Having a difficult time

Woke up very depressed today. Was real anxious, too-- not about anything in particular, just an overall feeling of being completely unsafe. I laid around a lot... took a short nap... did some schoolwork... more laying around... now it's almost midnight and I'm wide awake... have been crying a bit on and off... gotta get up at 6:30. I am scared because when I get very depressed like this sometimes it means the beginning of an episode... they can last up to 7 weeks. That's the problem with my moods-- always a surprise. I could wake up tomorrow feeling better, worse, the same.... but I'm real nervous because I felt like this on Wednesday and now today. I want T. I don't feel comfortable calling him when I'm so down... I feel like I'd be bothering him. I just don't know what to do with myself right now.

((((((((((pinksoil)))))))))))))

I'd say contact your T and tell him what's happening. He's there for you, from all you've said you two have a wonderful relationship. I understand about the "bothering him" feelings though.

I'd still say call him, maybe he can help.

Can you plan to do something tomorrow? Go see a movie or go for a walk around a lake or something like that? Basically... Something to do no matter how you feel? I sometimes find that making a plan like that (and sticking to it no matter how I feel) can result in my feeling better by the end of the day. Getting tired out too so that I sleep better that night. Playing tennis with someone? Something where you are likely to have a positive social encounter, get some exercise (endorphins yay and tiredness), and treat yourself.

I'm going to get serious with the treatment
plan this week and see if there is anything to get me out
of my funk. Soon the cold weather will arrive and I need a
long term solution to bring change, lasting change. Some
peace of mind and a new job would be the cure but how
do you go about testing the waters when you don't feel
in focus and pretending everything's OK, when its not.
Please help.

DB

((Pinksoil))

I hope you made it to work.

And I hope you call T.

Peace.

pink, I hope you can call your T if you need him. I hope it was just a one day thing and you woke up this morning feeling better. ((((hugs))))

((Pink)), I think AK suggestion is a good one provided you are well enough to make a list of small activities to do tomorrow. Maybe force yourself to do a few nice things for yourself whether you feel like it or not. Some ideas might be 1) block an hour of time for a nice relaxing bath--throw in some Mister Bubble, light a candle and just relax and breathe for a hour. 2) Force yourself take a nice quiet walk in the park. 3) Make a cup of tea and watch the sun rise or set. 4) Stop at the flower store and buy yourself some flowers.

I really hope you are feeling better soon!

Pink maybe I am totally off base here but I just thought of sometime and don’t have time to go back and check your previous threads. Did you mention in another thread something about starting/stopping a new medication? Could your symptoms and their severity be related to that? If so, a call to your doctor might be good. You may also find some solace in knowing it might just be a temporary brain chemistry issue not a problem with YOU. Just had that thought on my way between classes. Sorry if I am totally off base and it wasn’t you how was trying out new meds.

How did your day go?

Did you manage to plan things that would get you exercise (to help you sleep) and that you enjoyed (to help you feel better) and to help you socialise (to help you feel connected in a meaningful way to others)?

Or... Did you decide that the answer lies in a pill?

There was a reason why I didn't adopt the 'obvious' explanation of the answer lying in a pill... I figured that your distress was around the medication situation not being satisfactorily sorted out (with respect to blood levels).

I guess I don't see... How the answer lies in a pill... Not really... I mean... If you don't learn to manage your emotional state by way of exercise (to physically tire you so you get a good nights sleep) and by way of enjoyable activities (so you feel valued by YOU) and by way of social connection (so you feel valued by others) then...

Well...

A pill can sedate you. And a pill can energise you. But a pill is (by admittance of the psychiatric profession) a way of helping people feel better when they are unable to take the steps in their life that would help them feel better.

And the negative side effects of a pill can be symptoms worse than you have ever experienced in your whole life. In some cases a worsening of symptoms. In some cases death.

But you aren't incapable of managing your own emotional state...

Are you?

Your decision.

Your distress being legitimate doesn't depend on a pill being the answer. But... It might be the easiest way...

Easier to take a pill and say 'I'm not responsible for managing my own emotional state - I have a chemical imbalannce' than to weather the normal variation in ones mental state and learn how to manage that better.

It does take time. It is an ongoing process. But how much to buy into the idea that 'I'm better learning how to manage my emotions - which is something that the majority of people are working on' compared with 'I need to take a pill to manage them for me because I have a biological disease that is completely outside my control'.

But then... Of course... There are issues with p-doc going away without making it clear that he is monitoring the situation adequatly. What a temptation... To show him... That he CAN"T DO THAT.

