“Dear Man”

In an earlier post, ‘DBT: The Skills’, DEAR MAN is used in objectiveness effectiveness as part of interpersonal effectiveness. Interpersonal effectiveness is described as the ability to increase the changes that will help you reach the outcome you are looking for in a specific situation, while not hurting the relationship you have with others or losing self-respect.

DEAR MAN is useful in situations in which you are asking for what you want or refusing a request from someone else. It is also useful for those with depression or mental illness because it is an effective way to communicate your emotions, your wishes and desires and allow you to negotiate a possibly tenuous situation.

DEAR MAN stands for:

Describe

Express

Assert

Reinforce

 

Mindful

Appear confident

Negotiate

Describe the current situation. Tell the person exactly what you are reacting to and stick to the facts. By doing this, you are making clear your perception of the situation but you aren’t coloring it with your feelings, but sticking only to the facts.

Express your feelings and opinions about the situation. Assume that others cannot read your mind and know how you feel. Don’t expect others to know how hard it is for you to ask directly for what you want or to refuse. Use ‘I want’ or ‘I don’t want’ statements instead of ‘I need’, or ‘you should’.

Assert yourself. Ask for what you want or say no clearly. Assume that others will not figure out what you want unless you ask. Don’t assume that others can read minds. And don’t expect others to know how hard it is for you to ask directly for what you want.

Reinforce the person ahead of time by explaining the consequences or the reward. Tell the person the positive effects of getting what you want or need. Also tell the person, if necessary, the negative effects of getting what you want or need. Help the person feel good ahead of time for doing or accepting what you want.

Mindfully keep your focus on your objectives. Maintain your position and don’t be distracted. Keep asking, or keep saying no, if necessary, express your opinion over and over, rewording but staying on point. Ignore the person if they attack, threaten, or try to change the subject and ignore any attempt to divert you from your goal. Don’t respond to attacks and just keep making your point!

Appear confident by using a confident tone and physical manner; make good eye contact. Appear effective and confident. Don’t stammer, whisper, stare at the floor, retreat or say things like ‘I’m not sure’ etc.

Negotiate by being willing to give to get. Maintain your point, but offer and ask for alternative solutions to the problem and ask what the other person is willing to do to fix the problem. Stick to simple things and make your goals realistic. Focus on what will work. What am I willing to ‘settle for’ or ‘give up’ in order to gain what I want in the situation?

Sometimes it helps to write out DEAR MAN for specific situations so you know what to say and how to say it. A more simplified version of DEAR MAN is: “I feel ______ when you ________. I want _______.”

Using ‘I feel’ and ‘I want’ can be difficult, but by phrasing your requests in this manner, you are refraining from accusations which can make people feel attacked.

I have also attached a form that can help you use DEAR MAN in real life situations.

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2015 Mental Health Awareness Month Speech

I would first like to begin by giving a trigger warning. I will be talking about mental health and depression and I realize that this may be triggering for some people. If that is the case, I would advise you to leave for the duration of my speech. Also, please note that the pastors and I will be available to talk about this subject after church (event).

Before I get started, I would like for all of you to imagine your worst day ever. Your alarm didn’t go off, so you barely have time to get ready. You struggle to get the kids ready for school. Your car won’t start and you’re late to work. At work, or if you’re in school maybe someone starts digging at you about a project, they’re making fun of you or yelling at you. You start thinking about all of the things you have to do, at work, at home and everything in-between. Do you remember how that felt? (Ask for opinions from audience.)You felt anger, sad, frustrated, lost, lonely, down, stressed, overwhelmed.  That is essentially how someone suffering from depression feels on a normal day.

How would I know? My name is Talia Malon and I know that I seem like your normal, average 20-something year old. I look healthy, however I am clinically diagnosed with depression and anxiety. I also have avoidant personality disorder tendencies. I have been in therapy for over 4 years and I was only recently discharged from an outpatient treatment program for mental health.  I’m here to talk to you about depression because May is Mental Health Awareness month (mental awareness is important) and I want you to understand mental illnesses. I want you to understand that I wake up fighting a battle everyday whether I am at work, at home or out with friends. Each day may be a battle where I am under siege for every waking hour but I am determined to win this war, because there is only one other alternative.

