woman wearing floral dress blocking sun with hand while walking on sand dune in desert

Mental Health and Resilience

GenevieveLeave a comment

Is it ever ok to give up? Cultures around the world are inundated with myths, lore, and tales of a protagonist overcoming seemingly insurmountable obstacles and emerging triumphant. They’re admirable, they’re heroic, and we strive to be like them. How do they do it? It’s not that they’re unaffected by tragedy and hardship. Their secret is resilience.

The concept of resilience can be difficult to pinpoint, but I think this quote by Janna Cachola encapsulates what I think of as the essence of resilience.

“Resilience is not about being able to bounce back like nothing has happened. Resilience is your consistent resistance to give up.”

Resilience does not mean that you’re the same after your ordeal as you were before; we’re constantly changing. It means that even in the darkest of times, we either wait for it to pass, or we work to change our reality. These are both demonstrations of resilience- sometimes you just have to hunker down and hold on. But no matter what, we refuse to give up.

TW: This section discusses suicide

September 10th is International Suicide Awareness Day. In the last few days, I’ve been reflecting on what it means to be resilient in the context of mental health.  Cultivating resilience is one way to help us resist hopelessness and feelings of helplessness. It puts the power back in our hands. It says “I can get through this, no matter what.” This line of thinking is in no way a judgment on those who have died by suicide. It’s simply an attempt to continue a conversation started by researchers, therapists, and people fighting mental illnesses every day.

I’m no stranger to the importance of resilience in mental health. I’ve thought about suicide in such detail and for so long, sometimes it seems like an acceptable option. At the same time, the part of me that values hard work and persistence is appalled that I would consider giving up. It’s a dangerous balance that I need to monitor carefully in order to remain safe. Resilience doesn’t mean that you have to do it on your own. Rely on the people who care about you and all of your other resources. Ask for help, and accept it when it’s offered. As the saying goes, you’ve survived every single bad day so far- that’s a damn good track record.

– Love, your brain

 

“i was not born with roses
in my chest
to be afraid of thorns.i was born to
bloom
in spite of them.”
― Vinati Bhola, Udaari

portrait view of black dog with pointy ears sleeping on bed with pillows

3 Things My Dog Teaches Me About Listening to My Body

Genevieve4 Comments

Ever since I welcomed my puppy, Stella, into my life, I’ve noticed some things about how she treats her body. Unlike Stella, I have trouble recognizing what my body needs; Sensory Processing Disorder can make it hard to discriminate one feeling from another, and to identify what actions would fix an uncomfortable sensation. My dog, however, is especially in tune with her body. Sometimes I marvel at how good she is at giving herself what she needs. In honor of that, here are three things I’ve learned from Stella about listening to my body.

Test Your Surroundings

Stella has no qualms about finding a new place to hang out, no worries about offending others by moving. She goes from place to place as she wants. If the bed becomes too hot or too soft, she switches to the floor. If she feels too exposed around loud noises, she finds somewhere sheltered to lay.

The number of times I’ve kept myself from moving or adjusting my surroundings because I might stand out is too many to count. The little things can make a big difference in how you see your environment and how you feel in your body. Small adjustments help us regulate our nervous systems– a cold drink can wake you up while a warm one can calm you. Do you like your feet to feel secure, or do you prefer the freedom of open-toed shoes? Break up the monotony of your schedule by riding your bike to school or work every once in a while. I work on the computer a lot, and when my slouch has reached extreme levels, I know it’s time to get up and stretch. Take a page from Stella’s book, and feel free to get comfortable in your environment.

Express Your Emotions

Dogs don’t lie about how they feel; if you know how to read their body language, it’s easy to tell when they’re feeling happy, anxious, confident, or any other reaction to outside stimuli. There’s a certain amount of uncomfortable stimuli that we all must face every day. Maybe you hate the feeling of brushing your teeth, yet you do it because it’s important for your health. Maybe you’re sensitive to temperatures and dislike walking to work in the heat, but have limited transportation options. There are times that we have to prepare ourselves for and recover from unpleasant feelings that are unavoidable. There are also times when we suppress our instincts because we think we “should” be able to handle something. If there’s a way that you or someone else can adjust your surroundings to make you more comfortable, speak up!

Look for Joy

Stella loves a lot of things; she loves barking at rabbits, playing in sprinklers, and rolling in the grass. The things that she enjoys the most are the ones that require spontaneity. She approaches every dog she meets with a play bow; there’s no time like the present to make a new friend. She lives entirely in the moment, and whatever feels right to her is what she does– (sometimes to my immense frustration).

