“I’m Sorry”

“I’m sorry.”

It’s two of the easiest and most overused words in the English language. ‘I’m sorry’ just rolls of the tongue for anything from being late to a meeting to breaking your mother’s favorite vase.

Over the years, ‘I’m sorry’ has lost the meaning that it once had. It’s become a phrase that once full of meaning has now lost all possible meaning. When you say, ‘I’m sorry’ do you actually mean it, or are you just fulfilling a societal norm? Do you actually mean the words; are you actually apologetic when you say ‘I’m sorry’? Or are they just words; something to say to fill the void but not really meaning anything.

Why do we say ‘I’m sorry’ if we don’t really mean it? Why do we say words that we don’t actually mean? Is it because that is what society expects of us? Are we just following the social norms by saying things we don’t actually mean and won’t ever follow through with? Why have these words been reduced to just words?

So many of the things we say today have no meaning behind them. They are empty societal norms that we instinctively follow without putting any thought, or emotion behind them. But I want to mean what I say, so from now on when I say ‘I’m sorry’, I’m going to mean it. When I speak, I’m going to mean exactly what I say and I’m going to say exactly what I mean. Words should always have meaning and impact. They are an integral way for people to communicate.

‘I’m sorry’ isn’t the only phrase that has lost all meaning. There are many more. Which ones can you think of?

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Dying Inside

Somedays, I wake up and I just want to scream at the world. How can nobody see that every day, I’m dying a little more inside? How can everyone who knows what is going on with me, ignore it and pretend that I don’t exist?

It’s funny the reactions I get when I tell people I only have one friend. They either insist that I have more than one friend or they try to by sympathetic. I don’t understand these reactions. I’m not saying that I have only one friend for your sympathy or your insistance that I have more friends, I’m telling you this because I want you to understand my life. I want you to look outside of your own life and consider others.

I feel like I’m dying inside and that nobody cares. That nobody can see. I put on a smiling face and pretend everything is all right, but in reality I’m thinking would anyone actually care if I wasn’t here? Would anyone really miss me if I was gone? Would it really be a bad thing if I wasn’t here?

And I know the logical answer to those questions. I know that my friend and my family would miss me. And I know that I wouldn’t be able to achieve all that I dream I can do. I know I have the potential, there are just days when I don’t care. There are days when my feelings, while knowingly illogical, win over my logical side. There are days when all I can do is feel. And right now, I’m trying to learn that feelings are not reality.

There are days when the researched posts are easier to write and there are days when the personal posts are easier to write. It’s hard to face your issues. It makes you face down the parts of you that you’d rather leave alone. Parts that you’d rather leave hidden. But if you keep leaving those parts alone, you’ll never fix them and you’ll never get better.

I face this everyday in therapy. And they make you look at the parts of you that are messed up and you wonder how it even got to this point. How certain things got so bad that you couldn’t cope or that you never developed the skills you needed to cope. You wonder what’s wrong with you. You wonder how it all went wrong. And you wonder if your world will ever be right again.

I’m working on it. And I’m hoping. At this point, that’s all I can do.

Alternative Medications & Therapies

There are multiple different ways to deal with depression and anxiety. This includes alternative medications and therapies. For mild depression, often herbal supplements are easier and more capable of helping than medication.

There are many different types of herbal supplements and remedies. I am only going to discuss three in this post. These would be St. John’s Wort, Omega-3 fatty acids and SAMe. St. John’s Wort is one of the most popular herbal supplements to treat depression. “In 2000, the FDA issued a Public Health Advisory letter stating that the herb may interfere with certain medications used to treat heart disease, depression, seizures, certain cancers, and those used to prevent organ transplant rejection. The herb also may interfere with the effectiveness of oral contraceptives. Consult with your doctor before taking any herbal supplement” (NIMH)1. Omega-3 fatty acids are found in nuts, flaxseed and oil as well as cold-water fish. More research is needed to determine if Omega-3 fatty acids can help with depression however, just a note that it may interact with other medications. SAMe is a synthetic form of a chemical occurring naturally in the body. More research is also needed to see how SAMe effects depression, however it should be taken carefully by people with bipolar disorder as it may trigger mania.

There are also different types of alternative therapies. These include expressive or creative arts therapy, dance & movement therapy, music therapy, animal-assisted therapy and light therapies. These alternatives can help those with mild to severe depression and are often used in conjunction with talk therapies.