Depression is defined by the Mayo Clinic as, “a mood disorder that causes a persistent feeling of sadness and loss of interest…. It affects how you feel, think and believe and can lead to a variety of emotional and physical problems.” While this definition works for the health institutions around the world, I find that there is an easier and more forthright definition. “Mental illnesses are diseases. Depression is a disease.” It is a disease of the mind and it’s not easy to physically see unlike cancer but nonetheless, it is a disease. “This disease affects approximately one in four adults” (NAMI). You can die from it. People have died from depression. The most recently notable, would be Robin Williams. The coroner’s report may say suicide, but honestly he died from depression. “Suicide is the 10th leading cause of death in the US and more than 90% of those who die by suicide had a mental disorder” (NAMI).

Trying to explain depression is like trying to teach physics to preschoolers; it’s virtually impossible because depression affects everyone differently which makes it so hard to describe. It’s hard to explain the numbness you feel, the uncaring, sadness, frustration, loneliness, worthlessness, etc. But what I can tell you is that depression lies. It’s like a bully, but it is able to reach into the darkest places of your mind and use it against you. .It magnifies every negative thought I’ve ever had about myself.  And it does so continuously. I won’t just ‘get better’ one day. It’s a continuous struggle between me and my brain. My therapist at Linden Oaks calls it a committee. This committee is my depression. It’s sitting in the back of my mind constantly, so I have to be careful because I know that there is something self destructive in me. Martha Manning, clinical psychologist and writer says, “Depression is such a cruel punishment. There are no fevers, no rashes, no blood tests to send people scurrying in concern, just the slow erosion of self, as insidious as cancer. And like cancer, it is essentially a solitary experience; a room in hell with only your name on the door.”

Mental illnesses are also invisible diseases. You can’t tell by looking at someone whether they have these diseases or not. Often times, we make split second decisions about a person without speaking a word to them, without knowing them at all. We don’t know if they are suffering from bipolar disorder, anxiety, depression or any other illnesses or issues, but we have already judged them based on their looks, their behaviors and their actions. I feel that this is an issue, because honestly, people with mental illnesses can’t help the way they think. As an individual with depression, there is something chemically wrong in my brain that affects my thinking and I cannot fix that on my own. As Trisha Goddard, a British actress and TV personality said, “Cancer is not the worst thing I’ve faced – that was depression. With depression, nobody brings you flowers, and the doctors can’t operate and tell you, you’ll be free of the disease within weeks.” (and she would know, she has suffered from both)

So what can you do? You can be part of a support group for someone with mental illness. You can help them and be there for them. Ask them how they are doing and really mean it. Sometimes there is nothing that will make them feel better. Sometimes there are only  things that will make it worse. You can not ‘fix’ them or cure them of their mental illness anymore than you can cure a person of leukemia. I feel that it is best understood in the words of one of my supporters. “I support Sara fully, no matter what. Even though I have feelings similar to hers, I still have trouble remembering that her thoughts of worst case scenario are not by choice.  I get frustrated talking with her. I get angry sometimes and just want to explode. But I take a moment to remember how I’ve felt and how she must feel; a million times worse. I take solace in knowing that I can be there for her. No matter what. If you know someone with depression, take the time to educate yourself. Listen to them, no matter how frustrating it can be, and give them a shoulder to cry on.  Don’t bother asking them what’s wrong because they probably don’t know. Just let them talk. Be their supporter. You could be the only motivation they have to do anything.”

Coming here to speak to you today is the first small step towards my ultimate goal.  These are the first steps as I try to start a non-profit organization for education, awareness and tolerance on mental illnesses.  I have named this foundation ADAPT; Advocates for Depression Awareness, Progress and Tolerance. I felt that this name was fitting because when you make the decision to be the supporter of somebody suffering from a mental illness, you have to adapt. Depressives also have to adapt as they try to cope with their illness. Both sides have to adapt their viewpoint and adapt how they interact with others.  Educating yourself and becoming an active supporter of someone with a mental illness may save a life.

