Life, Therapy

Challenges and benefits of getting better

(Note: brief, vague mentions of self harm, eating struggles, deaths, and violence) 

I am happy and proud to say that I have been feeling much better recently!

My PTSD has almost disappeared! I have nightmares less than once week now, and their content is much less violent and traumatic. I can’t remember the last time I had a flashback! I’ve had many fewer intrusive thoughts, too.

I think the main reason for these improvements in my PTSD is that I’ve been doing Prolonged Exposure and directly confronting traumatic memories. I’m proud of this because I’ve put in the work and done things that scared me and were hard to do. I may write about this more later, but it really is remarkable to me how much it has helped.

I have so much more free time in my day now. Being upset took up so much of my days! I have more time available for going to class, doing homework, and hanging out with my friends, and sometimes I even have free time left over after that!

I got grades that I am proud of this semester; I took on a leadership position in a club I’m part of; I even tried flirting with someone I had a crush on!

Getting better is a change, and change can be scary

However, there are still struggles in getting better. It’s new and very different from how the past few years of my life have been. Change of any type is hard and scary for me, even when it’s positive change. There are new things to get used to.

Experimenting with the possibility of dating someone was a very stressful experience for me, even though I’m glad I tried and have grown from it and made a new good friend (I told him I liked him; he said he didn’t like me back, but we’re still good friends). There are a lot of situations I’m not used to being in. Applying for jobs? Having interviews that aren’t for therapy programs?!

It’s scary, but I’m growing. 🙂

Higher expectations for myself

As my mental health improved, my expectations for myself shot up. Before, I called a day a success if I went to all my classes and ate some meals, and I’d be proud of that and pat myself on the back because I knew it had been hard to do. When those things got easier and more routine, I felt that I needed to do more. I thought that since I was doing better, I had to take school more seriously and actually get better grades (in part to make up for the lower ones I’d gotten when I was struggling more). My mental health had been holding me back before, and it wasn’t now, so I felt that there was no excuse to not do well, to not do everything, to not be like my peers.

I didn’t see it at the time, but those were unrealistic expectations. There is a lot of room in-between managing to make it to most classes and getting straight A’s; it’s not strictly one or the other. I expected myself to be perfect all of a sudden. I wanted to be able to make up for all the things I’d missed out on over the years all at once.

Wanting these things did make me more motivated, and I plan to achieve many of the things that I realized I wanted — someday. I have to radically accept that I can’t do everything all at once, and I can’t do everything so fast. I need to be patient with myself. While it’s great that I am getting better and seeing improvements, I’m not fully better. It’s a slow process and something that I need to keep working on.

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Not everything gets better

Another thing to radically accept is that there are some things in my life that don’t get better as my mental health gets better. I came home from college recently, and it was a bit of a rude awakening to see my parents arguing just as much as they had been when I left. My improvement hadn’t affected them — of course it wouldn’t, but somehow I just assumed that everything in my life would get better as my mental health improved. That’s not the case.

Therapy also can’t make up for the fact that I have two family members missing in my life. Opposite action can’t bring them back from the dead. I think that I am dealing with the losses better than I was a few months ago (I’m not incapacitated by sadness; I don’t spend most of my days lying on my bedroom floor crying; eating isn’t as much of a struggle), but they are still gone. I am still sad. The grief resurfaces every now and then.

Worries about things worsening

Another challenge is that I worry about my mental health worsening again. Now that I’ve experienced how good things can be, I feel a deeper loss when I’m temporarily feeling worse again. I know all the things I’m missing out on and feel sorry for myself.

When something goes wrong, I also worry that it’s the beginning of the end. Will I go back to being depressed and tormented by nightmares? Good things can’t last forever, right? Is this a temporary blip in my life, or a more lasting change?

If I check the facts on these fears, I can see that the gradual changes I’ve made over the past year have lasted so far. I can see that I have been doing the treatment recommended to me by multiple therapists who believed that it would improve my life, and they agree that I have made lots of progress.

Yes, more bad things are bound to happen in my life, but I do have better skills to deal with them now. I haven’t self-harmed in maybe four months? I “graduated” from DBT group, and I use the healthier coping skills that I learned there every day. I can get through things.

Same friends, new relationships?

