Acceptance

Approaching the one year anniversary of my “descent into hell”; and where am I today?  I am pleased to say that I am healthy and, for the most part, happy.   I’ve learned enough to mostly manage (live with) my troublesome anxiety and obsessive/compulsive behaviors.  Frankly I can’t really wrap my head around how my “OCD behaviors” are linked to my depression, having said that, I do find that doing the behavior is soothing, I guess because the act of performing certain behaviors consumes all of my focus and attention, which is sometimes a huge relief.   My compulsive cleaning is under control (most of the time), but, I simply cannot leave my face alone, touching, picking and making a mess of my skin – who wouldn’t pick at their face if they were always peering into a 15X magnifying mirror!!  Obviously, I still struggle and know that I still have things to work on, which is why I continue to see my therapist. 

I continue to struggle with the whole “not working” thing, which I was thrust into when I got sick.  If I am honest, I know that I have allowed myself to believe that my “value” is and has been defined by my career.  I have even considered going back to working fulltime with an organization, rather than maintain my consulting business.  I have had a couple of interesting interviews, however, nothing has panned out, which leaves me filled with self doubt and loathing.  I never once consider any other reason for my lack of success in landing something – must be that I’m a loser (core belief).   In any case, the more time that passes, the more I am enjoying not working.  Although, I struggle with the “guilt” that I feel as a result of not doing something of value (as I define it). 

I have always believed in the adage that what will be will be, and that all of us are exactly where we are supposed to be at any given moment in time, whether we understand why or not.  Honestly, had I not gotten ill last year, I am certain that I would still be spinning out of control in every aspect of my life.  Being forced to stop spinning allowed me to develop and utilize skills and tools to manage my OCD behaviors and thinking patterns, which are so disruptive and debilitating.  This is especially true when my thoughts concern my daughter.  I still get flashes of gut wrenching fear/panic that she will never get it together, which leaves me feeling helpless and sometimes hopeless.   I have been seeing her regularly for the last couple of months – post visit, I am always exhausted and emotionally drained, but, I am managing.  I will always struggle with setting boundaries (in every aspect of my life), however, at least I can have her in my life, after all, she is my child and I love her.  Just seeing her name flash across my blackberry causes my heart to palpitate and my breathing to become erratic –my fallback therapy and answer to everything is BREATHING.  Who knew that something so simple could be so impactful?  The single most important thing that I learned at Day Treatment, was how to control myself through belly breathing, I literally, do it whenever the thought pops into my head or when I feel anxious.  Works for me almost every time. 

I have gained and lost the same two pounds at least 6 times over the last year.  When I was switched from Zyprexa  to Abilify,  I foolishly thought I would be able to lost the 25 lbs that I gained from taking the Zyprexa.  NOT.  However, I must say that I am healthier than I have been in a very long time.  I am acutely aware of every morsel of food that goes into my mouth and I usually make good choices.  I am also back into my fitness routine, which I know is good for me regardless of my inability to lose weight.  I still despise conflict and do everything in my power to avoid or prevent it …this is exhausting and ineffective.  I firmly believe that if I never had to leave my home, I wouldn’t.  But, I force myself to go out when invited and meet my friend at least once a week to walk the dogs in the woods.  I shop compulsively (online) and feel remorse after every order I place, and then, turn around and inevitably repeat the pattern.  At the heart of everything I do or feel are my core beliefs, which are predominated by “I’m not good enough”.  I’m ok with this, as just knowing that this is one of my core beliefs gives me the ability to challenge it and makes me a stronger person.  My hope in the immediate future is to get agreement from my physician to stop taking the Abilify, with the full commitment to going back on the medication, if required.  Does the thought of a reoccurrence scare me?  Of course, but I know that in many ways I am no longer the same person I was before I got so sick.  I am stronger, both emotionally and physically and am ready to take the “risk”.

“You never know how strong you are until being strong is the only choice you have” -anonymous.

 

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Could I be Manic

What is wrong with me?  Honestly, sometimes I feel as though I’m incapable of not spending money.  I think I may have a serious problem with “impulse control” when it comes to purchasing.  Do you think I could I be manic?   

A friend told me about a website that carries the brand of swimsuit that I really like.  I already own one, it’s in great condition.  I rationalized that with the amount of time I spend in my suit at the cottage, it would make sense to have two that are comfortable (as opposed to the second one I own, which, impulsively I had to have, even though it clearly did not fit “properly”).  In any case, I found the same suit, different color and purchased it for just under $100 including tax and shipping.   I made that purchase on February 26, today is March 19, 2012 and I am still waiting on delivery.

