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.

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What’s In A Name?

When you are first diagnosed with a mental illness, it can be very confusing regarding the number of people you are going to meet on your journey to better health. All of these people are here to help you, but what exactly are the psychologists, psychiatrists, and therapists doing to help you? Here is a short guide on the difference between all the medical professionals you will meet when you are diagnosed with a mental illness.

A psychotherapist is an umbrella term for any professional trained to treat people for their emotional issues. A psychotherapist can be a psychologist, social worker, counselor, or psychiatrist.

A psychologist is an expert in the field of psychology which is the “science of the mind or of mental states and process”. Psychologists have to attend graduate school and obtain their doctoral degree, a PhD or PsyD. The difference between a PhD and PsyD, is that PsyD psychologists are trained specifically for clinical work, while PhD often focus on research. Psychologists often have to complete years of internships to gain further training and experience. They also must be licensed by their state boards of psychology. Psychologists are not medical doctors and can not prescribe medication. Psychologists are licensed to do counseling, psychotherapy, and provide treatment for mental disorders.

A psychiatrist is a medical doctor that specializes in the diagnosis and treatment of mental illness via medication. A psychiatrist usually has 4 years of medical school, followed by an internship and residency. They have a M.D. A psychiatrist can write prescriptions for medication. Psychiatrists must be licensed as a medical doctor in their state of residency. They must also pass the American Board of Psychiatry and Neurology’s Psychiatry Certification Examination. Many psychiatrists have a special focus such as major depressive disorder, schizophrenia or bipolar disorder. They will often work together with a psychologist to provide treatment for mental illness.

A therapist is a person trained in psychological methods to help patients. Therapists can be psychoanalysts, marriage counselors, social workers and life coaches among others. A therapist provides support and guidance and helps patients make decisions and clarify feelings to solve problems. Selecting a therapist is a personal experience. You should always feel comfortable and welcomed by your therapist, but also consider their licensing and professional credentials. It may take time to find the right therapist for you, so feel free to shop around for the right fit.

A licensed mental health counselor has at least a master’s degree in psychology or counseling. They are focused solely on providing therapy to individuals, families or couples. The mental health counselor has to have 2 years of additional experience working with a mental health professional after graduate school in order to be licensed. They are qualified to evaluate and treat mental health problems, with much of the emphasis on working with problems of normal living rather than mental illness.

A clinical social worker has at least a master’s degree in social work and very specialized training. Social workers provide case management and hospital discharge planning. They can also act as an advocate for the patients. Some social workers also practice psychotherapy. There are many different types of licensure depending on the state in which they are licensed.

Psychiatric or mental health nurses have specialized training in providing mental health services. They often work with the doctors to form an individualized therapy and medication program for their patients. Some nurses can prescribe and monitor medications depending on the states where they practice.

Here is a quick cheat sheet for clarification:

Psychologist Therapists Psychiatrist
  • Advanced degree in psychology
  • Does research or therapy
  • Diagnose disorders or problems with patients
  • Determine appropriate treatments
  • Work in tandem with psychiatrist
  • Help patients make decisions & clarify feelings
  • Provide support & guidance
  • Includes psychologists, psychiatrists, counselors, life coaches & social workers
  • Any number of degrees or certifications
  • Help patients make decisions & clarify feelings
  • Provide support & guidance
  • Medical degree
  • Does research or therapy
  • Diagnose disorders or problems with patients
  • Determine appropriate treatments
  • Work in tandem with psychologist
  • Prescribes medication
  • Help patients make decisions & clarify feelings
  • Provide support & guidance

 

http://www.webmd.com/mental-health/features/psychology-vs-psychiatry-which-is-better

http://www.webmd.com/mental-health/guide-to-psychiatry-and-counseling

http://education-portal.com/articles/Psychologist_vs_Psychiatrist_Whats_the_Difference.html

http://www.allpsychologyschools.com/psychology-careers/article/differences-therapist-psychologist/

https://www.psychologytoday.com/blog/couch-meets-world/201107/psychiatrist-psychotherapist-whos-who-in-mental-health

 

Rumination

Rumination is the continuous dwelling on issues in our past and difficulties and things that distress us in the present. It is becoming preoccupied with something and not being able to get it out of your mind. There is helpful and unhelpful rumination. The problem comes when you are focusing on what has gone wrong and this leads to negative thinking. Too much negative thinking can lead to depression and maintaining a depressive episode.

Rumination is normal because everyone dwells on their problems to a point. It’s when the circular thinking patterns that are rumination continue in overdrive, that it becomes a problem. Rumination is different than worry in than worry is future focused and often leads to anxiety. Rumination is past focused and leads to depression. Rumination is a learnt strategy for dealing with our problems however unhelpful rumination can lead to inactivity and avoidance of problem-solving.