Look for joy in the little things. Find ways to have fun with boring activities. When no input is exciting or fun, we become understimulated and listless. So, jump in those puddles, paint with your fingers, and put your waste paper basket far away so you have to toss things from your desk. I don’t know, whatever brings you joy.

watercolor painting of woman's putting hands on face with eyes closed and dark background

The Lithium Slumber

Genevieve1 Comment

There is no sleep like the sleep of parched eyelids and lithium limbs. Even before you swallow your nightly dose, your breathing deepens, your spine curves forward. Your thoughts retreat to a distant rumble, as if your brain is hosting a party to which you weren’t invited. Perhaps you’re already asleep. Maybe. Did you ever wake up? Maybe not.

In the morning, you place more pills on your tongue and let them be carried down with the water your kidneys are begging for. Today, you tell yourself, no more sleep. I have things to do. But then it’s only been three hours since you rose this morning, and you find yourself sitting heavy on your bed, quickly slipping into the horizontal. No! No more sleep. You drag yourself from your cozy nest and plod to a less comfortable seat.

Yesterday, you slept for four and a half hours in the afternoon, and at that point, is it even called a nap? That’s just second bedtime in your book. And so today, like all the other days, you vow no more sleep. But your bed has its own gravity just for you, and before long, you’re crawling in; a perfect cove, with blanket waves and a pillow beach. Through the open window, you can almost taste the breeze, laden with lithium salt.

Love,

Your brain

I should be clear. I’ve been plagued by suicidal thoughts for three years, sometimes worse than others. Taking a high dose of lithium has given me, by far, the most dramatic positive result of any medication I’ve taken in my adult life.

I don’t want this post to be just another internet story about how terrible a particular psychiatric medicine was for someone. Those reviews are usually written by the people who had the worst side effects and the least benefit; after all, they’re the most motivated to write a review. Every medication has benefits and drawbacks. Scrolling through pages and pages of negative experiences paints a picture that doesn’t capture the thousands of people whose lives are vastly improved by that medicine.

It’s not perfect, and I still have bad days. It’s also a possibility that these sleep marathons are partly a symptom of my depression or the combination of meds I take that can make you drowsy. While I hope that lithium is not a medication I have to take long-term, I would be remiss if I didn’t acknowledge that taking it has probably saved my life.

Be well,

lumpdates

How to Persist Through Apathy

GenevieveLeave a comment

In the depths of depression and throughout the hills and dips of recovery, apathy is a frequent visitor. It steals motivation and leaves nothing behind. When this happens, it’s tempting to let it overtake you. I’ve found that continuing with a task despite apathy can help end a spell of it. Here are some of the ways I use to get me through a period of apathy.

Rewards

Whatever gets you even a little bit motivated can be useful when battling apathy. Granted, if you’re feeling apathetic, even the usual rewards might not have much of an effect. For me, I sit in the shade with a book and my dog. Maybe for you, it’s watching your favorite show or treating yourself to a delicious snack. Whatever it is, reward yourself for your hard work; apathy isn’t easy to overcome.

A Conversation With Future You

You might not care right now, but you might care a lot in the future. We like to think that we can predict the future, but the truth is that none of us really know what’s going to happen in a week or a month or a year. So, while this one requires a little hope for the future, sometimes all it takes is to allow for the possibility that things might get better; to admit that you’re not a fortune-teller. In fact, I’m working on this one right now.

Cultivate Satisfaction

I know what you’re thinking–well, I don’t know. (That’s another distortion.) But you might be thinking “obviously, if I’m feeling apathetic, I don’t want to do anything because I don’t get satisfaction from completing a task. Why would I do something that gives me no intrinsic reward?”

Well, that’s a good point. I’ll counter with this: an oyster creates a pearl when a grain of sand becomes lodged in its tissues. Layer by layer, the mollusk coats the grain of sand with calcium carbonate to protect itself from the irritating particle. What began as a negative from the oyster’s perspective is turned into something valuable.

Motivation often comes from the desire to solve a problem. Whether it’s a seemingly small problem like noticing that your hair needs to be washed, or a larger-scale problem like slipping grades that could affect your graduation, everything we do, we do to solve a problem. Every time you do something that moves you towards a goal, you’re building a metaphorical layer around the underlying issue. Every time you go to class even though you don’t want to, you’re building up to something great. Every time you go for a run even though you’d rather sleep, you add another layer of persistence to your pearl.

Often, it’s only after many layers, many instances of forcing myself through apathy, that I begin to get a glimmer of satisfaction. Sometimes, the only way to reach the other side of apathy is to just begin. Momentum only comes when you start to move.

 

sketch-of-hand-holding-razor-blade-with-text-not-today-brain

Self-Harm: Is It Eating At You?

GenevieveLeave a comment

Lately, I’ve been noticing the return of one of my most distressing depression symptoms: thoughts about self-harm. When I first started harming myself, I was so ashamed that I couldn’t talk about it at all. When asked, I’d shut down and say nothing for fear of crying uncontrollably. I have the same struggle when it comes to suicidal ideation; I feel such overwhelming shame that just saying the words out loud has been a gradual process. I was recently talking to my (very patient) nurse practitioner, who reminded me that the first time we talked about my suicidal thoughts it took me about ten minutes to get the words out, and I was shaking like a leaf the whole time.

