How Finding NAMI Was Pivotal to My Recovery

DEC. 13, 2021

By Rebecca Coursey

group of people

As I reflect on my recovery story, I always come back to the ways in which NAMI facilitated my progress. In 2006, when I was 26 years old, I was diagnosed with bipolar I disorder. For a long time after my diagnosis, I felt alone — like I was the only one on the planet struggling. But when I found NAMI, and became open and honest about my journey, I found my community. After that, things began to fall into place in my life.

 

Finding My Community

Four years after my diagnosis, things were seemingly going well. I had weathered many medication changes and reached a point of stability. I was even working as a preschool teacher’s aide because I wanted to help people in some way.

Then, my little sister overdosed in 2010. I fell apart; I mourned in every waking moment and even in my dreams. I didn’t want to live, but also knew the devastation that taking my life would cause my family.

A year later, I woke from a nightmare. I sat up in bed with a spiritual pull on my heart. I suddenly felt as though I needed to do something to make a difference. I began researching the next day for support groups and programs to help people with mental illness.

I contacted the local community mental health center, and they said they would allow me to host support groups in their building. However, I felt I needed to be better educated. Someone suggested I look up the National Alliance on Mental Illness (I wish I remember who so I could thank them), but after finding a group in Bowling Green, I nervously attended a NAMI Connections meeting. Just introducing myself caused heart palpitations because I rarely interacted with people outside my family.

In the group, I met successful people who lived with bipolar disorder: People with master’s degrees in social work, therapists and people who volunteered as peer support specialists. I felt like I had finally found my community. I became more involved and volunteered to be on NAMI Bowling Green’s Board. I learned about programs and completed a training that would allow me to facilitate my own NAMI Connections groups.

 

Finding My Career

After becoming a board member, a new friend introduced me to the idea of becoming a peer support specialist. I received my certification in July 2014, and soon after, I began working as the first paid peer specialist for Lifeskills, a community mental health center in Bowling Green. In 2014, I also finished my bachelor’s degree from Western Kentucky University. Getting my degree was a goal I wasn’t sure I could achieve, but I did it, and it was one of the proudest moments of my life.

I left Lifeskills after two years to work at a state psychiatric hospital; I wanted to go back to working in the community and seeing people go from struggling to living independent, self-directed lives. I’ve been there since 2017, and now I get to see others’ recovery firsthand. It is rewarding and valuable work and gives me a purpose.

 

Reflecting On My Progress

A decade or so ago, I was hopeless. I had no friends or social network, and I didn’t want to live. Now, because of NAMI, my life is completely different. I have friends and a community. I get to feel like I make a difference.

I am now the lead Family Advocate for the state of Kentucky, which promotes supportive employment programs at community mental health centers across the state. I design, write for and edit the NAMI Kentucky newsletter. Recently, I was even named Interim Chair of Bowing Green NAMI, the affiliate I first walked into years ago as a scared and downtrodden person without hope.

Now, I get to help make decisions to grow and expand NAMI Bowling Green. I co-facilitate a NAMI Connections group in a new affiliate in Butler County. I continue to work as a peer support specialist.

Now, I find joy in every day. Recovery from a mental illness is not linear, and is often a struggle, but that won’t derail my progress. I may have an episode, but I have NAMI, my friends and family, and my coworkers to support me.

Of course, I wish my little sister was still with me, but I can’t change the past. Instead, I do what I can to help others know that there is always hope. I’ll hold hope for them until they find it on their own.

 

Rebecca Coursey is the Chair of NAMI Bowling Green and cofacilitates two NAMI Connections support groups. She is a graduate of Western Kentucky University with a degree in English Literature and Writing. Rebecca will be co-facilitating a support group for students of WKU through the NAMI On Campus program in 2022. She is also a mother of two young men. She lives in Spa, Ky., on a farm with her husband, Kevin, who is her biggest supporter.

How to Prepare for Your Psychiatric Appointment

DEC. 10, 2021

By Katherine Ponte, JD, MBA, CPRP; Mark Costa, M.D., MPH; and Anthony J. Pavlo, Ph.D.

woman speaking with psychiatrist

Seeing a psychiatrist, particularly for the first time, can be intimidating. Seeking help can mean confronting the unknowns, like a possible diagnosis. Moreover, trusting a practitioner with your mental and emotional well-being puts you in a vulnerable position. While your loved ones can support you, they can’t treat you — thus, your psychiatrist holds a powerful position in your treatment.

A little preparation before your appointment, however, can go a long way. This begins with finding the confidence to self-advocate, as you are the expert in yourself. Only you can best express your goals, values and preferences, and you have the right to take an active role in your care. In fact, new research suggests that active involvement of patients in their health care may significantly enhance outcomes.

With that in mind, here’s how you can best prepare yourself for seeing a psychiatrist.

 

Do Your Research

One of the best ways to find a qualified psychiatrist is often through referrals from a talk therapist, primary care doctor or member of your support system. If you’d prefer to do your own search, you can use online directories available through mental health publications and websites like Psychology Today. Make sure to research the background and specialties of all psychiatrists you are considering to ensure that they fit your needs. Before scheduling an appointment, ask about insurance coverage.

 

Know Your Medical History

Before meeting with a psychiatrist, you may want to assemble your complete medical history. Be familiar with and ready to share any prior diagnosis, symptoms and a summary of current and past medication regimens (including doses, time periods taken and side effects). If you are unsure about your medical history, you can obtain this information from the clinician who prescribed past medications or your pharmacist.

 

Educate Yourself On The Basics

A little at-home education on mental health conditions can be extremely helpful. Read up on your condition, symptoms and possible treatment options. You won’t become an expert, but you can learn enough to ask more targeted questions.

 

Advocate For A Shared Decision-Making Treatment Approach

Shared decision-making (SDM) is a collaborative approach to making decisions about your care. SDM requires that psychiatrists, chosen family members and patients come to mutual agreement about plans for treatment. Ultimately, this approach assumes “two experts” in the room: The psychiatrist with specialized medical knowledge and the person with the expertise of their lived experience, values, preferences and goals.