But... What about you?????

What about you?

> Pink maybe I am totally off base here but I just thought of sometime and don’t have time to go back and check your previous threads. Did you mention in another thread something about starting/stopping a new medication? Could your symptoms and their severity be related to that? If so, a call to your doctor might be good. You may also find some solace in knowing it might just be a temporary brain chemistry issue not a problem with YOU. Just had that thought on my way between classes. Sorry if I am totally off base and it wasn’t you how was trying out new meds.

Hey there. I really... Didn't mean to undermine your post. I agree with your post 100% that the reason for the present distress is indeed likely to be about the starting (and the absence of appropriate monitoring) of the new medication. I think it was really insightful of you for having figured that out :-)

But... I do worry about that... I worry about the divide that occurs in peoples way of thinking. For example:

A pill won't help me, therefore completely my fault

Compared with

A pill will help me, therefore completely out of my control

I think there is a middle ground (synthesis) between these ways of looking at things.

Don't get me wrong, I'm sure that some p-doc really believing that some medication is the answer is enough to inspire hope that it is the answer and temporary improvement.

But I'm worried about the harmful side-effects of the medication and the long term harms that can result from taking it and from putting ones faith in it.

I don't know a great deal about pinksoil... But from what I've observed... She has immense potential within herself to conceive of herself as a 'normal' person who struggles in some respects, sure. But basically as a 'normal' person who would like to improve in her functioning and feel less emotional pain. Compared with someone who really is unable to conceive of ways that they can manage their own emotional state and thereby come to learn successful ways of manageing it. This latter way which consists in drugs to wake you up and drugs to put you to sleep and drugs that have such harmful side effects. Lithium - where the effects of that are found in the SECOND GENERATION of offspring of rats. I don't see... P-doc may be charming and he might have hopes for some wonderful magical 'quick fix'. But really... Life doesn't work that way... And pinksoil is doing AMAZING work with her therapist and (even more importantly) with herself.

You can do it. Don't get me wrong, it can be %#@&#! HARD at times. But... You can do it. Don't let them categorise you as 'mentally ill'. All that is doing for you is harming your career and your self conception and ultimately... Resulting in your limiting yourself (I can't manage my moods but a pill can).

Hang in there.

Alex,
I was distressed when I read your post and hope you didn't mean to chastize those of us who use medication as an adjunct to therapy.

If everyone with MI should be able to cure themselves, then shouldn't everyone with a physical illness be able to do so also?

We now know that we can't separate mind and body--they are one.

Therefore, we must treat both aspects of our illness. Extreme psychological stress can have devastating effects on the body. The wellbeing of the entire organism is threatened. The first line of defense are those that you suggested--diet, exercise, mediation, prayer, all of those things that can help to ameliorate the symptoms.

HOWEVER, there are times when those methods are unemployable or just don't work. They may be unemployable because of physical manifestations of the illness (such as an inability to exercise) or because of psychological manifestations of the illness.

Sometimes the pain is so great that no matter how much you walk and meditate you are still in such incredible pain. And sometimes that pain is due to ongoing life circumstances beyond your control.

I guess the point I'm trying to make is that we are each so unique that there is no "right" answer that fits everyone. No "one size fits all" in life.

Some of us need medication to help us reach the state where other methods can begin to help or be effective.

Some of us need medication for life because we have such extreme manifestations of illness that we would not function without.

Some of us need medication because it enables us to get up in the morning or go to sleep at night.

Some of us can't use medication because it is not the answer for us.

Some of us use meditation, some of us pray some of us go to therapy and some of us walk, and some of use do all of the above PLUS use medication.

This is the beauty of the diversity of the human race.

Peace and love.

Funny, I must have read AK's post with a different perspective :-( I was reading as giving someone the encouragement to maintain their emotional state? I know for me Ive never felt able to attempt or look at a situation until someone has expressed "another" way. Or at least allowed me to believe that maybe, yes there is something I could do to feel more in control of my innerlife?

I'm sorry that you felt distressed to read my post. I certainly didn't mean to cause distress.

> If everyone with MI should be able to cure themselves, then shouldn't everyone with a physical illness be able to do so also?

I'm not going to answer that question because I think it is a false analogy (though indeed a tempting analogy that is encouraged by pharmaceutical companies, and indeed, an analogy that has been picked up on by many a consumer).

Here is a different analogy:

If you want to teach someone to cook a good curry then you need to alter their neurology in order to teach them.

