In Sickness and Mental Health

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It is a scary world out there for people living with mental health conditions. For example, changing medications can be scary. You never know what side effects are going to happen as your body chemistry changes, nor do you have an immediate way of controlling them when they start. The thought of being physically, mentally, or sexually abused or assaulted is also scary. Contrary to what many people may think, people living with a mental health condition are 2x more likely to be the victim of a violent crime than they are to be the perpetrator. So, there’s that. Additionally, seeing a new therapist can be terrifying. Telling your story over and over again is exhausting (especially if you’ve had to tell it multiple times already), and you never know what kind of therapy or treatment they might suggest without knowing your story and without knowing your personal preferences for treatment.

“…the minute it starts to mean something with someone, it scares me because there is that potential to fall hard for someone and lose myself in that.”
Regarding having feelings for someone. From my journal; November 4, 2011

However, the scariest thing when you have a mental health condition in my opinion is falling in love, and being in love in general. Giving your heart to someone, trusting them with it (scars, battle wounds, and all), and allowing them to see you vulnerable; to see you, mental health condition and all? That is absolutely terrifying. Even more terrifying is the idea of what falling in love DOES to someone who is living with a mental health condition like what I have.

Since the age of 10, I have struggled with depression, anxiety, and OCD. The OCD has made things particularly difficult for me. You see, the kind of OCD that I have lived with for the majority of my life always tended to rear its ugly head on my relationships in childhood/adolescence – both platonic and romantic. I lost friends over it and I lost people I loved because of it. Even though I was able to reconnect with most of those people later in life, it left scars on my heart that told me that people had left because I couldn’t control this part of me that I wanted so desperately to just disappear. Or at least, that is how it felt.

For a long time, I thought I was incapable of being in a relationship. I thought that it was impossible that anyone would ever be able to love me. I believed that one day, when someone would found out the truth about my mental health conditions, they would walk away and just like that, I’d be left to pick up the pieces. So, eventually I decided just not to tell anyone, and to just live my life. It was both a good decision, and a difficult one because I let my true emotions (depression, frustration) out in private.

However, my sophomore year of college, a man fell very, very hard for me. That person would be a very important part of my life for the next four years. I remember that from the moment he found out I liked him too, he began pursuing me. The man wouldn’t give up! Still, I was very hesitant to get into a relationship. I had previously been very hurt by someone else, and I knew how vulnerable telling someone about my mental health condition made me – why should I give someone this huge piece of me only to have them walk away? I wasn’t ready for that. I didn’t know if I ever would be either.

In November 2011, I had my first date with them. I’d been talking to this individual for about a month and had been friends with him for a few months longer. It was a really nice first date too. Although I was hesitant at first, I was glad that I finally agreed. The poor guy must have been so nervous because he missed his exit to his hometown while we were on the freeway!

After the first date went so well, I told him that I wanted to go for a drive, so he drove us into the hills that surrounded his city. There, he asked me for what must have been the 3rd time, about where we stood in terms of us dating or making things official. He told me he really wanted to be with me, and I told him I just wasn’t ready. He kept asking why, and eventually, I decided I would just tell him so we could get it over with and he could just leave after I told him. At least at this point I would have less broken pieces to pick up. I told this person about my mental health conditions, my depression, my anxiety, medication, therapy, hospital trips… everything. I full expected that would be it – he’d be gone the next day, and never reach out to me again. Instead, he said he needed to pull over, and I thought I saw tears in his eyes. We sat down on the sidewalk of a middle school, and he started crying. He cried, and he held me, and he told me he was sorry I had to go through that. I was shocked. That is a moment I will never, ever forget.

Two months later I ended up giving this person a chance, and it was one of the best decisions I ever made. I stand by that statement, because even though the relationship has since ended, I learned so much about myself, the depths of the love that exists in my heart and my soul for people, and that even though I have been hurt not just once, not just twice… my heart is still determined to beat, and to try again, despite the risks.

It wasn’t always easy with that person, and I am sure that it won’t always be easy with whomever I love next. That is the very nature of love. Not ease of practice, but how worth it it is in the end.

I guarantee that you, whoever you are, knows someone who is living with a mental health condition.

