101 things we never leave behind for mental development

The things we never leave behind

My eyes are closed behind polarized sunglasses I paid too much for. Controlling my breath, watching colors pulse on the inside of my eyelids, I am thankful for a daily ride in the slowest elevator ever and at the same time annoyed. Someone joined me just as the doors were closing.
Thirty seconds later, the doors open onto the third floor, and I step out. I am now the girl you see: calm, poised, ambitious, determined, and independent. The woman. Whatever.
Today I’ll keep my sunglasses on until I reach my desk…because I want to.
Every year at about this time, the graduate school sends out an email. The end of the semester is a hard time for students, it says. It can be particularly tough for graduate students who are prone to increased mental pressure, stress and anxiety. Visit the counseling center.
It’s been nearly two years since I took that advice. Taking that first step toward mental wellness changed my life.
The day before my 7th birthday, I spent some serious time thinking about what it meant to be 7 years old. I could no longer be the little kid that I was at 6. I’m not sure how or why or what I thought I knew, but everything was changing. I was just one grade level away from learning from my peer group that I was the poor kid. The one with the single mother. The one who probably wouldn’t make it though the system.
In 3rd grade, I had head lice and missed a field trip. In 4th grade, a popular girl put a Jolly Rancher in my hair. In 5th grade, I was the girl in Wal-Mart clothes. In 6th grade, all my friends were boys. In 7th grade, I ate alone on field trips. In 8th grade, I was voted Most Likely to Succeed. In 12th grade, Most Intellectual.
My grandmother finished second grade. My mother finished high school. I was about to take it one step further.


Finish high school. Check. Go to college. Check. Get a bunch of scholarships and breeze through classes. Check.
Break up with abusive college boyfriend during sophomore year. Check.
Go home to find ex-boyfriend slumped on the floor with a shotgun between his knees.
Go back to class two days later. Do not pass GO. Do not let anyone see you falter.
I finished college with a 3.9 GPA, and then I plunged headfirst into a Ph.D. program, and then I started crying. All. The. Damn. Time.
I couldn’t speak to my advisor without crying. I couldn’t walk into his office without tensing up. I could barely speak to him at all. It became a joke after a while. He’d always keep a box of Kleenex handy. Sometimes he’d go about checking his emails or editing a paper until I could compose myself, and that was OK. I needed those moments. Then we’d talk about football, and I would cry. We’d talk about a class, and I would cry. We’d talk about eating lunch, and I would sob uncontrollably, oftentimes laughing in embarrassment through my tears.
I passed my written exams. I got married a few months later. My dad died three weeks before my wedding. I never knew him. No one needed to know.
Graduate school continued to be an emotional roller-coaster. The learning curve was almost unbearable for a student who had never learned to fail.
After a particularly stressful fall semester leading up to a major conference presentation, I promised my husband that I would seek counseling as soon as I got back from the conference. The ups and downs of graduate school were getting to be too much…for both of us.
“I want to be swaddled. Wrap me up in a giant white cloth and hold me as tight as possible,” I said to my husband as I pressed my forehead — eyes squeezed shut — into his chest. “I need to hold it all in. There’s too much. I can’t keep it all together.”
Therapy helped. I talked. I stared at a corner of the room. I fidgeted. I took my shoes off. I put them back on. I cried. Of course. I carried on with therapy in private for more than a year before I told anyone. I carried on talking. We talked about ways to overcome grief and guilt, and how to manage my rampant anxiety. Only talking. I told my therapist on Day 1 that I didn’t want to be medicated.
I eventually opened up to my advisor. I let him know that I was in therapy, and everything was fine until it all fell apart.
I had a panic attack in someone else’s lab. I spent 24 hours wrought with embarrassment, angry that my unrelenting tears were met with condescension, utterly confused by my inability to control my emotions.
And then I wanted the pills. Whatever they were. Whatever people used to make this stuff stop. I wanted them.
See therapist. Check. See university psychiatrist. Check. Fill prescription for Lexapro. Check. Take the first pill.
My tears dried up immediately. I couldn’t cry at all. The psychiatrist had warned that this might happen, and I was thrilled.
Weeks later I was back to the curious, inquisitive version of myself that I remembered from grade school. I raised my hand to ask questions during seminars. I answered questions. I made jokes with people who had no idea how funny I could be. I joked with my advisor about his inability to make me cry.
But it’s not just the tears that have dried up. My anxiety is gone. I don’t worry about driving some place new from the moment I get into the car because I’m already thinking about how much I dislike backing out of parking spots even though I have no idea what the parking situation is going to be like. I don’t worry that it’s too late to ask that question because the conversation has already turned and then get frustrated when someone else asks that question. I don’t worry that my voice will shake. I don’t worry that my questions are stupid. The chatter is gone.
It’s been 9 months now. I left the safety of my lab and worked at a newspaper this summer. A big one. In a big city. I’m writing my dissertation. I have lunch with my advisor as often as possible. And though you wouldn’t have known it if I hadn’t let you in, I Am Mental Illness.

