Sensitivity

I am reading The Secret Life of Bees for book club, and I love it! I know it's old, but in our last meeting we discussed which books made us wish we could spend more time with the characters, and one of the members mentioned this one. I can see why. I love all of the characters, too. Well, maybe not June so much. She's a little too guarded for me. Although I wish I could be more like August, the matriarch of the sisters, I am actually more like May--the fragile one who feels other people's pain too deeply. Not as deeply as she did, thank goodness. But more so than I would like sometimes.

On the one hand, I recognize that it is a gift to have such a keen sense of empathy. I know I have helped a lot of people because of it. But I am also easily thrown off balance when the people I care about are in pain--especially since I am also prone to depression and anxiety. I have always assumed this meant that I was weak. Fragile. Too sensitive.

I spent time with my brother this weekend--the only one of the four siblings who does not have a mood disorder. In talking to him, it was clear that he does not experience his feelings as intensely as I do. He does not get his feelings hurt very often. He is better able to maintain distance from family drama, and his advice really is to tell them to suck it up.

I envy him for this, but I cannot be him. I can only be me. I feel things intensely. My feelings get hurt easily. And when someone is in pain, I feel what they feel and try to help them, even if it hurts me.

But rather than berate myself for it, I am learning to accept that this is who I am. We all have different vulnerabilities. Some people may be prone to heart disease. Other people have diabetes. I am a hyperempath with depression and anxiety. Therefore, I have to be sure to take care of myself in certain ways: make alone time a priority, set boundaries, and be more selective about who I spend time with.

I used to joke that I'm not trying to save the world--just the people that I meet. But perhaps I will have to narrow down my scope in my life-saving efforts, too.

Positively Selfish

One of the hazards of working in the helping professions is burnout. People who are drawn to helping others run the risk of giving too much of themselves. In my case, however, I run the risk of burnout in my personal relationships more so than I do at work.

There are a lot of advantages to working in a counseling center. Even though you don't make as much money, you have access to a lot of resources that you don't have in private practice. I have colleagues, the student health center, deans, RA's, and peer counselors who share the load. The most stressful periods of my job are predictable and time-limited: they occur around the middle of the semester and end around finals week. There are boundaries that are built into our schedule, as well. Appointments are 50 minutes long at the most. We don't schedule clients past 5 pm or on the weekends. Students go home for breaks. We don't see students after they graduate.

My personal life is a different story. Many of the people I love have emotional needs that they expect me to fulfill. Appointments are not time-limited. I am on call 24-7. I usually cannot terminate these relationships, nor do I want to. I have a hard time saying no to whatever they ask of me. And in many cases, I do not feel I am getting back as much as I am putting into the relationship because their emotional resources are more limited than my own. Which is not their fault. It's just unfortunate for me.

That is part of the reason why I want a hiatus from loving and caring for anyone or anything new. No dating. No pets. Just me and my plants. I'm burned out; I want a more solitary job in my personal life.

I was telling my therapist the other day how this makes me feel selfish. She told me that I'm being honest with myself--more authentic. That we need another word that conveys positive selfishness. Which is kind of sad, really. What does it say about our culture that there would be no word for a healthy focus on oneself?

She nominated the word selful. Full of oneself, but in a good way. More like being whole. But it doesn't roll off the tongue the way selfish and selfless do. Plus it looks weird. So I am open to suggestions.

The Battle Against Depression

I really wish that so much of my existence did not revolve around obsessing about sleep. I'm tired of writing about it, and I'm sure you're sick of reading about it. But this is the reality of my existence at the moment, and I am committed to being honest about my current state of mind.

Today was another day that was filled with sleep. It makes me feel like such a failure. My colleagues don't struggle to make it to work because they can't get out of bed. The physicians in my family never even take a sick day. Some depressed people manage to take care of their families. I can barely take care of myself. What is my excuse for my weakness?

Then I thought of physical conditions that leave people debilitated. Migraine headaches. Chronic Fatigue Syndrome. Lyme disease. Do the people who suffer from these conditions feel paralyzed with guilt and shame when they can't get out of bed? Or do they accept their fatigue as being part of their illness rather than a personal failing?

I think about the recommendations I give to clients who are depressed. Exercise. Get sunlight. Be social. Regulate your sleep cycle. If someone had the flu, you would tell them to rest. Listen to your body. But with depression, we tell people to ignore what their bodies and minds are telling them and to do the opposite. Fight it! Don't give in!

Don't get me wrong. I do all of these things when I can, and they work. After sleeping most of the day, I forced myself to do laundry, get some lunch, wave at my neighbors, put together my tennis schedule for the new league, and play tennis for 3 hours to make up for my lack of steps from yesterday. And I'm writing this blog post now. 

Because if I gave in to the desire to do nothing, I wouldn't really be trying to get better. I wouldn't be taking responsibility for my illness. But I don't think it's fair to hold it against someone if their depression is so severe that it's too much effort to go outside and get sunlight. Because sometimes I'm that person, too.

When I have a client who cannot will themselves to follow these recommendations, I don't judge them for it. But I tell them to keep trying to do them. And no mental health professional that I know would tell a client that if they felt like they need to sleep they should listen to their bodies and rest.

There is an article circulating on the internet about how for some depressed people, positive reframing doesn't work. Telling the person to be positive actually makes them feel worse. That it's better to support them by expressing empathy for their feelings. 

Perhaps someday, researchers are going to find that listening to your body when you are depressed is sometimes more effective than fighting it with wakeful activities like forced exercise and socialization--two things that can be difficult to do even when you're not depressed.

I'm going to do my own case study to see if this works.

Liebster Award

I would like to thank Somber Scribbler for nominating me for the Liebster Award. I am new to blogging so I always wondered how people got these awards. What a great way to find out! In the words of Sally Field, "You like me! You really like me!"

What is the Liebster Award?

