Brave

I recently submitted a video to a “Ted”-like speaking competition. While I did not get selected for the final presentation, a particular line of feedback stood out to me.  “Very  brave of her to share such a struggle”.

And while it was meant as a compliment, it rubbed me the wrong way.

See, I’m the “Manager of Business Intelligence” in my day job. That’s a fancy way to say, I spend my day helping programs/initiatives set goals and benchmarks for success.  Then I comb through their data to see if they’ve met their goals or how they can improve.

So I’ve always challenged myself to truly set metrics to my one of my life goals: “Raise awareness of mental illness and reduce stigma”. That’s always stumped me a little; after all how can you measure something so vague. A few metrics I’ve considered:

• Reduction in years between onset of disease and treatment
• Increased employment of individuals with a severe and persistent mental illness
• Decrease in Suicide Rate

I still think these are crucial, but the comment made me add a new one. I don’t want it to be considered ‘brave’ to admit you have a mental illness. It’s nothing to be ashamed of; so why can’t it be something that is as common place as admitting you have allergies or a bum knee? Sure, maybe not first date material or a linkedin profile description, but certainly not something that initiates the feedback that “it was very brave” to share it.

If I have a daughter with a mental illness in the future, I don’t want her to face this response.

Of course I want my daughter to be brave.

I want her to have the courage to stand up for what is right, when everyone else is swimming the other direction.

I want her to have the courage to admit her love and devotion to Christ.

I want her to have the courage to pursue dreams that seem impossible.

But have the courage to share she has a mental illness? No. That I want to be easy.

Judging by the pit I have in my stomach every time I post about or share my story, in actuality it does still require a level of bravery. But what provides courage to do it? Well that’s the thought and hope the next generation won’t require the same bravery.

 

My Break-Up with Mania

I recently (ok a while ago) wrote about my affair with mania. Since I gave you a brief look into our love story, I thought it only fair that I share the break-up letter I wrote him as well.

Dear Mania,

I know we’ve had some good times, but this just isn’t working out.

It’s not you, it’s me: This isn’t your fault–I know you’re just yourself. But I’ve changed since we got together all those years ago. I can’t take the irritability you bring out in me. Fighting the constant battle with impatience just isn’t fun anymore.

I need to focus on my job right now: I know we have such good times together. I know you’ve had some ideas that have been fun; but you’re distracting me from the things I value the most. You pull me in a 100 different directions, chasing the next shiny object, have me thinking everything is a great idea. But I need to focus on the goals outlined for the and do my job accordingly….

I’m not ready for a long-term commitment: I’m just not at a point in my life where I’m ready to make a  long-term commitment to you. While you might be fun in my youth, I want to be a mom who’s stable. I want to be a wife who manages her emotions. I want to grow into a grandma you can count on .

You deserve better: You deserve someone who loves all of you and I’m just not that person. I hate feeling like I’m going to just crawl out of my skin. It’s just exhausting to keep up with the racing thoughts. I hate having tons of unfinished projects when you go away.

My friends don’t like you: Hyper Tabitha can be quite overwhelming, and it’s too much work to constantly hold the energy in. Pretending I’m calm, trying to slow down my speech, not constantly jump from one idea to the next is wearing on me.

 I’ll always love you; you’ve shaped so much of who I am. But I really think it’s time we part ways.

I don’t think we can stay friends.

Tabitha

My affair with mania

I want the mania back. It can be so fun. So productive. So happy. So seductive.

Mania is formally defined as “a mental illness episode marked by period of great excitement, euphoria, delusions, over activity, irritability, or impulsiveness”

But I define mania as “a break”.

Because…just when I thought I couldn’t take the intense hopelessness anymore, the euphoria would hit. Just when I thought I might not make it out of bed, in came the energy.  Just when I thought I’d lost all interest in anything, the excitement arrived. Just when I thought I’d never be fun again, roll in the spontaneity.

Sure there are negative aspects of manic episodes, but they still always came as a relief. Gone was the longing looks at buses going by and wondering if someone would push me in front of one. Gone was the jealousy when I heard of someone getting a terminal diagnosis. Gone was staring at knives imaging where I could cut myself. Gone was the feeling of worthlessness.

