The Challenge of Mornings

By Rebecca Sande
And They Say It Could Be Worse

People always say that things could be worse. I am quite sure that indeed they could be. To some people who see me, I seem to have it all together. To the few who know the real me, even though I have a home and small support system, I sometimes feel like this is the worst. 

My name is Rebecca. I have two wonderful sons, and I suffer from severe mental health issues. My illnesses range from MDD (major depressive disorder) and OCD (obsessive compulsive disorder) to DID (dissociative identity disorder) and schizoaffective disorder. Some days are great and I love being the quirky person that I am, while other days are lower than low, and I just do not want to exist at all. It’s easy for someone on the outside looking in to think that things aren’t as bad as I might say, but for me it’s not like that at all. 

It starts out with just getting up in the morning. For some people, this is something you just do without much thought. For me, there are days when I have to fight myself to get out of bed and start my day. There are days when I compromise with myself and go back to bed after I do what I have to. Some days I wake up and begin the day with little effort at all. 

Once the early morning struggle is over and I am semi-exhausted with myself, I have another struggle ahead of me, which is eating. First, I must have my black coffee. Once that first cup is in me, I may try to eat (a battle I sometimes lose). The mental struggle of what should be a simple no-brainer has now turned into a duty. Soon after follows a bout of OCD and the accompanying anxiety: checking locks, lights, doors, appointments, phone, computer and anything else my obsessive little thoughts can find. It is only 10 A.M. and I am already dreading my day.

And now, a little bit about my attempts to go out in public. Let's talk about the voices in my head that yammer before I’ve even left home, the worry of the social mocking that is sure to come just from going out. What about the people who will stare at me? What about the whisperings? What if someone follows me? What if there is a horrible catastrophe? All of this and only one foot out of the front door. Meanwhile, the logical side of me fights and screams that I have to get the shopping done, or go pay that electric bill, and no one will even notice me (it would be nice if I could believe that).
This is why I have to start leaving an hour or two before I have to be somewhere. I do not drive myself anymore because I have a horrible fear that I will be the cause of some major accident, so I take the bus. Some days the bus is the safest place to blend in with my surroundings, but typically, not so much. 

Despite all of the daily challenges I face, I let a smile be my armor. It’s not especially easy for me to do so on days when I just want to give up. Despite the people who see me and say things could be worse, I face every day with a new hope that the next day has to be a little better.

I take my medicine and go to therapy like I am supposed to and it truly helps. No one would look at an elderly person and tell them to get over being old. So, I hope one day we all get to the point when we stop telling each other it could be worse and we start making it better.

The Aftermath of a Major Psychiatric Episode

The Aftermath of a Major Psychiatric Episode
By Kurt Sass
Coping Strategies for Dealing with Relapse Fears
Back in 1998, I began a two year, long-suffering battle with major depression, which included, among other things, daily suicidal thoughts, self-abuse (cutting myself up to 70 times a day), numerous hospitalizations, 22 ECT or “shock” treatments and a period of 11 months in which I could not leave my bed on my own—not even to take a shower or go to a doctor's appointment. 
Fortunately, I have not had to endure anything even remotely close to that in the 16 years since that two-year ordeal ended in the year 2000. 
One might think that it would be easy to be grateful that the “past” is behind me and that it is easy to go on. However, I think most people who have gone through the trauma of a major psychiatric episode would tell you otherwise. 
While I am extremely appreciative and grateful everyday that I have not returned to that horrible state, the fear of it recurring is always there. My belief is that most people who have endured a major psychiatric episode, especially a long-term episode, suffer from a form of Post-Traumatic Stress Disorder as a result. I still get flashbacks of when I cut myself and when I was hospitalized for attempting suicide. And when those flashbacks occur, the fear of the episode recurring also resurfaces.
This cycle occurs most often when my body is in a weakened state. A few years ago, I was confined to a bed for a number of days when I had a virus with a high fever. With my physical body feeling so weak, my thoughts began to shift. I started thinking that this was the beginning of a new depression and that I would not be able to get out of bed, even after the fever lifts. Another time this occurred was when I started a vigorous exercise routine and ran eight miles a day, without building up to that level. I wore out my body, and was almost too weak to fight my thoughts of oncoming depression.
I noticed that whenever I feel either tired or sad, I immediately start to panic and wonder if this is possibly the beginning of a major psychiatric breakdown.
The good news is that I have discovered many tools to successfully cope. The first is cognitive thinking. Whenever I start to feel any inkling or thought at all that I may be going into a deep depression, I sit back and analyze the situation. I ask myself questions: Are you physically sick at the moment? Are you tired because you didn't get enough sleep? Are you sad because of something that happened at work or with family? The answer to one of these questions is almost always yes, and that usually explains it. Meditation and yoga are two great ways to help get into a nice, relaxed state before asking yourself these questions.
Unfortunately, however, I sometimes go through unexplained periods of complete panic and fear which can last anywhere from a few hours up to seven to eight days. There seems to be no apparent trigger. When this happens, I must be continually cognizant that this is not going to end up being a two-year depression and that eventually it will fade away. It always does. 
Finding the right therapist, one you can trust, is an important piece of the puzzle, as well as finding close friends whom you are able to confide in.
If you have suffered through a major psychiatric breakdown, and you are often afraid that it may recur, you are not alone. If you think you see any signs of a possible recurrence, please take a moment to step back and analyze them first.

