxiety and depression are tied together but this is the reality for many.

For me, when I think back on it, I've probably had anxiety my whole life. It's to the point that some days I don't even think I have anxiety, due to how used to it I am. My psychiatrist framed it this way: "You're so used to it," she said, "that you've basically overcome it."

I believe her. In college I used to describe it this way: I'm terrified about everything so I might as well do what I want. Buying something from the store and going across the country caused me the same amount of anxiety so I figured I might as well go across the country.

Is this a great tactic? Eh. Honestly, I'm not much of an expert on anxiety -- I haven't read much or watched much on it. I only know what I know from my own experience.

Things that would probably help: Meditation (but I don't have the patience for it). That sensing exercise where you find 5 things you can see, 4 things you can hear . . . etc. Deep breathing.

Things I've found that actually help.

Music. Either very calming music (see sleep playlist on the other post) or just stuff I like. It takes my mind off stuff.
Puzzle games like candy crush (it's rhythm is soothing).
Focusing on something else. If you distract yourself enough, sometimes, if you're lucky, your brain will shut down.
Sleeping. Sometimes you just need to turn your brain off and on again. If you can manage to sleep, that is.
And lastly, meds. I've never tried Xanax, but I do have viseral (or hydroxizine) which they use in the mental hospitals. It just makes me fall asleep, but for me, my anxiety is at its worst at night. I get this shaky feeling where I feel like I'm going to fall off my bed. I want someone to put me in a small box to stop from falling. The more it goes on the worse it gets. When this happens, I take the meds. Sometimes it's happened in the day time, but mostly it is at night.

So that's what I do when I get shaky, but my anxiety is not limited to that.

It is also especially bad with new people, crowds, new situations, and things I am afraid of like driving or phones.

In many of these cases, I try to avoid the thing that makes me uncomfortable (example, parties) but that's not always good or healthy. The other things that help for me is doing things in small quantities -- challenging myself to go to a party every once in a while or focusing on something small I can control (who can I talk to that I know?) and then breaking the entire thing into steps (Ok. I know Natasha. But I also know Mala and Hani. I'll talk to Natasha first, then Mala, then Hani, then excuse myself to get some chips and a breather).

I also find though, more than anything else, exposure therapy to be the most helpful. This has helped the most with phones. You can go in bit by bit or go whole hog. I got a job in retail so we know what I chose . . . and still, bit by bit, the phone phobia gets better and better.

Also, for me, knowing what the worse case scenario is and having it happen actually makes me feel a little better. Because now I know what it is and I know what can happen. One of my biggest fears is being awkward on the phone. Well. I've done that probably about 50 times now. It doesn't bother me as much. You learn that people are generally more understanding than you'd think.

And if they're assholes, that reflects more on them than you. And you can breathe a bit better.

My biggest anxiety is around driving. To those with the same, I say, learn as much as you can first -- I took an extra 10 hours of driver's ed after I had my licence and it really helped.


Then I started driving with my mom.

Then I started driving behind my mom. (I was and am afraid of getting lost).

Then she drove behind me. (I was afraid something bad would happen and no one would find me).

I also challenged myself to drive very short drives to somewhere I really wanted to go (in my case, the library).

Finally, I stared driving the 40 minutes to work and once I got the hang of it it wasn't so bad. I had some things happen -- hydroplaned, hit a deer, hit a parked car -- but I learned how to deal with them and I realized that these things are not the norm. I drove to LA and back. It was hard. But I did it.

And now, even though I still struggle, especially driving some place new, I can do it.

Oh, two more things.

Talking to myself in the car and trusting my instincts were huge. But so was music when driving. Anxiety people, we need to override our brains sometimes.

And I've found the more attention you give your anxiety, the more it grows. Easier said than done, obviously.

Hope this was helpful.

Again, not an expert, just what I've experienced.

