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.

IMG_9186

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?”

312
“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. 🙂

Advertisements
Coping Skills

Getting stuff done when anxious and depressed

College has been a struggle with my mental illnesses. I thought I’d make a list of stuff that I have found through trial and error that works for me in hopes of having a nice list for other students who are struggling, anyone who has stuff to get done and has trouble doing it, and myself for when I inevitable forget about all the good skills I have to remind me that I can do things.

Set a timer and work on something for only x amount of time.

  • This is good if the assignment seems too scary or overwhelming.
  • You break it down into a smaller piece that you can handle and feel okay with. Sometimes I set my timer for 20 minutes, and sometimes I set it for 5, or even less. The key is to do something manageable.
  • Then when the timer goes off, I stop and take a break. If I’m up for it, I set the timer again, but I don’t put any pressure on myself to do that.

Rewards!

  • I give myself stickers when I do important stuff, especially stuff that’s hard for me or things that I’ve been procrastinating. I actually mainly use this for therapy stuff, not school stuff, e.g. I give myself stickers for doing exposures, being vulnerable, using skills instead of doing target behaviors, etc.
IMG_7580
I have a sheet of paper pinned to my wall where I write down my accomplishments in pretty colors and give myself a sticker and checkmark.
  • Rewards can go along with the timer thing above. During my break, I can get to  play one round of a game on my phone, go out to the lounge and hang out with friends, read comics, etc.
  • Important note: do not use self care as a reward. A reward is something extra. Keep up with your normal self care habits regardless of whether or not you complete something. Take breaks regardless of whether or not you got anything done.

Ask. for. help.

  • This can be really hard to do, and sometimes asking for help doesn’t actually get you the help you need, which feels awful, but overall asking for help is so essential. 
  • To me, asking for help means:
    • asking questions in class when I’m confused,
    • emailing the professor or TA when something is unclear,
    • emailing my professor to ask for an extension when I’m going through a rough time,
    • asking people in my class if we can work together on the problem set (if collaboration is allowed),
    • asking people in my class how they did x problem I’m struggling with,
    • going to office hours,
    • emailing my disability services coordinator if I have questions or need something or am having a rough time,
    • going to see my advisor,
    • asking to switch my advisor when the relationship isn’t working,
    • asking my friend if I can talk to her when I’m having a bad day,
    • asking a friend if I can hang out with her,
    • asking for a hug,
    • asking my therapist if we can talk about something that’s been bothering me, or if we can have more frequent sessions,
    • asking people in my suite if there’s a problem I’m not sure how to deal with or could just use some help with (mouse in my room, people are being too loud at night when I’m trying to sleep, etc.)
    • and many other things
  • The main thing that gets in the way of asking for help, for me, is lots of shame. I try to check the facts on whether the shame is justified and if the intensity is justified and effective. It’s usually not. Generally, asking for help will a) get me what I want and b) help to solve my problems and also c) show people I care enough about something and d) am working on it enough to ask.

Be realistic when planning out what to do.

  • This is hard for me, especially when the amount of things I have to do is not possible.
  • I have to radically accept that I cannot do everything, and I cannot be perfect.
  • In that case, I have to decide what to skip. Sometimes this means getting less sleep, but I try not to do that because I know less sleep will make me feel worse later. Sometimes it means I don’t go to a club meeting, don’t answer all the questions, get some wrong, skim readings, miss a class, and don’t do things as thoroughly as I like to or as thoroughly as I think my professor would like me to, ideally.
  • In these times it’s helpful for me to remember that other people are skimming the readings, not understanding everything, and getting questions wrong, too. No one is doing all the work.
  • Being realistic is beneficial in the long run because I don’t feel as guilty later for not doing everything. I knew from the start that it was unrealistic, and I had already decided not to do something and accepted that I wasn’t going to do it.

Prioritize, and do the priorities first.