Expressive or creative arts therapy is when a patient used expressive acts such as writing, art, or music to help themselves emotionally. Art therapy encourages patients to express their feelings through the use of artistic materials like paint, markers or pencils. Expressive therapy allows a person to express themselves emotionally, through a helpful medium and allows them to find coping skills and deal with traumatic events while healing. Dance and movement therapy or DMT follows the same theory as expressive or creative arts therapy. The patient uses dance and movement to express their feelings and thoughts about their life situations. DMT is based on the idea that the body and mind are interconnected and that movement can affect their minds and thoughts.

Music therapy is something people use daily without realizing it. Please click here to read more about music and its affect on a person’s mood. Music is often used to aid in meditation and relaxation. Often patients will either listen to music that they relate to or make music to explore ways of expressing oneself.

Animal-assisted therapy includes working with various animals to help patients cope with their wishes and develop ways to communicate. Companion animals are often used in hospitals, nursing humans and psychiatric wards to bring comfort and joy to those with despair. There are claims that working with animals has a physiological benefit through increased level of activity and the act of caring for another. Interacting with animals is believed to improve confidence and increase acceptance and empathy. I will be discussing the use of Emotional Support Animals in a future post.

Light therapy is most often used to treat seasonal affective disorder or SAD, which is a form of depression that occurs during the winter months. Light therapy is the use of a full spectrum light in either a lamp or a box, that a person uses for periods of time. This can help those who struggle when daylight is at its shortest.

Aromatherapy is also used as a self-sooth or de-stress technique. Incense, candles and essential oils are all used for aromatherapy. Other complementary or alternative treatments for depression are meditation, yoga, spirituality, exercise and acupuncture. I will be discussing meditation in a future post.

These are just some of the alternative and complementary medications and therapies that can be used to treat depression, however these will not replace traditional therapy and medications for moderate to severe mental illnesses. These therapies can be used in conjunction with modern medicine to lessen the affects of your disease.

Anxiety and Depression Association of America
National Institute of Mental Health
National Center for Complementary and Integrative Health
Mayo Clinic

My Life in Outpatient Treatment: Week 3

This is a continuation, Week 3, of my daily journal while in outpatient treatment for depression, anxiety and avoidant personality disorder. Click here to read Week 1 and Week 2.

Week 3, Day 14:
I don’t know what to do. I supposedly ‘need’ people but I honestly don’t want to need people. People are unreliable and dishonest. People hurt me.
I don’t know how to like myself. I have this craving for validation from others. It’s a need. And I know I have to break this need but I don’t know how.
My birthday is tomorrow and I’m honestly not looking forward to it. I feel like the day is just going to be crap. I don’t feel like I have anything to look forward to tomorrow. It’s just another day. Just another boring day with the same old schedule.
Being at therapy today has made me feel worse. This card project is just reminding me that I don’t have anything in my life. I don’t want to be here.
(Note: The card project was to create a card from someone you would probably never get a card from. Who would it be from? What would it say? This was a very difficult project for the entire group.)

Day 15:
Today was my birthday. It was more fun than I thought it would be. I didn’t have anything planned because I had to work, but one of my fellow patients brought in cupcakes & she gave me an awesome present of candles and scent hand soap. Hopefully I’ll have more fun in 2 days when I celebrate with my best friend and my family.

Day 16:
I need to start practicing my happiness sheet. (Link)
I need to change my perspective on life.
Homework – Go do things and keep an open mind. Don’t judge things, including myself & my opinions. Catch the judgements before I make them.

Day 17:
Get out and volunteer. It’s a good way to meet people with similar interests.
Trust = consistency/time
I need to get approval from myself first. I need to ask myself; Do I approve of this? Am I living by my values?

Day 18:
I had another quick mood change today. I don’t know why I have these mood swings. I was feeling all right. Now, I’m upset. I’m not sure what triggers these changes.
I need to figure out what my triggers are.
Today’s trigger – When I feel like I am being perceived or am accused of being childish or childlike.

Please stay tuned for Weeks 4 and 5. Click here to view Week 1 and Week 2.

My Dream

“I have a dream….”1 Ever since Martin Luther King Jr. uttered those words on the steps of the Lincoln Memorial, they have had a unique meaning. But in all honesty, I do have a dream. I have a dream that mental health will be regarded without stigma and prejudice. I have a dream that one day, people will realize that mental health is important and a mental illness is a disease much like cancer. However, unlike cancer, mental illness does not generally show major physical symptoms. There is no hair loss, no chemo or radiation treatments and a mentally ill person does not look physically sick. But this does not mean that they are not suffering just as much.