SO, IF THAT IS THE CASE, HOW DO YOU LOVE SOMEONE WHO IS LIVING WITH A MENTAL HEALTH CONDITION, AND LOVE THEM WELL?

The first thing is that you have to try to understand. You have to know, understand, and accept that mental health conditions such as depression, anxiety, etc. often come in waves, and carried in with those waves are often fear and shame. Fear that you’ll leave, fear that you won’t be able to “handle it”, and shame about the past, or about past experiences with feeling stigma from other people. The person’s depression or anxiety won’t always care that they are in a relationship with someone who loves them, tells them that they are beautiful/handsome, makes them laugh like crazy, cares for them deeply, and makes them feel safe. It just won’t, and it is important to understand that. With that understanding, comes the realization that the person you love may think to themself, “I can’t believe someone loves me.” I know I thought that. I knew how lucky I was to be loved, but I often feared that something I did would push him (or anyone else in my life who loves me) away and out of my life for good.

The second thing is that you must accept that that no relationship (or friendship) is going to be perfect. However, just like there isn’t always sunshine, there isn’t always rain either. Celebrate the good days with them, those are victories. When the bad days come in like the tide, ride it out with them, and just know that they will pass.

The third thing is to pay attention: to what they like, to what they don’t, and to what helps, and what doesn’t. On the days in which storms are surrounding that person, loving that person can take many different forms. It sure did for me. I was so grateful for the times that my previous partner made me my favorite tea when I was anxious or overwhelmed. I was grateful that he knew me enough to know when to leave me alone, and when to stay close. I knew he loved me, and he was able to fill me with hope, joy, and excitement for the future on the days when I didn’t have any. I loved that he knew how to make me fall asleep, and that he knew my favorite brands of creamer (in case he needed to pick something up at the store for me), and that he encouraged me to follow my dreams when I was about to give up. Even though he didn’t have a mental health condition himself, he tried so hard to understand and to be there for me.

The fourth thing is to know that we see you… and we try our hardest to be strong for you, even when we don’t have to. I knew that when I was depressed it upset my previous partner, even when it wasn’t his fault. That’s when I would try to reassure him through teary, blurred vision that I would be OK, even though I didn’t always believe it myself. I hated the idea that I may cause someone pain or make them upset. That is something that I guarantee if you love someone living with a mental health condition that they do think about, and are mindful of, even if it doesn’t seem like it. There were many nights in my previous relationship that ended in a tight hug and with me mumbling “I’m sorry for being ridiculous,” even if I knew deep down that the symptoms I was experiencing weren’t MY fault. There were also many times when I realized how much I learned about myself through the experience of loving someone else. For example, resisting my compulsions to seek reassurance just because I knew if I gave into them that it might make them feel like I didn’t pay attention when he said that he loved me.

The fifth thing, is to accept that this is their reality. Living with a mental health condition is no walk in the park, and it is a walk that many people walk for the rest of their lives. In my previous relationship, we had had a mutual understanding that there was a good chance that this was how it may always be, so considering what that meant for both of us (especially if we had decided to get married or have kids).

SO, WHAT IF YOU ARE THE PERSON LIVING WITH A MENTAL HEALTH CONDITION?

If you are like me and live with a mental health condition, don’t let anyone tell you that you are never going to be loved, or that you are incapable of it yourself. Don’t let someone tell you that your mental health condition is the reason why you are not in a relationship, because it isn’t. The right person will love you, the whole you, mental health conditions included. Never let anyone tell you that you should do anything other than how you are doing it now. Never let anyone make you feel bad about something that is out of your control. Above all, don’t ever believe that you need to love yourself before someone is going to love you because trust me, there were days when I definitely didn’t feel like I loved myself, nor did I even like myself. Yet I was loved through it anyway, in a romantic-love sense and by people who cared about me as friends.

Be with someone who is going to bring out the best in you. Be with someone who will love you even when they see the parts that aren’t “easy” or fantasy-like. Be with someone who will pray with you for peace and healing. Be with someone who will see your light, and yet still wants to seek out the darkest parts of you just to know all of who you are. Be with someone who will appreciate your highs because they know how far you’ve come and what you’ve had to do to get them; and yet be with someone who will stick by your side when you have your lows.