In closing, I would also like to encourage you to take care of your mental health. It is just as important as your physical health and it can be anything from taking a break from life and going for a walk outside to talking out a troubling situation with a friend to getting therapy for even a couple of sessions. I encourage those with depression to keep holding on. You are not alone and this may be the hardest fight of your life, but it is also one of the most important. We are here for you. Please visit my blog for more information on depression, how you can help and how you can find help. Thank you.

 

My Social Environment

I don’t do well in social environments in fact, I downright suck at them. I always feel awkward, like I don’t fit in. I never feel like I’m part of the group, but just hanging on by my fingertips.

Social environments have always been hard for me. I didn’t thrive, socially, in school. I usually had one or two close friends and many acquaintances. I remember times when I would be chasing after the popular group of girls, wanting them to accept me but never being accepted. This hurt, but I never considered it to be my fault. When I was younger, I just accepted it as status quo and I was ok with that. I had friends elsewhere and I never had to worry about having friends to hang out with.

As I grew older and entered high school, I never found my niche. I was involved, with my classes, with choir and theater, but I never quite fit in. It was the same story, feeling like I was on the outside looking in. I was never invited to events unless it was a group thing and while this bugged me every once and awhile, I was too busy for the most part to care. I may not have felt like I fit in but I was involved enough not to care.

College was a disaster for me. Everyone thought I would thrive in a college environment, at this point, I feel like I did everything but thrive. I feel like I crashed and burned. I had many issues with roommates and by the time I left college 3 years in, I hadn’t made any serious friends. In fact, the only thing I had done throughout college was lose friends. As I said, not a good experience for me.

Today, I have 2 friends, one of which is an ex-boyfriend while the other is my current boyfriend. I don’t know what they see that no one else can be I’m grateful that they do. My social environment still sucks. I don’t really get out, but then again I don’t enjoy doing the things normal 20-year-olds do, like drinking every weekend. But I do want to have fun. I want to hang out with people and do things, I just can’t find the people to do things with and I don’t even know how to go about meeting people at this point. I wish I could make friends but my depression makes that nearly impossible, so maybe if I get better, my social environment will change for the better.

My Story Part 8

This is a continuation, part 8, of my daily journal of life after outpatient treatment for depression, and anxiety. Please click for Part 1Part 2Part 3, Part 4, Part 5, Part 6, and Part 7.

Part 8, Day 1:

I’ve been so tired lately. I have a feeling this job is starting to take its toll on me. Working overnights and sleeping during the day is harder than I thought it would be. My new puppy has been driving me crazy lately. She won’t listen to me at all! It’s very frustrating and on top of being tired all of the time my patience is at an all time low. I need a break.

Day 6:

I’m nervous about this upcoming vacation/wedding. Things are tense with this side of the family, so it could be an interesting trip. The BF and I are killing two birds with one stone by going camping instead of staying at the hotel. It gives us a little  more room, more privacy, and this way I get to bring the new puppy with. Hopefully there is no bloodshed at the wedding and everyone is on their best behavior

Day 12:

The wedding/camping trip went very well. My cousin (the one who got married) and I had an interesting heart-to-heart and he told me that he only wants me to be happy. Of course, he and I were more than a little drunk when this occurred. I spent most of the reception getting drunk but had a lot of fun. I caught the bouquet, but I’m definitely not the next person getting married. That would be my other cousin. Unfortunately, I can’t go to his wedding because I have to work. I’ll be working 10 days in a row now because of this vacation and my next trip. This could be interesting.

Day 18:

I’m heading to my grandparents’ house this week. They live on a lake and I love it up there. It is so peaceful. Plus, being born a Pisces, I love the water. It’ll be fun spending the ‘weekend’ during the work week with my boyfriend in a place that I love. I am a little worried because sometimes I get cornered and have to discuss (or receive someone’s opinion) about a topic I would rather not talk about, but all in all it should be nice. When we get back, I’m going to help my best friend with his fundraiser and meet his new girlfriend. I’m a little worried about that, but then again, I worry a lot anyway.