Welcome are memories I develop with my crazy ideas. Welcome are the laughs my hyper excitement generates among friends. Welcome are the productivity I have at home and work. Welcome are the feelings of self-confidence and self-worth.

Welcome are the days I have without thinking about death.

So if you wonder why people with bipolar are resistant to medication, or go off a medication regime you think is working–consider this. Consider what they are giving up. Consider losing the break. Consider losing times when you are on top of the world. Consider losing times of immense self-esteem.

Consider losing the brief glimpses of happiness that rescue them from an often dark, scary, and overwhelming reality.

Intellectually, I know the negatives of mania outweigh the positives. I know treating bipolar can reduce the severity of depression. I know my overall quality of life is 100x better with medication, tools for bipolar management, and yes–a reduction in the swings of mania.

But emotionally….well that doesn’t stop me from missing it some days.

GO AWAY!

This picture makes me laugh eveytime I see it.  But it’s also a great reminder of one of the first tools I learned in therapy. Lable the feeling as anxiety and move on. See before I found out about my disease, I spent a ridiculous amount of time trying to figure out why I was anxious. Doing that would wind me up, or convince me I was more stressed about a situation than I really was. Rick worked with me to say “oh this is anxiety.  It is a result of the chemistry in my brian. Do some breathing and continue with your day”

Does it make the anxiety go away? No. But it does help manage it.

Welcome back–to myself

I feel like I was born to write…it’s one of the few things I truly enjoy doing.  So how come I let it fall to the end of my “to-do” list? Some of the things it falls behind make sense….work, laundry, exercising, eating.  But what about the other things? Those time wasting things I do!  Reading dumb books, watching mindless TV, browsing my some e-cards app.  I know that people with mental illness do not have the lock-down on this issue with distraction—the billions of dollars Facebook is worth is proof of that.

So, while it’s nice to know I’m in good company—I want to take back my writing! How can I do that?!  Well—like a true student of CBT, I am attempting to get to the root of why I stopped.

1. I was truly too busy. I was over stressed with a high impact job and looking for a new one. Then my mother-in-law got diagnosed with cancer and I want to focus on spending time with her.
2. I need to loosen my expectations on myself.  While a deep fantasy might be that one day I become famous, make lots of money, and retire early—well that’s not realistic. No wonder I quit blogging if I’m pressuring myself with that.

So what I decided is that I need to remind myself why I started blogging in the first place.  It was for me—and my support system to better understand me.  It was a way for me to work out things going through my head and on in my life.

But mostly, because it makes me happy. Because when I read back what I wrote—I make myself laugh. Because when I look back at things I’ve gone through I feel good about myself. Because sometimes I’m need to be reminded of the lessons I learned in the past—so I quit repeating the same mistakes.

Because for a moment in time when I do it, I’m ok with the fact that I’m bipolar. I’m ok with the fact that my life is going to have struggles that are related to my illness. I’m ok cutting myself some slack and admitting it’s not my fault.

So for anyone who still gets these notification emails—(mostly mom and dad ;))  I give you permission  to bug me, though I would prefer bribes, about writing. I ask you to encourage me—remind me that it’s healthy for me—and remind me that it makes me happy.

And hopefully—between all of us, I make it a habit again.

New NAMI PSAs

So I’ve been gone FOREVER. And I’ve missed it.  I’ve been looking for a new job—working crazy hours with my old one…and trying to sleep in the process.  But, my last day at my job is FRIDAY! And then I’ll have a short break before starting the new one.  So I’m hoping I’m back!

http://www.nami.org/Template.cfm?Section=NAMI_PSA&Template=/ContentManagement/ContentDisplay.cfm&ContentID=80156 

Here’s my first blog back!

Have you seen the “Monuments” PSA videos by NAMI?  Here’s a link to them.  You might want to take the 45 seconds to watch them before you continue reading, as this blog focuses on my thoughts on them.

http://www.nami.org/Template.cfm?Section=NAMI_PSA&Template=/ContentManagement/ContentDisplay.cfm&ContentID=80156

So when I heard that NAMI had new PSA videos out I was excited—anything to reduce the stereotype right? Well at the end I sat there and said “hmm…not sure how I feel about those”.  So I watched them again….and spent some time thinking about it. And I’ve decided—I’m pretty sure I hate them. 

