Category Archives: Living with Depression

My Plea for Suicide Prevention

Plea for Suicide Prevention

I am making a plea for suicide prevention.

Last week, someone I knew form high school killed herself. This is not someone I had been particularly close to or had even seen in the last 2 decades except for occasional Facebook posts. Still, I knew this person, and she was a friend of a friend.

According to a recent New York Times article titled U.S. Suicide Rate Surges to a 30-Year High, “From 1999 to 2014, suicide rates in the United States rose among most age groups. Men and women from 45 to 64 had a sharp increase.”

This is my age bracket. This was the age bracket of the woman who killed herself.

So I am making a plea for suicide prevention.

If you know someone who is suicidal, please don’t tell that the person that his or her life is not so bad or that things will get better. These platitudes do not register to a brain that is engulfed by darkness.

Instead, ask the question, “How can I help you?” And mean to help. Make yourself available. Call this person. Go see this person. Encourage this person get out of the house and do something. You can be a resource for that person, a part of a safety plan.

Yet, while you can be resource, what you cannot be is a savior. The ability to survive, to make it through an incapacitating depressive episode, is something that only the individual who is suffering can do. Simply put, there is no external factor you can throw at the situation (even your best intentions) that is going to save someone else. That has to come from within. It is the individual alone who is ultimately responsible for weathering their personal storm.

If you are suicidal, know that many people, including myself, have these feelings and do get through it. Also know that you do not have to experience this profound and debilitating sadness alone. Reach out. Speak up. Talk to someone. Call a friend or a psychotherapist or a suicide crisis line. Call 1-800-273-TALK or text 741741. Allow someone who is trained to help do just that.

Find some coping strategies. You may not be able to consciously change your thinking but you can unconsciously change it through your actions. A number of practices — being in nature, practicing gratitude, building social relationships, meditation — have been shown by science  to enhance subjective wellbeing. In other words, they actually can change how your thinking to a more positive mindset. So try to do one or more of these things every single day.

After the crisis ends, start building a mental health toolbox. Incorporate some positive rituals in your life that will enhance your emotional resilience. With this toolbox, if another crisis arises, you have strategies to help yourself already in place. You have tools to use and resources to draw on.

This is my plea for suicide prevention. Please don’t give up. Please hold on another day. Recovery from these dark feelings is possible. And I want you to recover.

 

Resources:

http://www.suicidepreventionlifeline.org

Suicide Prevention Dialog

 

 

To Live Successfully with Depression

I can’t tell you how long I’ve “suffered” from depression. I mean I took an intentional overdose at the age of 11 for crying out loud. So, yeah, a long fucking time. But, you’ll be happy to know that I’m no longer battling depression. Oh, don’t get the wrong idea. It’s not that I’ve conquered it, that I beat it or won the battle (the way some people talk about their relationship with cancer). I’m no longer battling it, because I’ve decided to accept it instead. I’ve decided to live successfully with depression.

I have depression like some people have herpes (I don’t by the way, just want to make that clear now). Okay, maybe it’s not the best comparison, but this is what I mean. If you have herpes,  the virus is always in the body even when you are symptom free. But when that herpes sore shows up (often triggered by stress or hormones), there is no denying it. It’s a wound that physically hurts.

Well, that’s how depression has been for me for most of my life. I’m not always a crying, withdrawn mess. In fact, in general, I’m a pretty happy, positive person. But, when I have a depressive episode, it’s undeniable. It’s a dark and painful place, and I believe it’s always going to be a part of my life. So I have to learn how to live successfully with depression, instead of trying to eradicate it, because it’s not just going to disappear.

In the 30+ years since I first thought something was a bit off with me and in the 20+ years that I’ve been diagnosed, I’ve fought the label. I mean, let’s face it, as enlightened as we claim to be, there is (still) a stigma attached to mental health issues. I didn’t want anyone to know that there were days when it literally took an act of god to get my crying, lethargic ass out of bed or that there were times when I had to force myself to eat or leave the house when really all I wanted to do was curl up and die. Or that I’ve tried to kill myself. Twice. No one wants to hear that shit.

But, February is Acceptance Month! I interpret acceptance as incorporating three qualities: becoming aware, being compassionate, and not being attached to specific outcome. You have to wake up to what’s going on. You have to treat the difficult reality with compassion. And, you have to let go of your expectations.