I spend, roughly $150 every other month on “supplements” which I purchase online.  This has been going on for approximately 6 months.  These purchases include PGx, for weight loss, weight maintenance and glycemic control.  I have yet to lose more than the six pounds I lost before I started taking it.  I can’t stop using it, just in case it might actually work.  Seriously pathetic.

I had earned a substantial amount of optimum points prior to Christmas.  I wasn’t sure of the total amount, but did know that it was at least $80.  I walk out of the store only after using all of my points and spending an additional $100 on stuff I absolutely do not need.  Ugh.

I’m not working right now so I need to fill my days with something stimulating, which wasn’t a “time waster”.   I was inspired to try my hand at painting by my neighbor and friend, Clara.  I started small, just a $20 kit from Walmart that included paper, brush and multiple tubes of acrylic paints.  Really enjoyed the time I spent painting, a few of the pieces I have done, I actually like.  Before my paints run out, I jump online and order some large tubes of acrylic paint and a number of different brushes (one I have no idea how to use).   Total bill was around $100.   Not surprisingly, I start to get disenchanted with the acrylic paints they dry so fast, I couldn’t get my paintings to look like they had movement.  The answer, of course, was to give up the acrylic and switch to oil paints.  I go with Clara to the art supply store, where I drop another $180 this time on oil paints and supplies!  Yikes.

I can’t tell you the number of sweaters/clothes/purses/jewelry that I own and have never worn; my therapist has instructed me on several occasions to always keep the receipts so things can be returned (I detest “returns” especially when I can more easily donate my new clothes in my community). 

I bought all of these things in the space of one month.  Remember, I am presently not working, my husband is self employed, we have 4 mostly adult daughters and we just spent a big chunk of change to get hardwood flooring installed throughout the house.  I have no business spending money on things I don’t need or even really want.  Thinking of my impulsive behavior leaves me feeling sick, guilty, exhausted and stupid.  The question is this, what do I need to do to take back control?

I think I need to understand why I behave this way before I can put a plan in place.  Too bad I don’t see my therapist for another two weeks.  Maybe I’m trying to fill some type of void … I honestly don’t know.  Being present and living in the moment is usually part of the answer, certainly applies to the guilt that comes with reliving the past, which cannot be changed.  

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Risk

March 7, 2012

Awake at 5:00 a.m., the “witching” hour, when I am most consumed with ruminating thoughts about my daughter, SA.  I do everything in my power to stay in the present moment, but I am unable to find the calm that almost always come when I do my diaphragmatic breathing.  I pray, but am not sure what it is that will bring me relief…I love my adult child, she needs help and I cannot provide her with what she needs.  Our situation, after nearly 8 months apart, has not improved.  I am not yet strong enough to have her in my life, it is simply too risky and my husband and other daughter are terrified that I will descend into the depths of hell again if our interactions continue.

In late November, after nearly 8 months of virtually no contact with each other (see Into the Darkness), my daughter and I reunited.  We met at my therapist’s (Marlene) office.  For the better part of an hour, Marlene spoke with SA about my illness and the impact that our relationship has on my psyche.  Marlene was brilliant; there was no finger pointing, no blame or shame.  Sarah and I held hands and cried throughout our session.

The thing that I struggle most with, is finding the strength to not try to “fix” her life.  It is wrong of me to expect or to assume that SA has or will truly change….how can she when she has yet to receive the help she so desperately needs.  In the past year, SA has been hired and fired from more jobs than I can remember, been picked up by the police at least twice and has moved into 4 different places.  She has to move again at the end of the month, as the house she is renting with friends has sold and is being torn down…Lord help me not to fixate on this latest development; she will be 21 this month, time that she begins to behave like an adult.  She actually accused me of “faking” my hospitalization, just to avoid seeing her…seriously, how is one supposed to deal with that?  The answer is really quite simple, do not engage.  What frightened me the most, was after a barrage of raging text messages to my husband (about me), I was sick to my stomach and filled with anxiety and went to lie down.  As I was doing my breathing, I was positive, beyond a shadow of a doubt that I heard her crying.  Just as I thought I heard her voice, the doorbell rang, and I nearly jumped out of my skin.  When I descended into hell last spring, it started with me hearing her voice, so you can imagine the gripping terror I was feeling.  When I spoke with my doctor, he reminded me that I am better, part of  the proof was in the fact that I recognized when I heard her voice, it was not real.   I have come too far to allow my mind to play tricks on me;  I am strong, I am loved and I am a good person.