Liebster is a German word that means lovely or valued. It's an award for relatively new bloggers with less than 200 followers. Nominating someone's blog is a way of letting them know that you like their work and a way to interact with other bloggers. 

Liebster Rules

In order to participate, Liebster nominees must:

1.  Thank the person who nominated you. (Thanks again to Somber Scribbler, who writes one of my favorite blogs.)

2. Answer the 11 questions given to you.

3. Nominate at least 5 blogs with less than 200 followers (approximately).

4.  Post 11 questions for your nominees to answer.

5.  Post a comment on your nominees' blogs to let them know that they've been nominated.

Questions from Somber Scribbler

1.  Why did you start blogging?

About 2 years ago I started writing a self-help book on self-acceptance, but I thought it was so terrible, I was embarrassed to let anyone read it. I had to figure out some way to let other people read about my ideas, so last September I decided to start a blog, even though I barely even knew what a blog was. It turns out blogging is perfect for my writing style.

2.  If you could describe yourself with one word, what would it be?

At the moment, I would say "hopeful." That's why I'm a therapist, why I continue to try to get better at tennis, and why I think I can write a book.

3.  If you could be famous for one thing, what would it be?

That's a tough one. I'd like to be famous for just about anything, as long as it's positive. But I'll say writing a best seller.

4.  What advice would you give to fellow mental health sufferers?

Listen to that voice that tells you to believe in yourself, regardless of how small it may be at the moment.

5.  If you could only eat one thing for the rest of your life, what would it be and why?

Another tough one. I will interpret "thing" as "ingredient" and say anything with sugar, for obvious reasons.

6.  Which fictional character do you relate to the most and why?

Ellen O'Farrell in "The Hypnotist's Love Story," by Liane Moriarty. She falls in love with a man whose ex is stalking her and becomes obsessed with her stalker because she has so much compassion for her suffering. That would totally be me. 

7.  What did you want to be when you grew up?

The first thing I remember wanting to be was a cashier when I was 5 because they had access to all that money. But then my parents told me that money wasn't theirs. So then I wanted to be a bank teller, but my parents said that money wasn't theirs, either. After that I clearly gave up on any attempt to make money.

8.  What is your greatest strength and your biggest weakness?

I would have to say that my greatest strength is my biggest weakness, which is my empathy and compassion for other people's suffering. It helps me to help people, but having too much empathy can be overwhelming at times.

9.  What is your dream vacation?

Maui is one of the few places that has lived up to all of my expectations, so that's where I would go for my dream vacation. With Roger Federer.

10.  Which of the many quotes about mental health speaks to you the most?

My favorite quote is from Kung Fu Panda (although I'm sure it's originally from somewhere else):

Yesterday is history,
Tomorrow a mystery.
But today is a gift.
That's why they call it the present.

I have a lot of trouble living in the moment, which is why in my blog I often start sentences with "In this moment...." A lot of suffering can be minimized with the practice of mindfulness.

11.  What is the most positive thing about today?

Today I got to spend time with my niece, Sadie, which is always a gift.

My Nominees

I'm going to interpret "new blogger" loosely so that I can nominate some of my favorite bloggers. So in no particular order, I nominate:

1.  Amy Purdy, who writes Bipolarly. Her blog on bipolar disorder is informative, personal, and from the heart.

2.  Matt Fried, who writes Fried's Blog, because he is committed to honesty and to eradicating stigma against mental illness.

3.  Tim Clark, who writes Life, Explained, because he rooted for UVA to win the NCAA championship in basketball after his team was eliminated.

4.  Joy Page Manuel, who writes Catharsis, because she is a fellow Filipino and we think alike.

5.  Somber Scribbler, which is probably cheating, but we think alike, she also writes about mental illness, she also includes doodles in her blog, and she would have been my first nominee, had she not nominated me first.

My Questions

1.  What job would make you say, "I can't believe I get paid to do this!"

2.  What's the last dream that you remember?

3.  Who was your favorite character on "The Brady Bunch" and why?

4.  What was your New Year's Resolution this year? 

5.  What do you want to be remembered for? 

6.  What advice would you give to someone who is thinking about starting a blog?

7.  How many jumping jacks can you do in a minute?

8.  If you could put 3 things into a time capsule, what would they be?

9.  Who is your favorite superhero? 

10.  What song best describes you?

11.  What's the last book that you couldn't put down?


Here is a random picture of Sadie and me in Legoland.

Swashbucklers Anonymous

My name is Christy Barongan and I am a swashbuckler.

I mentioned in a previous post that I'm reading The Art of Empathy in an attempt to help me with my hyperempath problem. I finished the chapter on empathic love, and it is so true of me that it freaked me out. I almost had a panic attack and had to take a nap afterwards.

In this chapter she lists 4 impediments in a potential mate: 1) a lack of emotional skills, 2) an active addiction, 3) unhealed childhood trauma, and 4) the presence of a toxic ex-mate. These impediments are practically criteria for a relationship for me. I like challenges, but come on! This is ridiculous! Reading this list drove home the fact that most my relationships had little chance of succeeding from the start.

Ironically, reading this chapter also helped me to not beat myself up about my relationship choices. I am drawn to people with these problems for the same reason that I chose to be a psychologist. I want to help people. I believe everyone is capable of turning their life around, and I am confident that I can help them do it. I never back down from a challenge, and I never give up. These are all qualities that I'm proud of.

However, I am beginning to realize that every challenge has a cost. Even if I do something I enjoy, like play tennis, write a blog post, or talk to my brother, it drains me mentally and physically. Which is OK. I love doing these things, so it's worth it. But in the past, having the ability to help someone was reason enough to do it. Whether I wanted to do it or not was irrelevant because my wants and needs didn't count. And I never paid attention to the impact that giving so much of myself had on my well-being.

In a way, that's one of the benefits of being prone to depression and anxiety and of having allergies, GERD, and asthma. Now I have to pay close attention to everything I do and how it will affect me. I have to be intentional about all of my choices. It's a pain, but it forces me to take care of myself.