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Using Wellness with borderline personality disorder forum.

PREFACE

Borderline Personality Disorder Symptoms

Borderline Personality Disorder, the most often misunderstood and difficult disorder to treat.  This difficulty may happens as it is so hard to diagnose a cause or to nail down a definite definition. It is clear that there are may have genetic factors behind the presence of the disorder because Borderline Personality Disorder tends to run in families.

Professionals from different forums like borderline personality disorder forum also admit that many individuals diagnosed with borderline personality disorder struggle with post traumatic stress disorder or PTSD, as well as there are movements among some forums to call it Complex Post Traumatic Stress Disorder.  Because of other mental and emotional disorders, the presence of borderline personality disorder is not something which the sufferer chooses. I think, as do other professionals or therapists, that there is a complex set of reasons and many factors that lead to this disorder.

TRADITIONAL TREATMENTS

The most common therapy to treat borderline personality disorder is Dialectical Behavioral Therapy or DBT.  It is the most popular therapy due to multiple studies demonstrating its effectiveness in treating Borderline Personality Disorder.  But, another similar therapy is Cognitive Behavioral Therapy or CBT.  Cognitive Behavioral Therapy specialists often make excellent progress in working with individuals with Borderline Personality Disorder.

Treatment has largely been inactive in treating the disorder, although anti-depressants are used to treat the depressive symptoms related to this disorder.   Mood stabilizing medicines are also prescribed, with different levels of activeness.  Some persons subjectively report that treatments are helpful in reducing the impulsivity associated with this disorder.

Borderline Personality disorder forum:  borderline personality disorder forum work well both with Cognitive Behavioral Therapy, as well as in a Dialectic Behavior Therapy setting.   The borderline personality disorder forum is especially helpful in dealing with increasing one’s ability to cope with everyday struggles and challenges and with the ability to rapid changes in mood.

The major focus of borderline personality disorder forum is mood regulation and should not be considered a stand alone approach of treatment.   Considering for a moment that individual has a metaphorical bucket to be used.  In our buckets we always keep all our positive thoughts, self confidence, and memories of the good times, and what we are, and those memories which we have experienced.  If then, we were to compare the buckets of an individual with Borderline Personality Disorder with someone without the disorder; we must find that the individual with borderline personality disorder had a hole in their bucket.  While the individual without borderline personality disorder could dip into his or her bucket at times of crisis, the individual with borderline personality disorder cannot.   Those positive emotions, thinking, and memories keep running out.   Any steps or attempt to fill up the blank space of the bucket with positive thoughts and reassurances will prove only temporary.  Therefore, the ultimate goal is not to fill the bucket but to repair the hole in the bucket.  The borderline personality disorder forum attempts to replace a faulty bucket.

When you are in good times, you should write in it, type letters, remind yourself of the positive things, make plans for the bad times, and remind yourself what you are thankful for.  Then during the bad times you make a proper utilize of it to remind yourself that you believe yourself to be a distinct person – a person with strengths, goals, accomplishments as well as commitment..