I may not have mastered acceptance in any other area of my life this past month, but I mastered it for depression. (Note: I didn’t say I mastered depression. I mastered accepting my depression. Big difference!)

Awareness. I worked really hard to become more aware of my mood, especially when it started to wane. I would literally tell myself, “You’re feeling sad right now” or “This is loneliness.” I labeled the mood and tried not to get swallowed up by it

Compassion. I treated myself with compassion, and by that I mean, I forced myself to do things that I knew intellectually were good for me, even if in the moment I had zero desire to do anything. I texted my bestest friend in Austin. I called my only friend in Munich. I made myself go run.

Non-attachment. In the end, I decided to stop thinking that depression is a battle where there’s going to be a winner (Happy Silke), of course. I can’t continue that charade, where there is only 1 outcome and it’s me never feeling down again. Sorry, it turns out that depression is part of who I am.

Acceptance. I let go of the fantasy and admitted to myself (and to my husband) that there will be hard times and I will have depressive episodes – probably for the rest of my life. And, if that’s the case, then I better get it together enough to do what I can in order to live as successfully as possible when I experience those episodes. I have 3 children and a husband who count on me to be here. I have friends and family who love me and want me around.

So, I better have a big old Rosie the Riveter tool belt full of tools I can use at my disposal – therapy, books, writing, meditation, social engagement, exercise, practices and habits that help me deal with depression – because I am going to need every single one of them and probably a combination of several to live successfully with depression.

I accept my depression and I am learning how to live successfully with it.

May I have the serenity to accept the things that cannot be changed, the courage to change what can be changed, and the wisdom to know the difference.

Amen to that!

 

Serenity Prayer

 

 

My Wonky Brain, Part 2

Part 2 – Change is Possible

This is the second part is a series in which I discuss my wonky, depressed brain and weaning myself off my anti-depressants. You can read Part 1 here

 

 

Look, I didn’t just decide to go all rogue with this. I wasn’t like, “Fuck You, Depression. You don’t own me!”

I am, generally, a rule follower. I take my meds (religiously). I go see my psychiatrist/therapist (religiously). I read tons of self-help books (religiously), and I’m working on changing my negative behavior patterns. I do what I’m supposed to do.

My Wonky Brain on Depression - Notice there is a wick, because I can go down in flames.

My Wonky Brain on Depression

…..

There are three truths I considered when deciding to go off my medication for major depression.

  1. All manner of things (which I’ll collectively call “input”) affect the brain’s anatomy and physiology.
  2. The brain’s anatomy and physiology affect behavior (which I’ll call “output”).
  3. Both behavior (input and output) and brain anatomy and physiology can change.

But, don’t trust me (the depressed person going off her meds) that these are truths. Trust the science.

The brain is a dynamic organ. It is uniquely influenced by all kinds of things – diet, stress, endogenous and exogenous chemicals (e.g. hormones and drugs), disease and injury, and pre- and post-natal experiences. Numerous studies show that not only can neural circuits be altered by what we experience but so can neuroanatomy. Hubel and Wiesel won a Nobel Prize for their work showing just this. They sewed close the eyes of baby monkeys for a few months and found that upon removing the sutures, the monkeys were essentially blind in the eye that had been closed. In this case, the lack of visual stimulation rendered the neurons in the visual cortex (the part of the brain that “sees”) non-functional, even though all the neurons leading up to that part of the brain were active and even though the neurons of the visual cortex were not damaged per se.

Furthermore, during certain critical periods of development, the brain is more susceptible to adverse input, including negative affective interactions. It is now accepted that emotional attachments early in a child’s life influence the development of the limbic system (this is the emotional brain) circuitry. Have you heard of Harlow’s monkeys?  Okay, those were pretty horrible experiments, but they showed that the relationships a child has with its caregivers (or “Mother” figure in Harlow’s experiments) form the framework from which the child will develop his or her personality and psychosocial skill set. This is what’s known as Attachment Theory.

Input – in the examples I’ve given, visual stimulation and nurturing – affects the brain, but we have to remember that this is a two-way street, because the brain affects output, that is behavior, too. I mean, just think about this. If you want to pick up that cup of coffee (or wine or water), that action is totally dependent on a signal from your brain to muscles in your arm and hand. This is the problem with people who have Parkinson’s disease (PD). The degeneration of dopaminergic neurons in a specific part of their brains affects ability to move intentionally. So,  people with PD develop tremors, are slower to move, and have difficulty initiating movement. Simply put, their brains don’t allow them to do what is is they want to do; their brains don’t allow the behavior to happen. The change in their brains –the loss of dopaminergic neurons and signaling – directly impacts their output.