I also read an interesting thing on the internet about people who have anxiety (officially, I have a MDD diagnosis with "anxious features" from my psychiatrist and a GAD diagnosis from my therapist. But you can have anxiety in so many forms!) is that we like what if statements, but we're all about the negative. What if I fail? What if this happens and I ___ (crash, get dumped, starve, etc). But you can also use that what if to a good end. What if I succeed? Make new friends? Find love? Have a perfect driving record? I haven't tried this yet, so I don't know if it works or not, but it's an interesting idea to be sure. And I'm all about those ideas, to be sure.

~ Emery

Saturday, April 11, 2020

Part two -- Food

I am really bad about eating and eating on time. When I don't eat, my mood drops and I'm screwed for the rest of the day. Even right now -- I haven't had lunch. This a big one for me, but I doubt I'm alone. Food is important. It keeps you stable.

If you're depressed though, it can seem really hard to make anything. Heck, it can seem hard to even EAT something premade. But here's what I can offer to help, of some really easy recipes.

Breakfast:

Cereal. Dear god, cereal. Try and get granola, and not something so sugary, but food is food in my book. Something is better than nothing.

Yogurt. Man I got so sick of these at one point. But they're genuinely helpful and full of nutrition. Stock up.

Lunch

Sandwich. It doesn't have to be complicated. My favorite has mayo, salami, and pickles, tomatoes if I'm fancy.

Cold cuts. (Not strictly a meal, but it's something!)

Salad with some chicken or cold cuts in it.

Pasta. Try some tomatoes and Parmesan on it.

Hard boiled egg.

Quesadilla

Grilled Cheese.

Perfect? Nope. But it's something. And you gotta eat something.

Dinner

pre frozen orange chicken.

Boxed mac and cheese

French Onion Soup. It's stupid easy to make. Onions + chicken and beef broth. The hardest part is chopping the onions. Plus you can make croutons really easily.

Nachos. Chips, tomatoes, beans, cheese. Done.

Pesto pasta. I have a recipe for it that just calls for you to put basil, cheese, pine nuts, and olive oil (I think that's it?) in a blender and pour it on the pasta.

You can also mix in some of your lunch options.

If I ever become a better cook, I will update this list, but this is what I have found helpful in my own sad food journey.

Good luck!

And remember that the internet is your friend.

~ Emery

Upkeep -- or how to stop the spiral before it stops. Part one.

We tend, when we're depressed, to forget about the essentials of life.

I would personally classify these as being things like sleep, food, hygiene, light, air, and breaking up the monotony. And of course, having a good support system.

Each one can really make a difference in your every day life.

Let's start with sleep. Most people with depression either have too much or too little. Of the two I tend to think that too little is the bigger one to worry about. If you're truly having trouble sleeping, then I recommend talking to a doctor. They can prescribe some pretty strong meds for that. If you're looking for something over the counter, melatonin and/or benadryl (check with your doctor first!!) can be a good start. My meds have helped make my sleep easier since they make me super sleepy, so that's nice.

Something that can be incredibly helpful is to have a proper bedtime. If you are staying up too late, try and peel your bedtime back bit by bit. Start by going to bed a half an hour earlier. Then, when that is comfy, try going to be a half hour before that until you finally reach your desired bedtime.

Bed prep is important too. If you have trouble with your phone, try turning it off up to an hour before you sleep. If you don't, turn it down all the way to nighttime mode and a low brightness setting. A lot phones have a nighttime mode that helps your brain shut off.

Personally, I go to bed at 8 (I used to go to bed at 11) because my meds kick in and make me really sleepy. But before my bedtime, I start winding down at 6. Important to note that these tools are optional. Use them for when you need them. If you don't want to use them, then don't. Some nights I stay up til 9 and look at my phone. Sometimes I'm out at 8.

Some things I do from 6-8:

Eat dinner. Take a hot bath. Get in my pjs. Make my bed, if I haven't already. Draw my curtains. Journal. Read a comforting book (for me, one I've already read is the most helpful). Read Webtoon. Play piano. Read relaxing articles. Brush my teeth.

Once I've brushed my teeth, I give myself ten minutes to turn off my phone. I play two songs: Weightless by Marconi Union and Monks Chanting Om Natural - meditation, relation, new age, yoga by Deep Sleep. Both help me get very tired very quickly and I'm usually out before I know it.

