Monthly Archives: October 2012

Wednesday Wishes: Number Twenty

Have you ever read one of those “Ten things your guy wished you knew” or “Ten things your mother-in-law would never tell you but thinks you should know” (though in many cases—unfortunately for you, there’s nothing your mother in law wouldn’t tell you). Well I wanted to create a lists of things that those of us who struggle with mental illness wished the rest of the world knew—and hopefully get insight from my support team about what they wish I knew!

Number Twenty: Following in line with Monday’s post….I wish I could express to you how I feel.

To help with that!  I’ve uploaded pictures of the feelings list I discussed!

Let me know–do these helps? Do any particular words resonate with you?

 

Disclaimer: Not all of these thought will reflect all people, in the same way not all “Ten things your guy wished you knew” would relate to my husband—some will not even relate to me. They are thoughts/concerns/opinions I’ve heard when talking with fellow adventurers along the journey that is mental illness.

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I feel scared…concerned….insecure…startled…restless…fearful…panicky….shaken…

As I’ve begun learning about my mental illness and how it affects my life, I’ve started to look back through journals I’ve written in the past.  It’s interesting to see what I wrote in a different light and to see how far I’ve come. Also, it’s pretty hilarious to read about my past crushes—glad I ended up with Sidney.

Another huge benefit for me is that it sheds a bit of light on one of the questions I identified my previous post. “Why do children not share the extreme of their emotions with adults?” One reason for me was an inability to express my emotions.  Two phrases I see over and over in my journals are “It feels so dark in my body” and “I am losing control of my mind”.

I was never able to describe that feeling better—but instead wrote it over and over. I knew I was feeling awful, but I didn’t know how to express it. I would tell my parents, “I’m stressed” or “I’m sad”.  Or I’d cry and scream but was not able to explain why I was doing it. Or I’d give a reason I was crying, but it did not convey the intensity of the feeling.

One friend of mine tells a story of sitting on her front porch crying uncontrollably before school. Her dad promised her she wouldn’t have to go if she would only tell him what was wrong.  But she couldn’t. All she could say was “I’m sad”.

In therapy one of the first skills Rick and I worked on was learning to identify my emotions. Rick claims this was to help me, but I’m pretty sure that he was bored listening to the same conversation.

Rick: “How are you today?”

Nicole: “Anxious”
Rick: “Anything else?”
Nicole: “Sad”

After about three weeks of that, Rick introduced me to my feelings list.  I have a sheet of 100 feeling words that I am can use to identify in various situations. There are 30 words alone that go under the “anxious” category.  If they would put these words on the GRE I’d knock that out of the water! Instead there’s words like noxious.

We teach kids to write descriptive paragraphs about scenery, explain how to perform mathematical operations, support a thesis with detailed evidence…yet do we teach them to identify feelings? I’m not even sure how we would start to do this—after all, many adults are not good at it.  But I think it would be a big step towards helping kids manage their emotions!

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Bridging the Gap between Parent and Child Perception of Emotions

I had an interesting childhood. You could maybe say I “rode some wavez”.   J

On one hand, I lived a rather easy life. My parents were still married, my siblings loved me (even if my brothers pretended not too), I never went hungry, we had spare money to go on vacation (“ARE WE THERE YET?!”), and I had a trunk full of sparkly princess dresses. What more could a girl want?

But on the inside, I was obsessively thinking about hurting myself, overly anxious about circumstances and yes, I was one of those “sensitive” children. Those negative emotions are part of how I remember my childhood.

Unfortunately, I did not get diagnosed until I was in graduate school. As such, I find the research discoveries being made in early detection and prevention particularly fascinating. I recently read this study that identifies an important obstacle to early identification of mental illness in children.

Here’s the abstract:

“Three studies assessed parent-child agreement in perceptions of children’s everyday emotions in typically developing 4- to 11-year-old children. Study 1 (N=228) and Study 2 (N=195) focused on children’s worry and anxiety. Study 3 (N=90) examined children’s optimism. Despite child and parent reporters providing internally consistent responses, their perceptions about children’s emotional wellbeing consistently failed to correlate. Parents significantly underestimated child worry and anxiety and overestimated optimism compared to child self-report (suggesting a parental positivity bias). Moreover, parents’ self-reported emotions correlated with how they reported their children’s emotions (suggesting an egocentric bias). These findings have implications for developmental researchers, clinicians, and parents.”

In English, the study indicates parents UNDERestimate the intensity of NEGATIVE emotions their children face. They also OVERestimate the intensity of POSITIVE emotions.  As the abstract suggests, this demonstrates a “parental positivity bias”. This bias is similar to hearing comments like “Susie only gets in trouble at school because she is just so smart the class material is boring her”….”Little Johnny sat on the bench the whole soccer game to give that poor other team a chance”….”My Mikey just has the cutest butt” (oh was that third comment too far? Little Mikey must be an only child…..)

