Personality

Personality is a very fluid idea. Often times, our actions or reactions are blamed on our personality. “That’s just how they are.” But personality is actually developed through the situations and environments we experience during adolescence. Our personality is affected by our temperament and our character. The APA defines personality as, “individual differences in characteristic patterns of thinking, feeling and behaving”. Personality can also be defined as a set of traits or characteristics that uniquely influence a person’s behaviors and thoughts is various situations.

Personality evolves over time. It does not remain stagnant. Our behaviors and traits are influenced by our life experiences and relationships. Personality traits are also reinforced by our experiences. In many ways an unhealthy personality trait can be reaffirmed when a life event doesn’t go as planned. However, in this way you may also be committing a self-fulfilling prophecy. A self-fulfilling prophecy is when a person unintentionally and/or unconsciously fulfills a preconceived notion or idea, whether it be positive or negative. The only experience I have ever had with self-fulfilling prophecies have been negative.

There are also illnesses regarding personality. These of course, would be considered personality disorders. A person can have certain individual traits of a disorder without having the disorder. A personality disorder is defined as “a pattern of thoughts, feelings and behaviors that are consistently exhibited over a long period of time and create emotional and mental distress”. Personality disorders exist on a continuum from mild to severe, but left untreated it can reduce a person’s quality of life. Personality disorders can also be considered ‘fatal flaws’.

Personality disorders are grouped into three clusters based on their similarities and symptoms. Cluster A disorders are considered odd or eccentric behavior. This would include schizoid or paranoid personalities. Cluster B disorders are dramatic, emotional or erratic behavior. This would include narcissistic or histrionic personalities. Cluster C disorders are considered anxious and fearful behavior. This would include avoidant, dependent or OCD personalities.

In the next post I will be discussing the various personality disorders within their clusters, their traits and how they are diagnosed. Please remember that even if you display some of these traits, that does not mean that you have a personality disorder. No one is perfect.

  1. American Psychological Association
  2. Mind for Better Mental Health

Change: A Clinical Definition

“There’s a difference between wanting to change because you hate yourself & wanting to change because you love yourself.” – Anonymous

According to psychology, there are 6 steps to change. These steps will help make change a less arduous process and open you up to possible new behaviors and habits that are currently holding you back. Please remember, it is normal & natural to regress, to attain one stage only to fall back to a previous stage. “No one can force a person to change their behavior, lifestyle, mentality, attitude, etc. The individual must be ready for change” – Psychology.tools

The first step is precontemplation. Here you have not yet acknowledged that there is a problem. At this point, you are in denial and will defend your current bad habit or behavior. You have no intention of changing this habit or behavior because you do not see a problem.

The second step is contemplation. Here you are acknowledging that there is a problem but you don’t know if you want or are ready to change. You are aware that a problem exists with your current behavior or habit, however you are ambivalent and have no commitment to making a change. You do spend time thinking about the problem, trying to determine if change is needed.

The third step is preparation or determination. You are getting ready to change and have an intention to take action. This is also known as the research phase because you are gathering information on how to make the needed change. This step is often skipped and leads the person to fail at their initial attempt to change because they haven’t accepted that it will be a change that will affect their lifestyle.

The four step is action. This involves the willpower to actively modify the behavior or habit. You have to have a belief in your ability to change and be actively involved by using different techniques and putting effort into the change. It is in the phase that people are at the greatest risk for relapse however they are also more open to receiving help and support from others.

The fifth step involves maintenance. Here you have to avoid temptations to return to bad habits and you have to maintain the behavior or habit change. You need to remain aware of the situation, be patient with yourself and remain on track. By sustaining the change, the new habit or behavior will replace the old.

The sixth step is relapse. This is included because it is considered normal to experience at least one relapse in the course of the change. In a relapse, you return to the old behaviors or habits and abandon your changes by falling back into old patterns of behavior. Most importantly you have to remember that you didn’t fail. Instead look at your relapse as an opportunity for learning and becoming stronger. The process can be restarted again at any of the last three phases: Preparation, action or maintenance.

Eventually you will have maintained maintenance long enough to attain transcendence. Transcendence is when the former habit or behavior has now become atypical and abnormal. You will also be able to work with your emotions, view your behaviors in a new light and understand them.

Now that you know the steps to making changes? What is it you would like to change in your life? The following is a prompt to inspire change.