Here’s why…

1. The depiction of mental illness is unrealistic: While I do not doubt these famous people struggled with mental illness, I don’t think it is fair to assume everyone with mental illness can achieve these “great” things. I know I cannot.  My brain needs lots of rest—and I doubt sleep was high on Churchill’s to-do list. My brain also over reacts to stress so I would not do well making decisions for the entire nation. I need time to go to yoga—meditate—and sometimes sit in the corner and suck my thumb. A huge part of my journey (that I have not yet achieved) is learning to accept my limitations, and not judge myself for them. So I don’t need PSA videos telling me that I can do “great” things. Also, I don’t want other people to say “well if they could do those things, I don’t understand why Tabitha can’t just stop crying today”.

2. They use the phrase “they won”:  What does the even mean?  What does it mean to “win” against mental illness. You don’t end up in the hospital? You don’t kill yourself? You stop spending time in your closet? You get off of your medication?  I don’t think there is a clear definition of “winning”. It’s different for everyone. Also, if you can “win” that means you can also “lose”.  And I think that’s bull s***. (excuse my French).  I wake up every day and have the same sick brain I had the day before. And I choose to live with it as best as I can.  Some days I live better than others, but on my bad days it doesn’t mean I lose. It just means my illness was particularly strong that day. 

Growing up my parents always told me I didn’t have a right to complain about something unless I had a better idea. So what would I like to see in PSAs? For me, maybe just normal people doing normal things. Or I always like the ones that show things/science talking about how the illness is real. Or maybe stats on the rate of mental illness—really showing that we are not alone.

What about you all?  Do you have any PSAs you really like?  Feel free to disagree with me on the NAMI ones—I’d like to hear other opinions—because clearly someone thought they were a good idea!!!

HILARIOUS example of CBT

So in addition to this photo being HILARIOUS—I think it’s a great visual of CBT.  Hold on—I’ll explain.

Last post I discussed the importance of CBT, cognitive-behavioral therapy.  Cognitive Behavioral Therapy (CBT) is a form of treatment that focuses on examining the relationships between thoughts, feelings and behaviors. By exploring patterns of thinking that lead to self-destructive actions and the beliefs that direct these thoughts, people with mental illness can modify their patterns of thinking to improve coping (NAMI).

CBT is a great tool for many mental illness, for me it’s been particularily helpful for managing my anxiety and “getting rid of the garbage” I discussed several posts ago. For those of us “lucky” enough to deal with mental illness, anxiety in particular, we often have many scary thoughts predicting the worst possible outcomes—regardless of the likelihood of the predictions coming true. When ignored or improperly dealt with, they can begin to take on a life of their own. Similar to the child in the photo, we can see this huge ball coming straight at our heads, and there is nothing we can do to stop it. It’s terrifying and dehabilitating….

BUT there’s hope!  With CBT, we can transfer ourselves to the second photo. One great tool is the “Dysfunctional Thought Record” I’ve attached below. It can help you identify a situation/thought, examine it for realism, and compose alternative responses. 

 When I’m feeling particularily anxious, I will do one of these to help me regain a sense of reality.  So I tend to do them at least three times a week.  While you can do them alone—sometimes you might need an outside perspective to help provide  the alternative responses. It’s great if you have someone you can trust to look at it, otherwise taking it with you to therapy is always a good option.

I have one final piece of advicethat is not covered on the DTR I attached, write down the alternative response you identify. Unfortunately, completing the DTR will rarely eliminate the anxious thoughts for good, instead they might intermittedly continue to bother you. Use the alterenative response you identify to combat the thoughts as they continue to pop into your head.

So like that baby now realizes, when that ball starts coming towards your head—remind yourself, that it can’t hit you. And if you can—laugh at the ridiculousness of the thought!

Anyone else use this tool?  If so, what’s your experience with it?

Try it—and let me know if you  have any questions or need an outside perspective—maybe we can muddle through the waters together.