For falling asleep, on the nights that it's challenging I tell myself that I don't actually have to sleep, it just feels better to keep my eyes closed. And then I sort of lean into that feeling.























Thursday, April 9, 2020

A few words on support groups

My absolute favorite support group is DBSA. There is many reasons for this, but one of my favorite things is that it focuses on the consumer.

There are many groups out there, but the ones I personally do not like the most are the friends and family groups FOR the consumer.

Friends and family groups are great for friends and family, but if you have a group that is more people who know someone with a mental illness then with a mental illness we have a problem. As a consumer, it makes me feel like a burden, to hear people come and bitch about their "problem child" or "wild niece". As a caregiver, this is needed. But not with people who are experiencing the illness. In my experience, people who want to talk about someone are the louder voice in the room than the people who are actually having the experience.

BUT fundamentally, the biggest thing is, the problems you have as a consumer are so drastically different than the ones that caregivers have. And the types of responses you get from each sort of person are very different. As they should be.

But most important to go to a consumer led group is the sensation that you're not alone. To be in a room of people who understand and aren't there to judge you is one of the best feelings in the world.

I highly recommend finding a support group. Hands down it is the best thing I did.

Go three times, then decide of course, but keep looking until you find one that meets your needs. It's important.

~ Emery

The beauty of a schedule

In the time of COVID 19, our schedules have vanished. In its place there is nothing but spare time, drifting off until goodness knows when. In my experience, there is nothing worse for a depressive than empty space.

For me, I have two triggers for my depression. The first one comes out of self esteem -- I suck. I'm an idiot. Why do I bother existing. Nothing I want will come true. It's pointless.

I still haven't figured out a solution for this one.

The second one often stems from boredom and lack of purpose, however, which is why we'll later explore in more depth. In my previous post, I talked about all the things I do to keep myself sane. To do this, you need to figure out what it is that still interests you.

There are multiple categories here, but I find the best way is to look at 3 main factors. You have passions, hobbies, and interests. There are important distinctions between the three, and if you mix them up, like I have, you're going to be in trouble, because the most important part of the schedule is that it not be arbitrary, boring, or forcing you to do things you don't want to do. So there's needs and wants on the schedule, and then there's things you've been meaning to do.

So let's look at passions. This is the thing that when you do it, the whole world stops. You lose track of time. You get addicted and you can't breathe right. You think if you had time and money you'd make a career out of it -- or maybe you love it so much you couldn't stand the idea of it as a career. Maybe it's music, magic, cross country skiing. Whatever it is, you live for it. If it was taken away, you'd feel like you couldn't manage. Maybe you haven't found this yet, or maybe you've forgotten. I bet you've forgotten. Think back on what you liked to do as a kid. Were you always into nature? Books? Comics? Chances are you still love them.

Passions should drive your schedule. They're the things that you should be learning in, growing it, finding ways to practice. It will help you feel alive.

Hobbies are the things you enjoy doing, but don't make you lose track of time. You'll happily spend a few hours sewing, or playing the piano, but you don't feel all that motivated to go out and master the entire soundtrack of frozen, or pull an all nighter sewing a dress. It's fun, and you like it, but that's it. It's a good way to pass the time. You can use these in your schedule when you're sick of your passions or you just want to shake things up. It's good to remember your hobbies.

Interests are things that you enjoy reading about or things that you find yourself scrolling through on reddit, but you haven't really gotten around to doing. You don't mind it when you flick on netflix and see a documentary on it, but it's only there when its . . . well, there.

Interests are good things to keep in mind when you're scrolling through the internet and trying to pretend like you're not bored out of your skull. It's a way to take control of your downtime again.

Sick of reading the news or about some new celeb thing? Find materials (either an ebook, a reddit thread, or a you tube video) about this thing and save it somewhere where you'll come back to it.

So these are your wants -- think too about your goals. What is it you really want to do. Money and time and skill are no object. Think about what you really want to do. Then find a way to do it, one step at a time. Use your downtime wisely.

