I absorb stress

 

 

I absorb stress I step in before the fight begins. I'm the calm that prevents the storm. I'm the deep breath that gives perspective. I'm patience in the face of crisis. And all of this is killing me.

I have changed my diagnosis

I have changed my diagnosis. I used to always say I suffered from depression, anxiety and suicide ideation. It was a disease I was fighting like cancer. It was win or lose. I lived in the hope that one day my medication and therapy would beat the disease, or at least send it into indefinite remission.

At our first appointment I remember telling my psychiatrist that suicide felt like the calm of a
shady river bank while life itself was the chaotic turmoil of the rapids below. Anxiety and fear felt like drowning. The doctor assured me that after treatment I would feel the exact opposite. Poor mental health would be the turmoil in the middle of the river while life itself was the calm on the bank. It was a promise I wanted to believe, after all hope is hard to resist.

But after four years, countless medication changes, dose adjustments, five different therapists, two different CBT workshops, three stints in hospital one of which lasted 6 weeks, it hasn't happened. I still get anxious. Suicide still seduces me with its promise of calm, its shady river bank safe from the turbulent river. I admit the rapids are not as chaotic as they once were, the overwhelming sense of drowning has settled but am I cured? No. Will I ever live without anxiety or suicide ideation. No. Without depression? No.

I have resigned myself to the fact, I will always have symptoms in varying degrees. Life still lives in the rapids and whirlpools. My thinking has not flipped. My psychiatrist lied. But at least now with therapy and medication, I have a life jacket and at times even a raft which I can pull myself up onto to escape the turmoil of living.

There is no cure. But there is a way to manage the distress and each day I get better at it. I have let go of the idea of being "all better". I no longer assess my progress based on how far I am away from a "normal" life. I no longer see myself as suffering from depression but rather living with it. I have decided my condition is more like diabetes than cancer. I have tools and strategies to manage the "glucose levels" in my brain. Do I sometimes make mistakes and let my thoughts get out of control? Yes. And the suicide ideation can be strong. But now I recognize the calm of the river bank is permanent. It's where life ends. And so I do my best to swim, to hold onto my safeties, my therapy, my meds and my resilience. The difference now from when I first sought help is that I now know I can do it. I know I can live.

Complements are complicated

Compliments are spontaneous words of praise or admiration but for me they are much more complicated than that.

I have lived my whole life with depression and anxiety. My self-esteem has never been strong. I often overthink someone's words and intentions to the point where my anxiety is spun into a tight knot. I am either scared of a new perceived expectation or I dismiss someone's words as unfounded.

When I was a child I hated going to the dentist. Not because it hurt or because I was scared but rather because I had never had a cavity and the dentist, after looking over my chart, always called me his "superstar". I was terrified I would let him down and he would find out his praise was unfounded. If I wasn't his superstar every time,  I was a failure.

Other types of compliments ring hollow. I once had a manager in a grocery store who was very upbeat and positive. He always said "Great work!" numerous times throughout a shift. I never believed I was worthy of all that praise, definitely not that much in one shift. His words were baseless. He didn't see me struggle with the apple display just moments before so I dismissed his compliments.

On the flip side though if he didn't compliment me the same number of times on another day, I interpreted it to mean I had let him down. I know it does not make sense to think his words are not sincere but then miss them when he remains quiet but that is how my mind works. I am either unworthy or a disappointment.

Therapy has helped me to identify this as distorted thinking. In the moment my self-esteem takes a hit but later, when I have the time to consciously go through the facts, I can talk myself down. CBT allows me to pick at the knot and put things into perspective so that I recognize that a compliment is often just a spontaneous comment, a nice thing to say. It is not a future expectation of performance or unfounded praise with some ulterior motive. It is just a kind word shared between two people. It's not meant to define who I am or gauge my value. It's just a smile that someone wants to share.

What helps when I'm suicidal (and what doesn't)

 

I suffer from chronic Suicide Ideation which at times becomes acute. In these moments of crisis, I am often asked "How can I help?" I know it is frustrating but in those moments I have no idea what to tell you. My mind is spiralling and overwhelmed. Part of me doesn't even consider suicide a problem. I have had these thoughts my whole life. They are who I am. Moreover, I am fiercely independent. I don't want to be a bother. I don't want to ask for "help". My answer will usually be, "It's OK. I'm OK."