Successful treatment of pediatric depression

Ah! TOO (much too!) long ago, I posted about the importance of intervention. I raised the question “What types of intervention are most successful?” I found a study by several professors of psychiatry that seeks to answer this question, specifically focusing on pediatric depression (youths 11-18).  The highlights of the study are below:

• Continuation-phase CBT combined with continuation pharmacotherapy reduced the risk of relapse 8-fold compared with continuation of medication alone.
• The continuation of medication treatment for 6 months after acute treatment (initial 12 weeks of treatment) reduced the relapse rate by 27% (42% vs 69%).
• 6 months of continuation-phase CBT (after acute-phase CBT) lowered the relapse rate by 46% (6% vs 50%).

Now to avoid “quote dropping” (a writing flaw my AP English teacher scared out of me), here’s the lessons I draw from these findings.

First, the most successful treatment is a combination of therapy and medication. While this is a “duh” statement to some, I think it is an important reminder. To those who are resistant to medication (Like me!), it is the reminder that to “retrain” your brain through CBT you might need the help of medication. For those resistant to therapy—well that’s a whole another blog.

Second, do NOT discontinue treatment too soon. While “too soon” is hard to identify, it appears treatment should last at least SIX months after the depression/anxiety goes into remission.

Recovery is hard!  So often I wish it was as easy as managing my allergies. The doctors gave me a nasal spray—and life has never been the same! But unfortunately, it’s hard work.  After graduating from my master’s program, my mom and I were going through old t-shirts from my childhood through college. You know all the swim team shirts or ones marking plays I was in (I know, me being dramatic is shocking!). 

I didn’t collect any in graduate school (and not just because I was older—you never outgrow those shirts. I just washed one for my husband the other day—it was from a bar), but because I was busy learning to take care of myself I didn’t commit myself to as many things. My mom jokingly suggested she could print me a “Proud Survivor–Therapy—2009-2011” t-shirt. While sometimes I did feel like I was missing out, I know dedicating two years of my life to continued treatment has helped me build the skills that keep me healthy and allowed me to re-engage on all those activities now. Score myself some free bar tshirts!

Rick recently reminded me, “I hope that I’ve mentioned to you that you are not going to have to be in therapy for the rest of your life (or even indefinitely). However it does seem to me that for the present it would be quite useful for you to maintain a relationship with a person that you have confidence in.”  He always joked his goal was to “work himself out of a job”. And trust me, there have been times (especially in the beginning when I hated therapy!) that I wished he was out of a job. : )

So when you start helping someone with a mental illness, here are the two clear steps to take. I suspect starting treatment will not be the problem, it will be convinceing them to continue treatment once they feel better. I had a friend the other day tell me he was likely going to go off his medication because he was feeling better. And it had only been three months!! Fortunately, I was able to whip out this study and convince him to stay with it. (Or at least lie and tell me he would!)

But what about those of us with “chronic and persistent mental illness”? I think this applies to us too. Keep on your medication, and realize that you are going to need to have some maintenance or “tune-up” therapy now and then as well. 

I write that very simply—like it’s oh so easy. And everyone reading this post knows how important these steps are. So why mention it? Because it’s not easy–even re-reading that gets me all wound up. So I give you this article so you can return to the statistics when you decide you no longer need treatment. I often use these short, clear facts to combat the dysfunctional thoughts in my head.

Thoughts?

http://www.psychiatrictimes.com/mdd/content/article/10168/1473061?pageNumber=1 

Intervention Matters

Intervention Matters.

If I wasn’t so partial to “One Wave at a Time”, I might change my motto to “Intervention Matters”.

And by ‘intervention’ I mean diagnose and treat. And by ‘matters’ I mean is life changing (or as a comedian would say “a BIG F****** deal”).

My personal adventure with mental illness demonstrates this, as well as a study from the child mind institute I heard recently regarding the progression of anxiety disorders in children.  I will be simplifying and summarizing this study, but I realize you all have other things to do then read my blog all day!

Part One: Child Mind Institute Study

Stage One: Between the ages of 5-9, anxiety disorders in children often manifest themselves first in the form of obsessive thoughts and compulsions.  

Stage Two: Around middle school, if the disease has been left untreated the stress of the disorder on the brain progresses, results in other anxiety disorders, most commonly generalized anxiety disorder and panic disorder.

Stage Three: Again, if left untreated, the stress on the brain results in bipolar 2 in high school and early college. This is when depression is most likely to show as well.

Stage Four: If left untreated, the individual might progress to bipolar 1 or experience some other form of emotional breakdown that results in a hospitalization.