Day 23:

The trip was amazing although the weather did not cooperate. We (the BF and I), ended up going to a couple of wineries because the weather was bad. This brings our total to 15 wineries in 3 months!! Good thing it’s something we like to do! We had nicer weather on the last full day before we left. We spent the day on the beach. My puppy wasn’t very happy because I wouldn’t let her out of her crate, but she had just gotten spayed and I didn’t want to risk infection. When we go up in 2 weeks, I’ll let her out and see what she does in the water. I have a feeling she’ll love it as much as I do!

The fundraiser was an interesting day. He ended up not needing my help which made me feel useless and unwanted. Plus, it seemed like I was ignored by everyone there like I was the plague. I felt like a social pariah. I met his new girlfriend and she seems nice, but I don’t think she likes me very much. Of course my BF says ‘you only said two words to her!’ but some things you can just feel. I hope this doesn’t cause problems between me and my best friend!

Please stay tuned for Part 8. Here are the links for Part 1Part 2Part 3, Part 4, Part 5, Part 6, and Part 7.

The Trouble with Psychiatrists & Doctors

Until my stint in outpatient treatment, I had my fair share of struggles with psychiatrists. I often felt like they weren’t listening to what I was saying. And out of the 3 that I had seen, the 5 different medications they had prescribed hadn’t worked.

With the initial psychiatrists I had seen, I felt ignored. You walked in for a 15 minute session, perhaps a 30 minute initial session and you talk to them. They ask you how you feel, and you give them some background history on your mental illness. At the end of that 15 minutes, they either up your dose, change your medication or tell you to continue taking it. This often frustrated me, because I would be told to continue taking something that I felt wasn’t working.

I’ll admit that a psychiatrist’s job isn’t easy. There are no tests that they can perform to find out exactly what medication you need to take for your illness. It’s all guess work based on what you tell them; trying to figure out which receptors in your brain are working overtime or are not working at all. But it’s still frustrating trying different types of medications and having them not work or getting viciously sick on them because of the way they are interacting with your body.

My previous therapist had heard so many complaints about psychiatrists and medication that she decided to go back to school to become an APN, or nurse practitioner. She felt that because she saw her clients weekly, it would be easier for her to prescribe a medication that would work for them. I think this is admirable because at the age of 50, she is going back to school and getting her bachelor’s, master’s and doctorate to become a nurse practitioner.

Now that I’ve finally found a medication that works, I feel better. I’m not so down anymore. I’m glad I followed my doctor’s directives at the outpatient center and I’m glad that I’ve found someone who listens to me.

If you don’t feel like your doctor is listening to you or if a treatment plan isn’t working, speak up. Try and explain to them how you feel or, look for another doctor. You’re allowed to see other doctors. Find a fit that works for you and will provide the best treatment so that you can recover. Be proactive, it’s your health that’s at risk.

My Story: Part 7

This is a continuation, part 7, of my daily journal of life after outpatient treatment for depression, and anxiety. Please click for Part 1Part 2Part 3, Part 4, Part 5, and Part 6.

Part 7, Day 1,:

Vacation was amazing!! I lived in the moment and all of my stress and depression melted away. I felt so good on vacation. Of course, the minute I walked through my door at home, everything came crashing down onto my shoulders. So I guess I need to learn how to live like I’m on vacation. That’s easier said than done.

Day 5:

So I’ve decided to get a dog, or more specifically an emotional support animal. I’ve been putting it off lately, but I’ve finally decided that it’s now or never. I can’t keep waiting forever. I’m looking forward to having an emotional support animal. Hopefully it will help me with my depression.

On the flip side, learning to live like I’m on vacation is not an easy task. I’m struggling with it. I was so happy and living in the moment while on vacation and now that I’m home, everything is getting to me. I feel like I’m upset every other day. I wish my depression would get better. Hopefully a dog will help.