“Things I Want to Change”

  • Two things I want to change about myself…
  • Two things I like about myself and don’t want to change are…
  • The most important change I’ve made since __________ is…
  • A change that I’ve made since ____________ is …
  • If I try to change, I worry that…
  • A Change that I would like to make in myself but don’t think I can is…
  • The reason it is hard for me to change is…

Psychology Tools

Acceptance

Acceptance is important in your life. It allows you to make peace with the your past and move forward with your life. The first step to acceptance is learning what acceptance is versus what it is not.

Acceptance is not forgiveness, forgetting, letting it go, being ok, denial, allowing it, agreeing with it or understanding.

Acceptance is making space, letting yourself off of the hook, especially from suffering and ‘It is what it is’.

There are 10 steps towards acceptance.

  1. Honor the full sweep of your emotions.
    1. Seek to fully feel your emotions and express those emotions that you feel. Understand your emotions, thoughts & embrace them as valuable feedback for your life.
  2. Give up your need for revenge but continue to seek a just resolution.
    1. Let go of your natural instinct to hurt back or take revenge from the person who hurt you. Revenge will give you a false sense of power over another, however this power is considered ‘cheap thrills’ & will ultimately hurt you more over time. Mindfully turn away from retaliation and look to empower, grow & strengthen yourself.
  3. Stop obsessing about the injury and re-engage with life.
    1. Gain awareness to stop & replace repetitive toxic thinking patterns which only cause ongoing distress, trauma and harm. You have to create a conscious awareness and be mindful.
  4. Protect yourself from further abuse.
    1. Accepting the wrongness of the actions allows you to learn how to distance and protect yourself in the future. Use the pain of the experience to learn & grow and take precautions to ensure your safety in the present and future. Make changes.
  5. Frame the offender’s behaviour in terms of their own problems and personal struggles
    1. Try to see things from the offender’s point of view. The wrongful actions are about the person who acted wrongly. “Their neediness to feel important by tearing others down”. The more you know about them and their situations, the more you won’t take their behavior personally. Never let another person’s actions dictate how you feel about yourself.
  6. Look honestly at your own contribution to the injury.
    1. Examine how your actions, approach & choices may have contributed to the situation.This is not about blaming yourself. Authentically examine your own life, self & issues to look at how your own fears, past experiences and beliefs, etc, prevented you from seeing that you deserved so much better. That you didn’t deserve to be hurt. Allow the pain of experience to teach you that you are more than a victim. The person who most needs your forgiveness is yourself.
  7. Challenge your false assumptions about what happened.
    1. Identify and challenge any limiting beliefs or false assumptions. Identify toxic or limiting patterns, and don’t edit or rationalize these ideas. Ask yourself, ‘Is it true? What toxic thinking pattern does it fall under? What limiting belief underlies this thinking? It is an empowering or a limiting belief?’ Is this typical of your thinking? If so, why? If not, why are you thinking in this manner?
  8. Look at the offender apart from his offense, weighing the good against the bad.
    1. Look at the person separate from their actions. Also look at the person & their behaviors for their impact on you and your life. Has their impact been mostly positive or negative?
  9. Decide carefully what kind of relationship you want in the future with the person who wronged you.
    1. How do you relate to this person overall? Is reconciliation possible? If not, is it possible to even interact with the person? Is forgiveness an option? Be gentle with yourself & take time to sort through your emotions. Learn to trust yourself and your feelings.
  10. Forgive yourself for your own failings.
    1. Fully forgive yourself for any of your own mistakes or failings related to the situation. As Maya Angelou has said, “When you know better, you do better”. Your mistakes or failings stem from ingrained old ways of getting your universally human need to matter met. Forgiving yourself will make it easier to let go of obsessive thinking patterns, such as blaming yourself for what happened, which would only keep you from living your life fully engaged with the people and activities you love.

Learning to accept situations, especially ones that are out of your control, will give you more control over your own life. Acceptance is not forgiveness but rather the willingness to allow yourself to learn from the experience rather than allowing the situation to continue to harm you.

Cutting

To this post I would like to attach a TRIGGER WARNING. This post will contain information about self-injurious behavior which may be triggering to some people.

I used to cut. I found it therapeutic and punishing. I felt like I needed to cut because I needed to be punished. I felt like I needed to be punished because I was a bad person, because I was always doing something wrong, because it felt like there was something wrong with me. There had to be something wrong with me, right? Afterall, that’s why I don’t have any friends. Right?