Also, when I choose to do something challenging, most of the time I'm not too attached to the outcome--except in relationships. I'd like to move up to 4.0 in tennis, but if I don't, I'll just keep trying. Same with writing a best seller. I know the odds aren't in my favor, but I enjoy the process, and if it never happens I won't be devastated. I don't even take it personally when I can't help a client get better.

If I had the same attitude in relationships--that I gave my best effort, and that's all I can do--then perhaps I wouldn't feel like such a failure in them.

It also helps that McLaren calls people like me swashbucklers rather than codependents or love addicts. She describes swashbucklers as people on a heroic journey filled with impossible tasks and mythical beasts. Sort of like relationship warriors. But like Odysseus at the end of his adventures, I think I'm ready to come home.

Maybe I can use my superhero skills to save myself.  After all, who is better qualified to help me than me? I don't even have to do it alone. I could create a support group for hyperempaths. A 12 step program for swashbucklers, if you will. I think it could be a big hit.

So if you're interested in participating, let me know.

Strength

In honor of Mental Health Awareness Month and Mother's Day, I am featuring a guest blogger, my youngest brother Romeo Barongan. He has been featured in several posts, including Hard Core Fan, The Best Valentine's Day Gift, and Let it Go. This post is an example of how good things can come from depression--like wisdom, gratitude, love, and strength.

Strength is not about how I look on the outside; but about what I’m made of on the inside. It’s not about how much weight I can lift; but about the burdens I’m able to bear….what I’m willing to endure when the cause is just. After a life of trying to keep up with the Big Boys in the gym, I’ve learned that strength isn’t about the body but the soul. In honor of Mother’s Day, I wish to acknowledge my own Mom for helping me realize the definition of true strength. While I have been striving to acquire strength of body, my Mom has consistently demonstrated strength of character.

I feel the need to create some context for the journey about which I will relay shortly. My parents are both successful professionals. They reared three over-achieving children. And then I came along to round our family of six. I’m not selling myself short or looking for pity; I’m no failure. But growing up as the youngest child in a household so rift with talent created a seemingly impossible path to follow. To worsen matters, people outside the family often chided me for my privileged upbringing. They would disregard my success with statements like, “Anyone could do that if their parents had the money yours do.” They disparaged me for my work ethic in the classroom & relative inexperience in blue collar affairs. “Spoiled rich boy should learn to do real man’s work & get his hands dirty every once in a while.” I wanted to prove that I was a “real man.” I had to show the world that I wasn’t the sheltered doctor’s son that they accused me of being. I would force the world to see that I was indeed strong.

I hit the gym hard. I tried to be more “blue collar” without the benefit of knowing exactly what being blue collar actually meant. It was an unusually painful separation when I finally moved out of my parent’s house to strike it out on my own. We’re such a close family with traditional Eastern culture values; I think my parent’s perceived it as a mild insult when their then 25-yr-old youngest son decided to leave their house. But I was driven by the need to establish the obligatory self-sufficiency that comes with adulthood. I had to prove not only to the world but to myself that I wasn’t the helpless youngest son of a privileged family. I had to prove I was normal; that I was “strong.”

The older I’ve gotten, the more I appreciate how amazing my parents are. Dealing with the often overwhelming constant bombardment or adult responsibilities is enough to suffocate me on most days. My career barely involves a fraction of the level of pressure & high stakes that characterized my parent’s careers—and yet, they were able to succeed & still have the time to make me feel like I was the center of their universe. All this year, I’ve been struggling with a life crisis that I tried to keep to myself & resolve on my own. I didn’t want to worry my poor Mother who has more than enough on her plate. I just had to “cowboy-up” & go it alone. But I recently broke down & shared my struggle with her. It’s ironic: I spent most of my 20’s trying to establish my independence in an effort to uphold my obligations as an adult. Now in my late 30’s, I realize that no matter how much I “grow up”, I’ll never outgrow a parent’s love. And I’ll never be too old to realize how much I love & need my parent’s in my life.

I used to think that I was strong after a good workout in the gym or after standing up to a bully twice my size. But then I see my Mom at 70-yrs-old adapt to the computerized healthcare industry to order to extend her 40-year career as a doctor. I see her remain active in the Church & community on her off days. I see her remain the dutiful wife to my Father. And I benefit from her seemingly never-ending support in my own life. I was looking at myself in the mirror after a solid workout this morning when I began to think that strength is too great a quality to be measured in a single act; & certainly too immense to assess through anything we can see in a mirror. With my reflection staring back at me, I realized that I had been strong on this day; but there were far more days when I hadn’t been. With Mom, there’s never an off day. Her love knows no limits. Her commitment to those she loves never wavers. Today, I want to thank her for helping me realize where true strength lies—otherwise, I could have spent my whole life looking strength in all the wrong places instead of summoning it from my own heart.  Even on my best day, I’m not half as strong as my Mom is every day. But I am making progress. For example, I used to be afraid of telling the people in my life how important they were to me----afraid of sounding sappy or weak. But now, all I’m afraid of is failing to be sincere. I love you, Mom. Thanks for everything. And Happy Mother’s Day to you & all the Mothers out there. Oh, & if you haven’t already done so; please don’t be afraid to let your own mom what she means to you. Thanks for reading.

Losing Control

I am seeing a couple of clients whose lives revolve around not losing control of their emotions. They both have a parent who is very out of control--addictions, emotional outbursts, marginally functional--the kind of people who seem beyond hope. "Black hole people," as my client calls them. These clients fear that if they let their emotions out, they will get lost in them like their parents.

This is a common fear. Most people think that having feelings makes you needy. Weak. Crazy. It's better to do whatever you can to avoid feelings altogether. Ironically, it is the things that people do to control their feelings that brings them to therapy.

Eating disorders are a good example of this. Every client says that their eating disorder began as a way to have control. They can't control any other aspect of their lives, but they can control what goes into and comes out of their bodies. Stuff down their feelings with food. Numb themselves by restricting and exercising. Get rid of feelings by purging.

