Discharged

To prep myself for discharge I set up my journal with check in sheets similar to those we did daily in outpatient but adjusted to best benefit me. It includes a scale of 1-7 rating of my depression, anxiety and suicidal idiation in both the morning and evening at the bottom and top of the page. It additionally has a space for 3 things I’m thankful for that day. Additionally there’s a space for goals for the day, for daily wins and accomplishments, a space that says “I used [skill] today to:” in which I can write things like “I used radical acceptance today to accept that I am anxious about going to the show tonight and seeing my friends I haven’t seen in 2 months since I left for outpatient. I accept that this is where I am right now and that is okay” or “I used opposite action to go to the show even though I was anxious”. Lastly there’s a spot for exercising my self worth that reads, “The thing I love about myself most today is:”. I feel like this will help keep me mentally structured and build upon everything I’ve worked on at outpatient.

I returned to work as well twice this past week and 6 days a week starting next week. I came back feeling excited, overstimulated and confident. I surely did miss my job. I’m scared the most that I’ll not practice my skills as well as I did while I was in outpatient, but there’s no reason for me not to be able to build upon what I’ve started and exercise the new neural pathways I’ve been creating for myself. I need to remember to look at my affirmations, my vision board, journal and track my wins. These are things I have set up in my favor for success. I feel that transitions are usually hard and this one in particular because of the uncertainty is stressful, but I think I’m sitting with the uncertainty and uncomfortable feelings pretty well and stopping my rumination as fast as I can.

Lastly for this post I wanted to share a letter I wrote to a future patient at the hospital outpatient program I just finished. It was my last assignment before I finished and it was optional.

“Dear Future Patient,

You are a wonderful person. Don’t believe me? I mean we don’t know each other, but I say this with confidence because despite the things you feel like you can’t do right now (which is okay by the way, work from where you are toward who you want to become and accept where you are as a first step to moving forward) and despite the things you may have done that you don’t feel so good about, you are worthwhile of a full life and of help.

Outpatient was my second place I went for help. I was leaving outpatient elsewhere a month before and walking in here I felt like an embarrassment to myself and becoming vulnerable was brutal. However, it was a necessary personal choice I made that helped me grow. It’s a safe environment to be challenged in and supported and the discomfort I felt here made changes in myself.

Because of the paradigm shifts I experienced each week I challenged myself to work a little harder. Your treatment team here will give you tools, teach you and be the tools for processing, guidance and growth. May you open your toolbox here and be willing to use what you’ve been given. There are no comparisons as our struggles are each uniquely our own but for me there has been no better place to be while facing the hard bits of life than at outpatient.

May you grow, even just a little, for little wins add up to benefit the future self you want to be, even if just in this moment you’re not 100% sure you know what that looks like. You will.

My very best wishes for you,

Former patient”

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Graduating Outpatient – Letter to my future self

The prompt: It may be difficult to remember all the things you have learned and are feeling right now as you complete the program especially when you find yourself feeling highly anxious/depressed again. Write a supportive note from your current self to your future self who may need a reminder.

What I wrote: Dear BipolarBarbieQ,
We wrote all our coping skills in the journal Jas gave us and you can look at them often. If we keep practicing our skills we’ll dig new neural pathways. I’ve already laid the ground works for you and planted all the seeds. In fact, you can look back and remember this was the day Ashley led Experiential Therapy we read the story of the butterfly and the caterpillar pillar then shredded our papers and made new paper with seeds in it.

Make sure you look at our affirmations often. Find new ones. Decorate everything. I did some but you can do more! We are the observer from the meditation that had us dig through our memories. Life is context but we, the observer remain a mystical force and a representation of a full person which we always will be no matter the circumstances. Though I have struggled with negative core beliefs about myself and unearthed all the roots attached to them I also started trying to catch and challenge these. Add to the living list of positive attributes of us and don’t be shy to read it to remind our-self that we are enough. Even if we are not where we want to be yet, that is okay. Remember to accept reality wholey as it is.

Opposite action and behavioral activation are our sword and shield against avoidance and isolation. Adjust your goals to where you’re at and don’t take on too much at once. It is okay to cry, healing is not linear. We have the power to make wise choices to change our future with the knowledge we’ve gained and that you will gain for me as my future self. We are enough. We are worthy of good things and have an ability not all have – the ability to ask for help if we need it. It may seem like just a tiny thing but think of how beneficial it has been for us.