How I Deal with Loneliness in the Big City

How I Deal with Loneliness in the Big City
By Ted Walner
Seek Out Some People to Be With
Coming from a family of five children, I always had people around me growing up. Even if we didn’t talk to one another, there was the security of knowing someone was always around. Life is much different in the big city. Now, I live in a studio apartment in Manhattan. I can always call someone, but it is much different than having people around you when you need them. It doesn’t bother me that much during the weekdays because I spend my time with nice people at work and then usually enjoy my “down” time. But it does hit me on weekends when I spend time on my own. Sometimes solitude sets in. I enjoy being by myself, but sometimes I feel lonely and can’t wait to be with someone. This article is going to deal with how I fill those gaps so I don’t feel so lonely. I will provide suggestions on how I do it and hopefully this will help others who experience feelings of loneliness.
A dear friend bought me a book on a set of DVDs for the holidays that I was interested in. It is amazing how this system counteracts the feelings of loneliness. You have a person narrating the book, which makes you feel like someone is talking to you. You can concentrate on this topic of interest, which stimulates you. It is much easier than the eye-strain of reading. You also learn something new. 
On the weekends, I listen to the DVDs and it helps me to focus on something I find interesting. You almost feel as if you have someone in the room with you and it really helps with the feelings of loneliness. You can purchase a variety of topics on Amazon.com and they aren’t very expensive. If you’re interested in reading Hemmingway, Herman Hesse or any author, you can get these books narrated to you on a DVD. It’s a fun way to learn and has a lot of benefits.
You can make friends as well as find romance on dating websites. You have to be careful because there are some fraudulent people trying to get your money, but most of the people are simply interested in socializing. You should meet in a public place until you feel comfortable with that person. I advise that you get to know the person through texts, emails and phone calls before you meet. Once you feel comfortable, take it one step further and meet in a public place.
Not every person you meet is going to become a romantic interest. Sometimes, you make friends with people of similar interests as well. I have made three friends in the past few years on the Internet. It is possible. Not all sites charge a fee. Okcupid.com, nolongerlonely.com, mingle2.com, and pof.com all have a lot of free activities. You can pay, but you can also do a lot for free. 
Nolongerlonely.com is a site for people with mental illness. I have made a friend on this site. These sites do help you find a mate and make friends although you should always be cautious. This is a definite antidote to loneliness.
There are many clubhouses one can go to. Fountain House offers a work-oriented program and you are bound to make friends with the wonderful people and staff there. They have different units, such as the Culinary Unit, the Employment Unit, the Communications Unit, and the Wellness Unit. One can decide what area they would like to join.
Baltic Street AEH, Inc. has the Resource and Wellness Center where you can socialize and get involved in group activities such as the expressive arts groups, meditation, arts and crafts, wellness and self-esteem-building groups.
Rainbow Heights is a clubhouse for the LGBTQ community that deals with mental health issues. They have film night on Thursday evenings where you can watch a current film together. These organizations also have interesting discussion groups. 
At Fountain House, there is a women’s group and a LGBTQ talk group. You can discuss topics of interest in these groups and it’s a great way to socialize.
Groups provide a social outlet, a place to express yourself, and a way of meeting people. I encourage you to give them a try to combat the sadness of loneliness. They do help.
There are many things you can do in the big city to socialize on a budget. A lot of the museums have a free day. Going out to lunch is usually less expensive than dinner. You may borrow movies on DVD from the library and watch them with a friend.
I hope I have helped by offering some good suggestions to change loneliness into productive times with people. I still battle with it at times, but the activities mentioned have surely helped me. Hopefully, they will help you too. 