When I became friends with the people I’m friends with now, I was struggling, and I was looking (consciously or unconsciously) for certain things in friends — sensitive, a good listener, etc. In addition, many of my friends have their own struggles with mental illness. I’ve also stayed in touch with some people I knew from group therapies.

As a result of these things, many of my interactions with my friends were centered around me venting/asking for support, or me providing emotional support to my friends. I was happy and grateful for that, and it enabled me to have deep, intimate friendships, but I’m not struggling as much anymore. What do we talk about now?? What if we can’t relate as much because we’re not in the same dark place anymore? What if my friend liked me because she felt like she was helping me, and now there’s nothing left to be helped? The dynamics have shifted.

I don’t think that any friendships will end over this, but I may end up more distant from certain people, and that makes me sad. I suppose it’s also possible for friendships to evolve as people evolve, and I hope that mine will, because I really do like my friends.

On the other hand, I am also making new friends. Now humor and playfulness are more attractive qualities to me. I want to laugh for a while with a friend more than I want to express to them how badly I’ve been feeling. There is a time and place for both, but I find myself wanting more fun now than I did before. This is another change that is scary for me at times!

My friends enabled my avoidance

Some of my friends also enabled some bad habits that I want to stop doing now. They let me and even encouraged me to avoid things. Part of my exposure therapy is not avoiding things that aren’t objectively dangerous. I don’t want to avoid things anymore, but the message hasn’t sunk in for my friends yet.

Several people know that I hate blood, decapitation, violence, and related things. When there are scenes in movies with those things, they say, “[My Name], don’t look!” They say, “I don’t think you’ll like this movie, it’s not for you.” When I ask, “What are you laughing at on your phone?” they say, “You don’t want to know, you won’t like it, it’s bad, trust me.”

I very much appreciated these warnings at times when I felt like I needed them, but now I feel like I can handle things. I know that avoidance makes my fears stronger. I don’t want to avoid! I am ready to face scary things!

It’s just frustrating that my old habits were so deeply engrained that they spread to my friends, and now I have to change my friends’ habits, too, not just my own.

Overall

Overall, I’m doing so much better now than I was a few months ago. A couple of weeks before final exams, someone asked me how I was doing, and I said “good”! She said, “haha, like the dog in the fire meme?”

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“This is fine” meme — image from https://knowyourmeme.com/photos/1401347-this-is-fine

Meaning, was I saying that things were fine when I was really super stressed out about finals? I wasn’t! I was serious that I was doing well! As I thought back on the conversation afterwards, I realized that I wasn’t just doing well, I was doing the best I had been in the past two years. That seems quite amazing to me.

I wrote this post because I think I had an idea in my head of “getting better” that was all perfect sunshine and butterflies, and I wanted to express the ways in which getting better is still hard. But the positives definitely outweigh the negatives. 🙂

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Affirmations

Affirmation #16 — I am imperfect

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cannot be perfect.

It is impossible.

I cannot do everything.

I cannot prevent everything bad from happening.

I am imperfect.

The world is imperfect.

It sucks sometimes.

It’s the way it is.

I have a life to live,

Not a death to prevent.


 

This affirmation is maybe not as uplifting as some of the others, but it can be freeing. It’s more about radical acceptance of my inability to control everything.

I was in a bad car accident a few years ago, and for a long time afterwards, I fixated on the things I could have done to prevent it and ways to be safer in the future. I was very cautious. I avoided traveling, long car trips, and driving on the highway because I feared they would lead to situations where another accident would happen. I carried safety gear around with me wherever I went. My backpack was big and bulky, but I carried it with me everywhere.

Over time, these things and many more worsened my PTSD because I was avoiding so much and made me depressed because I was limiting my life. I ended up in a partial hospital program, and, with the help of my therapist, realized that some things in my life needed to change.

Some bad things will happen no matter how hard I try to prevent them. It’s sad and awful and makes me feel scared, helpless, and out of control, but it’s true. There are some measures I can take to be safe, of course — always wearing my seatbelt, maybe keeping a resQme tool in the glove compartment of the car but not carrying it with me otherwise, practicing driving on the highway when it’s less busy so that I build up my driving skills over time, etc. — but staying in my safe bubble was making my life miserable. Thus, I have a life to live, not a death to prevent. I can’t do everything, but I will do what I can and live my life.

Affirmations

Affirmation #10 — Good AND Bad

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There are good days AND bad days. Keep going, and you’ll find both.