We can not change the past nor will any good come of tripping over things that are behind you. Don’t live too far in the future either. Remember we are in the moment and want to be there. Wherever “there” is. Ajham Brahm helped us tie together all the mindfulness we took in every day in so many ways. I’m cheering you on to keep practicing everything we’ve learned.

It’s been a long journey without question but I’m proud of you just as you are proud of you at the moment this was written. Write your wins and remember who you are and who you want to be. Believe in yourself a little more and follow your own example. Taking risks takes practice and your future self will thank you for it.

Love you,

Bipolar BBQ

From Outpatient to The World

Some of you know I’ve been in outpatient therapy for anxiety and depression for about the past month and a half (I had a major depressive episode – I have bipolar disorder type 1), some of you don’t (a couple months prior to that I was in outpatient for a month but I fell back down deep again), but I wanted to flash my pride that I’m graduating from it tomorrow and I’m a more educated, practiced person creating new neural pathways for myself that I vow to keep active and re-train my brain to think better and be more mindful. I may not be where I want to be but I’m way better off.

The globe below is something I’d add progress to every week on a Wednesday. The leaf was in art therapy that looked like I plant I started growing from a cut to metaphoricalize my roots and growth in outpatient. The actual plant has since been repotted from the water glass it grew in and is pictured with another art therapy project from a book that speaks to sitting with emotions being an uncomfortable and new process.

Last pictures are of my vision board  I never thought I’d make one and now I can’t imagine a world had I not made one, I just want to keep adding! Re-reading affirmations REALLY DOES work to make you start to believe them and make them a part of your life energy.

Fighting perfectionism by leaving this post as is is a huge exposure and you’re part of it!

100 Minute Panic Attacks & Other Fine Feelings

For an hour my mind had been processing at over 100 wpm. I say words per minute (wpm) because I know I type on average 100 wpm and I was thinking way faster than I could type everything I wanted to say. In fact it had been one of those wormhole experiences where the electrical signals in my brain were playing tag so fast that only my body was responding at that point. My heart also surpassed the 100 wpm mark which made mindful deep breathing a chore and light-headedness a constant. I was having a full-blown panic attack and screaming quite loudly, internally, of course. The whole house was asleep for the night and I’m far too medicated to freak out like a feral child over my first toaster surprise experience.

So what the hell set me off? I won the lottery! Not the fun never-have-to-work-another-day-in-my-life lottery, but the knowledge lottery. Check this THE HELL OUT! http://psychology.tools/download-therapy-worksheets.html

During my in and out-of-body experience I downloaded/saved/printed 100 or so worksheets and handouts (100 is a popular number tonight). I made extra copies of some of them, so I’d have a few to go off of before I’d need to make more copies for a thought log CBT diary, etc. I want to have one master hard copy of them all in addition to the saved .pdf’s I made. I wanted to cry at how glad I was that people had come together and made these resources and shared them FOR FREE. You know, when I go digging around online for grade school and special ed teaching tool worksheets there are websites that limit the amount of downloads you can have per month and other websites that want you to pay money for worksheets on identifying basic coins or color by numbers. It’s the reality of the internet, which makes finds like this site even more golden. The thing that makes this a “Mega Millions” kind of win is that people put these resources up to aid other counselors, educators, and seekers of self-help, “just because”. That’s what I’m here to do, that’s why I got into the field, and I’m so damn lucky for someone who struggles with bipolar and OCD on a daily basis as well as someone who is studying to help people who need these resources implemented in a therapeutic environment to get better to have access to these materials.

(I may laugh and/or groan tomorrow if I find this all way less exciting than I do now after admitting it to my WordPress community in writing, but let me not get ahead of myself.)

On my journey to build a bigger better therapy binder (for personal use, I need to get back on the structured recovery and maintenance track) I’ll find other sites, other resources and feel really really bad that I blew through so much ink…but I’m trying on a daily basis to fight the good fight, and this is a great achievement even just to collect materials I know I need and will help me, and then to use them. My obsessions are getting a little out of control lately and my catastrophic thinking is becoming more problematic than usual. Believe me, there’ll be lots of highlighting, section dividers and spazzing about how to organize it all in the days ahead. Of course I’ll sneak in the replying to posts and catching up on blogs too, because that is at the top of the priority list after every entry I make!