Don’t just be with the person who is going to love you when you’re having your best day, look your best, and have a lot of success. Be with the person who is going to love you when you’re having your best day, but loves you and shows you so even more when you’re struggling, can barely make it out of bed, and feel like you’re never going to make it out alive. Trust me, you will make it out alive… and if that person is still there, friend or lover… hold them tight, and hang onto them.

Coffee Date with OCD

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The second part of my three-part “Coffee date” series is focused on OCD. OCD, like other mental health conditions is highly individual. Thus, anything mentioned in this article as being helpful is purely based on my own personal experience with OCD.

What things trigger my OCD?
Is it an action? Is it a thought? Something on the news? A smell? Knowing your OCD and knowing it well is honestly a huge part of getting past an episode. I’ve lived with OCD since I was very young (before the age of 10). As a result, I’ve gotten pretty good at identifying what my triggers are over time. One of them related to my fear of contamination (especially connected to the smell) is rubberbands. To this day, if I touch a rubberband, it feels like there are literal bugs crawling on my the skin where I touched it. When it comes to the main focus of my OCD (people), there is nothing that terrifies me more than someone asking for space. It automatically triggers a compulsive response to ask the person repeatedly for confirmation that it isn’t forever, that they still care about me, etc. When I get those urges, it is incredibly hard to control myself, but I do, because I know if I don’t that it can impact my relationships with other people (and it has in the past). When I was a kid, the form of OCD I have (relationship OCD, also known as ROCD) was not as widely recognized. As a result, I had a great deal of self-stigma thinking I was weird, strange, and every other synonym for those two in the book. However, now that there is more research around ROCD out there, I can say confidently that I am not alone in the struggle of OCD, and if you live with OCD I guarantee you aren’t either. Do you think the things that trigger your OCD are weird or strange? Check out the list of different kinds of obsessions/compulsions on almost any website, and you will soon come to the realization that what you’re experiencing is actually pretty normal. The International OCD Foundation (IOCDF) is a fantastic resource that I highly recommend by the way.

What do I tend to focus on or think about (obsessions) most when I have an episode of OCD?
Knowing what your own thought patterns are is so incredibly important. Do you focus on a specific item? A specific texture? A specific feeling? When you know what it is you tend to negatively focus on, you can better utilize certain coping skills (such as positive self-talk). For example, I know that when I have an OCD episode that I am likely to doubt people around me, and to become suspicious of their actions and their intentions with me. By anticipating this, I know that when I am NOT going through an episode but yet I know I still have specific trigger(s) that I can find a way to remind myself that when I do go through an episode I have something to count on. For example, if there is a certain person that I tend to doubt, when I am in a good place with them I can write words of affirmation for myself and for my relationship with that person.

What behavioral changes (compulsions) occur when I have an episode of OCD?
This looks different for every individual, depending of course on what form of OCD they have. For me, my friends may describe me as acting a bit more “needy” or “needing reassurance” when I am having an episode. Honestly though, saying I get a little needy is kind of a compliment compared to how I used to be, asking the object of my OCD 25x or more per day, “Are you my friend?” “Do you love me?” “Are you still mad at me?” For others, this may look like taking showers more frequently than normal (I’m talking like 3+ times a day), checking the stove or locks more often, or seeking reassurance that you did.

What are some signs that I might be going through an OCD episode?
I am a huge advocate for providing education to those around you about your OCD (if you feel safe to do so). This can be a family member or friend, or really anyone you surround yourself with, just as long as you have someone who can act as a mirror, or be able to show you where your “blind spots” are. Personally, there have been times when I’ve struggled even recently, and it has been a friend who knows me well who is able to point out to me things that I don’t even notice yet. In my case, I am likely going through an episode or approaching an episode if I am isolating myself from people I normally spend time with (especially to spend time with one person in particular), if I seem particularly anxious or more forgetful than normal, or if I am placing too much mental energy on a particular person. For other people, it may be more or less obvious.