You can ask your provider if they are familiar with shared decision-making and determine if they will include your thoughts and expertise when deciding about your treatment plan. Knowing up front how you will be involved in your treatment plan will help you decide whether this is the best provider for you.

 

Assess The Relationship Fit

Most likely, you do not feel comfortable with every person you meet. The same applies to working with mental health professionals. It often takes a few meetings to figure out whether you feel comfortable enough to work with someone. Connecting with your mental health professional is key — researchers have found that the quality of the therapeutic relationship (including their warmth, interest and responsiveness to your needs) has been shown to improve outcomes in psychotherapy.

After the first few appointments, it is important to consider whether you connect with your psychiatrist. Ask yourself:

  • Did you feel you comfortable talking to them?
  • Did you feel like they cared about what was important to you?
  • Did you feel like you could express what was important to you?

Difficulties in these areas could suggest that this may not be the right psychiatrist for you. Talk about your concerns with your psychiatrist and decide whether switching to someone else would better support your needs.

 

Ask Questions

An effective psychiatrist should be willing to answer any questions you have — respectfully. Dismissing your questions may be a sign that they may limit your involvement in your care. Some possible questions to pose are:

  1. What is your treatment approach?
  2. How can I be involved in my care?
  3. I would like to be treated to achieve my life goals rather than to address symptoms. What do you think of this approach?
  4. What are my medication options? Can you thoroughly explain each one, including what symptoms they will treat?
  5. Can you carefully explain any side effects, including physical impacts, such as sedation or weight gain or activity restrictions such as alcohol consumption?
  6. How can side effects be addressed? Are there any adverse impacts with the other medications I am on (if applicable)?
  7. Are you available outside appointments to address medication and other concerns, such as refills and emergencies? What’s the best way to reach you?
  8. Are you able to recommend additional resources that might be helpful for me?

 

Keep Records

In between appointments, it can be helpful to keep a log of your moods, triggers, symptoms, medication observations and any self-care practices. These trends can be useful data to evaluate with your doctor, including progress between appointments. You can also use this information to make a list of discussion points for your next appointment.

A meaningful relationship with your psychiatrist is critical to receiving the best care possible. Your psychiatrist’s role is to share their expertise to guide you on your journey, but for the best results, this relationship requires your effort and preparation as well.

 

Katherine is happily living in recovery from severe bipolar I disorder. She’s the Founder of ForLikeMinds’ mental illness peer support community, BipolarThriving: Recovery Coaching, and Psych Ward Greeting Cards. Katherine is also a Faculty Member of the Yale University Program for Recovery and Community Health and has authored ForLikeMinds: Mental Illness Recovery Insights. She is on the NAMI-NYC Board.

Mark Costa, M.D., MPH, is a psychiatrist and an Associate Research Scientist at the Yale University Program for Recovery and Community Health. He is the project coordinator of the Yale Post-Doctoral Research Training Program to Advance Competitive Integrated Employment for People with Psychiatric Disabilities.

Anthony J. Pavlo, Ph.D., is a clinical psychologist and an Associate Research Scientist at the Yale University Program for Recovery and Community Health. His research focuses on recovery-oriented and person-centered practices in mental health care, therapeutic relationships and shared decision-making for persons who are diagnosed with serious mental illnesses.

Learning to Identify and Self-Manage Mania

DEC. 08, 2021

By Max E. Guttman, LCSW

man experiencing mania at home

I first experienced mania during my sophomore year of college. My highs were mountaintop experiences filled with euphoria, drama, risky behavior, gambling, substance use and poor judgment calls.

Mania is intoxicating and can feel like a force binding all your physicality into a cauldron of energy and creativity. During a manic episode, it can seem as though you are transcending history and yet entangled into it. It can feel “right” in a way that does not make you realize that something is wrong. In other words, when going through mania, it can be hard to recognize what is happening or that medical attention is necessary.

If it weren’t for my friends in college who were constantly looking out for my safety and checking in with me every day, I would have likely dropped off the map with my risky behavior, rather than getting help.

As I know firsthand how difficult it is to identify, self-assess and manage a manic episode, I want to help others experiencing something similar. Here are my tips on how to navigate mania.

 

Identifying A Manic Episode

Signs of an underlying issue may start in a mostly “unproblematic” manner in your life, such as feeling very energetic or impulsive — this is often referred to as hypomania — but if unaddressed, it can quickly escalate to a manic episode.

During an episode, many people experience extreme euphoria, decreased need for sleep and hyper-sexual arousal. Manic episodes often kept me awake for weeks at a time without feeling the need for rest. I have even witnessed patients doing somersaults across the floors of the psychiatric ward, as they were so dysregulated during manic episodes.

With specific diagnoses, manic symptoms become more difficult to identify. People with diagnoses that include psychotic symptoms should pay even closer attention to their moods because psychosis can worsen with extreme elevations of mood, which then further complicates a person’s judgment and insight into their symptoms. Sometimes, religious ideation can be indicative of activating psychosis.

If you notice any change in your energy levels, thought patterns, impulsivity, etc., it is best to address it right away before symptoms escalate.

 

Using Tools For Self-Management

If you identify that you are experiencing a manic episode, there are several options for reducing the harm to your interpersonal life using self-management and self-regulation tools.

One tool you can use is completing Activities of Daily Living (ADL) checklists to remain as independent as possible during an episode of active mania symptoms. Your ongoing capacity to execute daily living activities without incident is always a good measure of how well you are managing your mania symptoms. For example, someone eating, bathing, sleeping and coping with life stressors is on the road to self-managing their symptoms. The more life tasks you meet without incident, the less your manic symptoms are interfering with your life and your goals.

 

Addressing Drug-Induced Mania

Stimulant and drug-induced mania can be just as dangerous as organically, internally driven manic episodes. Considering substance use treatment may be an essential step in managing your symptoms for the long-term.