A Whole Bunch of Really Crunchy Thoughts

My to-do list is like decomposing matter. Something that’s new on the list only just begins to decompose, while something that’s been on the list for a week is in a much later state of decomposition. Now imagine all of this matter neatly organized into a basket and left in your stomach. The stomach acids only add to the deconstruction of the matter and because the materials don’t agree, this poisonous gas and slimey ooze starts to fill up the cavity it’s in. When there’s nowhere else for it to go, it crawls through the rest of your body and makes you sick. The pain swelling inside of you makes it even harder to face your to-do list and finally you’re so sick that you want to cry. That’s pretty much been my situation the past couple of weeks. Tonight I can feel the noxious gasses stuck inside of me and trying to push their way out if it kills me.

On a positive note, getting a blog post out of the way will be a good removal of one of the old to-do list items, which should clear up some of the gunk in my system.

I’ve been depressed. I’m working myself to the max in school and at work to do the best job I can do. At work I now have the complication of being treated like crap, because of the whole reporting mistreatment incident. That gives me anxiety while I’m there that I brush off the best I can, but it effects me. Taking care of people for a living effects me too. Every day I go out there, mask my depression or irritation and make sure I’m tending to everyone in the classroom and encouraging them to challenge themselves whilst helping them face those challenges and praising their good work. I sat with one of our clients whose two decades older than I am on Friday and helped him get through word problems on a math sheet. I was SO PROUD of him and he was so proud of himself. It feels good, that’s what gets you through the day, making a difference. A lot of our clients call me mommy. Most all of them are considerably older than me. I feel like Wendy to the Lost Boys some days. But everybody needs a mother.

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After work, if there’s school I need to mask my mood further to interact with my peers, particularly the ones on my research team. Then I go home, and do a few things to help out (laundry, garbage, putting non perishable groceries that have been sitting out away, etc.). Finally by the time I’m showered and in bed I just want to cuddle up with my stuffed Pusheen, play a few casual games on my tablet, and knock out. I probably won’t even get 8 hours of sleep. I’ll remind myself that I’m getting a B in my class, and for how hard I’m working, it breaks my heart and makes me want to hibernate forever. So does the fact that I have no time or energy to go to the gym and shed some pounds. My relationship though is going really amazingly at the moment, and I’m terrified to say that and jinx it, but that’s one of the few happy thoughts that helps me fly.

There are other tender situations. The other night I was already in bed when I heard my dad and sister get home. He had brought her home from school and my mom got up to help make her dinner. I heard their soft voices in the kitchen, everyone calm. We’re a family who takes care of each other. My parents are getting older, and they still baby my Asperger’s sister, which is fine I suppose, but what’s going to happen when they can’t do it anymore? (i.e. when they pass away). Already there’s two things that make me want to throw up at this thought.

First, I can’t deal with the idea of my parents dying. I don’t deal well with change. I don’t even deal well with having an abnormal schedule. I’m not as bad as the clients we have at work who will completely become hulk versions of themselves, but I crumble easy. Even the loss of one of my parents. God. It makes me sick to think about. And when they do pass who will take care of my sister? She literally does not know how to function as an adult in the world. I don’t even know what kind of job she could get. Will it fall to me to support her? Will she let me? She’s insistent she’s normal and can do x, y and z but I don’t think it’s hit her yet that life is going to be a lot harder when she doesn’t have that overflow of support and help to sail through it.

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Fear. Fear is getting to me. I’m having obsessions about these sorts of things on a daily basis. Getting a medication change might help a little. I haven’t had my medicine adjusted in over a year. I need a new doctor though. My GP can keep the refills coming, but can’t adjust any milligrams. Therapy would help too. But can I afford that? Can I afford the TIME even? I need to do something though to assist my mental health, because though I’m functioning well enough, I’m a wreck on the inside and it’s wasting precious seconds, minutes, hours, days, weeks and MONTHS of my life. And for what?

I began reading a book called Hyperbole and a Half by Allie Brosh. There are some serious laugh out loud moments, and also some very real passages about what it’s like to deal with depression. I’m not finished with it, but I recommend what I’ve so far read of it. Sometimes I get real angry that I didn’t write a charming and funny book about my life yet and get jealous someone else did, but this one I enjoy without the resentment.

On page 132, there was a particular passage that struck home, and I thought I’d share it with you.

“And that’s the most frustrating thing about depression. It isn’t always something you can fight back against with hope. It isn’t even something–it’s nothing. And you can’t combat nothing. You can’t fill it up. You can’t cover it. It’s just there, pulling the meaning out of everything. That being the case, all the hopeful, proactive solutions start to sound completely insane in contrast to the scope of the problem.

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It would be like having a bunch of dead fish, but no one around you will acknowledge that the fish are dead. Instead, they offer to help you look for the fish or try to help you figure out why they disappeared.