Now... Is the best way to teach someone how to cook a good curry to give them psychosurgery (neurosurgery) or to give them medication (pharmacology) or to give them a few lessons in how to cook a good curry (environmental intervention / social skills training)?

Nobody is going to deny that in order to learn how to cook a good curry your neurology needs to change. The controversy is over the best way to get your neurology to change. Psychosurgery, pharmacology, environmental (social skills) training. That is the million dollar question, really.

Typically... We start with environmental (social skills) training as much as possible. How come? Because the side-effects of medication can be really quite serious (raised blood pressure, gained weight where obesity is close to an 'epidemic), sexual dysfunction, diabetes, worsening of depression, worsening of anxiety, death in some instances). Given the harmful side-effects of medications and given the fact that a lot of people simply don't seem to benefit significantly from them the issue becomes:

Have other methods been exhausted?

And so I repeat:

If you feel like your mood is bad and you are heading for a major depressive episode then:

Schedule your activities such that:

- You do something nice for yourself (to show you that you value yourself)
- You do something nice for others (so you feel a sense of meaningful connection to others)
- And where your sleep is disturbed tire yourself out (exercise stimulates edorphins which is a 'feel good' drug and it tires you).

Activity schedule for a couple days. MAKE youself do this. And then... After sticking to your activity schedule... Then see how you feel. If you feel better then CONGRADULATIONS you are in the majority of people in the world who feel jolly bad sometimes and have learned some strageties to successfully manage your emoitons (and that will help you considerably when you seek a lisence to practice as a mental health professional). If you try and do that and you successfully complete the activities and you still feel like %#@&#! in a few days... Then matters need to be reassessed. And that reassessment (in pinksoils case) will (or might) affect her lisence to practice as a mental health professional in the future.

So... WOrth trying? You bet.

You %#@&#! bet.

the issue is basically one of exhausting environmental / social interventions BEFORE resorting to medications.

pinksoil felt like she was heading for a major depressive episode...

therefore... give environmental / social interventions ONE WEEK before resorting to medications.

given the side effects of medications.

some people activity schedule for a week and find that they aren't doing any better. in that case... well... after two weeks of that... maybe take so meds to give you a hand.

but to resort to medications on the basis of distress lasting... a couple hours? is likely to result in more harm than help.

and really... the idea is for you to ultimately learn to manage your moods yourself without relying on meds (ie to come off the meds) and so... why not try it BEFORE your body becomes tolerant to the meds (such that you will have to suffer through a withdrawal syndrome at the other end as well as getting better at the activity scheduling).

?

******** aside... dx of mental illness DOES affect ones career (or potential career) as a mental health professional. it affects what you can and cannot say (in good conscience) on your applications and it affects what you can and cannot say (in good conscience) on your application for a lisence to practice as a mental health professional. given that pinksoil wants to be a mental health professional it is a significant advantage for her career for her to be able to say (in good conscience) SURE I STRUGGLE WITH %#@&#! - AS DO MOST PEOPLE. WILL IT AFFECT MY ABILITY TO PRACTICE? HELL NO!

whereas if she belives she has a mental disorder... she is screwing herself over, basically. especially when... she hasn't taken the steps to help herself BEFORE resorting to medication.

it is of course up to her.
my take is of course different from the drug companies perspective (which has come to be endorsed by consumers)
but with respect to mental health professionals...
well...
best not go there.

I am bumping this conversation to a new thread so that the debate needn't pertain to a particular individual, which isn't fair.

BUMP>>>>>>>>>>>>>>>>

To Alexendra, to heck with the drug companies, you are being rude, rapid in your firing off responses and non-supportive. What stake do you have in drug companies? Why are you so off base and strange tonight? I have some odd ideas. Never the less, let it go. You are way off and not appropriate in my own opinion. This is the woman who watched her friend dying of cancer state that other people told her that if she had cured her inner demons better she would have healed from the cancer. And the was older male calf poop.

Boy did I miss an interesting argument about myself while I was in school tonight-- glad I'm back, lol.

First I just wanna say that it takes a lot to distress me on a message board. Under most circumstances, I appreciate that something I posted sparked thought, debate, whatevever. This is one of those circumstances, so don't worry-- Alex and Sister, thanks for your thoughts. And Alex, I personally do not think you were being rude at all. When I come to this board, I think that the support is great, but support comes in all different forms-- I'm not the type of person who often looks for a hug or kind words-- more like a fresh perspective, some insight, etc. I don't think that Alex was being unsupportive because she obviously took the time to read, think about, and type well thought-out posts in response to my situation. I appreciate that.