I was very wrong. Cutting or self-injuring as it is known, is the deliberate act of harming your body. Self-injury is an unhealthy way to handle your issues and is most often done impulsively. There are many ways to self-injure, but I don’t want to get into the how of self-injury. I would like to discuss the why.

For me, there were three reasons why I cut myself. The first was because I was feeling too much emotion and I couldn’t find a way to let it out. These emotions were negative, but I must admit that they were triggered by specific situations and instead of addressing these situations and facing my emotions, I cut to let these emotions out. The second was when I felt numb. I cut because I couldn’t feel any emotion and I wanted, no I needed to feel something, anything, even if it was physical pain. The third reason was because I felt a need to punish myself. There had to be something wrong with me and because I couldn’t figure out what it was, I cut and I punished.

I learned that self-injury wasn’t going to fix my problems. Self-injury could, if continued, make my problems worse. Often, it is seen as a cry for help. Self-injury is not meant to be suicide but it can often follow that path if the person doesn’t seek help.

If you see someone who is self-injuring, talk to them. Don’t accuse them of doing something wrong, just ask them what is wrong. Often times having someone honestly ask, ‘what is wrong’ or ‘is everything ok’ can open up the self-injurer to seeking help. Sometimes all we need to know is that someone cares.

Self-injuring can be a part of mental illness and needs to be treated as such. Therapy can help a self-injuring person with this issue. It can be a temporary, situational issue like mine or it can be a continuing circle. Self-injury is never the answer, and although I understand why people do it, I hope you’ll seek help. I hope you’ll find the help and treatment you need. You don’t need to hurt yourself, you don’t need to punish yourself. Everything will be ok.

Cutting

Mayo Clinic

What Are Emotions?

Emotions are feelings that are felt during a particular situation or event.

Here are some facts you need to know about emotions:

  1. Emotions are neither good or bad, right or wrong. Emotions just are; they exist.
  2. Emotions don’t last forever.
  3. Emotions are not facts.
  4. When a strong emotion comes, you do not have to act on that emotion.
  5. You can’t get rid of emotions because they serve as important survival functions.

There are eight primary emotions.

  • Anger
  • Sorrow
  • Joy
  • Fear
  • Disgust
  • Guilt/Shame
  • Interest
  • Surprise

Secondary emotions also exist. These are an emotional reaction to a primary emotion. An example would be to feel shame when your primary emotion is anger. Secondary emotions are learned emotions from families, cultures and our environments. Secondary emotions are important, but it is more important to discover the primary emotion so you can get to the root of the problem.

Emotions have three jobs.

The first is communication. They can be communicated both verbally and nonverbally. Verbal communication of emotion occurs through words, voice tone and volume. Nonverbally, emotions can be communicated through our faces, posture and gestures. Non-verbal communication happens very rapidly and can often help us in certain situations. Even if we try to hide an emotion, it is often communicated through our nonverbal actions.

Emotions also motivate us. They tell us to ‘act now’ and to ‘stay focused’. They give us the motivation we need to change certain situations and strong emotions allow us to overcome obstacles both in our minds and in our environments. Emotions also save us time in important situations because we don’t have to think everything through.

Lastly, emotions can give us validation. Emotions can be informative about a situation. ‘Gut Instinct’ emotions can be used as signals and alarms. However, when carried to the extreme, emotions can often be treated as facts. This is where validation turns against us and this will be discussed in a future post.

Some last notes about emotions. To discover an issue, it can often help to discover where you ‘feel’ this emotion. For an example anger is often felt in the stomach, with a tensioning of the muscles.Urges to do something are natural, but not necessarily healthy. Everyone’s emotions are different so everyone will react differently to different emotions. Finally, unhealthy thoughts occur when we attach judgements to our emotions. You need to be willing to radically accept your emotions as they occur (Radical Acceptance).

Emotions are not bad. In fact, they often can be helpful depending on the situation. It’s how we react to our emotions that can cause us problems.

Emotions
Dealing with Negative Emotions

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

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)

Self-Soothing

One of the biggest coping skills taught in outpatient treatment is self-soothing. Self-soothing falls under DBT or the Dialectical Behavior Therapy. It is used when a person is feeling distressing, and when situations and emotions are overwhelming. Self-soothing is also known as a deterrent to self harm, because instead of doing something to hurt yourself, you’re doing something that gives you comfort and pleasure. These suggestions can help you feel better, calm down, and even feel relaxation or pleasure. Self-soothing most often uses the 5 senses; touch, taste, sight, smell and hearing. Try a variety of these items until you find a combination that works for you.