Am I willing and able to try to challenge my OCD-related fears?
If there is one thing I have learned about OCD, it is that the key to overcoming it is saying “no” to it. This is different from the other mental health conditions I live with. When I was younger, my therapist did Exposure Response Prevention (ERP) with me to try to lessen my anxiety around certain aspects of my OCD. I will talk more about ERP and my thoughts on it later, but for now, just know that I have adopted some of the techniques from that and the Cognitive Behavioral Therapy (CBT) modalities to help me challenge my OCD, the thoughts I’m having, and to try to stay more grounded in what I know to be reality. A friend of mine describes this process of challenging OCD to be like trying to get the monster back in the cage, or the worms back in the can, or however you want to look at it. I sometimes do this in a way that is similar to exposure therapy too by exposing myself to what it is that bothers me, and then slowly desensitizing myself to it over time. I can talk about this in a future post as well.

Do I have anyone I can talk to about this?
OCD is slightly less common than anxiety and depression, so in this case I find it particularly helpful to have a friend or family member who can support me through this, and remind me that I am not my OCD, and check-in. For example, I got my OCD from my dad, so I know if I want to relate to someone about it I can talk to him, or one of my other good friends.

How do I know when it is time to reach out for help?
I say it again, I know it is time to reach out when my OCD is interfering with my daily functioning. Is the checking getting in the way of my working, or am I being too open with coworkers about it? Is it getting in the way of my usual activities? Am I still going to church? Is it keeping me from doing things I love with people who love me? We are our own best judges when it comes to what is normal for us, so having an awareness is really the key here.

Be on the look-out for my final post in this series about depression!

How do I actively fight periods of depression? Part 1

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Believe it or not, this question is honestly what led to the creation of Life with a Side of Katie. I was previously active on a blog that I had named after my favorite bible verse, where I talked a lot about mental health as well. What I realized however is that even though my faith and my faith community are huge factors in my recovery, they are not necessarily going to be huge factors in everyone else’s recovery journey. It works for me, and it is something that I strongly believe in, but not everyone believes in the same things I do. Yet I still wanted people to get the information. Thus, Life with a Side of Katie was born.

This question is also what prompted me to begin posting about mental health again. It’s amazing how when people know that you’ve lived through (and still live with) depression, how many people look to you as someone who must have the answers to the questions they are asking. A really good friend of mine asked me about this topic in particular a while ago, so I just knew I had to post about it.

Before you read any further however, it needs to be said that these are the ways that I (read: me, myself) fight depression. This may not be how you do it, and it might not be how your neighbor, or sister, or friend does it either. Not all of these things will fit, although I am hoping some might. Depression tends to be an individual condition (despite some commonalities of course), and therefore it is fought in individual ways as well.

Prioritizing my own health and well being.
It is my belief that the best way to actively fight my depression is always to prioritize my own health and well being however that may look. For me, this looks like getting enough sleep, minimizing my intake of alcohol, making sure I take my medication, eating nutritious and good foods, and trying to get activity in where I can. When I go through a period of depression, I do everything in my power to make sure that those things happen. This brings me to the next thing I do…

Saying “no.”
I don’t know about you, but I tend to be the worst at saying “no” to people at times. However, if there is one thing I’ve learned when it comes to the people in our lives, it is that the ones that truly matter won’t hold our periods of depression against us, nor will they try to convince us to do things that are going to jeopardize our mental health. When I am actively trying to fight a period of depression, I have to say “no” to several different things. There have been many times when I’ve been torn about whether to stay in or go out for example when I am coming out of a period of depression. However, I am very diligent about listening to my body, and if there is even a little part of me saying, “you should rest instead” then I try to listen to that instead of going out with friends. I also say “no” to excessive alcohol intake. Alcohol is a depressant which means that it makes depression WORSE. Even if I don’t always feel it when I actually drink, I am very aware that its effects often carry over into the following day. Not to mention that alcohol interferes with the efficacy of many psychotropic medications.

