“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.

 

The Word “Should”

While in therapy, we talked about the word ‘should’. Because of this discussion, it is my honest belief that ‘should’ is one of the worst words in the English language. The word should is defined as used to indicate duty, propriety, or expediency. I think it’s easier to say that the word should most often is used to place guilt or blame. We say someone should do something because that is our opinion however our opinion, while it might have some weight based on our relationship with that person, can’t be the deciding factor for someone to do something. Instead, should is used to indicate blame or lay guilt if the person doesn’t do what we say they ‘should’.

A good replacement for the word should, is like or want. “I would like you to…” rather than “You should…” By replacing should with like you are stating your opinion rather than placing blame or guilt. I’m not saying that the word be removed from our language entirely because there are some instances when it is appropriate to use. However, when it is used to place guilt or blame, it can hurt or harm another person.

So lately, I have been attempting to remove the word ‘should’ from my vocabulary. It’s proven harder than I thought. In just writing this post, I’ve had to rethink how to word sentences because I would normally use the word ‘should’. But this exercise has taught me that is important to think about what you say before you say it. You never know how what you say may affect another person.

 

Control

“We first make our habits, then our habits make us.” – Charles C. Noble

We all have a desire to control our lives. We feel helpless when we feel like our lives are not in control, and the problem comes when we can’t let go of that control. The only thing we can control is our behaviors and actions. We can’t control other people, certain situations and their behaviors. Anxiety comes from the worry that we have because of the uncertainty of our situations. By letting go of our need for control, we can find some peace within our lives.

We have a number of choices when it comes to letting go of control. We can accept people as they are and let go of our need to ‘fix’ them. We can let go of the ‘victim’ role within relationships. Be strong enough to get your emotional needs met. Let go of your ‘shoulds’ for people and yourself. Should implies guilt and shame. Read more about Should here. See other people as having wounds, not faults. Realize that the only ‘failed’ relationship is one that you didn’t learn from. Often failed relationships are helpful life lessons. Choose to see the love and the good in other people and yourself. We also need to let go of a thirst for approval, super competitive-comparative mode (comparing yourself to others) and relying too much on other people.

You can understand more about yourself and where your need for control comes into play, by asking yourself two questions. What are three unhealthy habits in your life? And what are you willing to do to break these habits?

In the end, you have to remember that all we can change is ourselves. “It is as it is.” So if you’re having trouble remembering this, ask yourself these four questions:

  1. How much control do I have? What is outside my control?
  2. “It is as it is”. I’m not agreeing with or giving up on it, but I can let it go for now
  3. If I can’t change the situation, can I change the way I think or do about it?
  4. What can I do that is within my control?

 

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.

The Definition of Success

Success is defined as the accomplishment of one’s goals or a person or thing that achieves desired aims. In this definition, it doesn’t matter what your goals or aims are, you are deemed successful as long as you complete them. The goals could be short term like finishing a book or long term, like going back to school, however you are only successful if you complete these goals.

Our goals change as we grow and change. I know that I started off with one life plan only to be heading in a totally different direction once my depression hit. And while, I’ll admit that I like this plan better than the old one, I’ve discovered that my life rarely ever goes as planned. I find that even my daily plans change constantly which can be frustrating for someone who is searching for stability.

I don’t feel successful. Honestly, I feel like a total failure. I feel like I’ve let down so many people in my life because I don’t have a college degree and it doesn’t look like I’m going to get one any time soon. There are days when I feel successful because I am independent and live on my own, but because I don’t have a degree or a decent job, I feel like my family looks down on me with disapproval and disdain.

I want to be successful and I need to stop looking for approval from other people. I only need approval from myself. Do I approve of what is going on in my life? The answer is I’m not sure. I feel like I’m headed in the right direction with my dream of starting ADAPT, but I’ve had enough plans go awry to know that it might not happen the way I plan.