You don’t need to write in the borderline personality disorder forum every day. Actually, when you are feeling upset, you probably shouldn’t write in it.  The one objection to this may be thankfulness.  Therefore, there is no need for continuity.  This is the perfect match for the individual struggling with borderline personality disorder inconsistency. The best results for mine have been to catch a person with borderline personality disorder when they are in an up, and then together write in borderline personality disorder forum, taking turns writing, and sharing what I have

Please feel free to leave a comment as we encourage your comments.

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What to do if you are thinking about suicide at day time

What to do if you are thinking about suicide

Alive everyday. Sure the lungs work naturally but to actually breathe freely without this elephant sitting on your chest that is what I am talking about. I used to say weight on the chest but what What to do if you are thinking about suicide as ‘’Suicide’’ is the ultimate way to be escaped. Where you can go to when all seems and feels hopeless. Most often, I think about killing myself at least twice a day or more if I am feeling really hurt as well as hopeless. Pain is another reason why I think about suicide. Most often my heart ask me what to do if you are thinking about suicide. Pain can be either physical or mental to me. These days it’s mental. I do not like myself. I thought myself to the degree I would rather be dead than live this way. I hate the way I search. I hate the way my body is. I am not so good to look at and disgusting. No one can tell me otherwise. My doctor says that I have a form of body dysmorphic disorder because I think myself so. It’s just another reason to suicide. Another reason why I think about suicide to end my painful life.
Yet despite all this thoughts and self-hating and pain, I’m still alive. I’ve chalked up a date to kill myself. But then my heart ask me about ‘’what to do if you are thinking about suicide’’I have decided that 30 years of living is long enough, or close to it anyways. I try not to think about it I try to think of now and live but it’s just too damn hard when you are to force yourself to be is that exactly. Not very accurate visually. Unless you have been to a gym and know what a weight is and looks like, most people don’t know. An elephant is easier to visualize and imagine better.
Right now I am at a café in a bookstore in my university campus. I bet no one knows that I am suicidal and why I think about suicide. They just see a guy writing in a notebook, drinking a lime soda. That’s the main reason what kills me. The invisibility of this fact is all. These thoughts are only for mine, unless I speak of it like I am doing now. No one knows. Nobody knows except my doctor (therapist and psychiatrist). Sometimes guilt will make me not want to commit suicide. I feel worse because I have worked with these caregivers for more than a decade. MY psychiatrist I have worked with for almost two decades. Yet I don’t but do care how they will react to my thought of suicide. Will their attitudes ever be changed? Will they deny seeing other clients who are like mine? Most will.