At some point they lose control over this strategy. They think about food, exercise, bodies, and weight all day long, every day. They eat in isolation. They lose friends because they are constantly lying and hiding. When it gets really bad, a dean forces them to come to the counseling center. But no one can help them until they are willing to let go. Until they are willing to feel, to be vulnerable.

We all have ways that we try to control our emotions. Mine is to help other people. I don't have problems. I don't need anyone. I've got all the answers; I don't need help.

A client recently asked if I had any flaws. I told her that I have all kinds of flaws. She seemed relieved. I almost told her about my blog--but I'm not ready to go that far.

So what do we do with all of these feelings if we don't suppress them, deny them, or push them away? How do we keep from falling into the black hole?

One of my favorite movies is "The Matrix." By the end of the movie, Neo realizes that all of his fears are an illusion. He has to die first to realize this, but once he is outside of the matrix, his fears no longer control him. Feelings are the same way. Your feelings are a part of you, and you are larger than any of your parts.

Sometimes you have to let go before you can discover that you have control.

2014 Blog for Mental Health Project

“I pledge my commitment to the Blog for Mental Health 2014 Project. I will blog about mental health topics not only for myself, but for others. By displaying this badge, I show my pride, dedication, and acceptance for mental health. I use this to promote mental health education in the struggle to erase stigma.”  
A Canvas of the Minds

Sometimes we make the most important decisions in our lives without consciously knowing why we made them at the time.

I knew that I wanted to become a psychologist since I was in high school. At the time I wasn't fully aware of being depressed in the clinical sense. Being anxious was so much a part of my personality that I didn't think I had an anxiety disorder. And I definitely wasn't aware of any mental illness in my family. I had no idea at the time that depression, bipolar disorder, and anxiety would impact every aspect of my life--in both positive and negative ways.

It's probably not surprising that I have been negatively affected by mental illness. But as I write this post, I realize that there have been positive things about it, too. I have learned the most important lessons in life through suffering and loss.

Even as a therapist, when I heard clients make comments about how they had a bad week, it didn't fully register how horrible that week was for them. In part because clients don't elaborate unless you ask them to. Unless they are certain that you really want to know. And because they are embarrassed about it. Ashamed, even. But after going through my worst depression 5 years ago, I have much more compassion when clients make these offhanded comments.

I admit, during that period there were times when suicide would cross my mind. But there were two things that kept me from seriously entertaining it. One is that my dad would be devastated, and I feared he would never recover if I went through with it. 

The other reason is that if I took my own life, it would undermine everything I ever said to my clients about how pain passes. That one day when they look back they will realize how strong they were at the time. That they will learn lessons from their suffering that it takes some people a lifetime to learn. How can you believe anything your therapist said if she committed suicide? That would be the ultimate betrayal.

So I spent months willing myself to get better.  I went back to therapy, started meds again, meditated and prayed, and forced myself to play tennis and spend time with friends. And I did get better. And everything I said about realizing my strength, becoming more compassionate, and acquiring wisdom were all true. I would have never chosen depression, but we usually don't choose the experiences that teach us the most about life.

People often ask me how I can listen to client's problems all day long. In all honesty, I can't imagine what else I would do for a living. It feels more like psychology chose me.  And when I hear a client's story, I always have hope that together we can change the plot for the better. After all, I always root for the underdog. I am the eternal optimist. And I never back down from a challenge.

There was a time when I would never have told this story about my struggles with depression and anxiety to my students or clients. Or even friends and family. But now I want to share it with the world, because every act of courage benefits someone else. My blog is proof of that.

Obsessiveness

I don't know if you've noticed, but I'm kind of obsessive. I can't blame people for being annoyed with me. Sometimes I annoy myself.

I'm an excessive planner.  For example, because of my GERD and exercise-induced asthma, I'm constantly obsessing about what and when to eat. Last night I made rice at 1 a.m. while I worked on this post because it will save time and decrease the likelihood that I will throw up on the court tonight.

Sometimes obsessing is a memory device. Like I'll repeat a sentence that I want to say over and over until I see the person. Writing it down helps, but I can't always do that--like when I'm driving. Lots of obsessing while I'm driving.

You know how I said that blogging is my new boyfriend? Well, I'm kind of a stalker girlfriend.  I will check my blog stats repeatedly--hundreds of times on the first day I publish a post. Thank goodness it can't break up with me.

Sometimes I obsess like it's a hobby. I might obsess about my next blog topic.  Or what my strategy will be in my tennis match. Or when I can schedule my next haircut and if I want to try something different, like get bangs.

Obsessing is the most painful when it is fueled by the inner critic or drill sergeant or perfectionism. Then it's this relentless voice pointing out all my flaws (Your arms look fat in that picture!). Or when I'm not being productive (Get out of bed and do something!). Or how stupid I am for making a mistake (You shouldn't have dated that loser!).

There are things that help. I take antidepressants, which also help with anxiety. And when the obsessing gets out of control, I take Ativan. I used to obsess for days rather than take the Ativan, but my psychiatrist reframed taking it as a way to have control over my anxiety. And I'm all about having control.

I also practice mindfulness meditation.  You're not supposed to judge how well you meditate, so I will just say that I obsess about random things for 95% of the time while I'm doing it. But it seems to work, nevertheless.

I tell myself the same things I tell my clients. I remind myself that I don't know what will happen and I can't prepare for every possible scenario. To take one worry at a time. That no matter what happens, I will be able to cope with it. And that I have an excellent memory and won't forget.

Most importantly, I try to accept that this is a part of who I am. Some people may not have to deal with obsessive thoughts, but everyone has to deal with something. This is my thing.

Since blogging has helped me accept other aspects of my personality, I thought I would try blogging about my obsessions. Sometimes it helps just to say them out loud. And it's an added bonus when readers say they can relate.