  • I have a new planner this year that categorizes the to-do list into three sections: top priority, priority, and errands. This has been helpful to me because I sometimes feel overwhelmed by all the things I have to do. When I put them into the categories, I find that I only have a few top priority things to do, and most of the things I have to do are errands. It will be okay if I don’t get to the errands because they’re less important and less urgent. Knowing this helps me feel less stressed.
  • When deciding what’s a priority, I think about this equation: priority = important + urgent.
  • I also have a drawing on my wall of the fish tank thing where you put the big rocks in first. The fish tank thing…I’m not sure where I heard of this, but it was a while ago. Basically, you want to put the big rocks (important things) into your fish tank (you life, day, schedule) first so that the extra space is filled up with the less important things. If you put the smaller things (sand, gravel) in first, you will fill up your tank before you have room for all the big rocks. Here’s a video explaining it.
IMG_7579
This is my drawing. It’s some sort of vase instead of a fish tank, and I have flowers instead of rocks. The size of the flowers roughly represents the amount of time, relative to the other things, that I want to spend on it. Sleep and self care are the biggest. Classes, homework, and eating are second. Hygiene, fun, planning, and replying are third. Clubs, socializing, and cleaning are next. (some of these things also fall under self care) Projects, events, and volunteering are the smallest.
  • In more concrete terms, for me this means having a rough bedtime to make sure I get enough sleep, blocking out time for meals, going to classes and doing homework before reading random emails and fiddling around on my computer, doing the assignment that’s due tomorrow instead of the one that’s due in two weeks, etc.
  • Sometimes it’s hard to motivate me to do the highest priority things first when other things are more fun or easier. Recently I’ve learned (the hard way) just how guilty, ashamed, sad, angry at myself, and stressed I feel when I don’t do the important things. Although the intensity of these feelings is not justified (i.e. the magnitude is greater than the actual situation calls for, and I should use opposite action), I still want to avoid feeling like that. I’m currently using that as motivation to do the most important things first. (or first-ish)

Take breaks!

  • Lots of little breaks while you’re working (see timer thing),
  • some longer breaks, maybe every few hours (or more/less frequently, depending on how you’re doing)
  • and some really long breaks — I like to take Friday afternoon though Saturday afternoon off and not do things related to school. I also go home about once a month.

Have other important things in your life besides school/work.

  • I like to think of the saying, “Don’t put all your eggs in one basket.” If you put all your eggs in one basket and happen to drop the basket accidentally, all the eggs will crack. But if you keep some eggs at home and put some in a purple basket and some in a green basket, and then if something happens to the eggs in the purple basket, you will still have most of your eggs.
It’s like this cartoon. 🙂 (image from https://www.reddit.com/r/GetMotivated/comments/3i8z5r/image_convertible_and_a_lake_peanuts_by_charles/)
  • When one things gets tough, you can rely on another to keep you going.
  • Therapy, dancing/ballet, arts and crafts, and relationships with friends are things important to me outside of school. I spend time on them, have fun, and make progress. This also helps me keep some perspective. There is more to me than this one thing.

If you’re going to procrastinate, procrastinate effectively. 

  • If you just can’t do that hard thing now, do something else productive. Take a shower, do laundry, eat a meal, reply to an email, etc. Then you won’t have to do it later on, and you’ll feel accomplished!

Take care of yourself when you need to.

  • If your anxiety is too high to concentrate at all, or you’re dissociating and can’t focus, or can’t stop crying and thinking bad thoughts, take a step back and evaluate what skills you need to use. Forget about work for now and just focus on taking care of yourself and your mental health. It’s more important. Use skills that you know work for you. Then go back to the work later, once you’ve recovered. Communicate upfront if you didn’t do something that others were relying on or expecting (e.g. group project). Be honest if you can.

Budget in extra time. Allow for mishaps. 

  • I’m not very good at this now but hope to be better at it. I sometimes have flashbacks or other crises that take me out of commission for a few hours. Ideally, I would not be doing my homework right before the deadline, and I would schedule in a few spare hours with nothing planned so that other things can flow over into it so that when this happens, it wouldn’t cause as great a problem, but I’m not there yet. I’m working on it.

Listen to music while working.

  • This probably doesn’t work for everyone (well, nothing works for everyone), but I find music helpful in blocking out distractions. If I listen to upbeat music, it also keeps me somewhat energized and hopeful about what I’m doing. Today I’ve been listening to a 60s music playlist on youtube. 🙂

Keep up with normal self care habits.

  • They generally make people feel better overall and more motivated and able to do things.
IMG_7582
Also on my wall — this reminds me of what self care means to me. The blowing bubbles imagery reminds me to breathe out as if I’m blowing a bubble.
  • Take a deep breath and let it out slowly. You can do it!! 🙂

 

In summary, because this was a long post:

  1. Set a timer and work on something for only x amount of time.
  2. Rewards!
  3. Ask. for. help.
  4. Be realistic when planning out what to do.
  5. Prioritize, and do the priorities first.
  6. Take breaks!
  7. Have other important things in your life besides school/work.
  8. If you’re going to procrastinate, procrastinate effectively.
  9. Take care of yourself when you need to.
  10. Allow for mishaps. Budget in extra time.
  11. Listen to music while working.
  12. Keep up with normal self care habits.
  13. Take a deep breath and let it out slowly. You can do it!! 🙂