My doctor still keeps saying I am the exception not the rule. But I am tired of living in constant misery. Miseries those only the blog world knows about. I can’t share my miseries with others because I have become rooted deeply to keep it to myself. I keep it to myself so as not to worry my friends and family members. They can’t understand me anyways. My family is not one of openness. I am not blaming them for how I grown up. I don’t blame friends too but myself for my suicidal thoughts. It’s my fault. Maybe if I got help sooner I wouldn’t be this way but that isn’t clear, it took me twelve years of therapy to realize that the root of my suicidal thought was. I was suicidal since I was eight. It wasn’t because I was abused though I have been by multiple family members but not at that ago. Suicide just came to me at that ago and has been with me ever since. I didn’t like myself back then anymore than I do now. But it was because of reasons I had not thought of. Reasons I could not pronounce distinctly like I can now as an adult. I realized I was a girl and I didn’t like it. I developed into one hated it. But I couldn’t say anything to anyone, not even to my best friend because back then you just didn’t say what you felt or what you thought about. I would have fallen on deaf ears and it’s not like psychiatry/psychology is like it is in present . I have always felt like an alien or outcast would have further set me into outcast land. Just like when I thought I was a homosexual, I thought of suicide. I felt like I was severely psychotic liking another person. Again I didn’t say anything to anybody, not even my doctor at the time because I was afraid of being admitted to the hospital. I already had a few by this point. But I met a fellow inpatient that showed me it was ok to be gay and I’m grateful for that.
My therapist now does what she can for helping me accept being a transgender but part of me always wonders whether one day she will have me committed for these thoughts. And I don’t mean the suicidal ones.
Why am I not in the hospital if I am suicidal for long time? Because I’m not active suicidal. If I was in hidden danger to myself, like I was going to do it right this second, at this moment, I would be admitted to hospital, probably against my will.
But at this stage I just feel like my telling my providers I’m suicidal is like me crying wolf. I’ve said this so many times I don’t really think anyone believes I will kill myself. Hell I don’t even feel like I will act on it. I want so much to die and though I have made active plans to kill myself, I am still here. I have not attempted in several years now. At this point I wish it could be just a wish that I could be killed myself at anytime. Most often I wish I lived in the times of the Ancient Greeks where if you constantly asked for permission, eventually you were granted permission and “permitted” to kill yourself with hemlock. Now the governments of most societies say it’s all part of mental disorder and every single life should be saved. Now do you see why I am not active on my suicide thoughts. I have to keep them secret afraid of commitment. But a hospital admission is not what I need. Being six feet under and pushing up daisies is what I desire. That is exactly what I want.
Somehow between my last “activities” seven years ago, I lost my lethality. I lost the will to kill myself truly. Even though I wish to be dead on a regular basis, don’t get me wrong, I have no will so to speak to truly act on my feelings anymore. I lost the severity of my constriction, my narrow minded thinking. As a result I am still alive though I desperately wish I was dead.if you have any better idea about what to do if you are thinking about suicide then feel free to share in comment box

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I admit We were skeptical at first

‘I admit that I was skeptical at first’

It’s high time we had another post from Stephen O’Connor, a founding contributor of this site and a faculty member in the department of psychiatry and behavioral sciences at the University of Washington. The timing works well after last week’s post created interest in forming an online support group.

After discussing a couple of familiar therapies, this week’s post explores the subject of support groups for attempt survivors. “This is a sensitive topic,” Stephen writes. “I have noticed many of my colleagues recoiling at the idea of groups where the content focuses explicitly on suicidal ideation, out of fear that it may actually lead group members to feel more suicidal and reinforce self-harm behaviors.”
But be sure to read on.