I still obsessed all the way home about what to eat before and after tennis tonight and how to end this post, though. Oh well. I guess practice makes perfect.

Let it Go

I love Disney movies. And Disney's latest, Frozen, is one of my favorites, not only because the music is awesome, but also because it is a story about self-acceptance and love between two sisters.

Elsa is the heir to the throne in the kingdom of Arendale. She has spent her life locked in her room, afraid of her power to create ice and snow, because she accidentally injured her sister Anna when they were children. At her coronation, Elsa's powers are revealed when she sets off an eternal winter. When she sings the theme song, she is exhilarated that she no longer has to hide her secret. She creates her own palace of ice and snow on an isolated mountain top.

Although Elsa is free from her secret, she still doesn't want to let her sister into her life. And ironically, in her effort to protect her sister, she accidentally freezes Anna's heart, which almost kills her. But even then, she still tries to push Anna away, for fear that her powers will do even more damage.

It is not until the end of the movie, when Anna sacrifices her life to save her sister, that Elsa understands that surrendering to love is the answer to controlling her power. She is then able to unfreeze the kingdom and open the doors to the palace.

Tonight my brother called me because he has been depressed and struggling to make it to work. For the first time I shared with him how I had gone through the same thing 5 years ago in an effort to convince him to get on meds and to reassure him that this is not a sign of weakness. He was surprised that I had suffered as he had and that he had not known about it. But it wasn't his fault, because I didn't tell any of my brothers about it.

Although I had been on and off meds for several years, this episode forced me to accept that they would have to be a permanent part of my life. As humbling as this was to acknowledge, it was also freeing. But even after I felt better, I still remained in my kingdom of isolation, afraid to let people know.

Writing this blog is the first time I have been completely honest about how dark my depression was. And perhaps sharing my story will save someone else. But in this moment, the most important thing to me is that it saves my brother's life.

We all have the power to create barriers to keep our loved ones away from the darkness inside us. Yet the real answer is to let go and to bring that darkness into the light.

Meds

The first time I started anti-depressants I was 30. By this time I had been depressed for at least 15 years on and off and anxious non-stop for about 30 years.

Obviously, it would have made more sense to start them sooner, and people told me that, but I was anti-meds up until this time. I was in a research program that strongly favored psychological interventions. Meds were just a product of the money-making pharmaceutical industry and were over-prescribed. People were more likely to relapse when they stopped taking meds. Blah blah blah.

Most of my resistance was really because I was stubborn. No one could have talked me into taking them any sooner.

I finally decided to try them after my husband and I had moved again after a year. Before we finished unpacking, he was already obsessing about buying a house. I knew at some level that we weren't going to make it, which triggered a depressive episode.

I started on Paxil and sure enough, I felt better immediately. So much better that I wondered why I had allowed myself to suffer for decades when I could have just put myself out of my misery by taking the freaking pill.

Still, after being on them for a year and a half, I stopped taking them--with my doctor's approval. And I was OK for awhile. But then we bought a house and my husband wanted to find another one a year later. My marriage was moving closer to its sad conclusion.

This time I took Lexapro and stayed on it for much longer. When my life finally seemed stable, I tried going off them again. As soon as the meds were completely out of my system, I felt the depression slowly creeping back. I was a little more irritable. It was a little harder to tolerate stress. My thoughts were a little more negative. Occasionally I was emotionally explosive. And finally, I was barely able to get out of bed.

It turned out to be the most severe episode I had ever experienced. It seemed out of the blue at the time, but now I know that it was because my dad was also experiencing his most severe depressive episode. Even though I didn't talk to him much, I felt it. That whole super-empath thing. Damn empathy. So annoying sometimes.

I can honestly say that this time the meds saved my life. The depression and anxiety were so debilitating that I spent most of my time lying on the couch, willing myself to keep living, counting the days until the drugs kicked in.  And when they did, I was immensely grateful for the pharmaceutical companies that came up with drugs that allowed me to be myself again.

All clients want to try therapy without drugs, and we always do.  And sometimes that's enough.  But sometimes it's not.  And the process of going on and staying on meds for as long as necessary--which might not be for life--is long and arduous.  But when they finally take them, they are thankful that they did and wonder why it took them so long.

But they still want to go off them.

I don't criticize them for this, because my path to acceptance was longer than theirs.  I used to beat myself up over my stubbornness, but the reality is, you can't be ready until you're ready.

It takes a long time before we are willing to give up suffering.

Self-Disclosure

I started this blog as a way to put Brene Brown's claim that vulnerability leads to connection to the test. I believed it in theory but now I have empirical evidence that it works. But self-disclosure is still scary.

It's still a challenge to write about myself in a way that doesn't out all of the people in my life who have not chosen to be vulnerable. So I try to talk about myself without blaming anyone else for my problems--in public, at least. Which is a good approach to life in general, I think.

It's still hard to be open about my weaknesses, although people's responses have been positive. I freak out a little when people remark on how honest a post was, because that means I said something that they probably wouldn't have shared about themselves. But mostly I take it as a compliment.

There are still some posts that I have the urge to take down.  I haven't done so yet, because then it will take me longer to get to 100 posts. Luckily I have enough posts that only the most dedicated readers will find them. And if they like my blog that much, they probably won't judge me for them.

I still haven't told clients about my blog. Partly because I'm not brave enough, but also because therapy needs to be about them. Usually they come to see me because they don't have anyone else who will give them their undivided attention. If I were to say, Hey you know what? I wrote a blog on that very same problem. Here's the address, that seems a little self-serving.

It's hard to draw the line between unburdening yourself and burdening someone else. The best part about blogging is that I don't have to feel guilty about unburdening myself because if you're reading this, you have chosen to give me your undivided attention.

And for that, I am thankful.

No Good Reason

Most people who come to therapy for depression berate themselves for not having an excuse for their feelings.  Even when they can identify the stressors that led to their depression, they claim that these aren't good enough reasons to be depressed.
 