I know you mean well but there are a number of things that only make the crisis worse. Minimizing my challenge does not help. Telling me a string of positive thoughts just betrays how little you understand. Saying "It's not that bad.", "Look on the bright side.", "You can do this." makes me dismiss your intentions. Your words and thoughts become trivial in my mind because you have no idea what you are talking about. "Don't worry. Be happy." is just a catchy song.

"Count your blessings" is also not helpful. You are just trying to change the subject. "You have so much to live for.", "Other people have it so much worse.", "Don't be so dramatic.", "You are being selfish." They are all insulting. They invalidate what I am going through. I know my thoughts are distorted but they are mine and they are stuck in crisis. At that moment, I don't care about anyone else. You suggesting that I should, tells me that you don't care about me specifically.

When you say "I know how you feel." and suggest my crisis is somehow common, you make me feel less important. I'm a failure. Clearly others have handled this. Why can't I? My thoughts will then become defensive. My SI is not like everyone else's.

The desperate appeal of "I would be devastated if you were gone." also invalidates my own experience. Now I don't only have to think of my own consequences but yours as well. You are guilting me into staying alive. My crisis turns to anger and resentment. It amplifies my distress. I can barely take care of myself and now you're dumping your happiness on me.

Telling me to think of my children, my wife, my extended family only makes me angry. They are already always in my thoughts. I know they will be devastated if I die by suicide. I know it will change their lives forever. Accusing me of neglect is not helpful. Instead you only heighten the guilt I am already feeling. I'm already ashamed of my disease. Your accusation justifies why I should die. Does it make logical sense? No. But that is the inevitable path my thoughts will take. I will shut down and not listen to your words.

Don't ask me for reasons to live. In crisis, there are none. The more you push the more I will dig in. We are not dealing with logical thoughts. Everything is jumbled and hyper-focused on distress and its relief by suicide.

Asking if I have been taking my medication feels like an accusation. It undermines my own emotions. It blames me for the crisis. The dark thoughts are not real. Rather they are just a chemical stew that has boiled over. For the record, I have never missed a dose of medication. The mere suggestion is enough to make me shut you out.

Also, don't tell me to call a help line. If you are there during my crisis that is not by coincidence. I have chosen you to witness me in a very vulnerable moment. I trust you. I understand why you would want me to reach out to professionals but by telling me to do so in that moment you are abandoning me, at least that is how it feels. Similarly asking for my safety plan is dismissive. If you are there, you are already part of my plan.

So, what can you do?

First off, stay quiet. Listen. Be there for me. Let me know I am not alone but don't try to talk me down. The more words you use the less I'll listen. Conversation only amplifies the agitation. Don't bombard me with questions or try to engage me in some sort of verbal distraction. Changing the subject is not helpful. I will just hide deeper in the crisis and put up my usual defences. I will quickly say "I'm fine." in the hope that you will leave me alone.

Demonstrate empathy not judgment. See if there is a way to give me more time, to free up my schedule and relieve external pressures. Is there an upcoming event or appointment or do I have to go to work soon? Is there a way I can cancel or phone in sick? Simplify my day.

Stay with me or arrange for someone to stay with me. I'm not looking for a therapist at this point. Don't try to explore my psyche or uncover past traumas. I'll do that later with my actual therapist. In the moment I just need time to de-escalate on my own. Having someone there keeps me safe. I'll initiate any conversation when I am ready. Just be patient.

If you do want to say something, the most powerful words you can use are: "You are important to me." If you just say "You are important." I will dismiss you because I do not feel that way. In my mind that is hyperbole. But by adding "to me" it changes the meaning. I can't argue with what you believe. These words make me stop and think. They make me see you. They give me value that in that moment I don't realize I have.

I know it is hard to watch a loved one suffer. The most important thing you can do when I reach out for help is to be there for me. Without a word, you are more supportive than you could ever imagine. You give me value so I can breath deeply again.