Like most people, even minor stimulant use from caffeine can trigger an episode or lead to self-activation, which means inducing mania by engaging in unhealthy activities or stopping medication without medical oversight.

Accordingly, it is critical to consider your baseline mood (everyday mood) when engaging in stimulant or caffeine use like coffee or energy drinks. Understanding your baseline will allow you to gauge, for instance, whether consuming one more coffee or can of soda will trigger a manic episode.

 

Knowing Your Baseline

Internal and external barometers are essential for knowing your baseline. Listen to your friends and colleagues and take in their assessment (even if informal) of your mood.

Ask yourself these questions to create a barometer to self-assess for mania:

  • How do you feel when friends and family members think you are upbeat?
  • Do you think your friends and family are misinterpreting your mood?
  • How many hours of sleep did you get, or are you still awake from the previous day?
  • Have there been recent complaints about your behavior?
  • Are you able to make it to work?
  • Have you done anything risky?

 

Finding A Safe Zone

Some folks find it helpful to create markers in their local environment. Identifying these spots, small safe havens to migrate to when a potential problem may be in the works. For example, when you are feeling speedy on the climb up to mania, locate one of these spots you can go to when you aren’t feeling safe.

Examples of safe zones include:

  • Nearby close friend’s home
  • Coffee shop
  • Respite service
  • Chapel or religious haven
  • Local public area (e.g., park with benches and seating)

Mania may feel good at first, but, ultimately, it will put your safety at risk. So, find safe zones that will keep you protected when you are manic and lacking your usual insight into your behaviors. While in your safety zone or on the way to it, you can begin to recalibrate your internal guidance system to register that you are manic and need to return to a calmer, more stable baseline. Visualize what that will look and feel like to begin the recalibration process.

 

Creating A Plan With Loved Ones And Managing The Aftermath

Ultimately, there will be times when you have to live with unresolved symptoms. Creating a plan for friends and family will significantly reduce the risk of potential harm from an episode. Friends and family can also help you make decisions if your judgment and insight are too impaired for rational decision-making.

I send warning emails to friends and family, flagging them down when I feel like my moods may have impaired my decisions and/or might affect others in the future. Preparedness and attention to detail are always essential when managing an illness. Surrounding yourself with supportive people and allies can bolster recovery.

While you should never feel embarrassed by your behavior during an episode, you do need to accept responsibility for it. That’s how healing works — acknowledging that change is necessary and moving forward in the process of adapting our behavior to build a healthy, fulfilling life.

 

Max E. Guttman is a Licensed Clinical Social Worker, mental health therapist and disability rights advocate. He has worked in various systems of care in New York State, both as a clinician and as a peer. Max is also the editor-in-chief of Mental Health Affairs, a website for the mental health prosumer.

What I Learned from Experiencing Postpartum OCD and Depression

DEC. 06, 2021

By Patricia DiJoseph, Ph.D.

mother leaning over baby crib

Looking back, I had all the classic symptoms — and they were severe.

I believed someone had to be in the back seat with my son Thomas in the car; otherwise, he’d die. I believed I had to stay awake all night while I was watching him, otherwise, he’d die in his sleep. I feared “the agency” was going to come at any moment and take him back and say he wasn’t mine. These fears were all so real to me — never did I think, “I have an illness, and with help I can get better.”

The thoughts got worse, now telling me in detail to commit the gravest sin. I hated those thoughts, the thoughts of hurting my baby, and I didn’t want to listen to them.

Day and night, I would be on guard in case they came. When they did come, I would use all my willpower to bury them. It was mentally and emotionally exhausting. I was terrified because I thought, “What if they win and my strength fails me?” or “What if I actually act on them?”

When the thoughts kept coming — and their frequency increased — somewhere deep down, my intellect kicked in, and I knew I needed to see a psychiatrist.

 

Seeking Help

I still had no idea that I was experiencing postpartum OCD and depression, but I did know the terrible thoughts meant my brain chemistry was off.

When I talked to a doctor, he said I’d get better the fastest if I went to an inpatient mental health facility. I agreed, as I just wanted to get better. He described me as homicidal to the facility while trying to secure me a spot. So, that is how I began to see myself. Even after a week in the facility (and over two months of partial inpatient and outpatient therapy), I still believed I was a threat to my baby. I was told I couldn’t be alone with him. No one told me differently. The fear of hurting my baby overtook my whole life. I was no longer me; I was no longer confident, I had no joy, I had no self-love.

We all have blessings in our life. Four months after being told I was homicidal, we moved to a different state due to my husband’s new job. I got a new psychologist and psychiatrist who specialized in maternal medicine and therapy. They recognized that my intrusive thoughts were, in fact, symptoms of OCD. They assured me that I wouldn’t act on my thoughts. Their assurance immediately lifted the largest weight from my shoulders. I did not have to fear myself anymore and always be on guard.

My therapist taught me how to recognize and ground myself when I had these alarming thoughts. With the professional help I needed, I came to accept that no grave harm would come to my baby, either from myself or elsewhere, so the intrusive thoughts held little weight and no longer effected my day-to-day living.

 

What I Learned

I learned that the people who truly care will still love you. My relationship with my husband is better than it’s ever been (learning emotional intelligence and communication skills in therapy has been great for our marriage). I’m still very close with my family. I know they always want me to do well. I also am fortunate to have the best girlfriends who I still love getting together and having open, honest conversations (I even learned that some also experience mental illness).

I learned sympathy for those with mental illness. I understood intimately how some people might not even know that there is a path to recovery — that we just need the right help to get there. Sometimes, we need medicine. Sometimes, we need to train ourselves to think, process and react in new ways.

I learned that we need more experienced mental health practitioners and psychiatrists. We need caregivers to be familiar with all the proper signs, diagnoses and treatments for mental health.

I learned we need dedicated support for families who are drained from taking care of their loved ones with mental illness. We all need to be checked on; not just “how are you” but “I’m concerned. Please take this mental health survey and let’s see if there are any warning signs.”