I realize there are many questions and “what ifs” related to this study. If you are a nerd like me and what to see the statistics and research parameters of it, read the full article (citation at end of post). But if you are more normal and don’t enjoy the research aspect, while no study is perfect, trust that this study was published by a team from the University of California in a well respected academic peer reviewed journal, Journal of Experimental Child Psychology. So for the purpose of this blog—let’s take that main finding as gospel.

As you can guess, this finding was not surprising to me. My parents would likely have underestimated the frequency and intensity of the anxiety I faced as a child.  But in their defense, if we had been in this study our answers would likely have matched. There is no way I would have admitted on a survey how terrible I was feeling.

How do we fix this problem?  I do not want anxiety disorders and depression to become the new “flavor” of the week; after all, growing up is hard! Anxiety and depression are an expected and normal part of development; majority of the children in this study likely did not suffer from a mental illness. But a few of them might show early signs of a mental illness. Either way, the children could use more support and help handling these complex emotions. As adults we have to bridge this gap between the emotions of the children we interact with and our perceptions of their emotions.

I believe the first step to tackling this problem is to answer the question, “Why does this gap exist?”.  I want to explore the many possible answers to this question—I’ve been looking through research, combing blogs of individuals parenting children with mental illness, and reflecting on my own experience as a child with mental illness. But before I go too far preparing the next blogs, I want your thoughts and input.

Here’s a few questions below to hopefully get some dialog going—but feel free to branch off from them.

  • What can adults do to increase understanding of child emotion?
  • Are children hiding their negative emotions? If so, why?
  • How do you differentiate a mental illness from “normal growing up”?

Here’s the citation to the mentioned article and other related resources:

  1. Lagattuta KH, Sayfan L, and Bamford C (2012). Do you know how I feel? Parents underestimate worry and overestimate optimism compared to child self-report. Journal of experimental child psychology, 113 (2), 211-32
  2. Children develop anxiety disorders: Too often the problem goes unrecognized http://www.dispatch.com/content/stories/local/2012/10/21/children-develop-anxiety-disorders.html
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A (Good) Side-Effect of SSRI??

Disclaimer: The following theory is not endorsed by the part of my brain that received an MPA from Indiana University (or wrote the few more intellectual blogs!).

Instead, it is a theory created by broken part of my brain that’s just trying to make sense of why it is the way it is.

Here’s the theory—of the many many side effects of anti-depressants, one side effect is intentional. Nausea. Unless I take my medication with food, I end up feel very nauseated, like I am going to throw up. I’m pretty sure the creators of Lexapro intended this effect to encourage me to eat.

See, it’s amazing to me how fast I can lose weight when I’m going through a time of high anxiety. If you had entered my room this morning you would have seen a significant amount of clothes on the floor. Now, I admit this is normal, but this morning instead of sitting in a big pile, I had tossed them across the room in frustration because they were too big. After fitting two weeks ago. I’ve lost about five-seven pounds in the last two weeks because I’ve been so anxious.

Despite the fact that my favorite foods are bacon and French fries, I’m never going to get fat—because my anxiety is probably never going to go away. By no means am I arguing that this is healthy. In fact, I know it’s not. Eating nutritious, regulated meals is a HUGE part showing mental illness who’s boss—so being too anxious to eat can actually make the problem worse. Over time, I’ve developed a few tricks to help make sure my body gets the energy it needs, despite how sick to my stomach I feel.

1. FLINTSTONES!! I take particular vitamins regularly, but when I’m feeling more stressed they are especially important, or I will add a multi-vitamin for a short period of time.

2. Easy does it: I can usually manage to eat small portions of food—so I just have to eat small bits all day long…..

3. Healthy choices: I make sure the times I do eat are the “power foods” such as blue berries, spinach and lean meat. If my stomach is only going to hold an ounce of food it should probably be an ounce of chicken instead of an ounce of French fries. The only exception is ice cream. As my sister declared at a very young age “Ice cream has a separate tummy”.

But this often is not enough (notice the 5lb loss?) so this is where amazing readers come in….do you experience this? Or maybe just no desire to eat with depression? If so, how do you manage it? Have you found any tricks to help? Please share!

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Wednesday Wishes: Number Nineteen

Have you ever read one of those “Ten things your guy wished you knew” or “Ten things your mother-in-law would never tell you but thinks you should know” (though in many cases—unfortunately for you, there’s nothing your mother in law wouldn’t tell you). Well I wanted to create a lists of things that those of us who struggle with mental illness wished the rest of the world knew—and hopefully get insight from my support team about what they wish I knew!

Number Nineteen: Make “my” limitations “OUR” limitations when we are in your social network. For example, after we drive 9-10 hours to get to Sidney’s parents’ house I can’t jump immediately into dinner/socializing/big plans. I need at least 30 minutes to relax and get out of my anxious car mindset!  If Sidney takes this time with me, and tells his parents WE need a break, I feel less self-conscious. By presenting us as a team, he helps prevent judgment or misunderstanding.