Sometimes people try to make them feel better with the "count your blessings" approach.  This usually makes them feel worse, because now they don't deserve to be depressed since they have so much going for them.

In cognitive-behavior therapy (CBT), therapists challenge irrational beliefs as a way to help clients see that their depression isn't logical.  Sometimes this works.  But sometimes they know their depression isn't logical, and pointing this out makes them feel even more ashamed for not being able to control their feelings.

For clients with the "no good reason" problem, I have found that the most useful strategy is to debunk their myths about feelings.  Since you probably believe these myths, too, I thought I would go through my whole therapy spiel.

1.  Feelings don't have to be rational.  That's why philosophers make such a big deal about distinguishing reason from emotion.  Sometimes they coincide, and it feels better when they do.  It feels better when we can say I'm sad because I'm sick of winter versus I'm sad and I have no idea why.  But we don't have to know the reason why for our feelings to be valid.

2.  There is no right or wrong way to feel.  We have a lot of implicit rules for what we should be feeling in a given situation.  Take my Ph.D. example in my post on self-worth.  I thought I would feel ecstatic after defending my dissertation.  Instead I got depressed.  Positive events don't always lead to positive feelings. 

3.  We can experience positive and negative feelings at once.  Researchers say that we can't do this, but I think they're wrong for reasons that are too complex to explain in this blog.  But I'll give you an example to prove that I'm right.  People cry at weddings because they are both happy and sad at the same time. 

4.  Your feelings aren't your fault.  We like to believe that we have more control over our feelings than we actually do because...well, because it makes us feel more in control.  But this illusion comes at a cost.  Which is why I wrote the posts on blame and free will.  You didn't choose to be depressed, and it's not your fault that you can't stop the depression.

 5.  If you try to make yourself stop feeling, you'll just make things worse.  Because this will involve some level of deception, like denying or suppressing or minimizing your feelings.  And at some point, this will blow up in your face when you least expect it.  Plus it will make you less empathic when other people tell you how they feel, which will lead to relationship problems.

Although I can write logically about these myths, I still fall prey to them, because feelings aren't always logical.  Knowing isn't enough to solve the problem; you still have to practice.  Which is why I practice mindfulness and self-acceptance.  And I encourage you to do the same.

So the next time you catch yourself saying that you have no good reason for your feelings, remind yourself that you don't need one. 



Fear of Sadness

Most people find it difficult to tolerate negative feelings like sadness.  This task is even more difficult when you suffer from depression, because any time your sadness feels too intense or lasts too long, you worry that the depression is coming back.  And if you've ever been depressed, you know how terrifying the prospect is of going back to that dark place.

Your loved ones also become hypersensitive to your sadness, which just exacerbates your fears.  If you're feeling down, they ask you if you're taking your meds, or if maybe your meds need to be adjusted.  Don't get me wrong--I'm all for meds.  I've tried to go off them several times, and each time I got depressed again.  But it's unfortunate that once you've been depressed, every feeling has to be scrutinized for potential pathology.

There's also this added sense of failure associated with relapse.  Like you should have been able to prevent it this time, since you've been there before.  And even though you recovered before, you fear that if it happens again, you won't be so lucky the next time.

And even if you do recover, you fear that the wait will be agony.  I fear depression much more than anxiety because when I'm anxious I can take an Ativan and I feel better immediately.  But antidepressants don't work that way, so there's not much I can do to feel better right away when I'm depressed.

Whenever I am afraid I'm becoming depressed, I journal about my fears, my sense of failure, and my pain.  And when I look back at these entries, I realize how strong I am.  There are a lot of things that suck about depression, but I have no doubt that it has made me a stronger person, even while it tries to convince me that I'm weak.

But how do I know when I'm sad versus depressed?  To be honest, I don't always know.  Sometimes I feel depressed for a day.  Sometimes I feel sad for what feels like an eternity.  The line is not as clear-cut as we'd like to think.  But regardless of whether it's sadness or depression, the best I can do is to control what I can control.  This includes therapy, meds, stress management, and self-care. 

And most importantly, for me, it means practicing self-acceptance--of my sadness, my depression, and everything else that makes me who I am, for better or worse. 

How to Save a Life

A few years ago a client told me that I saved his life.  Well, he didn't tell me directly.  He told my colleague when he was drunk at a gala. But he told her to tell me.  Although I'm not sure he remembers doing so.  Still, I was humbled by this.  I knew therapy was important to him, but I didn't think his life was in danger.  But then again, even when clients are in therapy, they don't always tell you the full story.

Once I had to cancel a session with this client and he stopped coming in for about a month.  Apparently he got depressed because he felt like I had abandoned him.  A professor contacted him because he had also stopped going to class.  When he came back to therapy, he told me that his professor saved his life.  That was the first time I really understood how much therapy means to some clients, even when they say they're not sure they want to be there. 

Last week I went to a threat assessment training, and the first case that the presenter discussed was a student who had to go to the police department because she told her roommate she was suicidal.  While she was there, she asked for a piece of paper and a pen.  She drew what appeared to be a bunch of random doodles.  But later when they looked at the drawing, they saw that she had embedded the word help three times.

This, too, reminded me that people may say they don't want help but their actions tell you otherwise.

Before I started blogging, I thought blogs were just another example of our narcissistic culture in that journaling, which is supposed to be a private experience, was turned into something that you shared with the world and everyone was free to comment.   But now I realize that blogs can be a way for people who have never had a voice to connect with people like themselves.

My favorite blog is by Nelly N.  She writes passionately and honestly about her struggles with obsessive-compulsive disorder, among other things.  She shares her most painful experiences so that other people who suffer in silence will realize that they are not alone.  And it works.

A few days ago the student group that I advise had their annual eating disorder panel.  It consists of students in recovery who are brave enough to share their story.  On our campus, people with eating disorders are blamed and judged more harshly than any other disorder.  Not surprisingly, no one wants to admit to having one publicly.