Aside from the Lithium, my doctor is trying to help me sleep without the use of meds. Each time we talk we go over more and more things I could try in order to make sleep easier. Last night I tried one of his suggestions-- a craft before bed. I did my needlepoint. I got into bed. Then I almost jumped out of my skin. Maybe next time I will try exercise.

Medication has always been a tricky issue for me. For the most part, I feel like I can manage my emotions. I can function but mostly to the level in which I am going through the motions. A lot of the time I don't feel well enough to enjoy what I'm doing. My T and I talk about having a better plan in place to pick up on the warning signs of a major depressive episode.

A couple of semesters ago I went through a depressive episode. I was taking two classes and I ended up having to drop one. I swore that I would never, under any circumstances, let that happen again. And that is when I spoke with T and talked about trying medication again, to use as a tool.

I know that I have a lot of issues that are far from being resolved. Most of them are ones I need to work on-- they are not biological, they are not ones that can be fixed my meds.

I do feel, though, that these depressions could be alleviated a bit by the right meds. They are nasty-- I go through about 3 of them a year, sometimes lasting up to 7 weeks each.

I pushed the hell out of myself today. I made it through my internship, did a good job with my patients, and then made it through class. During class I fought back stupid tears because I felt so sad. Yeah, I made it through the day. But I know that I could be doing a whole lot better than this.

Sometimes I am scared... am I doing therapy wrong? Why am I not getting any better? Is it because I'm just not trying enough? So I'm become aware, gaining insight, engaging in self-exploration-- but I'm not getting better.

This is very embarrassing (and it probably comes from my fear of abandonment) I panic irrationally when I cannot get in touch with my husband immediately. This has been going on for about three years now. Well tonight I was driving home from school and I called him twice and he did not pick up his cell phone. I immediately began to panic and decided he was probably dead. I could not think of rationally, I could not think of other (rational) reasons that he wasn't picking up the phone, I could not think about how this has happened so many times before and nothing has ever been wrong. So as it goes, I get home and he was sleeping. And I was supposed to go to CVS to pick up my meds but I couldn't do it because I needed to get home to make sure he was there and okay.

My point is, this is a very disturbing problem which often interrupts what I am trying to do. It is something that was there before therapy, and is still there at this present time. Why hasn't it gotten better? I am not working hard enough or at all, I suppose.

Ok, now I'm really starting to go off and get tearful and it's 11 PM and I still have to edit and print out my case presentation for tomorrow's class.

> you are being rude, rapid in your firing off responses and non-supportive.

Please don't call me names (rude) and make assumptions about my intention (non-supportive). Thanks.

Thanks for trusting that I'm generally well intentioned. People are (of course) free to disagree with my perspective. Take what you can from it and disregard it if you can't find anything of worth, thats my motto and I'm certainly accepting if people do the same with respect to me.

> I do feel, though, that these depressions could be alleviated a bit by the right meds. They are nasty-- I go through about 3 of them a year, sometimes lasting up to 7 weeks each.

Maybe meds could help a little... But maybe not. I'm not at all attempting (or intending) to undermine your very real distress, but I do think that while some people find a medication that they don't experience many side-effects of and that they find beneficial in some cases it is unclear whether the medication is helping or harming them and in some cases it is fairly clear that the medication is harming them. It is just that... They don't think they can do without it.

If something is biological that doesn't mean that medication (or psychosurgery for that matter) is the best way to intervene to alter the neurology. Back to the 'learning how to cook' example.

I really do understand about 'soldioring on' and feeling like one is straining through one minute at a time... Basically walking the walk but not getting much pleasure out of life. I think that that does happen sometimes for everyone. Sometimes things can be like that for a couple weeks, even (which is why they require that it lasts more than a couple weeks before a dx of depression). What usually pushes the cycle over... Is that the person stops walking the walk (stops doing the activity scheduling thing) and then things really start to spiral out of control.

> Yeah, I made it through the day. But I know that I could be doing a whole lot better than this.

Yeah, life certainly can go a whole lot better than that! One thing that was said to me (or to the group really) in DBT was that 'if your lives were destined to continue on being as painful as they have been up until now then you guys would be right - you would be better off dead'. But the thing was... That our lives aren't destined to continue on being as painful as they had been. There were times (hours, days, weeks) that they were. But there were moments, hours, days, weeks where those horrible feelings would lift.

> am I doing therapy wrong? Why am I not getting any better? Is it because I'm just not trying enough? So I'm become aware, gaining insight, engaging in self-exploration-- but I'm not getting better.