An episode of agitation

The other day I had an episode of agitation.  It happened on a moment. No warning. No build up.  I suddenly began to pace while juggling a small ball between my hands.  With each step, with each toss my thoughts spun tighter. I couldn't stop myself.  I was completely absorbed in the agitation.

By happy coincidence my adult son was there.  Happy for the outcome not the moment.  I was embarrassed to be in such a state, so isolated in my thoughts.  He had never seen me like that. I had always made sure of it.  This time though, I couldn't hide.

He watched in silence for a few minutes and then reached out, "Are you alright?"  

I couldn't quip my usual "I'm fine."  I was in too deep to fool anyone about my mental health. I could not pretend like I usually did. I tried to breath.  I tried to refocus but my state remained the same.  I was forced to confess I was not doing well.

He watched me in silence as I paced.  He didn't barrage me with questions or immediately try to refocus my thoughts. He didn't tell me to stop.  He let me continue while making sure I knew I was not alone. 

After a few minutes and a few more laps, he said "You have been working a lot lately."  He went and looked at the calendar and confirmed his statement.  He then suggested I take a mental health day.  He offered me a solution to change the situation.  He gave me permission to be agitated and offered a choice.  I knew by this point I was in no position to go to work.  My eyes were filled with tears.  My body was stuck in seemingly perpetual motion.  I tried my best to control my breathing - in for four and out for eight - through my nose out my mouth - but nothing worked.  

He then walked over and explained himself,  "I'll do what mom always does when I get upset." He gave me a big hug.  I stopped moving. The spinning stopped. He had interrupted the agitation.

We then composed a text explaining I would not be in to work that afternoon. The agitation further subsided. 

With my breathing returning to normal, he went off for a moment to call his mother (my wife) to tell her what was happening.  When he came back he told me he had kept "mom in the loop."  He had to go to work so we all decided (my son, my wife and myself) that it would be best if I was not alone.  My wife called my in-laws and arranged for me to stay there for dinner.

I was a little bit hesitant.  I didn't want to explain "why" it had happened or what they could do to help.  To be completely honest I didn't want to talk about it at all.  Happily my in-laws did not raise the topic of my mental health.  We talked about everything but my agitation which helped me to stay calm.  There were no awkward moments and for that I was truly thankful.

By the end of the day it was over. I was exhausted but safe.

I'm fine

"I'm fine."  It is a phase I say a lot. 

What does it mean? 

It means that I don't want to share my true feelings. It means I am protecting you from my thoughts which I am certain you will find distressing.  It means I am giving you permission to not be concerned about me. I said I'm fine so we can move on to other topics of conversation, something neutral like the weather.  It means I'm feeling overwhelmed, my anxiety has been triggered and I need to shut down and reset. It means please don't push me any further or I might crumble. 

I'm fine. Let's just move on.

Rachmaninov - Symphony 2, Adagio

 

My favorite part of my favorite symphony. It has been described as the unfurling of a "never-ending cascade of characteristically lush and opulent melodies, each one bound to speak directly to the heart." 

It will be performed by the TSO  in their upcoming concert season (April 1, 2022) . 

It completely embodies Rachmaninov's famous description of what music is:

What is Music? How do you define it? Music is a calm moonlit night, the rustle of leaves in Summer. Music is the far off peal of bells at dusk! Music comes straight from the heart and talks only to of Poetry and her Mother is sorrow!

 

I wish I could be confident that I will attend but it is too far away.  Even just the thought scares me.

New Year's Resolutions When You Live Day to Day for Your Mental Health

I don't make New Year's resolutions anymore. For me they always came from a dark place.  They identified everything that was wrong with me, real or imagined. They stomped on my self esteem. I was fat and ugly and needed to lose weight. I was lazy and listless without purpose. I needed to apply myself more strictly.  Resolutions fed on my insecurities and self-hate. 

 
And of course the moment I failed, which inevitably happened within a couple of days or weeks of the new year, the thoughts pounced even harder, and spiraled out of control. 