I learned that mental health should be prioritized early in life (at school and at home). We go to the dentist twice a year to have shiny white teeth. Can we approach mental health the same way? Imagine if everyone was taught that it’s important to go see a professional when you are struggling.

I learned I am strong. I am as strong as they come. I opened up about the awful thoughts in my head as I knew something needed to change. I never gave up. I was at a very low point during the period that I thought I was homicidal, but I just kept trudging through. I’m a more joyful person now than I was before this experience.

I’m very pleased with all my progress. I still see a therapist weekly and a psychiatrist monthly and take prescribed medications regularly. I hold a professional job in research and development of engineering technologies and, importantly, I love being a mommy.

 

Dr. Patricia DiJoseph lives in Virginia. Hew newest joy is playing, reading and cuddling with her two-year-old and getting to see him explore the world with fresh eyes. Patricia holds a Ph.D. in Transportation and has learned that there is something harder than writing a doctoral dissertation — navigating mental illness.

Listening to the Whispers of Mental Illness Before They Turn into Shouts

DEC. 03, 2021

By Yerika Germosen

woman in storm clouds

When I was a teenager, I would frequently remind myself not to be like my mother. My developing brain could not make sense of her behavior, which I would come to learn was actually bouts of hypomania, anxiety and depression. Even when she reached a crisis point and expressed suicidal ideation, I didn’t quite understand what she was experiencing. This was so out of character for her and incredibly disorienting for me, so it felt like my mom had turned into a troubled stranger.

A decade later, I would reach my own psychiatric crisis with mania, psychosis and depression. This experience forced me to understand what I couldn’t as a teenager. It unearthed the voice — sometimes quiet and sometimes loud — of mental illness.

The Onset Of My Mental Illness

When I was 19, I graduated from college with a degree in psychology. Starting a full-time job three days after graduation did not seem like too much to handle at the time, but it certainly was.

I started getting an avalanche of ideas that I imagined would radically improve the small company I was working for. I would wake up in the middle of the night fully energized to send emails and write things down without realizing how much friction I was creating. These whispers of warning signs didn’t raise a red flag for me because the mania felt so rewarding.

However, my mental illness escalated from whispers to shouts after I got fired from this job that was too much too soon. My family took me to a psychiatrist at the mental health clinic where my mom received treatment, and there I was diagnosed with bipolar I disorder. In my confusion and frustration, I believed my family was against me. I also believed that the psychiatrist was monitoring my every move by tracking my smart watch and conspiring with my neighbors. My psychosis had convinced me that he was madly in love with me and wanting to avoid a lawsuit for malpractice.

I can’t recall the point when a clinician told me I had bipolar I disorder. I remember talking with my doctor to express my many frustrations. I also remember having a lucid moment when my dad explained my diagnosis. He was incredibly compassionate during that conversation; he understood the disease because of my mom, and he knew to approach the subject delicately. When the mania returned, however, I felt like I had to prove my father wrong. The shouts of a mental illness are resounding when reality is too heavy for us to deal with.

Getting On The Right Path

Being hospitalized twice in less than a month (and, as a result, having frequent contact with patients who were also suffering from mental illness) helped me get on a path to recovery. I’d hear from peers that had been recently diagnosed with bipolar disorder and started treatment, and I’d listen to stories from those that stopped treatment and needed to restart intensive treatment. I’d also met people who had been in treatment for many years and created beautiful lives with children, serving the community and traveling. Hearing all these stories helped me realize that I can overcome and thrive — it gave me hope that things can get better no matter how awful they seem.

I also embraced techniques from interpersonal and social rhythm therapy, which centers on approaching life 24 hours at a time, with a routine for daily activities while also sustaining healthy interactions with a support system. True recovery from my mental illness has taken a village and persistence with maintaining my balanced rhythm.

My family’s involvement has also assisted me in my recovery. My parents will often ask me, “Where are we on a scale from one to 10?” with one meaning crisis and 10 meaning euthymia (wellness), which nudges me to be honest, self-aware and to rely on them when needed.

Creating The Silver Lining

Losing my mental health as I knew it before the onset of bipolar disorder involved grieving. Accepting the reality of my diagnosis after denial, anger and depression took time. I refused to take psychotropic medication when my mental illness was shouting, and this distressed me and my loved ones. Nonetheless, I believe that our biggest breakdowns can lead to our biggest breakthroughs.

I understand that although the shouts of my mom’s bipolar disorder were loud enough that everyone could hear, she worked tirelessly to remain safe with the whispers of it. She managed to raise three children, practice law in our native country and transition our family to live in the U.S. She was the source of my frustration as a teenager many times, but she has become my inspiration. She has taught me that it’s possible to get through life, with all its challenges, while not losing track of the voice of bipolar disorder.

Now I see my medication and coping mechanisms as a safety net rather than a sign of weakness. There are things I need to be mindful of like regular exercise, counseling, attending support group meetings and nutrition. This lifestyle makes it easy to recognize the voice of the mania and depression from my mental illness. We’re all capable of creating a life worth living if we’re willing to listen to the whispers before they become shouts.

Yerika Germosen grew up in the Dominican Republic and immigrated to the U.S. in 2013. She holds a Bachelor of Science in Psychology from the University of Central Florida and works as a crisis counselor. Her blog, “Pursuit of Eureka,” is about finding joy in discovery for living meaningfully.

Weaving the Threads of Healing Through Writing

DEC. 01, 2021

By Lyn Barrett

woman using laptop

As I’ve navigated a complex mental health journey, writing has been my anchor. When my life began unraveling, journaling helped me hang on to normalcy and my sense of self. It stabilized me when I was eventually diagnosed with dissociative identity disorder (DID), a mental health condition marked by the presence of at least two distinct personalities. Writing also helped me tease apart conflicting thoughts and emotions during an intense time of therapeutic healing. Then, it helped me create a coherent narrative after I recovered and began to live a happy, fulfilled life. Through writing, I wove a beautiful tapestry from what used to be a jumble of knotted, unkempt threads.