When you're developing your schedule, also be aware of what you need, both as an individual and a human. As an individual, maybe you don't think your day is perfect until you've watched the newest episode of your favorite show, or maybe catching up on the news is important to you. Blend these into your day. As a human, remember that you need to eat, sleep, and shower. If you go without these essentials, you will suffer.

Keep in mind that human contact, whether you're texting or skyping someone can make a difference. So can exercise, even if it's a five minute walk or three yoga poses. It's something.

Remember to schedule leisure into your day. I only schedule my day until three, because I know that I need the downtime. In between activities, I also wind down.

Lastly, think about your natural schedule. When are you the most productive? When are you the most happy? Are you a morning person? Or are you most awake at 2 am?

Find what works for you.

And good luck.

~ Emery

On Books

There are some books that I think are especially good.

First and foremost,

How I survived when my brain was trying to kill me by Susan Rose Blauner

Second

Welcome to the Jungle by Hillary Smith

Marbles and Rock Steady by Ellen Forney


Thirdly

A beginners guide to losing your mind by Emily Reynolds



On technology addiction, which many depressives may also struggle with (I know I do)

How to break up with your phone: the 30 day guide to taking back your life by Catherine Price


On changing your life

The Happiness Project, Happier at Home, Four Tendencies, and Better than Before by Gretchen Rubin

Inspirational books:

Wild
Zen Pencils

There are probably many more, but these are off the top of my head.

Sunday, April 5, 2020

What I did when the world was black

At the worst of my depression, when I could barely stand to wake up, I did the following things:

I went to a lot of therapy appointments. It got me out of the house, and kept me alive.
I was on my phone a lot.
I played Candy Crush. This was essential for keeping my mind off things.
I made lists.
I watched Great Big Story on You Tube
I read Zen Pencils when I felt ok.
Hiking

Find your own distractions. Whatever can cut through, even a little, is what you need to be doing. If you just feel less miserable for one second, then keep going. Right now, it's about survival.

Examining your life part 2

I worked my job for a month or so and then realized I needed more. I added in Ice Skating, as it was something I had always wanted to do.

But come September, I decided I wanted even more. I decided to create a list -- 12 things to do before I turned 26. They were crazy, off the wall things, many of which were things that my inner child would have really enjoyed. They included things like making a portfolio, visiting my dream school, and going to China.

I highly recommend doing something like that for yourself. I chose one thing for each month, but it was flexible.

But it wasn't until my New's Year's Resolutions I broke down even more what was important to me -- I wanted to write and I wanted to read. And more importantly, I wanted to make progress on those things that were important to me. So I looked at my schedule and decided that I wanted to put in the time where I could. My days off were Thursday, the weekend, and I had a short day on Friday. I decided I would read one book that I'd always wanted to read a month, by dividing it into 30 and reading a certain amount of pages a day. I decided I wanted to work on and finish one project a month so I decided I would write one page (later changed to working for 30 minutes) on Thursday and Saturday, and 2 pages (later changed to an hour) on Sunday. On Friday, I decided to work for an hour on my novel.

But I didn't start like that. The first thing I did was to start writing one page a week on Fridays and posting it to various writing sites. It wasn't much, but it was something. I did that page rain or shine, happy or suicidal. I let it be on whatever I wanted it to be and even gained a follower.

I also did small things like Inktober. Challenging myself to something I really wanted to do was the perfect motivator for me. So my advice -- find something small and do it consistently. It helps get you out of your own head for a while.

So where am I now? The quarantine of course. Now all my carefully scheduled time and effort, and getting out of the house has fallen.

Only, it hasn't. Because I found a new purpose. Art and writing. And I have created a routine that doesn't seem arbitrary and is also a lot of fun.


I have found videos and books that apply to what I want to learn which I read throughout the day. I start at 9, because I wake up usually at 7-8. At 9, I watch a masterclass or two or a pixar in a box.

Next, at 10, I read from my book of the month, in this case, The Animator's Survival Kit. I read my 13 pages then put it aside.
 
At 11 the activity varies. I might write something if it's Thursday-Sunday, I might draw for practice, I might do something banal, like wash my hair.

At 12 I often watch a cartoon to get inspired and relax.