Buying fresh flowers.
This is one of those small things that for me makes a huge difference. If you’ve ever been severely depressed, then you can probably relate to feeling lifeless at times while you’re experiencing it. Often times the windows are shut, the blinds are closed, you’re hidden behind locked doors, and you are in a dark room, and you feel trapped in your own mind like it is some kind of prison. When I experience that personally, having fresh flowers is that small light in my dark world that reminds me of life, and of the fact that I will soon be feeling alive again. The grass is greener where you water it, and I think this serves as a good reminder of that and of self-care.

Getting up and showing up.
If there is one thing I know about going out and doing things when you’re experiencing depression, it is that it is hard. When I am experiencing depression, I feel it physically. Many people do. I have often described periods of depression as feeling as though I have weights that are just glued to my ankles, and arms, making it incredibly difficult to walk let alone do much of anything at all. I’ve found though that perhaps the best thing for my own mental health is always to get up, and to show up, even when it feels impossible. Although it feels at times like life stops around us, it doesn’t. I will say that it would be amazing if job sites had some sort of a mental health leave, but I am also kind of glad they don’t, because it serves as motivation for me to continue to live my life, even when it is incredibly difficult. You are so much more resilient than you even know.

Dressing up.
If there could be a picture describing how I feel I look like (and sometimes what I do look like) when I am experiencing a period of depression, it would be one of me in pajamas that have not been washed in over a week. That is just the reality of things for me. Depression makes it hard to do much of anything, and showering / laundry are two of the things that just kind of get put on the back burner. There are many times when dressing up just isn’t an option during a depression, but I have found that doing one or two things can make so much difference. Think about what things you normally love to wear, and see if you can somehow incorporate them. You might be amazed at the difference it makes. For me, I have a hot pink scarf that I absolutely adore. Whenever I wear it, I just feel like I look better with that “pop” of color, so often times when I’m not really feeling great, I will wear that scarf. I also have a favorite electric blue purse that I’ll wear when the rest of me feels not so great. Again, this doesn’t work for everyone, but it works for me.

Journaling and writing things down.
I have also kept a journal documenting every little (and big) thing that has happened in my life since high school. It has been so therapeutic for me not just in the moment, but also to go back in time and see times where it felt like my depression would last forever, and then it didn’t. I always do my best to keep documenting, because recognizing our own patterns is definitely one of the keys to fighting depression, and fighting it well. I highly recommend journaling, or at least writing down what you’re feeling somewhere you can reference it later.

Spending time with my dog.
I have a nearly two year-old corgi named Leo who I absolute adore and love to spend time with whenever I possibly can, but especially when I am feeling depressed. I say this not just because he is the most cuddly and comforting little guy ever but he is also such a good example for me. He lives so lightheartedly, and is always excited to see people and to go places, and I always think to myself, I need to live my life like Leo does. I always recommend that people who are living with depression (both in my personal life, and the residents I work with) get a dog or a cat if they are able to (and if they like animals obviously) because they are so incredibly therapeutic. If it is the additional money that is a deterrent, particularly a pet deposit or pet rent, do not be deterred! I know that at least in California, people living with a mental health condition who regularly see a doctor or psychiatrist can request written documentation of their mental health condition or disability as a verification for needing an emotional support animal (ESA). With the documentation, places that are ADA-compliant cannot require pet rent, a pet deposit, or have breed restrictions for folks with an ESA.

 

 

Coffee Date with Anxiety

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If it is not already completely obvious, one of the things I am the most passionate about is mental health, and specifically mental health awareness. However, I believe this awareness starts at the individual level, and involves getting to know the very thing some of us want to run and hide from: the mental health condition itself.

For those of you who don’t know, I live with Generalized Anxiety Disorder, also know as GAD. I spent YEARS running from GAD, trust me. I treated GAD like an infection… like something that I was afraid if I got too close to would contaminate everything around it, and in my life. Little did I know that running from it was preventing me from doing the very thing that would eventually help set me free: getting to know GAD.

So, eventually I decided to try to do the unthinkable, and make friends with GAD. I went on walks with GAD. I introduced GAD to my friends and family. I took GAD out to coffee. As a result, I got to know GAD so well, that now when he appears, I don’t get scared or run away anymore. Instead, I greet him, I acknowledge him, and I live my life knowing that the sooner I embrace him, the sooner he will be on his way.