Disclaimer: Not all of these thought will reflect all people, in the same way not all “Ten things your guy wished you knew” would relate to my husband—some will not even relate to me. They are thoughts/concerns/opinions I’ve heard when talking with fellow adventurers along the journey that is mental illness.

337 W. 11th Street

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Am I a Client or Patient?

Last week I introduced the topic of integration of primary and behavioral health care. I’ve been listening to some podcasts about it (got to love those) and heard about an interesting system a local hospital is piloting. Each general care practitioner clinic is required to have a behavior health professional on staff. That professional has two roles.

  • See individuals referred by the general care staff.
  • Keep the staff current on new mental health medications and research.

Evaluations of the program have been positive thus far. The primary care physicians have seen a dramatic decrease in the resistance of individuals in scheduling and attending an appointment with a mental health counselor. The doctor will write a note in the individual’s chart, and when they check out the receptionist will ask when they would like to schedule an appointment with the mental health professional. Often, they are able to make same or next day appointments. Moving the mental health professionals into the same clinic as the primary care doctor increases convenience and lessens the stigma attached to therapy. The clinic has found the convenience of same day appointments is especially beneficial to low income individuals who have transportation concerns.

I love this idea—and will be interested in seeing if it spreads throughout the larger Indiana community. I’m not ashamed of therapy—but I still have some awkward moments in the waiting rooms. Everyone there is trying to avoid eye contact with you, and you start wondering why they are there. And figure they are trying to figure out why you are there……or what if you run into someone you know? What’s the protocol on that?  So sometimes I think it would be nice to park my car in my general care doctor’s office, and sit in the waiting room. Then people could just assume I was there for an allergy shot or something.

But now I need your opinion on something! The administrator presenting the pilot project, said one of the most basic problems they are encountering is a debate between primary care practitioners and mental health practitioners. Are individuals being seen by mental health practitioners “patients” or “clients”? Primary care practitioners identify them as “patients” the same as every other individual they see. Mental health practitioners believe they should be addressed as “clients”.

Seems like a simple concern—but there’s actually a lot riding on this debate.  I see the case for both sides.

  • Client:  The connotation is of the individual having more responsibility and control over their treatment.
  • Patient: This connotation brings to mind someone who is sick—on one hand, I think that can be a good thing. I want to start to associate this anxiety/depression crap with physical illnesses so people realize it’s not my “fault”. But on the other hand, not everyone in therapy has a physical illness and sometimes when I am doing well I do not like to think of myself as sick.

So—I can be swayed either way on this issue!  VOTE and then leave a comment with your thoughts on why you voted the way you did (if you would like to!)

Man’s best friend….Again

As some of you know, I’ve been following the research regarding service dogs and treatment for PTSD.  The more I read about it, the more amazed I am at its success. The service dog in the article link below wakes his owner up at the BEGINNING of nightmares–before his owner even realized they were occurring. He also is able to sense anxiety in his owner and is trained to stay close and show affection during these times.  Anecdotal evidence is showing that service members paired with these dogs require less medication and are significantly less likely to attempt suicide.  I hope the research related to this movement progresses so the VA will help pay the costs of veterans being paired with service dogs. These folks deserve the best possible treatment when the return home, even if the treatment seems a bit out of the box!

http://www.chicagotribune.com/classified/realestate/sns-201210091900–tms–petwrldctnya-a20121010-20121010,0,1068272.column

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Inside Voices

Inside Voices

If we can’t make the voices go away…at least they could be quieter! Hope this made you laugh!

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A Day in My Life!

Like most people with a mental illness, I spend way too much time in my own brain. That’s where a lot of the anxiety breeds as I focus on my own thoughts and ideas. In fact, one tactic that I use to prevent panic attacks is to start to point out specific visual things around me. For example, “The clock says it is 9:10 in red numbers; there is a small red light in the bottom right hand corner to show that it is PM”

So for this blog I thought I’d post some photos of a “day in my life”.  These past few days I’ve been paying more attention to life around me wondering “hmm…what should I take pictures of”. I would recommend trying it for a few days and see if it helps get you out of your brain into the world around you.

 

So what do you think? Do you have other ways to help me get out of my anxiety filled brain?

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Wednesday Wishes – Number 18

Have you ever read one of those “Ten things your guy wished you knew” or “Ten things your mother-in-law would never tell you but thinks you should know” (though in many cases—unfortunately for you, there’s nothing your mother in law wouldn’t tell you). Well I wanted to create a lists of things that those of us who struggle with mental illness wished the rest of the world knew—and hopefully get insight from my support team about what they wish I knew!

Number Eighteen: Support the wider mental health community, such as my husband wearing the “One Wave at a Time” bracelet, or my mom talking to and supporting others struggling. This reminds me that you know this is a “wider” issue that affects millions. That you don’t think it is just “MY problem”

Disclaimer: Not all of these thought will reflect all people, in the same way not all “Ten things your guy wished you knew” would relate to my husband—some will not even relate to me. They are thoughts/concerns/opinions I’ve heard when talking with fellow adventurers along the journey that is mental illness.

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