Unhelpful rumination Helpful rumination
  • Ask my “why…?” questions
  • (Evaluative mode)
  • Why questions tend to focus on the problem, its causes and it consequences
  • “What did I do to deserve this?” & “Will my life ever get better?”
  • Is continuous
  • Asks more “How…?” questions
  • (Process-focused mode)
  • How questions tend to focus on solving problems
  • “How can I make my life better?”
  • Is time-limited. It stops when the problem is solved

One of the biggest strategies for unhelpful rumination is accepting the situation and being mindful in the present moment. Mindfulness is the most useful coping skill for dealing with depression and will be discussed in a future post.

There are many steps to stopping rumination. Some examples would be accepting your situation, being aware that you are ruminating, or distracting yourself. Please follow this link for a list on 11 Steps to Stop Ruminating.

Remember rumination can be helpful if it is time-limited and problem-solving. However, unhelpful rumination can cause and continue depression, so it is better to find ways to stop rumination if you want to continue your road of recovery.

http://jayuhdinger.com/chapters/chapter-3-practice-11-steps-to-stop-ruminating/

http://jayuhdinger.com/chapters/chapter-2-rumination-faulty-thinking/

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.

Cognitive Distortions: Fixes

Now that we know what cognitive distortions are and how this way of automatic thinking affects our moods, we must now find a way to counteract and change these thought processes. Here is a list of the cognitive distortions and steps that you can take to prevent  these types of thinking.

  1. All or nothing thinking
    1. Instead of categorizing things in black and white, try rating them on a scale from 1-10. By rating the situation, you are considering all sides instead of instantly picking a side.
  2. Overgeneralization
    1. Instead of making a judgment and reacting on that, view the evidence. Examine how others are behaving to the situation and why. Is there another perspective?
  3. Mental filter
    1. Am I only noticing the bad stuff? Am I filtering out the positives? What would be more realistic?
  4. Disqualifying the positive
    1. Am I exaggerating my negatives and minimizing the positives? How would someone else see it? What’s the bigger picture? It can also be helpful to minimize social media usage, where we compare our worst to other people’s best.
  5. Jumping to conclusions
    1. Mind reading
      1. Am I assuming I know what others are thinking? What’s the evidence? Those are my own thoughts, not theirs. Is there another, more balanced way of looking at it?
    2. Fortune teller error
      1. Am I thinking that I can predict the future? How likely is it that that might really happen?
  6. Magnification
    1. Thinking that the worst possible thing will definitely happen isn’t helpful right now. Ask yourself, “ what’s most likely to happen?”
  7. Emotional reasoning
    1. Just because it feels bad, doesn’t necessarily mean it is bad. My feelings are just a reaction to my thoughts – and thoughts are just automatic brain reflexes.
  8. Absolute Statements
    1. Am I putting more pressure on myself, setting up expectations of myself that are almost impossible? What would be more realistic? Avoid using words that have no meaning. Please see the list at the end of this article which shows what words are more helpful than others.
  9. Labeling & Mislabeling
    1. Instead of labeling the situation, look at the evidence. Also avoid double standards, these will only make a situation worse.
  10. Personalization
    1. Would most people who really know me say that about me? Is this something that I am totally responsible for? Instead of blaming yourself or another person, consider the circumstances. Look at the situation and view the evidence.
  11. Memories
    1. This is just a reminder of the past. That was then, and this is now. Even though this memory makes me feel upset, it’s not actually happening again right now.

 

Replace… with…
Should Like or Want
Should not Do not Like or Want
Have to Would Like
Must Wish
Must not Wish would not
Deserve Desire
Always Usually/Frequently
Forever Until/Unless
Never Rarely
Awful Disagreeable
Horrible Unfortunate
Terrible Unfavorable
Perfect Successful

http://jayuhdinger.com/chapters/faulty-thinking/

http://getselfhelp.co.uk/docs/FindingAlternativeThoughts.pdf

 

Cognitive Disorders

Cognitive Distortions are thoughts that cause reality to be inaccurately perceived. These inaccurate thoughts are usually reinforcing negative thoughts or emotions. This can lead to an anxious or depressive mental state when they combine to give an individual a negative outlook on their world. Cognitive distortions are also known as automatic thoughts. These thoughts are ingrained in individuals and affect the way they think. It takes time and patience to overcome these automatic distortions.

Here is a list of just a few of these distortions.