This post is the first in a 3-part “coffee date” series. 

What is my baseline?
I have this belief that everyone lives at a certain “baseline” of anxiety. What I mean by a baseline is the numerical rating on a scale of 1-10 that you would give yourself on an average day in your life. This is not necessarily a number that is stable over time. It can change, depending on your circumstances. I would say that my number is typically a 5. On my best days, it is maybe a 4. This is the baseline level of anxiety that I live with. Having an awareness of what that number is on a day when I am really anxious is helpful, because it shows me when the scale might be tipping a bit. It is also helpful to have an awareness of what the numbers higher up mean for you. For example, at what number should you reach out get help? It will be different for everyone, but for me I’d say when I get to about a 7, I know to start reaching out to my therapist, or someone familiar with me and my mental health needs.

What things trigger my anxiety?
As long as I am living with anxiety, I know that I will likely be discovering new triggers to add to this. It is just the nature of living. I don’t live my life in fear of this, I just keep it in mind so that when things come up I am not too hard on myself. If anything, I try to praise and reward myself for discovering something new about my anxiety. I also know that having triggers just comes with the territory. These are going to be different for everyone. For example, one of my triggers is being separated from friends when I am in a large crowd. Since I know this about myself, I know not to put myself in a situation where this will usually happen, and if by chance it ends up happening anyway, I remind myself that I am feeling anxious, but just like other feelings, it will pass and I WILL be okay.

What are some physical signs that I am becoming anxious?
Some of the typical signs I experience in the moment include a racing heart, sweating more than usual, shaking or “tapping,” and a feeling of restlessness. Anxiety at its worst goes so much deeper than that though. A lot of stress and anxiety-related symptoms tend to manifest as physical symptoms. For some people, this can mean that they get ulcers, acne break-outs, diarrhea, or all of the above. I tend to have a lot of digestive issues when I am going through a bad period of anxiety.

What are some mental/emotional signs that I am becoming anxious?
There are some signs indicating that I am anxious that are pretty obvious to me. For example, having racing thoughts that don’t seem to let up, or experiencing more agitation than normal when dealing with people around me. Again though, a lot of the symptoms go a lot deeper than that. For example, I’ve noticed that when I’m severely stressed or anxious that I begin to have more nightmares. In fact, there is a recurring dream that I have during periods of anxiety which serves as a sign to me that I am experiencing a higher level of anxiety than usual. I also tend to have more issues with my memory during those times, and when I am performing an activity like reading, I need to read the same page sometimes 5+ times to really soak up what I am reading.

What are some things I can do to cope?
Most of the things I do for myself when I go through periods of anxiety are related to self-care/relaxing. I prioritize making sure I get enough sleep, and I maintain good sleep hygiene by turning my iPhone on “night mode” (the blue light from the screen messes with our R.E.M or deep sleep), drinking herbal tea (my favorite is chamomile), and reading or writing at night instead of watching TV or looking at screens. I also do my best to only drink decaf or to stay away from caffeine altogether when I’m going through a period of anxiety. It really does help! Also, if you’re like me and take an SSRI, I recommend familiarizing yourself with the medication guide. Until I read that, I had no idea that caffeine messes with the medication I am on. I also cope by spending time with people who make me feel safe, love, and heard.

Who are some people I can talk to about this?
As I have gotten to know my anxiety, I have also gotten to know who has been there through it, and who has been willing to listen to me talk about what I am going through. I have a few designated people who I feel particularly safe talking to about my anxiety, and I tend to hold these people especially close during difficult periods of anxiety. I also have a therapist I see regularly who I feel safe with, and who I have a good relationship with who is willing to be with me during those difficult periods.

How do I know when it is time to reach out for help?
Just like any other physical illness or mental health condition, when anxiety begins interfering with your daily functioning, it is time to reach out. When it is interfering with your work, it is time to reach out. When you find yourself isolating from other people because of your symptoms, it is time to reach out. Every person has a different emotional distress tolerance, so this is going to look different for everyone. However, try to be mindful of your baseline, and recognize the point at which YOU need to reach out.

Stay tuned for my next “Coffee date” post. Next time, you’ll be meeting my OCD!