One quick, unrelated note: The Talking About Suicide blog has posted its 50th interview with an “out” attempt survivor, a modest milestone, and will post a new one later today. Now, here’s Stephen: There is a rich history of research conducted with the intention of improving the understanding of, and quality of life for, suicide attempt survivors. At the same time, our field is much less developed than others such as depression, anxiety and schizophrenia research, where interventions and medications have been studied extensively and are being disseminated on a national level. There are multiple reasons for this, including a traditional focus on psychiatric disorders when thinking about treating suicidal thoughts and behaviors (which doesn’t have much evidence of being effective at reducing suicidal thoughts and behaviors) and stigma associated with having made a suicide attempt that may have dissuaded individuals from wanting to participate in a formal research study in the past.
It wasn’t until the 1970s when researchers really began increasing efforts to empirically test interventions targeting suicide attempt survivors. There are numerous types of interventions that providers can choose from when providing clinical care. However, in order to establish a particular approach as effective, it is necessary to develop manuals and follow strict guidelines when delivering care. Otherwise, consumers wouldn’t know whether a treatment works because of its specific aspects or because of some other reason.
One of the most accessible approaches to standardize involves cognitive behavioral therapy (CBT), which consists of individuals learning new skills for solving problems and changing thought patterns to be more balanced when evaluating personal beliefs and expectations. CBT was initially shown to help reduce depression and anxiety, so it was naturally adapted to help suicide attempt survivors.
Over the past 40 years, CBT-based approaches have been tested in many studies (though still much less frequently than we would like) with suicide attempt survivors, and the results suggest this type of approach is most likely effective. Those CBT approaches that focused more heavily on improving problem-solving skills often showed greater reductions in suicide attempts than comparison treatments, which focused on a combination of medication management, supportive therapy and crisis intervention services. Most recently, a large study of individuals treated in an acute care medical setting after a suicide attempt found that those who received a robust CBT protocol focusing specifically on suicidal thoughts and behaviors were 50 percent less likely to make a suicide attempt than the comparison group.
Another type of therapy that has shown good evidence of reducing suicide attempts and self-injury is dialectical behavior therapy (DBT). This is an intensive treatment that includes weekly one-on-one therapy, weekly skills group training, 24/7 phone consultation and a consultation group for the therapists who provide DBT. The overarching focus of DBT is to help individuals build a life worth living so that suicide seems less appealing. Clients learn skills for managing intense emotions and crisis situations, as well as interpersonal skills so they can build and maintain meaningful relationships and feel good about themselves. Much of this is done through practicing skills, but it also involves improving awareness of
one’s thoughts, emotions and behaviors through mindfulness exercises.
Overall, it seems that CBT and DBT work well for helping suicide attempt survivors reduce subsequent suicide attempts and improve their overall quality of life, but the obvious problem is that there is more demand than supply when it comes to therapists who provide these treatments. If you think about this in terms of the overall population impact, fewer suicidal people can receive CBT and DBT, but those who receive it probably get much better. As a result, researchers are now testing innovative ways to engage suicide attempt survivors in efforts to reduce subsequent suicide attempts and help facilitate linkage to outpatient treatment, with less emphasis on treating longer-term issues that may partially contribute to mental health concerns. This means less intensive services that could keep someone from dying, but may not lead to as large of an improvement in one’s life. For example, a groundbreaking study focusing on impacting a larger population of at-risk patients was conducted in the years 1969-1974, when Jerome Motto and Alan Bostrom pioneered the use of “caring letters” sent to a sample of individuals who had recently been treated in an inpatient psychiatric hospital and were determined not to have engaged in their outpatient therapy plan one month following discharge, which typically meant seeing a therapist in the community. This group was split in half, and one group received supportive follow-up letters at least four times per year for five years, and the other group did not. The group who received the letters had significantly lower rates of suicide across the first two years, with diminishing effects thereafter. Although this study did not specifically recruit suicide attempt survivors, it has inspired other studies that have recruited individuals treated after a suicide attempt in emergency departments and inpatient psychiatric units. Although not always found to be more effective than a comparison group, brief, low-cost interventions such as letters, postcards, and phone calls do seem to show evidence of reducing suicide attempts for suicide attempt survivors. Of note, none of these approaches have been compared to CBT or DBT, so it’s not clear how they compare. But such a comparison would be inherently difficult, since the smaller effects of brief intervention require larger samples, while the resources
needed to treat patients with a DBT limits how many people you could recruit. What is less clear is why these contacts have such a positive impact. Motto used his experience of having a wartime pen pal as inspiration for sending caring letters, but researchers aren’t sure exactly what it is about the contacts that people find useful. One hypothesis is that follow-up contacts help maintain a connection with another human being for people who may be isolated or feel that they are nothing but a burden to others. Or perhaps receiving follow-up contacts may lead to a greater willingness to connect with outpatient treatment, which may ultimately be responsible for better outcomes.
Several studies are currently under way replicating the Motto and Bostrom study with different forms of follow-up contacts with suicide attempt survivors and other at-risk individuals, including letters and text messages, which may provide answers to why these contacts are effective. One additional area that needs further exploration is the impact of support groups and group therapies for suicide attempt survivors. This is a sensitive topic. I have noticed many of my colleagues recoiling at the idea of groups where the content focuses explicitly on suicidal ideation, out of fear that it may actually lead group members to feel more suicidal and reinforce self-harm behaviors. For instance, suicidal thoughts and behaviors are not discussed in
DBT groups, out of fear of contagion among members. Instead, suicidal thoughts and behaviors are discussed in individual therapy sessions where they can be understood in depth and targeted with proactive problem-solving strategies. Our suicide prevention community tends to be a tight-knit group, and I don’t think that researchers are trying to prevent forms of treatment that are preferred by suicide attempt survivors. Instead, I think that we are a data-driven contingent that wants to have evidence-based approaches to help ensure that suicide attempt survivors receive the most acceptable and effective interventions to help in attaining their personal goals.
Currently, I am collaborating on a study involving a group therapy originally created for suicide attempt survivors receiving care in a Veterans Affairs medical center. I admit that I was skeptical at first, but I was won over by the thoughtfulness of the clinicians who created the group therapy and the preliminary data demonstrating that many attempt survivors have transcended beyond the identity of a full-time patient to that of an inspirational speaker engaged in universal suicide prevention efforts at active-duty military bases. Our study focus is on evaluating whether an additional collaborative suicide risk assessment taken from the Collaborative Assessment and Management of Suicidality (CAMS)* improves the overall impact of the group therapy. We opened recruitment to all suicidal veterans discharged from an inpatient psychiatry unit, many of whom report previous suicide attempts, and hope to recruit approximately 150 veterans to participate. We estimate the study will conclude in 2014 or 2015, after which we will publish the results.