 

Writing Held Me Together

When I was 35 years old, my seemingly normal life began to fall apart. My happy marriage was on the rocks, and my wonderful children were acting out. Worse yet, my usual, competent approach to tackling problems disappeared. Someone gave me a journal as a gift, so I began writing.

At first, I made lists: What I need to accomplish today. Five things that will help me get through the day. 10 ways to avoid the wrath of my ex-husband. These lists helped me cling to the capable self that was slipping away. I never completed the tasks on the lists because my chaotic inner world would get in the way. Still, they formed the first threads in the tapestry of my healing.

 

My Words Helped Me To “Meet Myself”

In my early 40s, my writing “let loose.” In place of lists, I began spewing words and incoherent phrases into my journal. I didn’t know where they came from, and I didn’t know what they meant. Oftentimes, they were indecipherable, but occasionally they had an almost poetic quality. The deep poignancy of my words made more sense when I was diagnosed with DID when I was 44 years old.

After receiving my diagnosis, I began to work with a therapist who helped me take great strides in understanding my condition. She encouraged me to continue writing in my journal — and she pushed me not to “edit” the words as they came out, but rather to give the other voices inside me a chance to speak.

Through this process, I was able to get to know the different “parts” I unknowingly created to protect me from chronic early childhood trauma (these “parts,” often referred to as “alters,” are a result of the personality fragmenting in response to sustained trauma). As they wrote more, they had the confidence to speak more. As they spoke more, their trauma began to heal.

 

Writing Became A Constant In My Life

My parts “integrated” when I was 54 years old. By that time, I was writing poetry and taking pleasure in the imagery my words created. My professional life was growing, and I wrote expository pieces required for work.

Even my spiritual life was evolving, and I wrote sermons to express the work of light inside me and the world around me. I did far less journaling because I no longer needed that unbridled expression, but I continued to put pen to paper to convey words nestled deep within me.

 

I Hope To Teach Others How To Heal Through Writing

Today, at the age of 73, I am awed by the power of writing. I facilitate two writers’ workshops and host a website for people with dissociative disorders. The poems, essays and memoirs dissociative writers submit for feedback are rich in thought, in the variety of stories they tell, and in the trust they reveal simply by the writers’ willingness to share. I have learned as much from these writers as they have learned from me.

I encourage anyone who is struggling with their mental health to write their way toward healing, too. There is no one way to approach writing, so what I share here are hints. You’ll find your own way.

    1. Journal: Write what comes. Don’t be afraid of putting your deepest thoughts and most difficult emotions on the page. They won’t hurt you. In fact, they may heal you.
    2. Find your own rhythm: Experts tell us to set a time to write every day and that’s a good practice, if you can do it. Some of us can’t. Some of us have to wait for the right moment to pick up pen and paper whether it is every morning, every evening, once a week or as the spirit moves.
    3. Engage with your words: Reread your journals frequently. Sometimes you may find a gem among the weeds. Pull the passage out and give it a special place in your computer file or in your notebook. These gems will form the foundations of your own tapestry. They will remind you that you have something important to say.
    4. Develop your words: Sometimes you may want to develop a short passage from your journal. If it’s a memory or true story, add setting, character and dialogue. Create a scene so others can imagine it, just like you. If it’s an essay or reflection, dig deeper. Who else thinks the way you do? How can your thoughts impact someone else positively? If it’s a poem, create a file of all your poetry and consider what your heart and soul want to share.
    5. Find other writers: Read memoirs, books on your topic or volumes of poetry. Join a writers’ workshop in your area or an online group. Other writers can help you with your craft, give you confidence and something to strive for.

By writing, you will be weaving your own tapestry and honoring the life journey you have taken. Whether you’re writing only for yourself or hope to share your writing with others someday, take your pen in hand (or computer) and write!

 

Lyn Barrett hosts free, virtual Dissociative Writers workshops at www.dissociativewriters.com. Her memoir, “Crazy: Reclaiming Life from the Shadow of Traumatic Memory,” will be released in January 2022. A retired teacher, school principal and pastor, Lyn was diagnosed with multiple personality disorder (now dissociative identity disorder) in 1992.

How My Husband’s Untreated Symptoms Affected My Anxiety

NOV. 29, 2021

By A. D.

two people disagreeing

As I sat on the couch ordering clothes for my then five-month-old daughter, my husband — seemingly out of the blue — told me that he was not a good husband and father, he was no longer in love with me, and he wanted to end our marriage.

Had I heard him correctly? What was happening?

Time froze. The room began spinning. I got nauseous and threw up. I cried. I begged for compromise. I pleaded for answers. We went to bed that night agreeing to stay in separate rooms so we could think things over.

The next several months were a rollercoaster of emotions. My husband and I had several long talks, with many tears shed. He eventually moved out, only to move back in several days later. I tried to convince him to go to therapy, but he refused to go, as is common among men struggling with their mental health, largely due to the stigma surrounding seeking help.

I’ve dealt with anxiety for most of my life and this situation wreaked havoc on my mind. As someone who already struggled with overthinking and excessive worrying, I was now consumed by my thoughts. I overanalyzed every interaction with my husband and obsessed over the unknowns. I was devastated by the idea that I would miss half my daughter’s life to shared custody if we divorced. My self-esteem plummeted as I considered why I wasn’t good enough for him anymore.

Starting Therapy

Even though my husband was not willing to join me, I decided to seek therapy on my own. At the very least, I figured, I could talk about our issues with a professional and work on my side of the relationship. I loved my time in therapy. I learned things about myself that shed light on my own anxiety and discovered some useful coping techniques.

My therapist helped me understand why I become highly irritated by spontaneity or changed plans (loss of/need to control), why I repeat conversations in my head to the point of frustration and exhaustion (rumination) and why I have vivid, morbid daydreams about my loved ones (my fear of losing them). Though I had always known my constant worrying, restlessness and inability to concentrate were signs of anxiety, I hadn’t put together all the ways anxiety impacts my daily life.