I miss my daughter and I love her more than words can say; our relationship deeply saddens me,  it is certainly not what I imagined  it would be when I first held her in my arms.  Truly, my heart is full of sorrow and torment.  I need to have her in my life in some fashion, as such, I am once again taking a risk and allowing myself to see her, this time, guarded with the knowledge that I should have no expectations of her, and that in order for her to respect my boundaries, I must first do so myself! 

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The Present

Twelve weeks of Day Treatment and 8 weeks of Anxiety Clinic all come down to being mindful; actively participating and staying in the present.  Sounds easy right?  Not so much.  Just ask anyone who lives with chronic anxiety, (anxious predictions lie in the future, not the present), depression, bipolar,  OCD or any other mental health challenge.  My prediction is that they would tell you that being mindful takes practice, dedication, and focus and that sometimes it is just plain hard work.

Don’t get me wrong, I get why “all roads lead to mindfulness“. When you are actively focused on the present, there quite literally is no room for  those pesky, irksome  “should haves”, “could haves”, and “what ifs” that can drag us back into the past or take us to some imagined crisis in the future.

Being mindful requires living with uncertainty (frankly, just typing the word causes my heart rate to accelerate).   Personally, when the gnawing, nagging fear of uncertainty starts to take over,  I do my best to quickly identify the thought, push it away, and then deal with it in my “worry” place (area reserved for worrying, where I  challenge and then change the worry thought triggering my anxiety).  In order to be successful at pushing the worry thought out, I visualize a rather large, bright red,  sign.  With that image in mind, I then work to get my breathing on track (this may involve counting breaths, (in 10, hold 10, out 10) which means diaphragmatic, or belly breathing needs to be activated.

Going through this process/behavior allows me to get back in control of my thoughts, (unlike my compulsive worry behaviors which have tricked me for decades!)  It is astonishing to me how well this practical behavior works to help me “get a grip”  when I am struggling with my ever present worry thought demons.

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Journal Entry

UGH, longest day ever in Day Treatment… I hate how I feel; fat, bloated, irritable, sad, exhausted (depression or menopause; doesn’t matter, the symptoms for both are almost identical), skin and everything else totally dried out, worrying non stop about everything and nothing until I want to scream STOP.   Jeez, with all these amazing feelings how can I possibly NOT love myself (core belief=I’m unlovable).   In any case Wednesday is the day we do Self-esteem, Depression and Worry (I am a star pupil in all classes, but these in particular, I really excel at).

Key learning in Self-esteem today? Apparently having a minimum of 10 “Rules to Live By” is a bit ambitious for someone like myself to take on and “challenge”.   I need to get it together, focus and figure out which one or two rules are the most debilitating so I can damn well start to change my automatic thoughts.  Such difficult work; honestly, overwhelmingly, mind numbing hard work and self-examination.  Needs to be done or change is not possible.  I need to control my thoughts, my thoughts can’t continue to control me (I’m exhausted just thinking about how difficult this will be for me to master).

The focus during Depression class was getting over the overpowering lethargy that is so prevalent with depression.  Our focus for the session was to set short, medium and long-term goals for the coming week.  Being the “good” pupil (Oh Gosh, I feel a rule for living coming on) I committed to myself, in front of the group,  that I would register for a fitness class before the end of the afternoon.  Did I mention that I had the very same goal last week?  I actually began the registration process only after we walked the dogs, and I spent way too long mowing and picking the front lawn. “OCD”.  Believe me, I have compulsions and obsessions, but thankfully no rituals.  So basically, I put off  registering for a class for the better part of the afternoon (avoidance).  Finally, shortly before 6 pm, I was successfully registered for a beginner Yoga class!  I did it, and for that, I am proud.

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The Journey Continues

A major part of my journey back to mental health is “self care” which includes dragging myself to the hospital every Monday, Wednesday and Friday morning to attend/participate in Day Treatment.  Wednesday’s tend to be the most draining, as we cover self-esteem, depression and anxiety.  One thing I now know to be true is that you can be depressed and not have low self- esteem, however people who suffer from low self-esteem almost always suffer from depression.   I happen to be one of the unfortunate ones to have low self-esteem, depression and severe anxiety.