At 1, I try to talk to a friend. Skype, call, whatever.

At 2 I choose another activity that seems relevant, maybe I watch something on how to draw, maybe I make my bed, something relevant.

At 3, I do the same thing every day except for Sunday. I go out and get the mail.

And after that, I let myself do whatever I want.

At six, if I want to, I can do some bed related activities (I fall asleep at 8) like writing in a journal or taking a hot bath.

Scheduling, in short, can be a great way to take control of your life and have things to look forward to. When scheduling, think about the things you always wanted to do, and do them. Don't wait. Do it now.

~ Emery

Examining your life part 1

When I was most depressed, I had just moved into a small forest town with a population of less that 1500, after living most of my life in Los Angeles, I was afraid of driving, I wasn't working, and my days were spent on my phone. I couldn't cook and was too depressed to have any hobbies. My mother had begun working, my brother was at college, and my dad was at home but just as depressed as I was. I had a bad ankle, which made it so that I couldn't walk very far, and my creativity was blocked.

When you look at your life, you need to imagine what you would most like. What are your wildest dreams and how can you make them come true? But limit yourself to things that you can do. Don't say you'll be discovered, published, or have the world's best boyfriend. You can't control these things.
Think about the things that bother you about your life. Think about your daily schedule. How are you spending your time? I highly recommend reading books like the Artist's Way to get back in touch with your inner dreams. I also read a bunch of inspirational books during this time, my favorite of which was Wild by Cheryl Strayed. Find people who have actually done things with their life. Then imagine what you can do with yours. It's not impossible, I promise.


I had multiple iterations of what I wanted to do. I made all kinds of lists. I started small. What could I do that would help. Well, cooking was something, and so was learning to drive -- or being confident about it, was more accurate.
So that was the first iteration, I decided I was going to try driving to the library once a month.

But that wasn't enough.

I knew I wanted to get out of the house. The easiest way to do that was to get a job. But I wasn't confident that I could do that.

So instead, I thought about the other thing I wanted to do. Work in mental health. Just volunteer, help somehow.

I mentioned it to my case worker, and my doctor and boom, there was a job opening. Was I interested? I was. I had been out of the hospital for six months. I could handle it, couldn't I? So I applied. And I got the job. (Ok, it was more complicated than that, but its the jist)

Having a job helped a lot. I started out with just 16 hours. But it got me out of the house. And because I wanted the job so badly, and it required that I drive, I started to learn to drive.

But having that job gave me something I hadn't had in a while -- a way to get out of the house, money to spend, and a purpose. Having a purpose was really helpful.

It pulled me up a little.

I also was around people again. There is a reason that isolation is the drug of choice for depressed people, and there's a reason we shouldn't partake in it.

But suddenly, I began to notice the good again. I was doing something that mattered, and if I did this, I couldn't suck that much, could I?

I also felt like I wasn't alone. Here were people like me and worse. I wasn't just a freak of nature. This was a thing. And I wasn't any worse for having these struggles.

I suddenly had community, between that and DBSA, which I had started about 2 months earlier. I started laughing again. It was a hollow laugh, but a laugh nonetheless.

I wasn't ok, but it was something. It was a start.

My team

So let's go into it, shall we? How do you find your team.

First off, get some insurance. If you have a job, use that. If you don't, Medi-cal (or Medicaid in some states) is the way to go. If you have less than $1000 a month, you may be eligible. Do your research on that. Find something that will work for you. Mental health is expensive.

I personal have medical and go through my county services. I recommend this route for anyone as broke as me. There are other options, such as paying on a sliding scale (always ask therapists about this!), paying out of pocket, or trying an online alternative, such as talkspace. (though I haven't worked with them so I can't say how good they are).

So first, you're going to want a therapist. I personally like the https://www.psychologytoday.com/us/therapists option. I've found many therapists that way and it sorts for insurance. Another way is if you're receiving county services, you will be assigned a case worker. The case worker can often refer you to a therapist. That is how I got my current one.