Luckily, for me, as far as I know, there is no neurodegeneration happening in depression. As a result of my condition, I may have altered levels of certain neurotransmitters and, as a result, altered neurocircuits and signaling. But, given everything I’ve written here, just because I suffer from depression and just because it’s a diagnosed illness, doesn’t mean that (1) taking my anti-depressant every day (at maximum dose) will “cure me” (clearly that has yet to happen) or that (2) going off my anti-depressants is a recipe for disaster. If the input can modify my brain, and the brain can change and modify the output, then, I think there is reason to believe I can improve (or get worse – it goes both ways) without medication.

I have to trust in neuroscience (and I do).

Yes, this may be (very) wishful thinking, but my desire to “treat” my depression without medication implies that I have some control over the manifestation of my illness (just like a diabetic has some control over the manifestation of his or her illness, depending on what she eats). And I intend to exert that control and change my behavior so that I change my brain so that my behavior is changed.

It’s kind of circular, but you get what I mean, right?

…..

So here’s where I am. I’m about 9 months into this. I’ve been weaning myself off Cymbalta since last spring. First, I switched from a dose of 60mg to a dose of 30mg, and I kept at that dosage for several months. Then I switched from taking a pill every day to taking one every other day (which I did for 3 months) to taking one every third day (which I did for 2 months). Currently, I take a pill every fourth day, and, in the next month, I will switch to taking a pill once a week. And then…I’m off meds altogether.

Oh, I still have times when I’m sad and when I struggle, but who doesn’t? But now, during times, I call on my mental and emotional reserves to get me through. The truth is that sometimes I’m successful, and other times I’m a work in progress. But, I now acknowledge that life is hard, that bad stuff happens. Yet, I know it will change. It won’t stay bad forever. And, I acknowledge that it isn’t just me to whom bad stuff happens. It happens to everyone. It took forty odd years, but I got that. Finally.

So, here I am, not exactly going rogue, but going off my meds all the same.

 

Here’s where you can learn more about what the science behind this.

https://www.psychologicalscience.org/journals/cd/12_1/Kolb.cfm

http://www.sciencedirect.com/science/article/pii/S0531513105013403

http://allanschore.com/pdf/SchoreIMHJAttachment.pdf

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2228409/

 

Here’s some other books if you are interested.

The Man Who Mistook His Wife for a Hat (Oliver Sacks)

Phantoms in the Brain (V.S. Ramachandran)

 

Stages of Wound Healing

There are four stages of wound healing. When tissue is damaged, the immediate response is hemostasis, which involves blood vessels constricting and blood clotting. This is essentially the body’s Band-Aid, a quick fix that prevents death by hemorrhaging (yeah, that doesn’t sound good). Following this is inflammation. The damaged area becomes swollen and red while immune cells carry out their job of destroying invaders and removing the damaged, dead, and unhealthy tissue. During proliferation new cells grow in the area of damage. In essence, what has been destroyed is rebuilt. Finally, there is resolution of the wound, during which the damaged tissue restores its functionality and physical appearance. This stage may take years.

Ewwww gross!! Yes, it's ugly, and it hurts, but that's part of healing. Deal with it. Courtesy of taliesin (morguefile.com)

Ewwww gross!! Yes, it’s ugly, and it hurts, but those are essential parts of the healing process. Courtesy of taliesin (morguefile.com)

Although this is an accurate (albeit simplified) summary, it illustrates the similarities between physical wound healing and psychological wound healing.

When we are psychologically hurt, our first reaction is to use something to help us right then and there (or as soon as humanly possible). How many times have you had a bad day and your immediate response was to pour a stiff drink or stuff your face with chocolate? Drinking alcohol or eating to excess or taking a Xanax or screaming at your child/husband/grocery store clerk or shopping, or whatever it is, allows us immediate satisfaction, relief from our pain or stressor. While some of us may actually engage in healthier options (like going for a run or meditating) when we are in mental pain, the Band-Aid is temporary and probably won’t provide a long-term solution to healing underlying injury.