SIGHT: Be mindful of every sight, but do not linger on any. Allow the sights to calm you.

  • View pictures of family/friends.
  • View pictures of your favorite vacation spot or place you wish to go.
  • Look at art or go to a museum.
  • Go for a nature walk.
  • Walk through a pretty part of town.
  • Buy some flowers for your home.
  • Light a candle and watch the flame.
  • Watch an uplifting movie or video.
  • Be creative.
  • Painting, markers, crayons & a coloring book or sketch pad.
  • Mandalas (Coloring Castle, Free Mandalas, Printable Mandalas).

HEARING: When you are listening, be mindful, letting the sounds come and go. Be mindful of different sounds and let them flow through you.

  • Listen to relaxing music (via youtube, pandora, etc).
  • Listen to sounds of the ocean, forest, rain, or other sounds of nature.
  • Listen to a small animal.
  • Sit by a waterfall.
  • Play a musical instruments if possible.
  • Sing your favorite songs.
  • Do a guided meditation.

SMELL: Notice all the different smells around you and take in all the smells.

  • Smell a meal being cooked either at home or in a restaurant.
  • Walk in a garden or in the woods.
  • Breath the smells of nature.
  • Light a scented candle or incense.
  • Use essential oils.
  • Use hand lotion and/or drawer packets.
  • Use perfume or bath salts (Epsom salts).
  • Bake some bread, cake or cookies.

TASTE: Let the taste run over your tongue and slowly down your throat. Mindfully taste each new thing.

  • Cook a favorite meal.
  • Drink a soothing drink like hot chocolate or tea (especially blends for stress or anxiety).
  • Chew gum.
  • Eat hard candy or chocolate.
  • Go to a potluck and eat a little of each dish.

TOUCH: Take a bubble bath. Pet your dog or cat or cuddle a baby. Put on a silk shirt shirt or blouse, and feel its softness and smoothness. Sink into a really comfortable bed.  Float or swim in a pool, and feel the water caress your body.

  • Play with sand.
  • Use hand lotion.
  • Use a heating pad, back massage pad, or rice pack (hot or cold).
  • Play with modeling clay.
  • Dance.
  • Use a stress ball.
  • Play with silly putty.
  • Pet an animal or cuddle a baby.
  • Take a bubble bath.
  • Float or swim in a pool and feel the water caress your body.
  • Brush your hair.
  • Sink into a really comfortable bed.
  • Nap with a soft and furry blanket.
  • Use a weighted blanket (Bought Blanket; Sew-able Blanket; Tyable BlanketNo-Sew Blanket).

The entire point of self-soothing is to do something that is comforting to you and to continue doing it until you feel better.

DBT Self Help: Self Soothing

Outpatient Treatment Center

To make the next few posts easier to understand, I want to describe to you the treatment center that I was admitted to, the various programs they have and the types of therapies we learned about.

At this center, there are three levels of treatment; Inpatient Hospital Treatment, Partial Hospitalization Program, and Intensive Outpatient Program. There is also a residential facility for patients with eating disorders. In all of these programs, the adults are separated from the adolescents.

With inpatient treatment, there are various units to which a patient could be assigned. This includes the Special Intensity Unit for patients who are experiencing more acute symptoms of their mental illness. While in inpatient care the doctors, therapists and nurses work together to address the patient’s disorder and work towards long-term recovery. After discharge from inpatient treatment, the patient continues care with the Partial Hospitalization Program or PHP.

Partial Hospitalization Program or PHP, is considered the highest level of outpatient treatment. PHP is a full day program that consists of group, individual, family and other various therapies. PHP is the follow up to inpatient treatment but can also be the starting point for another patient. Each patient is placed within different programs where it is deemed that they will receive the most amount of beneficial therapy.

Intensive Outpatient Program or IOP, is a half day program that helps patients transition to life outside of the program. It is often a follow-up to inpatient treatment and PHP. IOP offers group, individual and family therapy along with transitioning to daily routines. It is considered the lowest level of outpatient treatment for the program and transitions patients to life outside of treatment including setting up schedules and appointments with outside therapists and psychologists.