You aren't doing anything wrong. You are getting better. When things are going badly it can feel like things have been going badly for a very long time (state dependent memory). But similarly, when things are going really well it can feel like things have been going well for a while. You were really happy about your internship and the poetry reading... You have experienced happiness recently.

Part of it can be about maximising those moments that you can take some pleasure from. Trying to set up your environment so you can have more of those. Taking some time... To smell a flower. To really focus all your attention on the aroma and on how the petals feel and taking some kind of gentle pleasure in that moment. Sometimes thinking about the past and the future just seems to make one feel worse... On those cases all that is to be done is to try and create some positive experiences in the present moment. Excercise is terrific because endorphins are your body's natural 'feel good' pick me up and tension reducer. Thats kinda what they are there for ;-)

Life is a process. Sometimes it can feel like two steps forward one step back. I'm not sure that there is a genuine 'forwards' and 'backwards', however. Sometimes 'backwards' (though it can feel jolly horrible) is really one hell of a step forwards. I'm wondering how much your present distress is tied up with feeling abandoned. By p-doc... By your husband...

> This is very embarrassing (and it probably comes from my fear of abandonment) I panic irrationally when I cannot get in touch with my husband immediately...

> Why hasn't it gotten better?

Have you talked about this with your therapist?

Remember to do things that are kind to yourself...
And excercise... Can help considerably with alleviating anxiety (it is impossible to feel sad when endorphins are being released) and helping with sleep...

Hang in there.

Alex,
I hear what you are saying and respect your opinion. You make some valid points about how some people use medications before trying therapy or how people may not realize whether the total effect of the drug is positive or negative.

When being good to yourself, others, exercising, and being in therapy don't produce an outcome that enables one to function daily (hourly, minute to minute, etc.) then I think medication can be a good option.

I have OCD and ADD and issues resulting from these. I used to be on antidepressants, sedatives, antipsychotics (for anxiety), and stimulants. I knew within a few weeks that the antipsychotics were causing me extreme fatigue and stopped taking them. However, much like a point you made, it took me years to figure out that the antidepressants also were causing fatigue. I have not taken an antidepressant in about six months and actually feel better than I have in awhile (which is also due to being in therapy).

However, I still take a stimulant and a sedative (benzo) as needed. I continue to work on emotional/anxiety issues in therapy and have made considerable progress.

Can I function without the stimulant? Yes, and I have tried. However, whenever I don't take it each second of the day is excruciating. I have to constantly push to overcome inertia. I honestly feel that my medication at this point is serving its purpose well. So, it seems that I can be an example of your point as well as a counterexample. Thanks for making me think
But now I have a headache. Excuse me while I go to the medicine cabinet . . . Just kidding.

> When being good to yourself, others, exercising, and being in therapy don't produce an outcome that enables one to function daily (hourly, minute to minute, etc.) then I think medication can be a good option.

The first thing to think about is the kind of 'functioning' that is problematic. Painful feelings? Psychosis? What one should do depends on the nature of the problem in functioning.

So... Painful feelings - loss of enjoyment of things (a kind of depressed feeling) and the experience of pain.

So... How long should one experience those painful feelings and loss of enjoyment before trying medication? Should the feelings be lasting for a couple days... A couple weeks... A couple months?

How long should one solier on with exercise and mindfulness exercises and activity scheduling etc etc before resorting to medication?

What I was responding to was Pinksoil saying 'pretty much stayed home today and didn't do a great deal and felt like %#@&#! and couldn't sleep'. The idea was that getting out and doing stuff might well result in one feeling better.

I didn't really want to talk about other people and other peoples situation. I wanted to talk to Pinksoil about my understanding of her situation (which was why I was reluctant to participate in a thread where this wasn't about Pinksoil so much as about other people). Different people have different circumstances, I get that. I was speaking to lots of people, however, I was speaking to Pinksoil.

I have never really exercised before. I mean, besides walking. But that's just exercise by default. Once I took a yoga class and I hated it because I do like physical exertion... I don't like to sit quiet and focus on my body. Once I joined a gym and fell off the treadmill so I never went back. What do I do? Where do I start? I am so depressed and unmotivated. Going to school this evening was like the event of the century for me. Other than that, I could barely get myself off the sofa to pour myself some juice.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
I didn't really want to talk about other people and other peoples situation.

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There was no obligation for you to read or reply to my post.

((Pinksoil)),
I hope you start to feel better soon! I can empathize with you.

I know. I just meant to say that I do understand and appreciate that other people have different issues and different circumstances around those issues.


Peace.