You might have noticed that I continually used the phrase “if left untreated”. This was intentional, not just a lack of vocabulary on my part.  See, the key part of the finding was that if diagnosed and treated the child is 30-50% less likely to progress to the next stage.

Note: I apologize I cannot find the link to this podcast…my professors would give me an “F” for plagiarizing since I do not have the source, but I’m hoping you’ll cut me a bit more slack!)

Part Two: My Story

You’ve read about a lot of my different symptoms and experiences, so I’m not going to rehash them here.  Long (15 year long!) story short; my symptoms got progressively worse until the age of 21 when I was diagnosed.

I’m blessed that I don’t have a dramatic breaking story. Instead, the summer after graduating from undergrad I was living at home before I started a graduate program at IU. I spent abnormal amount of time crying and my mom asked me if I wanted to go talk to someone. I have no doubt I would likely have a much uglier story if I had not lived at home that summer and had her intervene.

I began a medication regime and started therapy.  Neither of which I was particularly happy about at the time, but really who is? 

As you all know, I still have bad days (and unfortunately bad weeks), but  I also have seen a tremendous amount of improvement and progress.

So as you can see—in my life a diagnosis and treatment (intervention) changed my life (matters).

Now that I’ve convinced you intervention matters—the question becomes, “What is intervention?” but more importantly “What is SUCCESSFUL intervention?” 

As an adult, we notice the girl in our class is more moody than most, the boy on our soccer team is more aggressive than expected, we suspect our daughter is struggling with more than teenage angst—now what?  As the adult and often times decision maker—what treatment options do we pursue? What type of intervention do we seek?

That is the question is nearly impossible to answer—but research is trying.  I found a great study I’m going to address in the next few posts.  But what are your opinions? Either as a consumer or advocate—what is the first course of treatment you suggest or encourage?

Oh and by the way

Hope you all had a 

Merry Christmas!

Get out of your own way!

NCAA Div 1 Soccer Championship

My husband and I took a spontaneous road trip to Alabama last weekend. By no means are we groupies (I unfortunately realized this year that college boys are too young for me…I’m getting so old!). But we do like watching soccer. On Friday, IU our Alma Mater, won a semi-final game qualifying them for the National Championship on Sunday. Around two on Saturday, while doing some work and I texted my husband, “Hey–let’s go to Alabama”.  He writes back “Is this you procrastinating from work?” Me: “Um…yes?  But I’m serious”  So an hour later we found ourselves pulling out of our parking lot headed to Birmingham, Alabama–heartland of America.

My adrenaline had me running through the hour of getting ready, but as we get into the car I started panicking   “WHAT AM I DOING? WHY DID I THINK THIS WAS A GOOD IDEA?”  Here’s a list of the things I was worried about:

1. I had work that needed to be done
2. I wanted to clean the bathroom
3. I wanted to cook and freeze some food for the week

Now…these were all legit concerns, but I had weighed them (albeit briefly) before I sent my husband the text about going. But know what my largest concern was? BEING ANXIOUS! Yep, I was worried about triggering a mood swing because we would be getting completely off my schedule. I’d be up late, sleeping in a different place, and traveling–all which can cause anxiety for me.  And wait, does this idea mean I’m going into a manic swing? Should I not go??

But you know what!

I NEEDED TO GET THE HECK OUT OF MY OWN WAY!

Sure, keeping a schedule is good for me. But know what else is good? Spending time with the hubby. Building good memories. Feeling like a “normal” person. AND HAVING FUN!

The ACTUAL trophy–can’t believe they let me get that close…I didn’t break it though!

Sometimes, we just need to get out of our own way and let ourselves cut loose. Having a mental illness is alot of work and sometimes to stay healthy you do miss out on stuff–so give yourself some space to have fun. This spontaneous trip was great and it reminded me how much better I can feel when I let myself have a good time.

So tonight–in honor of this post I am going to make myself a peppermint milkshake. And I give all of you permission to do so as well!  Screw calories and do something fun!

Yes, I am drinking it out of a wine glass. Got a problem with that?!

  oh and btw: THEY WON! GO HHHHOOOOOSSSSIIIIEEEERRRRSSSS!!!!!!!!

Eyewitness to the EIGHTH National Soccer Championship