Honestly, if you were to meet me or ask anyone who knows me, to describe me, they would not use the words “low self-esteem“; which makes me feel all the more like an”impostor”, which, it turns out is one of the many aspects or types of anxiety that I suffer from. Needless to say, I am learning a great deal about myself.

At the heart of self-esteem lies the central bottom line or core beliefs that we have about ourselves. These are almost always deep-seated, basic, negative beliefs about ourselves and the kind of person we are.  These beliefs are the result of experiences in our lives, particularly those that occurred in early life.  Rarely do these beliefs reflect the real truth about us, in fact, most are nothing more than opinions (versus facts) that are inaccurate and biased.

If these negative beliefs are based on experiences we had as children, as most are, then how or why are they negatively impacting our self-esteem now?  Simply put, our experiences have led us to make judgments about ourselves as people (core beliefs); these judgments are what lie at the heart of low self-esteem.  Some examples of negative core beliefs include:

  • I’m no good
  • I am not lovable
  • I don’t matter
  • I don’t belong
  • I am worthless
  • I am no good
  • I am weak
  • I’m crazy
  • I’m fat

Someone with low self-esteem, such as myself, rarely recognizes anything positive about themselves.  In fact, what happens is that we learn to develop “rules for living” which dictate how we should act or behave because we believe our core belief or bottom line. These rules actually work to maintain the negative core beliefs we have about ourselves.  It is likely that we are not even consciously aware that these rules exist, however, they consistently influence how we behave.  Unhelpful rules or assumptions are unrealistic, unreasonable, excessive, rigid and not adaptable.  The good news is that not all of our rules for living are unhelpful; some of our rules are realistic, flexible and adaptable and serve to help us function in healthy and safe ways.  Below is an example of one of my own bottom line core beliefs and how it manifests.


Core Belief 

I am not good enough

Rule for Living

I must always do everything perfectly

Policy

Go for perfection all the time; avoid criticism at all costs

Advantage

I do a lot of great work

Problem

No matter how hard I try, it is impossible to be perfect and to expect that I will never be criticized.  when I break my rule for living it causes me to feel stressed, anxious and depressed; in addition, I feel like a fraud and know that when something goes wrong, or people are less than positive about me I feel terrible

Bottom Line

I’m not good enough

Reasonable Rule

I will do the best I am capable of and recognize that my best may be different each day

Understanding even just this one bottom line/core beliefs and identifying new, more reasonable rules for living has taken me a long way on my journey back to mental health.  I recognize I have much work to do, and that is o.k., I finally recognize and understand that I am worthy of the time and investment that I am making to become well, that, in and of itself, is a major accomplishment.

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What is Major Depression

Webster’s dictionary defines major depression as “a mood disorder having a clinical course involving one or more episodes of serious psychological depression lasting two or more weeks each with no intervening episodes of mania”.

I realized, only recently, that what happened in May (see blog archive) was, in fact, my fifth episode of major depression, this time with psychotic features. My first episode occurred when my girls were just 2 and 6 months old. My then and now ex-husband confessed to me that he had been having an affair, on and off, with his best friend’s wife for the better part of our 6 year marriage (wonderful news for my already low self esteem).  His confession came just as I was returning to work after having our second daughter and 2 years after I lost my father to cancer (while I was pregnant) at the young age of 60.  I felt completely alone, isolated and ashamed.  I was embarrassed and scared; I could see no way to survive outside of the marriage and so I stayed, despite ongoing and continuous “mental abuse” suffered at the hands of my narcissistic husband; I could see no financial way for me to leave him and take care of my young children. I stayed in the marriage and did all of the recommended marriage counseling, I was miserable, living a lie, but could see no way out.

The second episode occurred approximately 3 years later (the girls were 3 and 5).  I was still married to my emotionally abusive husband, working in an exciting, new, demanding job that I loved.  The job required that I leave the house extremely early (to avoid traffic) and return home quite late, most days of the week. My husband had to take on more of the household responsibilities which, apparently was too much for him to handle.  He could not find it in his heart to support me, even though my work was good for my fragile and extremely low self esteem. He did all he could to make me feel pathetic.  We were two enemies living in the same house.  Not a good environment for our two small children.  Finally I had had enough. After an exceptionally brutal encounter with my husband, I came home from work and declared that enough was enough.  I wanted out and I was leaving him; the battle that ensued was mind blowing (topic of a later blog).  My self esteem was all but destroyed.