Realizing this fact, and discovering the root of my anxiety, helped me to better manage my symptoms. Instead of getting angry and frustrated when plans changed suddenly, I forced myself to pause before responding. I acknowledged my fear of change and loss of control, and I learned to think through situations to determine if they were as serious as they felt to me. Most often, they weren’t, and I just needed a moment to process.

Going to therapy helped me get through the three years that my husband’s symptoms lasted. That period felt like a dark cloud was hanging over my house. I would come home and sit in my car, staring at the place where I was supposed to feel happy and safe. Instead, I would feel dread wash over me. I would hesitate going inside, knowing I would see my partner in pain.

Additionally, I would have to pick up all the slack, maintaining the house, caring for the baby and caring for my husband. I was exhausted — mentally, physically and emotionally. Many days, I was ready to give up. I would think to myself, “just get through today, sleep on it, reevaluate tomorrow.”

Why We Need To Reduce Stigma

After about two years, I started to see glimpses of the man I used to know. They didn’t appear often, but they were there. Then one day, after confronting him about some debt I discovered, he finally broke and admitted he had gotten into online gambling and lost a lot of money. On top of that, he was severely unhappy at his job. He felt like a failure.

I had spent so much time overthinking and overanalyzing that it was a relief to finally have some concrete answers. Though I was grateful he had opened up, and I felt hopeful things would get better, I was also afraid and unsure. Two years of uncertainty and worrying had taken a toll on me.

I suggested again that we go to therapy. He still wasn’t convinced. I truly wished he would go with me, so we could have a professional to talk to and guide us on how to move forward. Even though he said no, we still actively worked together on our relationship and his health.

We still do not use labels to describe his mental health. If I mention the term “depression,” he’ll avert his eyes and brush it off. I believe he may feel uncomfortable and ashamed, largely due to the enduring stigma surrounding mental illness. I frequently think about how perhaps more people would seek help if, as a society, we were more open about mental illness and more vocal that mental health is not a sign of weakness. If my husband had sought help from a professional, his symptoms may not have lasted as long or impacted me the way they did.

However, I’m thankful for my awareness of my own mental illness. My experience and insights from therapy allowed me to cope while supporting my husband. And ultimately, I’m grateful that my understanding of mental health could help him too.

I am not one to have regrets as I truly find everything to be a learning experience. This time in my life, and in our marriage, was a painful lesson. We were lucky to get through it, and now, several years later, we are both happy and thriving. But our story’s ending is not necessarily common. Mental illness affects so many individuals and the ripple effect onto friends and family can be devastating.

Reducing the stigma surrounding mental illness is critical and seeking help shouldn’t be taboo. Just as we’d go to a dentist for dental issues, we should be going to mental health professionals for our mental health issues. Professionals can help us, and our loved ones, work through our issues far more productively and effectively than we can on our own.

A.D. has a background in business management but recently left her career of 11 years to focus on her mental wellbeing and pursue creative passions. She currently writes about mental health and substance use for St. John’s Recovery Place.

Finding Emotional Well-Being as an Indigenous Woman in America

NOV. 24, 2021

By Kola Shippentower-Thompson

silhouette of person

How does one describe Indigenous identity?

Hundreds of years ago, talks about “Indigenous identity” would not have taken place. We were who we were. The People. The Original People. We didn’t have to explain who we were, what we were doing or what value we brought. We simply existed and thrived.

Fast forward to modern times, and our reality is different. Indigenous people must fight for everything: The air we breathe, the water we drink, the land we inhabit. We must fight to exist. However, that fight — against oppression from non-Natives, the government, law enforcement, etc. — is only one aspect of our battle. There is another aspect that hits a little closer to home: The fight to be accepted amongst our own.

Naturally, the combination of our complex and traumatic history, ongoing oppression and internal identity crises all weigh heavily on our emotional well-being and mental health. For these reasons, we are seeing upticks in depression, anxiety, suicide and even homicide rates among Indigenous people.

It is time that we make our mental health a priority.

 

We Need To Acknowledge Our Trauma

Now that we are beginning to have more honest conversations — turning a critical eye to history and sharing the current experience of Indigenous people — we are getting to the root of our mental health struggles.

We’re shedding light on a rising crisis in the disappearance and murder of Indigenous people; we’re uncovering an ugly past of assimilation in schools; we’re calling out the broken treaties and the ways in which the government still does not hold up their end of the bargain, today. These awareness movements and conversations are critical. However, this exposure to past trauma and generational trauma is painful to relive.

Additionally, a harsh reality for many Indigenous people is a fight to exist amongst our own. One painful product of colonialism is its ability to turn a family and a people against one another — in the form of blood quantum (a measure of the amount of Native American blood an individual can prove that they have), certificates of Indian Blood, assimilation of culture and traditions. Comments like “you must be mixed,” and judgments like, “what do you know?” spur a new level of identity crisis.

Imagine, for a moment, trying to explain yourself to an aunt or an uncle that, no matter what knowledge you bring to the table, it’ll never be enough. So here you are, not “Indian enough…” for anyone. This kind of rejection compounds the pain of generational trauma and current injustices.

 

We Need Spaces To Heal

As a survivor of domestic violence, sexual assault and sexual harassment by law enforcement, I felt as though I needed to take the fight for my own Indigenous identity into my own hands. I wanted to make sure that every space I inhabited felt my presence. I wasn’t going to be a victim to the atrocities our people have faced anymore. I wasn’t going to end up on the other side of the statistics. I saw a need, because of my own journey, that our women needed a plan. A plan to stand up to power and to preserve our emotional well-being — a plan to ensure our survival.

I created the Wisàwca Project to further the Missing & Murdered Indigenous Women & Relatives movement (MMIW). The initiative, which helps families to create a written safety plan to be given to loved ones in the event of a disappearance, acts as a response to law enforcement’s handling of missing persons cases; many of our reports or complaints are met with victim blaming, shaming and stereotyping.