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The problem might not even HAVE a solution. But you aren’t necessarily looking for solutions. You’re maybe just looking for someone to say ‘Sorry about how dead your fish are,’ or ‘Wow, those are super dead. I still like you, though.’”

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In conclusion, I’m struggling right now. And to all of you out there who are reading this and struggling too, I’m sorry about how dead your fish are.

Day Hospital: Part 1

I finally got into Adult Day Hospital. It’s about 20 adults in the basement of a hospital doing 4 hours of different group therapies and one hour for lunch (unless you’re on half days – which happens when you’ve been there for a while.) The program is about 4 weeks give or take a week or two depending on what your insurance will pop for but if you really need to be there the staff will try to work with the insurance companies to keep you there. It’s my one week one day anniversary today and I’m feeling really positive. All the grieving over Chris I’ve done has NOT come to a halt or been in vein, but rather now I have a place to process my feelings and to help me mourn the loss. My case worker thinks it’s a good idea if I stay away from talking to him until he comes home in which case if I want to reconcile that sounds like an alright idea, but for now, keeping ‘clean’ of a toxic relationship is important. If it’s going to hurt me to talk to him then don’t talk to him.

It hurts, it really does, but it’s good to be in a supportive environment of people who may have different issues than you (some way worse). Brian, for instance, is an older gentleman probably my dads age (late 50’s) who just joined group last week. People trickle in and others trickle out. When they leave we have rock ceremonies for them. I’ll go through one the next time we get to one. Anyway, Brian.

He’s a dad of 1, step-dad of 1 (of whom he’s been in the kids life since he was 8 and he’s 23 now) and husband of (well, 1). He’s been an alcoholic 27 years, married 16, never tried to quit until now. He got thrown into the hospital when his wife wasn’t responding to his calls at work so he texted her pictures of him slitting his wrists in a drunken stooper. He’s never tried to quit alcohol before and now that he’s two and a half weeks sober, two weeks out of the hospital and into Day Hospital for depression, he’s doing really well. Unfortunately, his 23 year old stepson gave his mother an ultimatum that it was Brian coming home or the stepson moving out. Brian is currently living at a halfway house now while he works out his treatment and goes to AA meetings after Day Hospital. He’s starting to look at some of his anger right now in small group psychotherapy (He’s in my group), and today I had a gift for him.

Two years ago when I was there one of the alcoholics was giving up coins that he was going to give in an AA meeting which had a sailboat on one side and the words “We cannot control the wind but we can adjust our sails”. Just some crappy little brass or nickel coin, but a coin that was supposed to symbolize that you’re doing well, and remind yourself of what’s in your control. I took that coin out last night from my keepsake box and brought it this morning for Brian who fiddled with it in his fingers all day, twirling it and occasionally dropping it, you could hear him go “shit!” or “goddamnit!” He called me sweetheart and gave me a hug and kiss on the cheek though so overall I think it was a good investment giving it to him. I’m really sentimental and I lost my rock from my last rock ceremony there, so that was my replacement for it. However, I have a new rock coming up in a few weeks and I’ll just have to accept and mourn the loss of my rock, which is a common theme quite obviously here in my treatment.

Fangs, I mean, Daniel, has also got it worse off than me. I’m not 100% sure why he’s there other than “I’m really fucked up.” But the 37 year old with surgically implanted fangs, hot topic pants as well as black hoodies and tattoos of his bones over his skin (so it looks like the skin is inside out) always has a lot to say. His stories are all over the place. I don’t believe half of them unfortunately but even if they aren’t true, he’s got to have gone through some heavy shit to make him the way he is today even if it really was an abundance of alcohol or drugs. He’s claimed to have had three heart attacks, died twice on the operating table, had a girl die of heroin in his arms, been in jail 15 times, been shot, shot a gun, been in a gang, and move a guy who was dead of an OD out onto the patio from inside the kitchen because he thought he was just “really fucked up”.

Not everyone there was a user. There are NA and AA meetings for that. This is a swimming pool for the emotionally unfit. The people who tried committing suicide from clinical depression or had manic episodes for the first time in their lives at age 61, or whose anxiety is so bad they can’t work anymore and need help learning how to function again.

There’s plenty of stories left to tell, but for now you can chew on Brian and Daniel. I’m just happy that I was able to bring myself to blog again. It felt uncomfortable not having the concentration to be able to string words together for a week, but to be kind to myself, it was a really heavy week.

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