Recollections of Recovery: An Alphabet of Emotions from Anger to Hope

Recollections of Recovery: An Alphabet of Emotions from Anger to Hope
By S.A. Green

Poetically Peeling the Mask of Stigma

Note: The following text is an abbreviated version of “Recollections of Recovery: An Alphabet of Emotions from Anger to Hope” published for the Center of Rehabilitation and Recovery, a project of the Coalition of Behavioral Health Agencies, Inc. in the years after Ms. Green's diagnosis of bipolar disorder.

Anger

When I went to the drugstore to pick up my medication, the pharmacist informed me she could not fill prescriptions for psychotropic drugs. I insisted she was supposed to do so according to Timothy’s Law, state legislation to ensure that insurance companies cover physical health and mental health medications alike.

Perhaps inadvertently, she said, “You’d be surprised at all the things we’re supposed to do that we don’t.”

Betrayal

I wanted a psychiatrist who was not influenced by drug companies. Instead of asking prospective providers where they went to school, or whether they were board certified in psychiatry and neurology, I asked about their relationships with the pharmaceutical industry.

I started to see a psychiatrist who told me he had cut his ties to drug companies. However, one day he suggested an exorbitant formulation of a particular medication.
I told him I was outraged that he wasn’t recommending the regular pill, or a cheap generic. He responded by prescribing an antipsychotic with sedating side effects.

Did he want to muzzle me chemically, like Russian dissidents who received a diagnosis of “sluggish schizophrenia”? I, too, showed symptoms of “perseverance” and “struggle for truth.”

Confusion

Confusion is having more pills to take than you could keep track of if you were normal—and then trying to keep track of them while you are on those pills, and psychotic.

Determination

I remember a morning during an episode of depression, when I couldn’t figure out how to get out of the bathtub. As I struggled, it struck me that it had been easier to write my doctoral dissertation. 

Somehow, eventually, I did it, making little waves. Maybe I did it the way flowers sprout from cracks in the asphalt—cracks I believe they make in their blind struggle to reach towards the sun.

Elation

Being manic had its good sides, especially when I was a square twenty-something who didn’t do drugs. It broadened my experience with the spectrum of elation.

During one episode, I roamed the streets in the wee hours of the morning with a stranger who was used to artificially induced highs. He said, “I don’t know what you’re on, but I wish I had some of it!”

My manic self would think, “But yes, I can bottle it! I can sell spirits of mania in blue glass bottles, each with a message, like the ones sailors toss from a sinking ship, hoping that the message would find a reader. And let me see… these glass bottles at the discount store on the corner are a bargain. Let me order a few dozen, so I can have prototypes on hand for the next convention of behavioral health providers...”

Whether you want to start a business, jump into an affair, plan your presidential campaign, or conduct an imaginary orchestra in your living room, the elation in mania gives you energy, self-confidence, and an infectious happiness that makes people say, “yes.”

Grateful

Although I do not lack self-esteem, sometimes I am surprised my husband married me. It must be difficult to deal with a woman who buys eight wedding gowns on eBay before you’ve even proposed.

I am also grateful because family and friends take me to hospitals in the middle of the night, visit me in psychiatric wards, and insist I see doctors when I think, with manic exuberance, I've never felt better in my life.

And they do one thing more. They prevent me from taking what cripples so many people with mental illness: the sick role.

Glibness

“When do you want to come back to see me?” asked my psychiatrist.

I liked him. He was smart, decent, and genuinely cared about me. Since we lived in a small community, we had “dual relationships,” if not "triple relationships." He didn’t want to complicate matters further, or risk exploiting me, so he never charged me for visits.

We had already established that I wasn’t quite myself, but he didn’t know I had no idea what day, month, and perhaps year it was. I said smoothly, “Oh, I don’t have my appointment book with me. Can I call you?”

Concealing impairment, adaptive at work and at school, but not everywhere, had become an inseparable part of me.

Hopeful

We have images of mass violence welded to mental illness, and disparities in health and mental health care. But we also have peer services, supportive housing, trauma-informed care, crisis respite centers, and more.

I do not foresee an end to stigma and discrimination in my lifetime, but I am hopeful for the next generation.