When I’m not doing well, it sometimes seems like these bad things are all that have ever existed and all that will ever exist. But that’s not true! Good days will come again.

Conversely, sometimes when I’m doing well, I think that I’m finally at an idealized “better” place and that my life will be perfect from now on. That’s not true either. There will always be hard times, easier times, neutral times, happier times, sadder times, etc., throughout life. When I expect things to be more perfect than is realistic, it a) makes me stressed about the good times ending because I know deeper down that I won’t be able to keep up with these expectations, and b) makes me crash harder when I start to feel worse again.

Reminding myself of the duality and accepting both the good and the bad helps me to keep a more balanced perspective.

Coping Skills, Life

What to do when things aren’t working

I’ve heard other people on blogs and in person express the sentiment that they’re trying everything they know how to do, and it’s not working. What do you do when nothing seems to work?

I’ve been struggling with feeling like nothing’s working recently and then feeling even more hopeless as a result. I’ve been having a tough time since my uncle and and grandmother passed away. I’m grieving and being reminded of past trauma and the recent trauma of their deaths in intrusive and unpleasant ways, all the while being apart from my family (away at college) and trying to literally survive and not fail my classes.

So what do you do??? I wish I had more answers than what I have, but I’ll share what’s getting me through so far, and if anyone has any other ideas, please let me know.

Validate yourself. If you’re trying everything you know and using all the skills you have, you’re probably trying really hard and dealing with some pretty hard stuff! Give yourself some credit and acknowledge that you are struggling.

Think about what you mean when you say “things aren’t working.” Sometimes the skills I use do work; they just don’t solve all my problems. For example, the goal of distress tolerance skills in DBT is to get you through the moment without worsening the situation. They’re not supposed to make you feel happy or to get rid of whatever was causing the strong emotion. If I hold ice up to my face (the TIPP skill) in place of acting on crisis urges, then the skill worked. Even if I am still really upset and the crisis urges come back soon, the skill got me through that moment. I expect that skills will help more than they are able to. Having more realistic expectations here would help, I think.

Make sure you’re doing the things that have helped in the past. Personally, I know that I have to eat enough and sleep enough and get exercise and see my friends and have time to myself regularly in order to maximize my okay-ness. Sometimes I get frustrated thinking, “But I slept so much! I ate three meals! I did so much good work and tried so hard! Whyyy am I not feeling better?” and maybe it’s because I’m avoiding my friends and haven’t had a real conversation with anyone in a week. Not doing one essential thing, even when you’re doing all the others, could be the missing piece.

Ask for and accept help from other people. You don’t have to do everything alone! Friends, family, strangers, online friends, old friends, therapists, doctors, etc. can all help! For example, my mom visited me at college this past weekend. She has offered to do this in the past, but this was the first time that I accepted her offer. She was willing to help, and I knew it probably would make me feel better and was desperate. Her visit ended up going great, and I felt much better afterwards deep down.

Still on the topic of asking for help, I sometimes know that I need help but don’t know what I need. When people ask, “What can I do?” or “How can I help?” I don’t know how to answer. I’m still working on learning what I need, but here are some things that I have asked for: a hug (many times), for my friend to let me vent, for my therapist to reply to my email, for an extension on an assignment, for someone to eat a meal with me, for a friend to send me something in the mail, to schedule an appointment with a doctor, to set up a time to facetime a friend. These are things I can ask for! People can always choose to say no, but asking doesn’t hurt and often helps a lot!

Maybe consider bigger changes in your life. I know that if I keep on feeling this badly, taking a semester or a year off of school is an option. Dropping some classes is an option. Going to an inpatient, residential, or day treatment center is an option. Changing my therapist is an option. Transferring schools or switching my major are options. There are lots of options!

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Radically accept that 1) you are having a tough time right now, and that 2) there are things you can’t change and have no control over. This can allow you to see a situation more realistically and therefore make better decisions about the things you can control. I can’t change the fact that my uncle and grandmother died, but I can celebrate their lives, think of fond memories, and strive to embody the qualities I admired in them.

Have patience. I know that this can be really hard to do. But giving things time and just pushing forward can work. Hold on. Time may not heal everything, but it can help with a lot. I have a saying that I like: “There are good days and bad days. Keep going, and you’ll find both.”