What to look for in a therapist: fundamentally, you want someone who is kind, present, a good listener, and has ideas about what you're facing. But honestly, you can't intellectualize it that much. You have to go in and see if it feels like a good fit. A good therapist should feel like a best friend, but without the baggage. They should like you, want to help, but also be the adult you never knew you needed in your life. They should be calm and present. They should ask a lot of questions and not jump to conclusions. Therapy is very effective, but it takes time. That said, if you can tell a therapist isn't a good fit for you, don't feel shy about finding someone else. The guy who used to run my support group had a three time rule. Go three times and see if it makes sense. They may just be having an off day. But after three times, it's probably not a good fit.

With a case worker, while you may be assigned one, you may have the option of changing case workers as well. You're looking for much of the same thing -- someone who is compassionate, who knows their stuff and is responsive. Case workers are also special because they often tie into a larger system, and as a result, may have more resources to tap into, including housing resources.

Now, meds. Meds are a tricky subject because all meds are a case of trial and error. Each person reacts differently to different meds even if they have the same condition. You psychiatrist will help you navigate, and you should pick someone who, again, is knowledgeable, likes you, and listens. Meds are tricky and you don't want someone who is in a completely different world than you are. You can also ask if you can take the Genesight test, which will show you genetically which meds are least likely to have adverse effects, though it is not a perfect system.

As to the question of meds or not meds, I say if you're suicidal, you should be on meds. They help a lot, though they take time. For me, meds have been life saving and frankly, I don't see the point in suffering if you have an option not to. However, meds do come with very real side effects.

Lithium, which I take, has very much evened out my moods, but left me with awful acne. I don't mind that, I think it's worth it, but common side effects can be anything from weight changes to an increase in suicidal thoughts. Keep that in mind.

But something else to keep in mind is that most meds are not addictive. There is a special class of meds that are, and if you're on them, your doctor will tell you, but most meds don't have that effect. However, never EVER go off your meds without telling your doctor. You need to titrate down and even then, you can have some nasty side effects, not to mention your symptoms can come back.

There are many different categories of meds, including mood stabilizers, that include Latuda, Lithium, and Lamictal, Anti-Depressants, with many nuances there as well, and anti psychotics.

Your doctor can tell you much more about these. But the takeaway should be that these meds should make you feel more like yourself, not less. They should help you be the best version of yourself.

Saturday, April 4, 2020

The best comic on depression

Whenever I think of depression, I always come back to this comic, which is the most accurate thing on depression I've found yet.

http://hyperboleandahalf.blogspot.com/2013/05/depression-part-two.html


My fish are dead. Yes, yes, they are. And it's ok. It will be okay, I promise. Even if you don't have fish I still think you (yes, you) are awesome.

Light will come back, I promise.

~ Emery

My current experience

I am currently surviving. 

This is how I'm doing it. 

First of all, you need a good team. For my team, I have a therapist who I talk to twice a week, a caseworker that I meet with once a week to check in, and a psychiatrist who I meet with once a month. 

All of these are important factors and you need all three. Without one, the system breaks down. 

Second, you need to look at your life and decide what is working for you and what isn't. What is the life you are living in comparison to the life you want to live, both external and internal. How are you spending your time? Who are you around all the time? What is your job (or lack thereof like?) What are your dreams? 

Third, you need a sense of purpose. When you are depressed, you cannot feel like you are wasting your life. What is it that means more to you then anything else? How can you feel like you have a meaning to your life? Do you need a job? A religion? A passion? Do you need to do volunteering? 

Fourth, you need to be kind to yourself. Every day is not going to be great. That is ok. 

Fifth, you need a support group. Finding people like you who are living the same life and surviving is critical, and they will not judge you and help you find coping skills. My go to is DBSA. 

Sixth, you need to track your moods and find your patterns and triggers. I recommend Sanvello for this, but there are many others. This way you can know to avoid them when possible and know how to find what's bothering you.

Seventh, you need a crisis plan, or know how to know when you're spiraling. You need to be able to act on it, or have someone who will help you implement it. More on this later. 

Eighth, you need to have coping skills. Depression is in the prevention. If you can stop the spiral by distracting yourself, all the better. If you can't, then those distractions will save your life. Find some good ones. 