I found a lovely little house to rent in the same neighborhood so the girls could continue at the same school.  Once I was settled into “my” own house, I began seeing a work colleague who had also recently separated.  Ironically he had two girls, aged 3 and 5.   I was finally beginning to feel good about myself and the care that I was able to provide for my children.  I really believed that life could and would be good.  For a brief period it really was, and then, unexpectedly, I was terminated from the job I loved without cause.  I was beside myself and terrified.  How could I possibly take care of two small children, pay rent and expenses with no job?!  I was given a six month package, which meant I only had a short time to find another job to ensure that I would be able to maintain the children’s care.  I was “teetering” on the brink of another breakdown when I landed another job, this time, closer to home.

My third major depressive episode occurred immediately after I married my present husband. I felt I was losing control over who I was; now, instead of two little girls to love and worry about, I had 4! I need to mention that throughout and between each of these episodes, my oldest daughter was being seen and treated by countless specialists to try and determine what emotional issues she was struggling to deal with.  Difficult to comprehend how a child who was so young could have so much bottled up inside; anger, frustration, anxiety.  No one could provide us with any specific answers and so, we managed the best we could while we continued to seek help and support for her.  Blending a family comes with its own unique set of challenges but, add to that, a vindictive mean spirited ex-husband with a wife who despised me and my husband the challenge became like living in a minefield.  I was travelling a great deal for work, as was my husband, leaving the kids with their “other” parents made me physically and emotionally ill.  My husband started to drink excessively, which only compounded all of the struggles we were having with managing the girls.  My ex made life miserable, after years of being divorce we actually had to go to mediation to renegotiate our separation agreement, which was a joke (his financial contribution to the care and well being was actually reduced, even though he was paying me less than the guidelines mandated).  I agreed to his absurd demands simply to get him, literally out of my face.  Six years into the new job, I walked into the office to learn that the company was going to be taken over; the new office would not be in Toronto.   Another job search, another package.

I landed a great position in a new company and felt like, for once, things might be getting better.  I was working in a senior role, which was extremely demanding, but also very rewarding.  I was director of a new business unit, charged with launching an important new team and product.  Things were hectic, but I loved the pace and the challenge.  The only nagging feeling continued to be regarding my eldest child and the emotional difficulties she was experiencing, which were, to say the least, disruptive to our home life.  I continued to work with our family physician to try and find her the help that she desperately needed.

In 2005, I was asked to take over the oncology business unit, a challenge I accepted.  Just as I was getting up to speed, my boss was diagnosed with breast cancer and went on an indefinite medical leave.  The president of the company asked me to take on her role (vice president, specialty) while I maintained all of my other responsibilities.  I was thrilled to be part of the leadership team and that senior management believed that I had the intellect and capacity to manage both jobs.   While I loved the work and was intellectually challenged, the job was demanding; extremely long hours, work at night and a great deal of travel.  Although my family was supportive, it was difficult on all of us.  My oldest daughter was now in grade 8 and her behavior was becoming more and more disruptive and troublesome.  The school offered no help or guidance at all; we made the decision to have her assessed for psychological and learning disabilities.  The school did not or would not do the assessment so we sought the help of a private child psychologist.

The results of her assessment were mind blowing; I was not really able to comprehend the meaning of the results, I just knew that before she started high school, she was going to need an Individual Education Plan (IEP) , medication for severe Attention Deficit with Hyperactivity (ADHD) and further medical care to get at the root of all of her behavioral issues.  I was devastated, confused and terrified.   In 2006, once she was in high school things continued to get worse; parties while we were away, binge drinking, hanging out with people who took advantage of her, constant arguments with her friends and sisters, yelling, screaming, swearing, never ending stress…when she came home one day and told me that she wished she had a gun so she could kill herself, I snapped.  One call to our family doctor and we were off to see a pediatric psychiatrist and had her admitted to hospital.   Through all of this, I continued to work.  Then, without warning, after an exhausting argument with her on the phone, while I was working, I simply broke down.  I went to see the company nurse who sent me home.  I was off work for over a year.

Five episodes…am I resilient?  I believe I am.  Next blog topic will be about recovery and the self care required to survive major depression and be happy.

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