Finally, it is worth noting that we currently have no data on suicide attempt survivor support groups, and this is needed badly. I would urge the suicide attempt survivor community and my own colleagues to work together to study the impact of attempt survivor support groups so that we have data to inform future efforts and hopefully demonstrate that speaking about suicidal ideation in a group setting can at times be healing and helpful, in certain contexts, if conducted in a responsible and thoughtful manner.
___
* CAMS is a treatment framework that helps providers and clients focus on the specific factors underlying the suicidal wish, which involves collaborative assessments and treatment planning until the suicide crisis resolves

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What Will distress Be Like in 100 Years?

Distressed

Emotional Distress

I know I have been writing more and more about my transgender issues and more of my identity crisis that I am. I am deeply distressed right now and don’t know what else to do but write. I started working on a blog for my 400th blog but the meds are interfering with my thought process. I took 2400 mg of neurontin to calm down the horrible burning pains in my foot that I have been experiencing all day. I just can’t take it anymore. I took some of my pain meds with the neurontin and I am kind of feeling kind of out of it but I still haven’t passed out yet. I think I will in a few minutes as I can barely hold my head up anymore as I am fighting the fatigue. I am just so damn upset over the stupid menses. I know that even if I get to my doc there is nothing really she could do. I will still have to wait at least three weeks to see if the next treatment works, that is if I stop bleeding. I would be OK if I would just stop bleeding. It so distresses me and usually I am able to handle it but now this is going on for almost three weeks and I am losing my handle on the rope that is holding me together. I think tomorrow if my flow is still the same I will stop the patch and see what happens. I don’t know what else to go. i will go a few days of not wearing the stupid fucker and see if that helps.

I am deeply suicidal and yet deeply concerned about someone who just wrote to me that she is planning her final affairs. There is nothing I can do to stop this lady, she has her mind set on killing herself. I don’t blame her. I really don’t. There is only so much pain you can take before you finally snap and have to do something to get rid of it. I have been where she is right now. She doesn’t have a good support system and I think she is mad at me in some way that I have abandoned her. I feel bad that I have not called her like I have said before but I just don’t feel like talking. I guess I am afraid of calling a stranger and letting her in my life. I am scared. I once got close to a member of the support group and then she just stopped contact. No more emails, no more phone calls, no messages returned. Nothing. I later found out through her husband that she just got tired of her condition that she became constricted and didn’t want to reach out anymore. It was too painful for her. I lost my friend to this horrible condition because she has the active form due to another dreaded condition that is worse than the other. I would name them but they are conditions that no one really understands. I might as well as be talking about the moon and the stars and how far away they are. I think they name them these big ass names so that no one can understand and push us further apart from the human race.
So Ms. M, if you are reading this, I am sorry that I failed you. I wish there was a way that I could stop you from doing what you are planning but I guess there is no way to stop you. Just like no one can stop me in my planning. I hope that we both succeed. I know that dealing with constant, excruciating pain and loss of bodily functions really suck. I know this first hand. I can’t stand it that someone so sweet could hurt so much and no one notice. It is not fair. But I understand. I really do.

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