It’s only recently that I’ve really been working on seeing these things – self-harm and suicidal thoughts – for what they are: symptoms of a larger issue. They’re indicators that my depression has worsened. There should be no judgments about willpower or self-control. They’re symptoms that should be taken seriously, but they’re nothing more or less – just symptoms.

While I know this intellectually, when those old thoughts come rushing back, so do the remnants of guilt and shame that I’ve worked to eliminate. It eats at me – the thoughts themselves and the judgments I hold against them. That’s how it always is; whether it’s a trickle or a flood, the thoughts eventually erode my determination not to give in to self-harm. It’s a battle to hold out until the thoughts pass, and sometimes I make it, but sometimes I don’t. The good news is, it does get easier with time and practice. If you relapse it can feel like you’re back at square one, but you’re not. If you need a little encouragement today, keep going. Keep working to treat yourself with kindness. You’ve got this.

Two Black Dogs

GenevieveLeave a comment

A short drive up a dirt road after a long drive up a canyon, there is a cabin in the woods. Inside, there is a sleeping dog–wearing her coat of all-black fur, resting on her side, one upright ear has flopped over. She has sniffed every inch of this cabin since we arrived yesterday afternoon. Her job complete for now, she allows herself a brief intermission to do what puppies do– nap soundly and sweetly.

I am sitting in an armchair near the sleeping dog. I came to the cabin for a short reprieve, to escape the relentless tide of life’s obligations. Most of them, I left behind. But one, I can’t seem to shake. A black dog followed me up here, and not the one at my feet. It goes where I go, does what I do. It can be menacing and imposing, or familiar and safe. This black dog is of my brain’s own creation, made from worry and sadness and guilt. It was set in motion before I knew of its existence. It came from faulty neurotransmitters, genetic predispositions, and the fickle imaginings of chance.

The black dog at my feet jolts awake — a noise on the stairs. It is only the cabin creaking, so she returns to her slumber. We both settle into the peaceful sounds of the woods. A duck laughs on the pond. Swallows swoop and chirp over the water, plucking mosquitos from the sky. A gurgling brook feeds the pond, and its sound is a balm to a worn-out mind. But a balm cannot evict the black dog of depression. It howls its objection, then herds me back to bed, nipping my heels with fatigue and foggy thoughts. As I sink into sleep, I know that soon, my other black dog will come to wake me. She will breathe on my face and wag her tail. She will tell me that it’s time to get up, time to go out, time to take in the sounds and smells of this short reprieve in the woods.

roadsigns-pointing-different-directions-at-golden-hour

Considering My Next Mental Health Treatment

GenevieveLeave a comment

I have an appointment coming up with my psychiatric nurse practitioner, and that means my thoughts frequently settle on the effectiveness of my mental health treatment. By now, I’m familiar with the questions she’ll likely ask me, but somehow the answers never come easily. Determining how I feel is not something I’m very good at, although I’ve gotten better at it. This time, I’ll attempt to describe the seemingly endless plateau of “meh” on which my mood currently resides. I have occasional dips into the dark chasm of “really bad,” but for the most part, things are ok. But as I decided after I was released from the hospital, I’m not settling for “ok” this time. I want to feel great, exuberant, joyful, even- happy. Happy would be good.

At this point, it seems like I’m running out of viable mental health treatment options that come in pill form. I was told I was a candidate for and encouraged to try Electroconvulsive Therapy (ECT) while in the hospital (a treatment that has changed immensely since it first began). My mother’s worried googling turned up IV ketamine as a promising treatment that my psych NP also encouraged. I knew people in my partial hospitalization program that moved on to do Transcranial Magnetic Stimulation (TMS). These are all safe treatments that, if they work, can change your life for the better. So, why am I so resistant to the idea?

I think it comes down to acceptance. When I first became depressed, it took me a long time to get to a place where I felt comfortable taking antidepressants. I clung to (and sometimes still do) the idea that if I just tried harder, all my problems would be solved. This is because, like many of us, I’m way too hard on myself. But it’s also because it was scary to fully accept that I have an illness that can’t be overcome through sheer force of will; a fact that my biochemical imbalance predetermines. On one hand, taking responsibility for your mental health is an important part of managing it. On the other, there’s an element of frightening imposition that comes with accepting that the very fact of your diagnosis is out of your control. I carry my depression around with me- not by choice or through lack of effort, but because its complex tangle of symptoms, neurological effects, and genetic alterations are not things I can leave behind.

Despite coming to terms with the apparent chronic nature of my depressive episodes and the fact that right now, I need antidepressants, I see this next step in mental health treatment options as Phase Two of my personal acceptance hurdle. It was tough to accept that I needed antidepressants, and now it’s tough to accept that I may benefit from another level of psychiatric treatment. I like to mull things over for a very long time, so until or if I decide to make that leap, I’m just considering it.