Ninth, you need to have a good support system. If not family, then very very good friends.

Tenth, you need to have hope. It will get better. 

Eleventh, you need to know that this journey is different for everyone and we find our own path. So, you need to have resources. Be active in your recovery. Find different ideas about depression and find what works for you. Read, watch, listen. It could save your life. 


The most important thing

The most important thing in depression management is to keep going. No matter how dark it seems, how hopeless, just keep going. Do not give up. Trust that there will be a better day, because there will be. It is not a quick process but it is a very real one. Keep going, keep going, keep going. If all you've done in a day is stay alive, you've succeeded. Depression is very hard to deal with. Most people will not understand, but speaking for myself, it's the hardest thing I've ever encountered. You are strong and you are a fighter and you can do it. 

~ Emery 

Thursday, April 2, 2020

A little about me/some rules

So, my story. I'll try to make it brief.

First -- why this project: I've wanted to create a resource guide for probably about a year. I wanted my personal experience to be intertwined with the resources that I personally found the most helpful. I'm still struggling to put together that guide, so this is a sort of a more personal test run. I will be running this blog from today until the end of April. It will update with multiple posts on Thursday, Saturday, and Sunday of each week. At the end of April I will reassess and see where this takes me from there.

For my part, depression sort of crept up on me. I experienced some in college, in differentiating frequencies, but it wasn't until in July of 2018 that my depression really began to kick up as we moved from Los Angeles to Northern California, and I felt as if my whole world had fallen apart. I became very depressed very quickly. I felt trapped and miserable. Then, on September 9th, 2018, I became suicidal. And once you've passed that point, it's very hard to turn back. I continued to struggle with suicidal thoughts and depression in massive amounts until I was hospitalized on October 31st, 2018. I spent 9 days in a locked ward. Then I transferred to an unlocked ward where I spent 2 weeks.

After that, I became an outpatient, but this didn't mean I didn't struggle. I constantly struggled with suicidal thoughts. I probably should have been hospitalized many more times. But slowly, slowly, slowly, SLOWLY, I began to get better.

In May of 2019 I began work as a peer advocate in a walk in center. My work is currently on hold due to the virus that is now going around.

As for myself, I am not an expert. All my knowledge comes from personal experience and that can differ from person to person. Please talk to the professionals in your life. But for my own part, I have come from severe, life-threatening depression to moderate, sometimes even mild, depression, and I can once more function in my life.

I may write more about my circumstance as time permits, but there is one thing I absolutely will not tolerate on the blog.

I will never give details of how I hoped I would kill myself, even though at the time I had plenty of ideas. This is a dangerous thing for any suicidal person and can endanger their lives. Thus, if anyone reads this, I will block you so fast your head will spin if you mention details of a suicidal attempt or ideation. And of course if you are suicidal, don't hesitate to contact a hotline or check yourself into the ER. This really is the best course of action, and nothing beats medical professionals.

  Anyway, that's all about me for now. It's a hard thing to talk about, but I hope to share more as time goes on. But the most important thing to know is that you're not alone. Really. I promise. It may feel like it, and like the tunnel will never end, but it will. I promise. Just hang in there.

~ Emery

Welcome

Welcome --

This is a blog about depression, but I also hope it to act as a resource guide for those in need of help and those who need somewhere to start with. It's what I wish I had when I fell down the rabbit hole.
It's a little scary to be writing this, especially under my own name, but I want to break the stigma. I think that's important.

Most of all, I want you to understand that this is just the tip of the iceberg. There are so many resources out there and there is so much help. If you haven't found something that works yet, don't worry. You will.

I am living proof that you can and do get better. It doesn't always look like it does now.

You can get through this. Day by day, hour by hour, it all brings you forward. But, as a wise friend of mine once said, recovery is not linear. You will have bad days. But you will get through them. You have gotten through all the bad days before. You will get through this one. You can do it. You are a fighter.

And I know you can do this.

So, here it is, all the wisdom I've picked up from my research, my experience, and my work.

I hope it helps.

Best,

~ Emery