Do I feel successful now? No. In fact, I mostly feel like a failure, but will I continue to strive for success? Yes. I have to. There is a part of me that is constantly climbing that ladder to success and maybe someday, I’ll be able to look back on my life and say that I’m successful. I know I need to look at my life now, and say that I am a success. I am still alive, I am still fighting and I have new goals to accomplishment. I am successful because I am alive despite a disease that kills so many, but I don’t feel successful. Hopefully one day, I will.

 

How to Deal With Being Mentally Ill Part II

So you’ve just been diagnosed with a mental illness. You’re scared, you don’t know what to do and you don’t know what other people are going to think of you now. You feel like you’ve been labeled and this label only makes you feel worse. Don’t worry, I’m here to help. Here are some things you should know.

I’d like to first describe depression for you. Depression is like your high school bully. Except, unlike that bully who is taking stabs in the dark trying to find what to say to hurt you the most, the depression is in our mind and knows exactly what to say. It pulls out everything we don’t like or that we think is not good enough about ourselves and shouts it at us just like that high school bully would. The depression knows exactly which nerve to strike. And while you can walk away from your high school bully, you can’t walk away from your mind and the depression that preys on it.

So you’re probably going to need medication and therapy. This doesn’t make you a bad person. In fact, this makes you a better person. You are doing what you need to do to be healthy. Medication will help fix the chemical imbalance in your brain. It’s necessary just like the treatment needed for cancer and you shouldn’t be ashamed to have a little help. This fight is just as important as fighting cancer, or any other sickness.

Your next step would be to find a therapist. Make sure you find someone that you like and whom you feel comfortable talking to. They are there to help you. Don’t be ashamed of asking for a little help. These are trained professionals who deal with mental illness on a daily basis. They want to help you and they want to help you help yourself. Learn what works best for you. Everyone’s struggle is different. You’ll have to learn of your triggers and warning signs and figure out what coping skills work best for you.

Mental illness isn’t easy. It is a disease of the mind. It is something you might have to work against for the rest of your life, but you are not alone. I urge you to seek out groups in your area for people with mental illness. Depression often makes you feel isolated, so hearing of other people’s struggles will remind you that you are not alone.

And I am here for you. If you need to talk, please don’t hesitate to message me. I understand the struggle you’re facing and how much of an upward battle it can seem like. I am facing it myself, every day. Just remember, you are not alone and you can do this. Win your fight!

 

How to Deal With Being Mentally Ill Part I

Being diagnosed with a mental illness can seem overwhelming at first. Here are some simple tips for dealing with your mental illness.

  • Take care of yourself. Eat a healthy diet, be physically active and get plenty of sleep.
  • Get exercise. Physical activity reduces depression symptoms. Consider walking, jogging, swimming, gardening or taking up another activity that you enjoy.
  • Get plenty of sleep. Sleeping well is important for both your physical and mental well-being. If you’re having trouble sleeping, talk to your doctor about what you can do.
  • Simplify your life. Cut back on obligations when possible, and set reasonable goals for yourself. Give yourself permission to do less when you feel down.
  • Structure your time. Plan your day. You may find it helps to make a list of daily tasks, use sticky notes as reminders or use a planner to stay organized.
  • Stick to your treatment plan. Don’t skip psychotherapy sessions or appointments. Even if you’re feeling well, don’t skip your medications. If you stop, depression symptoms may come back, and you could also experience withdrawal-like symptoms.
  • Learn about depression. Education about your condition can empower you and motivate you to stick to your treatment plan. Encourage your family to learn about depression to help them understand and be more supportive of you.
  • Learn ways to relax and manage your stress. Examples include meditation, progressive muscle relaxation, yoga and tai chi.
  • Pay attention to warning signs and learn your triggers. Work with your doctor or therapist to learn what might trigger your depression symptoms. Make a plan so you know what to do if your symptoms get worse. Contact your doctor or therapist if you notice any changes in symptoms or how you feel. Ask family members or friends to help watch for warning signs.
  • Write in a journal. Journaling may improve mood by allowing you to express pain, anger, fear or other emotions.
  • Avoid alcohol and illegal drugs. It may seem like alcohol or drugs lessen depression symptoms, but in the long run they generally worsen symptoms and make depression harder to treat. Talk with your doctor or therapist if you need help with alcohol or substance abuse.
  • Locate helpful organizations. Many organizations, such as the National Alliance on Mental Illness (NAMI) and the Depression and Bipolar Support Alliance (DBSA), offer education, support groups, counseling and other resources to help with depression.
  • Don’t become isolated. Try to participate in social activities, and get together with family or friends regularly.
  • Don’t make important decisions when you’re down. Avoid decision-making when you’re feeling depressed, since you may not be thinking clearly.