I truly believe that depression and mental illness is a disease. It’s like getting a tumor; it’s not your fault. Are you going to turn around and tell a person with a tumor or cancerous growth that it’s their fault for getting that? Would you tell a person with a broken leg to ‘just get over it’? Why would you do the same to a mentally ill person who also is struggling with the question; ‘Why me?’.

My dream is to start a nonprofit foundation to not only help those with mental illness, but to also fight the stigmas and cliches that have permeated the idea of mental illness. Those with depression and anxiety are sick, not lazy, crazy or faking it.

The name for this nonprofit would be ADAPT. Advocates for Depression Awareness, Progress & Tolerance, all of which is needed in the field of mental health. If I can educate or bring awareness to those who don’t understand depression, progress and tolerance will follow.

Martin Luther King Jr’s most famous words were uttered that day. “I have a dream that my four little children will one day live in a nation where they will not be judged by the color of their skin, but by the content of their character”.1 Today, people are still judged by their looks and actions rather than their character. So let me ask you, how do you want to be judged? Or do you even want to be judged at all?

I have a mental illness; this makes me sick and I can’t just ‘get over it’ and I’m not ‘being lazy’. There are days that I struggle to make through. There are habits and behaviors that I have to change, but this is not a disease that I have to fight alone. Just as people support friends and family with cancer, people also need to support and help those with mental illness.

So my dream, to start a nonprofit; ADAPT, could change the world. I want it to change the world and I want it to change your mind about mental health.

  1. Martin Luther King Jr.’s Speech “I Have A Dream”

Me Against the World

I often feel like it is me against the world. Mental health is still stigmatized, at least one hundred years after it was first considered a legitimate clinical diagnosis. I feel like people, including my family, look at me and see that I look normal and therefore think that there is no possible way that I could be sick.

I often wish that mental illness was like cancer, where you end up in the hospital or at least you look sick. I consider depression to actually be a cancer, but because you don’t look sick everyone says “you’re fine” and should just “get over it.”

There are times when I feel like crying for absolutely no reason. Or my mood will change at the drop of a hat. One little thing could trigger me, like it did today, and there goes my good or at least, baseline mood and I have to fight to get it back.

Today I walked into work and we have a log book so that each shift can know what major things happened in previous shifts. Unfortunately, this log-book is mostly used to list complaints and to nitpick people’s job performances. I worked my butt off last night, with the hotel being at almost full capacity and I feel like I did the best that I could possibly do. I walk into work today and there is a list of complaints of things that didn’t get done or weren’t done satisfactorily. My mood immediately went south. I was frustrated, I was angry and I felt like I wasn’t good enough. It took me 4 hours to bring me back to baseline. Four hours to come to terms with the fact that they were nitpicking because they wanted to find something wrong. Almost like they had to find something wrong. And now I’m starting to feel sorry for them and I wonder what misery in their lives is causing them to take it out on us at work.

I realize that I make snap judgements about things and emotions. I decide within seconds how I want to feel about something and it takes hours of turning it over in my mind, to change how I feel. I need to learn and I’m trying to learn to take my time to ride the wave of my emotions and not just settle on feeling only one, especially a negative one.

So while I often feel like it’s me against the world, in reality it’s not. I have many people rooting for me to succeed and many people believe in me and believe that I can get better; that I can become a healthier person.

Even in treatment, I feel like i’m struggling to tread water while I’m surrounded by boats of people, all shouting vague suggestions to me, including swim harder. All of these people are shouting suggestions at me rather than trying to help me into the boat. It’s like they’re afraid that helping me might tip their own boat over. But that’s not true. They just don’t understand.

So to that end, I’m writing these posts to promote understanding. Because I want the people in my life to at least partly understand what I’m going through. But I don’t think people understand how stressful it is to explain what’s going on in your head when you don’t even understand it yourself. But I’m going to keep on trying and struggling to promote awareness, progress and tolerance. There needs to be a change. We need to ADAPT!!!

Coping Skills

Coping skills are the biggest thing they teach you in therapy. By learning different coping skills, you can help yourself relax, calm down and manage your mental illness. Different skills work better than others in different situations, you just have to find the ones that work for you. Take the time to practice these skills, so that when you need to use them, you have them available for your use. *I will be posting about many of these coping skills more in detail at a later time.

5, 4, 3, 2, 1

  • Observe 5 things you see, notice 4 sounds you hear, 3 things you feel, 2 things you smell & 1 thing you taste.