  1. All or nothing thinking:
    1. Also known as black and white thinking, it is ignoring all forms of in between or the ‘shades of grey’. This thinking also involves using absolute terms like ‘always’, ‘every’ or ‘never’. The thing to remember is that there is usually some grey in a situation and all or nothing thinking leads an individual to ignoring that.
  2. Overgeneralization
    1. Also known as categorizing, it is placing judgements or evaluations on an event, person or thing rather than describing the item or person. This thinking usually involves absolute terms such as ‘always’ or ‘never’. Overgeneralization causes individuals to ignore the facts and evidence in favor of their distorted vision.
  3. Mental filter
    1. This filter allows an individual to focus on a single detail (usually negative), about an event or person so that they overlook any positive. This thinking blocks out what doesn’t ‘fit’ with our ‘filter’ and is also known as looking through dark blinkers or ‘gloomy specs’. A mental filter causes individuals to ignore the positive or anything outside of what that filter provides.
  4. Disqualifying the positive
    1. This distortion causes individuals to overlook their positive experiences in favor of negative ones. It is also known as compare and despair, seeing only the good and positive aspects in others and comparing ourselves negatively against them. This can often be seen via Facebook, where people compare their everyday life to their friend’s ‘highlights reel’.
  5. Jumping to conclusions
    1. Mind reading
      1. Mind reading is assuming we know what other people are thinking, usually about ourselves. This distortion causes people to believe they can predict a person’s reaction or attitude.
    2. Fortune teller error
      1. Fortune teller error is assuming that a situation is going to end negatively despite lack of evidence. This can also be known as a self-fulfilling prophecy; because you assume a situation won’t end well, oftentimes it doesn’t because of that mindset.
  6. Magnification
    1. Also known as exaggeration or catastrophizing, this distortion causes individuals to overlook the one side in favor of the other. For example, overlooking the negative in a person by exaggerating the positive. It’s also known as making mountains out of molehills or imagining and believing that the worst possible thing will happen.
  7. Emotional reasoning
    1. This distortion causes individuals to take feelings as fact and base your decisions and actions on them. An example would be ‘I feel bad so it must be bad’. Individuals use this distortion to often put off doing something because they don’t ‘feel’ like doing it.
  8. Absolute Statements
    1. Absolute statements are words such as ‘should’, ‘must’, or ‘ought’. These statements raise expectations, and if these expectations are not met anger, frustration and disappointment occur. Absolute statements set up unrealistic expectations and can make people feel guilty.
  9. Labeling & Mislabeling
    1. Labeling is another form of black and white thinking. This is done by assigning either good or bad labels to yourself or other people. Again, there are no shades of grey and outside circumstances are not taken into consideration.
  10. Personalization
    1. Personalization is blaming yourself or taking responsibility for something that wasn’t your fault. Blaming others for something that is your fault, also falls under this category. This distortion is taking things personally when perhaps they didn’t involve you in the first place.
  11. Memories
    1. This distortion is when current situations or events trigger upsetting memories and lead you to believe that the danger is in the present rather than in the past. This causes distress in the present when the situation isn’t in the present, but in the past.

Perhaps after reading through these cognitive distortions, you realize that your way of thinking tends to lean towards these distortions. The first step to fixing these distortions is to realize that you have them. Please read the following article, Cognitive Distortions: Fixing the Problems for information on how to retrain your thinking away from distorted thoughts.

 

Cognitive Distortions

From: The Feeling Good Handbook

By: Dr. David Burns

 

http://jayuhdinger.com/chapters/faulty-thinking/

http://getselfhelp.co.uk/docs/AutomaticThoughts.pdf

http://getselfhelp.co.uk/docs/UnhelpfulThinkingHabits.pdf

http://getselfhelp.co.uk/docs/FindingAlternativeThoughts.pdf

 

Sleep: It’s Important!

We all grew up knowing that sleep is important. It helps us rejuvenate our bodies for another active day. But why is sleep so important for depressives? Sleep helps our bodies feel better and when we feel better, our minds are less likely to be as negative. The more tired we are, the worse our thoughts get.So here are some quick tips for better sleep.

  • Avoid naps during the day.
  • Sleep only as much as you need.
  • Exercise regularly.
  • Avoid excessive liquids in the evening and cut down on all caffeinated products.
  • Avoid watching television in bed and using a device with a bright screen (e.g. a smartphone, laptop) an hour before bed.
  • If you can’t fall asleep, get about and do something relaxing then try again later.

Remember to make your bedroom a pleasant place to be. Make it dark, make sure the bed is comfortable and make sure the room is a comfortable temperature. These conditions will help you enjoy better sleep.

These are just a few suggestions for enjoying better sleep. Please view the link below for more guidelines for better sleep.

http://media.psychology.tools/worksheets/english_us/guidelines_for_better_sleep_en-us.pdf