http://www.mayoclinic.org/diseases-conditions/depression/basics/treatment/con-20032977

Self-Compassion

“I don’t think anyone could ever criticize me more severely than the way I viciously criticize myself.”

We are our hardest critic. Sometimes I don’t think I even know what self-compassion is. I don’t know how to be nice to myself. I can be extremely kind to strangers, but I am consistently putting myself down because I don’t feel like I’m good enough. I recently wrote this in a ‘getting it off my chest’ piece:

“I’m feeling frustrated as well. I feel like life isn’t moving fast enough for me, that it’s just dragging by. I feel like I’m going nowhere in life and doing that fast. I don’t feel like a success and I often feel like I’ll never be one and that’s all I want. I feel like I have something I have to prove to the world, and right now I’m failing at it. I want to be proud of myself, instead I find that I want to crawl into a corner and hide. How can I be proud of myself and my accomplishments, when I have depression? I think this is compounded by the fact that when I am proud of my little accomplishments, I get made fun of. I almost wrote ‘silly little accomplishments’, which tells you exactly where my frame of mind is….”

I’m being hard on myself. People tell me that I’m exactly where I need to be, but I feel like I should be somewhere else. I feel like I should be further along with my life. (And there I go using ‘should’ in regards to my life. I swear it’s the worst word in the English language.)

I need to learn to be compassionate towards myself; to give myself a little more credit. I am successful in many ways. Living alone and being independent in my early 20s, is a great accomplishment. Knowing what I want to do with my life and having the courage to work toward, albeit however slowly that may be, is also a success. I need to be nicer to myself, because I know that I am not a bad person.

So why is it I can be nice to others but not myself? Why am I so viciously cruel to myself, when I know I’m not a bad person? In some ways, it makes me better because by criticizing myself, I’m working towards being a better person. But for the most part, I need to be nicer towards myself like I am towards strangers. I’m just as good as anybody else in this world, I just have to believe it.

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Self-Compassion Exercises

How Family and Friends Can Help Those with Mental Illness

One of the many questions I get when speaking is “How can we help those with depression?” I’m so glad to hear people asking this question because it shows that they see, at least partially, the pain that their friend or family member is going through and they want to help. So here are a couple of suggestions I have gotten from friends who also suffer from mental illness.

My first response to this question is to tell the person that you are there for them. Depression and anxiety often make a person feel very alone. But these diseases can also make a person push family and friends away because they don’t believe that anyone can understand how they feel. Showing a depressed person that you are there for them by doing little things like helping around the house, can help that person start their road to recovery.

A friend with depression said this when asked what family and friends can do to help, “Invites back to life. Depression is not living. People should try to push you to resume daily life starting with fun!” She’s right. Depression is not living, depression is only an existence. By inviting a depressive out to daily events like shopping or just taking a walk, you are inviting them back to having a life.

Another way to help someone with a mental illness is to encourage them to seek professional help. Help them find a psychiatrist or therapist that they like. Make sure they are getting to their appointments and taking their meds.

The biggest gift you can give them is being nonjudgmental. They often can’t help the direction their mind is going in. By being nonjudgmental and showing understanding, you can help them stop the rumination which is a big part of depression and anxiety. The best thing you can do is be supportive and ask if there is anything they need.

Encourage them also to get involved with art, music, or anything that allows them to creatively express themselves. Expressive therapy is known to be extremely therapeutic.

It is often the smallest things that can have the biggest impact for a person with depression. Inviting them out to dinner or trying to establish some type of normalcy will help them feel much better about themselves and help pull them from the depression. For us, it’s the small things that count the most.

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