Assertiveness

  • “I” Statements. Assertive communication of your feelings: “I feel __, when you __, because __. In the future, I’d like you to __.
  • Also use DEAR MAN (described here) to be assertive.

3 C’s (Catch, challenge & Change)/Thought Stopping

  • Catch the negative/unhealthy thought, challenge it, and change it. Notice the impulse or thought. Say or think “STOP” either out loud or to yourself. Replace the troubling thought with a positive alternative thought.

Challenge Distorted Thoughts (CBT Skill)

  • Notice the negative/distorted though. Ask yourself, is there evidence for my thought or am I exaggerating? Think of a few alternative, less negative possibilities.

Distract (DBT: Distress Tolerance Skill)

  • ACCEPTS: A – Activites; C – Contributing; C – Comparisions; E – Emotions; P – Pushing Away;
  • Do a puzzle, go shopping, clean one room in the house. DO SOMETHING!!!!!

Exercise

  • Work out the emotion through physical exercise. Walk, weights, jog, biking, etc.

Gratitude list

  • Write down a list of 10 things you are grateful for every night. Make sure at least 5 of them are not the same as the night before.

Imagery

  • Guided imagery uses your 5 senses and imagination to attempt to manage your emotions. Please visit the Inner Health Studio for more information.

Improve the moment (DBT: Distress Tolerance Skill)

  • I – Imagery; M – Meaning; P – Prayer; R – Relaxation; O – One Thing in the Moment; V – Vacation; E – Encourage

Journal

  • Write about a strong emotion you are experiencing, how you coped with it, and what you can do differently next time.

Lemonade

  • Taking the lemons that life hands you and making lemonade.
  • Dilute the situation (add water).
  • Find or add something positive to the situation (Add sugar).

Make/use a self sooth kit

  • Please view the separate post here on making & using a self sooth kit.

Mirror Work

  • Look at yourself in a mirror and repeat a positive self-statement out loud 3-10 times. Run the water if you don’t want anyone to hear you. “I am _______.”

Non-judgmental (DBT: Mindfulness Skill)

  • Not judging anyone or anything.
  • This includes not judging your own thoughts, actions, etc.
  • Accepts the situation as is, for the moment.

Observe breathing (4 square breathing)

  • Breathe in while counting to 4. Hold it for 4. Exhale while counting to 4. Repeat.

One Mind/Mindfulness (DBT: Mindfulness Skill)

  • Focus on something around you. Notice the details. Describe it to yourself. (Will be discussed in further detail in a future post).

Opposite to Emotion (Emotion Regulation Skill)

  • Identify your problematic emotion, and actively engage in activities that bring the opposite emotion to your awareness as well.
  • To change the emotion, acting contrary to how you feel.

PMR – Progressive Muscle Relaxation

  • Involves tensing and relaxing various muscle groups.
  • Listen to a cd or online PMR relaxation meditation.

Positive Self-Talk

  • Focusing on your positive qualities and repeating them to yourself

Pros & Cons (DBT: Distress Tolerance Skill)

  • Think about the positives and negatives to the situation. Write them down.

Radical Acceptance (DBT: Distress Tolerance Skill)

  • Accepting the situation & continuing on
  • Accept what you can’t change and let it go. Focus your attention and energy on what you can control and change: Yourself
  • Accepting is not the same as approving. Tolerate the moment.

Ride the wave

  • Emotions come and go like the waves in the ocean. When you are experiencing a strong negative emotion, visualize that you are surfing on a wave of your emotions, letting it ride.

Stop. Think. Act

  • A strong impulse or emotion is not the same as acting on it. Think it through. You can choose to engage in the impulse, use a skill to manage it or tolerate it while doing nothing. You have the choice.

Talk to Someone

  • Talk  out the troublesome emotion or situation with someone you trust. Often just getting it out verbally is all we need to improve our mood. Helpful advice can put things into perspective too.

Time Out

  • Separate yourself from the situation allowing yourself time to calm down and restore emotional balance.

Turtling

  • Retreat inside yourself and then reemerge when it is safe. Use hard outer shell to let things roll off your back. When you feel knocked down, turn yourself right side up and back in balance.

Volunteer

  • Volunteering and helping others can take your mind out of itself by focusing on helping someone or something else.

Wise mind (DBT: Distress Tolerance Skill)

  • A combination of reasonable (logical) mind and emotional mind.

DBT Skills Handbook
Relaxation & Guided Imagery
Emergency Bag or Box (Self-soothing)