Day 12:

Today was a horrible day. I spent most of the day crying. First, I found out that the third dog that I was interested in was no longer available for adoption. Then, I found out that my best friend had changed his plans, making me feel like he had lied to me. Normally, we get lunch or dinner every Thursday, but today I feel like he is blowing me off. I feel like I’m not important or wanted.

All of which is a little ridiculous, because my boyfriend was hanging out with me today so it should have been a good day. At least he lets me use his shoulder to cry on. He even cried a little because I was so upset and he hates seeing me that way. He can be so cute. Of course, I cried when he left. I hate when he leaves. I know I’ll see him again, but I hate that we only get to see each other twice a week. I wish we could be together more.

Day 15:

It’s hard to stay angry at your best friend when he does nice things for you. I’ve been angry at him ever since I felt like he lied to me. But today, he might have found me a puppy and then he stopped by my work on his way home just to say hi. It was very nice of him and I made sure he knew that I appreciated it. It’s just been a struggle with him having a new girlfriend. I feel forgotten until he suddenly decides to do something to show me that I still exist in his life. I just wish those gestures weren’t so few and far between. That can make it difficult to remember.

Day 18:

I got the puppy!!! I was so nervous that my application was going to get turned down. I went and visited them yesterday, but they didn’t have any of the unadopted puppies in so I was told to come back tomorrow. Boy, was I surprised when she asked me if I wanted to take the puppy home with me that day. I wasn’t ready at all!! I had to ask my mom to puppy-sit so I could go get everything I need for her. I’m sure she’ll be a handful but it’ll be so nice having a dog to come home to. I can’t wait to train her!!!

Please stay tuned for Part 8. Here are the links for Part 1Part 2Part 3, Part 4, Part 5, and Part 6.

Reprogramming Me: My Issues & My Struggles

According to the doctors, I have ingrained personality traits that are causing my depression. This means that I have learned certain ways of thinking and doing things that are actually part of the problem. This basically means that I have to learn how to reprogram my ways of thinking and my outlook on the world. Here are a couple of things they believe I need to work on:

  1. Mindfulness
    1. I’m not very mindful. I’m constantly reviewing the past or worrying about the future, so I have a very hard time being present. I need to learn to stay in the moment and be mindful, to pay attention to what is going on around me and to what I am doing in the moment.
  2. Quick Fix
    1. I want a quick fix to everything. I don’t want to have to struggle for answers or solutions to problems, I just want them fixed immediately.
  3. Catastrophize
    1. This is one of a couple cognitive distortions that I have. I tend to view situations in the worst possible light and look for the worst possible situation to occur. You can read about Cognitive Distortions here.
  4. Avoidance and Fixations
    1. I tend to avoid situations that I don’t want to deal with and fixate on things I shouldn’t.
  5. Negative outlook and worst case scenario
    1. I tend to have a negative outlook on life and believe that the worst possible scenario will occur.
  6. Expectation for things to go my way, or the way I plan.
    1. I have an expectation for things to go the way I plan and for everything to work out exactly as I specify. This is often not the case, and I can get extremely upset when the plans I have made go awry.
  7. Fixation on connection.
    1. Because of a lack of friendships, I have a fixation on connection. I yearn to connect with people and make friends. Oftentimes this connection causes me more harm because I form connections quickly and often believe I have a close friendship with someone who may only consider me as a passing friend.
  8. I also need to explore why group social settings are so uncomfortable
    1. Despite my need for connection, I have a hard time thriving in a group social setting. I need to explore why this is the case. I yearn for connection, but feel uncomfortable in group settings. Why?

I also have issues with my primary support group (my family) which I have discussed here and problems related to social environment which I will be discussing in a later post.

Some of the ways the doctors and therapists have suggested that I work on these issues is by focusing on and accepting myself. I’m holding onto ideals and an old relationship with myself that is only hurting me now. By focusing on myself, something I’m not very good at, I can form a new relationship and connection with myself that will make me a stronger person, and help me fight depression

All of these problems are works in progress and I will continue to update you on my progress in my journey to mental healthiness.