To further complicate New Year's resolution, I suffer from Chronophobia, a fear of time and the future. Plans made months, weeks or even just a few days in advance overwhelm me. Every night I hope is my last, that time will stop. The idea of doing something new for a whole year is debilitating. I am scared and more certain than ever that suicide will overrun me first.

So instead of making resolutions, I now make a daily list of things I want to accomplish for next day.

Someone not suffering with mental health challenges might think my daily goals are laughable. Spending time with my children and my wife, reading, listening to music, remembering to breath when anxious all might seem like obvious activities that don't need to be itemized but for me they provide the opportunity of accomplishment. I make sure that each is meaningful and achievable. I write down "eat well" instead of eat less or lose weight. 

Then before I go to bed I reflect back on what I can check off my list.  If there is something I was unable to do, it's not a big deal. I just add it to tomorrow's list and try again. One day I may look to the big picture but for now I live life day to day. It is the only way I know how.

A version of the article has been published on The Mighty. 

How my covid mask helps with anxiety

When you have glasses, wearing a mask can be challenging.  The Covid fog is a nuisance.  With a bit of adjusting though you can minimize the impact. The fabric, shape and design of your mask all play a part. After a bit of trial and error, an effective combination can limit fog due to regular breathing or environmental conditions such as moving from wintery frost to a comfy fire. It took me a while but I finally found a tolerable mask combination only to discover that I still had unexpected and severe fogging episodes. At first I was puzzled and more than a bit  frustrated and then I realized these occasions were tied directly to my level of anxiety. Something was triggering my body's response even before I realized it. The fog and its severity were an indication of my own mental state. At first this insight seemed to double the effect. I crumbled, overwhelmed  by my own anxiety and its relentless pursuit. But then I realized that instead of being a new symptom of despair, the fog could be used as an early warning sign.  Now, the moment my vision begins to cloud, I stop and take stock of what I am doing. I ask myself if my reaction is due to some real threat or are my thoughts distorting the situation. I reflect using my CBT training to identify my thinking patterns, to determine if I am catastrophizing or labelling or something else. I then take a few deep breaths, do a quick body scan to reset and restore myself and then finally consider how best to manage my reaction, how best to prevent my anxiety from escalating out of control.  By stepping back to think about my thinking I have found the fog dissipates and I can begin managing a crisis even before I realized one was building. Rather than a nuisance, the fog has become a very helpful tool.  It helps to challenge my cognitive distortions and let me live with a more balanced and helpful outlook. A version of the article has been published on The Mighty.

Listen

I can hear all the people calling me back, searching the wilderness for me, praying outloud, shouting my name. Why don't they leave me alone?  Why can't they be quiet, and listen to the birds, like I do; their cheery call, echoing back and forth? Just listen. Don't use words. Just breath, and listen and you'll understand why. Let me go.

When they were bullied, I was too.

When they were bullied, I was too. I made note of the target his tragic flaws and what made him so susceptible to abuse. Then I made sure I never made the same mistake myself. I lived my life in fear of being bullied. I'm sorry to those I let down I should have been there for you. Instead I ran away and hid.

I just want it to end

I just want it to end. The hopelessness, the fear, the constant critic in my head: I've lived with them all for too long. All I've ever known is this war, this endless battle. There's nothing wrong with wanting it to end. To wish that it didn't is cruel. But why can't the best solution be the simplest? Why do I have to keep fighting? At times it's deafening, and I'm so exhausted. Why can't I just lay down in no man's land and let this battle fall silent around me? Why can't that be the end? Because... I'll never know what's possible.

As sudden as a lightning strike

As sudden as a lightning strike, I find myself felled and the fear of life, the fear of living surges through my veins. I want this anxiety to stop, not just be forgotten but is that even possible?

Delaying

My fingers betray my mind's discord as they shuffle through a random pattern. My intentions threaten to become actions and I stumble between fear and exhilaration. . It's not a choice I have to make, it's a decision that my fingers aptly delay: what must never be, must always be, to act or to remain.

They don't stop

I hear their thoughts, I hear their chatter, their opinions and complaints. I know they're only in my mind I know that is a fact but they don't stop...  ever.