Every year, at least one student seeks treatment after attending the panel.  And the next year, those students volunteer to speak on the panel so that they can help someone else who is alone with their eating disorder.  Sometimes they use the opportunity to speak as motivation to get better.

We don't have to be able to leap tall buildings to save someone's life.  Sometimes heroes are ordinary people who take action when someone needs help.

                    

Free Will

When I was in college, one of my fellow psychology majors asked me if learning about psychological theories made me question whether we had free will.  It did not.  Although his question did make me read through the theories again, just to make sure I understood them correctly.  But I was still convinced of my free will.

In my last post I used the example of an alcoholic father to illustrate how difficult it is to sort out blame and responsibility.  If alcoholism is genetic, and his parents were alcoholics, and all of his friends drink, what chance does he have of living a sober life?  How much of his behavior is in his control?

What if you have someone who is depressed with no family history of depression and no apparent cause, and she can't get out of bed to make it to class.  Is her depression real?  Does she deserve to fail?  What about if she refused to go to therapy and start meds?

I mentioned in my last post that these problems require forgiveness.  We have to forgive ourselves for having the disorder.  We may have to ask for forgiveness from people whom we have harmed.  And we may have to forgive people who have added to our suffering. 

When I'm depressed, I think everything is my fault.  In the midst of an episode, I am angry at myself for not being able to function.  I don't think I have an excuse to be depressed.  In those moments, it's hard to forgive myself for not being able to control everything.

I also mentioned that there is always some part of the problem that we can take responsibility for.  It may not be the alcoholic dad's fault that he is prone to addiction, but he can join AA.  He can stay away from friends who pressure him to drink.  He can see a therapist.

I believe that knowing our limitations allows us to have more freedom.  In my work, clients often try to convince other people that their suffering is real.  I tell them that they have limited control over what other people think about their disorder.  However, they don't have to blame themselves.  They can take control of what they can control.

Some people think that going to therapy is a sign of weakness.  In reality, therapy increases your degrees of freedom.  And I want to make sure I capitalize on all the freedom I can get.

Whose Fault is It?

I love playing games.  One of my favorites is the Blame Game.  Even though any couples therapist will tell you that you're not supposed to do this, I'll use every piece of evidence of every argument I can remember to prove that it's not my fault.  I have no doubt this has contributed in part to the demise of some of my relationships. 

However, even though I don't like being at fault, I also blame myself for everything.  I'm one of those people who takes too much responsibility for problems.  Maybe that's why I am also willing to do more than half of the work to try to "fix" the relationship.

The whole blame and responsibility thing is even harder to sort out when you throw in mental illness.  Lets say, for example, that you have an abusive alcoholic father.  Is it his fault if he hits you while he's black out drunk?  Is it his fault that he has an addiction-prone brain and can't just have one drink?  What if he had been sober for a year but relapsed because a buddy guilt-tripped him into going to a bar to celebrate his new job?  What parts of the alcoholism are his responsibility?

In my work, the Blame Game is the most problematic in a sexual assault.  It is often the case that both parties were drinking.  However, when friends are assigning blame, the perpetrator is seen as being less responsible because he was black out drunk.  The victim is seen as being more responsible for allowing herself to get that drunk. 

And when the victim comes to therapy, she also believes it was her fault because she had been drinking.  The perpetrator usually doesn't come to therapy.  In rare cases, the victim will bring the sexual assault to our judicial system to get the perpetrator to take responsibility for his behavior.  And the victim almost never wins.

The two most common disorders we see in the Counseling Center are depression and anxiety.  These are disorders where the person takes too much responsibility for their problems.  If they can't will themselves to get out of bed and go to class, it's their fault for being lazy.  When I suggest that a client try meds for her panic attacks, she often says no.  That's a cop out. She should be able to do it on her own.

I don't claim to know the answers for how much blame a person should assume.  I do know that the split in assigning blame is rarely 100% to 0%.  There is always some part of the problem that we can take responsibility for.  And when we take responsibility for our part, it usually makes things better.

Sometimes no one is to blame.  This one is really hard for people to accept.  How can you play the Blame Game if it's no one's fault?  But let's say a typhoon hits the Philippines and causes mass destruction.  Whose fault is it?  There is power in blame because it gives us the illusion of control. 

But there is also power in forgiveness.  We can forgive the other person for wrongdoing, even if they haven't accepted any responsibility.  And we can forgive ourselves for our role in the problem.  And forgiveness is much more freeing than blame, regardless of whose fault it is.

Wants and Needs

The other day I had a session where I was talking to a client about wants and needs.  She said that she knows that she needs to allow herself to be taken care of, but she doesn't want to do it.  I thought that was interesting.  How can you not want what you need?  But then after I thought about it some more, I realized that there are all kinds of things that people don't want to need.  They are usually the things that bring people to therapy.

Most people don't want to need other people.  That would make them dependent, and dependency is bad.  It's a sign of weakness.  There is even a diagnosis called dependent personality disorder.  Excessive independence, however, is not considered a problem.  In our culture, you can never be too self-reliant.

While I have certainly seen clients who depend too much on others, more frequently I see people who are afraid to rely on anyone, like this client.  Which is strange, because in the animal kingdom, humans have the longest period of dependence on their parents.  And even as independent adults, we still need other people to have babies, to have jobs, and to survive.  Even hunters and gatherers relied on one another.  I don't think anyone would consider them weak.

Despite this knowledge, I have to admit, I don't like to rely on other people, either.  I don't ask for help unless absolutely necessary.  And the flaw that I am most of ashamed of is my need to be in a relationship.  That's why I'm so proud of myself right now for being alone.  But the truth is, while I'm not in a romantic relationship, I'm not really alone.

The other thing that people don't want is to feel.  Usually they come to therapy with the hope that I can help them stop feeling.  This includes the feelings that accompany disorders like anxiety and depression, as well as normal feelings like sadness after a breakup or loneliness--because that makes you weak.