Ultimately, this project channels the strength and resilience passed down from our ancestors by saying, “We are enough, we are important and we are still here.” We are still present. I believe this to be particularly impactful for those struggling with mental health because we are taking back our power and demanding to be seen.

Indigenous people are born with an advantage, and it flows through our veins. I have been so fortunate to have been raised traditionally by my grandparents and parents, while given the freedom to grow into who I am today. If it were not for this upbringing and reminders of who I am, this work would’ve been impossible.

 

We Need To Advocate For Our Mental Health

Our culture is beautiful. Our culture is strong. Our culture is resilient. But the emotional and mental toll it can take on one’s life is taxing, to say the least. Additionally, the existing mental health resources aren’t sufficient to keep up with community needs — and many community members don’t trust the programs available to them. Historically, the government systems that were supposed to help failed us.

I hope to see more mental health resources readily available — and to see more Indigenous people using available resources. I also hope to break down cultural barriers that prevent people from speaking openly about health. An open, honest discussion is the first step.

The fight for our mental health — for peace, happiness and to simply be Indigenous — continues today. Whether it be in the form of hunting, fishing, gathering our traditional foods, beadwork, dancing, working at a restaurant, modeling, playing basketball or taking up graphic design — we all have the same goal, to just be.

I don’t think our ancestors ever meant for us to judge each other for how “Indian” we can be. I believe they meant for us to live, be happy, love one another and take care of the Earth and our people. I hope that in advocating for our personal safety and mental health, I’m contributing just a little bit to the preservation and survival of our people for generations to come.

Chawnuh muun naampta — We will never fade.

 

Kola Shippentower-Thompson (Tumhiya) is an enrolled tribal member of the CTUIR. A mother and wife, she’s also a professional fighter in mixed martial arts. With the numbers of cases rising in violent crimes against Indigenous women, Kola has created and developed the Wisàwca Project. This personal safety coaching provides participants a means to advocate for themselves in many areas, including personal security, confidence and preservation.

The Benefit of Support Groups When You Love Someone with Borderline Personality Disorder

NOV. 22, 2021

By Maureen O’Dougherty

people at a support group

After navigating a close relationship with someone who lives with borderline personality disorder (BPD) — and meeting dozens of people navigating similar situations — I developed an interest in better understanding the disorder. To broaden my understanding, I read the existing literature about BPD, completed a NAMI Family Connections class and participated in a peer support group.

As an anthropologist, I also took an interest in hearing other perspectives. So, I conducted research, which entailed in-depth interviews with people who have a family member with BPD.

Between my own support group experience and hearing the experiences of families who sought help, I have collected a wealth of information that I would like to share with anyone who may be looking for guidance.

 

Deepening Understanding Of BPD And Connecting With Others

I’ve learned that it often takes time for family and friends to fully digest the complexities of BPD. Figuring out how to best support the treatment and recovery of a person with BPD can be a complicated process and loved ones may find themselves in social misunderstandings.

Parents I interviewed often felt that “no one” in their communities knew anything about BPD. As a result, they were tasked with navigating uncomfortable social situations in addition to caring for their children.

As one mother said, “Nobody really understands borderline behavior unless you’ve lived with it. Otherwise, they think you’re just bad parents or you’re lying, you’re making it up.” A father noted, “There seems to be a belief that everything falls in line when you do things right as parents. There’s an idea of ‘best practices.’”

Unfortunately, parents operate in a context of unforgiving cultural norms: judgments about not properly raising their kids and punishing social norms of parental self-sacrifice with no time limits. As a result, parents of individuals with BPD lose much of their social life; there is little time for it while providing vigilant care and navigating stigma.

Accessing appropriate education and support, however, proved to make a difference. While attending the 12-session NAMI Family Connections course, I noticed that participants first arrived in a beleaguered state struggling to understand their distressed loved one. By the end, most became more self-assured, thanks to our deepened understanding of BPD, our newfound skills for positive interaction with loved ones and the constant reminders to take care of ourselves.

This outcome is not surprising, as a wealth of studies underscores the benefits of peer support groups. Participants often realize they are not alone in their difficulties, and they can connect with others who understand without judgment. Moreover, attendees learn ways to simultaneously aid their loved one’s recovery and their own well-being.

 

Developing Effective Communication

Taking part in monthly follow-up BPD support groups has also proven to help people become more effective communicators and problem solvers — with institutions and with their loved ones with BPD. For example, one support group participant learned not to take a health insurance provider’s denial of residential treatment for their loved one as a final answer.

As for managing relationships, parents reported learning how to better manage tense conversations with their children. One issue that parents often found bewildering was how “anything” could provoke an argument. They registered that popular parenting techniques and verbal responses often backfired. A woman with a background in health care described her daughter’s emotional sensitivity as akin to “burn patients who are so sensitive. I try to remember how painful it is for her being in her skin, how life is so hard for her.”

In support groups, however, attendees practice how to improve communications with individuals with BPD. Naturally, there is a learning curve; participants will patiently coach one another on “radical acceptance.” They come to see their loved ones’ actions not as manipulative, but as a reflection of their inability to ask for what they need. Attendees also learn to relate to the emotional basis of the words or action; for example, they learn to relate to their loved ones’ anxiety rather than getting upset with their seemingly rash decisions.

One woman I interviewed offered pointers handily capturing many suggestions from the NAMI course and support group.

  • Accept the person, not necessarily the behavior (which you can communicate is not ok when needed).
  • Choose your battles wisely.
  • Don’t forget the other family members, especially the other child/ren.
  • Take care of yourself. Doing so models how to combat negativity. Emphasize activities that emotionally and physically fulfill you; exercise, eating, sleeping, having friends, nature, music, art, sports, etc.
  • Expand your circle of support.