The center also includes an after care program which is a once a week group therapy session. This allows for continued group therapy alongside your individual outside therapist and doctors.

Each day started with our morning check-ins. With these, we described how we felt at the moment, any questions or concerns we had with medications or therapies and how our previous evenings had occurred. After check in, we had our one hour group therapy session which met daily. During these sessions anyone was free to talk about anything and everyone was allowed to talk, discuss and suggest ideas and solutions. After group therapy, we would either have expressive (art) therapy, music therapy, medication education, emotional regulation, or weekend planning depending on the day. The last hour before lunch, which was also the last hour for the IOP patients, was spent learning about different therapies, issues and ideas dealing with mental health or if you were fighting an addiction, learning about co-dependence on drugs and/or alcohol Many of these classes have given me ideas and information to use for posts.

After lunch the PHP program would continue with two more class periods. During the first class period, patients would learn about distress tolerance, cognitive behavioral therapy or CBT, expressive therapy and anger management. During the second class, patients learned about mindfulness skills, healthy alternatives, communication skills, expressive therapy, and interpersonal effectiveness. Expressive therapy is taught often because it allows patients to express how they feel in a safe environment. Please read Alternative Medications & Therapies for more information on expressive therapy. During the day, we are also pulled out by our doctors, therapists and APNs for meetings and check-ups.

At the end of the day, we would fill out our daily wrap up sheets, detailing how we felt and if we felt we could stay safe during the evening. After the program, our doctors, therapists and staff would meet to discuss our continuing treatment and eventual discharge.

The program I attended is an accredited program within the nation. But if you think you need more help than a weekly therapist appointment please check within your area for a program that can teach you to manage your mental illness.

“Hey! How are you?”

One of the easiest phrases people use today is, “Hey! How are you?”. But when it comes to this question, they aren’t actually looking for a serious, honest answer. For them it’s a formality, a courtesy to get out of the way before either moving on with the conversation or walking away. For those of us with depression, ‘how are you?’, is a loaded question. Do we answer honestly? Or do we follow formality and courtesy and just say fine, all while hiding how we really feel?

Asking ‘how are you’ is the easiest question, but can actually mean so much to a person if you’re asking it honestly. Maybe you won’t like to hear the answer that they aren’t feeling well, or mentally they are struggling, but they’ll feel so much better being able to tell you the truth instead of hiding how they feel. But there are good and bad ways to ask someone if they are ok.

The first step is to ask the question, “Are you ok?” or “How are you?”. Be honest, and try to get the person to open up. Sometimes they need to talk, but don’t know what to say when confronted with the question, “how are you?”. Continue asking questions about them, and their life. You may have to work a little to earn their trust so that they will open up to you. This may be one of the hardest steps, especially if they don’t know how to respond, but it is also the most important one. It starts a conversation about the person’s mental well-being.

The second step is to listen without judgement. The first sign that the person feels like they are being judged, they will shut down and you have completely lost their trust. Don’t give advice, just listen. Just like you occasionally need to vent to someone about work, life, etc, so do they, especially because they have a disease that makes it difficult for them to be happy or see the good in their life. Also, don’t try to solve their problems. While that might be easier for you, it could be detrimental to their recovery. Depressed people have to face their problems if they’re going to get better. And let them know that you’re there for them whenever they need to talk.

The third step is to encourage action. Ask them what steps they’re taking to get better. Encourage them to see a doctor, psychiatrist, and/or therapist, if they are not already. Ask them if they need help with anything. Don’t let them become fully reliant on you for everything but help them when they’re stuck in a certain situation, environment or dilemma.

The final step is to follow up with them. Depressive people often have a hard time following through with actions that have been put in place. Try to make time for them, not so much that it interferes with your life, but enough so that they know you are thinking about them and hoping that they are taking the right steps to work through their depression.

These steps can be taken face to face, over the phone, over text or even over social media. When you are talking to them, make sure that they are the center of your attention for that moment. Take any threats of suicide seriously and get them to seek help immediately. Think carefully about what you post, or say about that person to others. It will often be seen as a breach of trust and at the very least make that person uncomfortable, especially if they haven’t gone public with their illness.

These steps are good for talking to anyone, not just a depressive or mentally ill person. So next time you say “Hey! How are you?” to someone, be genuinely interested in their answer. You never know how much of a difference that could make.

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