Like dependency, feelings are also necessary for survival.  Without feelings, we would have no signal to figure out what is causing us pain.  Without feelings, we aren't able to empathize with other people.  Without feelings, we would be classified as reptiles in the animal kingdom. 

I don't want to be a reptile, but I do get frustrated with the intensity of my feelings.  Sometimes they reach the level of depression and anxiety.  And then I feel other people's feelings, too.  That's a lot of feeling for one person to tolerate.  And some people do find my feelings overwhelming.  I'm too needy. Too sensitive. Too much. 

Or maybe they were too reptilian to be able to empathize with me.

I often have to tell clients up front that if what they want is to stop needing and feeling, I can't help them.  Sometimes they transfer to other therapists, which I understand.  Who wants to be told that they have to accept being human?  But most people stay.  When I point out that only robots have the luxury of not needing or feeling, they acknowledge that they don't want to be a robot.

But it's surprisingly hard work, this being human stuff.  It requires a lot of self-compassion, self-acceptance.

Which is why I started this blog.

Judgment

There are certain personality types that are sensitive to being judged, and I have one of them.  It takes very little criticism for me to feel ashamed that I have done something wrong.  Sometimes I interpret neutral comments as criticism.  And in some cases, I've even interpreted positive feedback as criticism.

Once my first husband was talking about a picture of Alicia Keys and commented on how she had big hips.  I replied with, Are you calling me fat?  Which really annoyed him.  I kind of thought it was funny but true.  Even if I get what is intended to be a compliment about having an athletic build, I take this to mean that I look fat.  This is why it's better to refrain from comments about women's bodies in general. 

Although I have never had an eating disorder, I can relate to being obsessed about my body.  I also have a similar personality to the types of people who develop anorexia.  I am prone to anxiety and depression.  I am perfectionistic.  I am highly motivated to avoid harming others, even if it means hurting myself.  And I am so sensitive to criticism that I never forget a mistake.

This is why I am drawn to Buddhism--especially the practices of mindfulness and compassion.  I find comfort in the idea of letting go of what I "should" be thinking, feeling, and doing.  That I can accept whatever is true of myself at this point in time, without judgment or criticism--even if it's something that I hope to change. 

I often point out to clients when they are using judgment words to describe their feelings.  For example, if you say I feel pathetic, the word pathetic is not a feeling.  There is no emoticon for pathetic.  Sometimes it's actually hard to come up with a feeling word.  Usually when you can't think of one, you're probably feeling ashamed.

Even when we're successful in describing our feelings, we often get judged for them.  For example, if I say I feel depressed, someone might say You shouldn't feel that way.  You should be happy because you have so much going for you.  This is meant to make me feel better about myself, and perhaps it works for some people, but it never works for me. 

Sometimes I have tried to point out to the person that they are judging me, but people who judge others are often sensitive to being judged.  So they usually get defensive and say they were just trying to be helpful--that I'm being too sensitive.  So then I judge myself for being too sensitive.

But I am all about controlling what I can control.  Today, I realized that I can't control whether someone else chooses to practice nonjudgmental acceptance of my feelings.  I can only control what I say to myself. 

I can also choose not to share my feelings with people who judge me.  I think I'm going to start doing that, too.

Addiction

I've been thinking a lot about addictions lately.  Even before Phillip Seymour Hoffman's death.  I have never been the addictive type.  My history is so clean I would have made a great political candidate, if I didn't dislike politics so much.  But Richard Rohr, my spiritual guru, says that everyone is addicted to something.  So I'm trying to be honest with myself about what that might be.

At times my hobbies have been like addictions.  When I first started knitting, I would crank out so much stuff that I made all my Christmas gifts in a month and still had scarves to give away.  Same thing with making jewelry.  I sold a lot of what I made, but all my profits went towards buying more beads.   And I can sing Karaoke for hours.  I hosted a small Karaoke party over the summer and we sang for 6 hours straight. 

But knitters tend to be fanatical bunch.  Jewelry makers can be, too.  And for a Filipino, my Karaoke usage is average, at best.  Plus these hobbies tend to go in phases.  I'm in a knitting phase now.  I would describe my interest in these activities as obsessive rather than addictive.

The next addiction candidates would be tennis and sugar.  These two things are a consistent presence in my day-to-day life, and I cannot imagine living without either of them indefinitely.  Giving them up would require some kind of intensive inpatient treatment program, and even then the probability of relapse would be high. 

But playing tennis and consuming desserts has not significantly impaired my functioning, and I've been able to cut back.  I am only playing 3-4 times a week to prevent injury.  And I don't eat 3-4 desserts a day any more.  So I would classify myself as a heavy user but not an addict. 

As I was thinking about this post, one of my FB friends messaged me and asked me to write something about codependence.  And that's when it hit me:  I am addicted to unhealthy relationships.  Ostensibly because I want to help people, but needing to be needed is a form of addiction, too.   In the post on solitude I talked about how ashamed I feel for tolerating so much crappiness to avoid being alone.

Based on my experience as a therapist, I know that many people have the same problem.  Often clients come in for a relationship addiction.  Their friends and family are sick of listening to them.  They know they should break it off, but they can't.  They live in secrecy because they're still in contact with the other person.  If someone came up with a detox program for unhealthy relationships, they could probably make a fortune.

I guess in a way I have completed my own self-imposed detox program.  And for the first time in 30 years, I did not use another relationship to ease the pain.  I rank this accomplishment right up there with defending my dissertation.  Maybe even higher.  Because after my dissertation I got depressed because there was nothing left for me to accomplish.  But as far as relationships are concerned, it's all up from here.

Interestingly, I started this blog right before the breakup.  It wasn't conscious, but I guess at some level I decided that the energy I was investing in my relationship would be better spent writing.  And blogging helped me tremendously during the breakup process.  I don't think I could have made it this far without it.

So until someone comes up with a detox program for unhealthy relationships, I would highly recommend intensive blogging as a treatment strategy.