 

Creating A Community

One of the most difficult issues parents face is how to “launch” their young adult toward self-sustaining adulthood, or if that’s not possible, accepting the responsibility to take care of their child long-term. Stepping back in caregiving (with a safety plan in place) could spur the person with BPD to develop greater independence in their path to recovery.

Still, I have found parents only reduce caregiving if another critical demand emerges — perhaps if a son or daughter’s substance use or disordered behavior is too upsetting for younger siblings or if there is marital discord or another serious health issue. Listening to peers about these trials, and being heard, is itself an immense benefit or peer support.

Going to the monthly meeting via Zoom or in an in-person setting signifies entering and creating a community of mutual aid, where participants can safely talk through culturally, morally and emotionally harrowing decisions. To my surprise, peer support groups also provide comedic relief. Such moments of humor provide space for peers to air the challenges they face and relate to one another.

Hearing one another’s stories, weighing different approaches, being reminded of self-care — and at nearly every meeting, laughing over some farfetched situation or observation — is both heartening and beneficial.

 

Maureen O’Dougherty is a cultural anthropologist conducting research on the intersections of culture and mental health. Her current project investigates families’ experiences with borderline personality disorder. Maureen received her doctorate from the City University of New York. She is a faculty member at Metropolitan State University (St. Paul).

Five Things to Say to a Loved One with Anxiety

NOV. 19, 2021

By Melissa Lewis-Duarte, Ph.D.

woman comforting another woman

Confession: I’m anxious.

In what feels like a former lifetime, I taught psychology college courses and worked as a business consultant, trainer and coach. Given my mentoring roles (and my Ph.D. in psychology) it wasn’t uncommon for a student or training participant to pull me aside and admit that they were suffering from anxiety. The truth is, so was I.

Diagnosed with an anxiety disorder more than two decades ago, I’ve been both the giver and receiver of the “I’m anxious” confession. I understand what it’s like to struggle to find the right words, and I know how crushing it feels to receive the wrong response. Even well-intentioned loved ones can exacerbate anxiety with a comment that feels unsympathetic or judgmental.

To avoid misunderstandings and hurt feelings, here are five helpful responses when a loved one approaches you about their anxiety.

1. “You are not alone.”

Mental illness is common, and your anxious loved ones are not alone. In fact, anxiety became even more prevalent during the pandemic as people across the globe struggled with an unprecedented health crisis, loneliness and isolation. By reassuring your loved ones that their struggles are valid and reminding them that they aren’t alone, you can help them keep perspective and feel supported.

However, remember to tread carefully in this conversation. “You are not alone” does not equate to, “We all feel that way.” There’s a big difference between occasionally feeling anxious and being diagnosed with an anxiety disorder. You don’t want to be dismissive or minimize your loved one’s suffering.

2. “There is no reason to feel ashamed.”

Unfortunately, anxiety can spur feelings of shame, embarrassment and isolation. Further aggravating the situation, anxiety can cause people to withdraw from relationships and social interactions. You can help by reassuring your loved one that there is no reason for them to feel shame — that it is a health condition and not their fault; that anxiety has nothing to do with strength or weakness.

The best approach is to treat an anxiety diagnosis the same as you would a high blood pressure diagnosis: Without judgement. When both your words and actions show acceptance, you can make your loved ones feel supported and loved.

3. “It’s ok to not be ok.”

When I feel anxious, I want to run, both figuratively and literally. I want to run away from wherever I am, and I want to run from the internal sensations of anxiety. However, I started practicing mindfulness and am learning to sit with these emotions more. Part of that success comes from realizing it’s ok to not feel ok. There’s a freedom in not “fearing the fear” — in not allowing the anxiety to be present. This helps me to accept that anxiety is simply a part of my life, and it does not have to control my life.

To clarify, you shouldn’t tell your anxious loved ones they need a dose of mindfulness. While attempting to be helpful, responses like, “Just relax. Maybe you need to take a deep breath,” can have the opposite effect. While you can support them, you likely will not be able to solve the problem.

It’s important for your loved ones to hear, “It’s ok that you feel anxious. I’m here with you. There’s no pressure for you to feel good right now.” This is different from saying, “You’re ok,” which can be incredibly invalidating. Rather, you are making it clear that, “It’s ok that you’re not ok.” This can help them to feel safer, supported and validated. It can also help them to feel safe admitting they are not ok.

4. “How can I help?”

Chances are, your loved ones have at least a few coping techniques that relieve their anxiety. So, there’s no need to tell them what you think they should do. No one wants to be lectured by their loved one during a moment of need.

Instead, it’s best to let them tell you what they need. Perhaps, like me, they get relief from moving. If they need to go on a walk, you can offer to keep them company. Or you can offer to watch their kids (if applicable) so they can walk alone. Additionally, people are much more likely to accept help when it is offered than if they have to ask for it. The key is to simply offer.

5. “I support your decision.” (If they need counseling or medication.)

Mental illness is treatable. Unfortunately, less than half of U.S. adults experiencing mental illness get treatment. There are multiple reasons for this, from lack of insurance to feelings of shame. You may not be able to provide insurance to your loved ones, but you can certainly encourage them to seek help.

People are more likely to seek help if they don’t feel judged. Likely, you would never question someone for going to a cardiologist or doubt their need to take blood pressure medicine. Likewise, you should never question someone who needs professional guidance or medication for a mental illness. As a loved one, your role is not to be a doctor, nor an expert, but rather to help your loved one seek the help they need.

Ultimately, if your loved ones have an anxiety disorder, the best thing you can do is show them love and acceptance. You can be open and curious without judgement. That’s what works when I communicate about anxiety, both as the sender and receiver.

As an anxious mom in search of calm, Melissa Lewis-Duarte, Ph.D., writes about living with anxiety and mindfulness-based behavioral change in real life. Prior to founding Working On Calm, she enjoyed working as a business consultant, college instructor and corporate trainer. Currently, Melissa lives with her husband in Scottsdale, Ariz., managing their chaotic life, three young boys and a barking dog.