To address the underlying injury, we must enter an inflammatory stage in which we excise the damaged parts. We recognize the bad stuff and say, “I’m done with this. It’s got to go if I’m going to get better.” This bad stuff may be old trauma that we’ve never addressed, unskillful habits that prevent us from getting better, or even existential angst – putting ourselves into a continual state of stress. Regardless, we don’t heal unless we face the bad stuff, face the pain and all its ickiness, and deal with it head on. If we don’t go through this stage, we delay our own healing. We get stuck and allow ourselves to continue to hurt. Just like a physical wound without functioning immune cells to remove necrotic tissue, we must confront our psychological wounds or they fester and grow, which is not good for us or anyone else.

When we go through the painful but necessary response of removing the bad stuff, the next step is when true healing begins. The earlier stages lay the groundwork, but healing happens when we engage in healthy habits, healthy thinking, and restorative practices. Healing happens when we grow ourselves and recreate what we need to be fully functioning. Eventually, we get to a mental place where our damaged parts have been completely transformed. Our pain is gone, and the injury we sustained in the past no longer affects us in the present.

Of course, as with a physical wound, healing our psychological wounds can be hindered by so many other factors – life stressors, disease states, medications we take, and vices we’re prone to (food, alcohol, cigarettes). These things can alter our mood, change our brain chemistry, disrupt our ability to heal, and, in fact, introduce other complications into our lives. So a note of caution. If you want to heal what hurts you, also be aware of what might slow your progress.

Deep, psychological hurt is just that. It’s painful. But, allowing yourself to move through the stages of wound healing will help. There’s no magic elixir or quick fix to getting better. Trust me, if there were, I’d be the first in line to buy it. Healing takes time and work and going through some really yucky stuff before things improve. But, wounds heal, and pain dissipates. You move on to a better place. I hope we are all moving in that direction and healing our deepest wounds.

 

References (because I’m a scientist. I like the facts, thank you.)

(Physical) Wound healing

http://jcs.biologists.org/content/122/18/3209.full

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903966/pdf/10.1177_0022034509359125.pdf

 

 

A book about an analogy between physical wounds and psychological wounds (Disclaimer: I have not read this book, I only see that my idea is not unique – surprise!)

http://www.amazon.com/The-Wisdom-Healing-Wound-Emotional/dp/0757315615

 

My Wonky Brain

Part 1 – Am I Ready to be Weaned?

This is the first part is a series in which I discuss my wonky depressed brain and weaning myself off my anti-depressants.

My Wonky Brain on Depression - Notice there is a wick, because I can go down in flames.

My Wonky Brain on Depression – Notice there is a wick, because I can go down in flames.

People, I am the first to say that I wallowed in being mentally unhealthy. Back when I was really depressed, I accepted conventional wisdom, which also happened to be the thinking of some of my previous doctors. This “wisdom” is that once you’re diagnosed, that’s it. You have a chronic illness, a life sentence. So now, for the rest of your life, take your meds. Doing so will help keep you stabilized and hopefully prevent you from going off the deep end.

(Oh, were it that simple. It’s not.)

Sure, it was hard on the ego to know that I had this permanently wonky brain, but if I could blame my behavior on my illness, how convenient was that?

“Look, I take my pills. But my brain isn’t right. That’s just how it is. Sorry that I fucked up again. I’ll try to be better.”

And it’s not like I didn’t try. I’ve been in therapy and medicated – off and on – for the last 20+ years. I’ve seen psychiatrists, psychologists, and social workers to try to get better. I’ve undergone hypnosis, eye movement densensitization and reprocessing, and, of course, traditional (cognitive) therapy to try to get better. I’ve taken alprazolam, citalopram, clonazepam, duloxetine, lorazepam, and trazodone, and those are just the names of the drugs I actually remember taking, to try to get better.

I really did try, but, despite my efforts, getting better never lasted very long, supporting the conventional wisdom that depression, for me anyway, is a forever disease. Yes, I had good months and years, and I’d go off my meds. Then I’d have a relapse, really bad months or even years, and I’d go back on my meds. But, I don’t know that the meds actually stabilized me. I mean, I still went off the deep end, even while religiously taking my anti-depressants at their highest dosage AND seeing a therapist AND wanting to be healthy, or at least mostly normal.

Clearly, pharmaceuticals weren’t enough.  So, after the last breakdown, I opted for intensive psychotherapy. I needed more than 60mg of Cymbalta every day to fix my wonky brain, and my doctor knew it, too. Taking a pill wouldn’t help me learn how to live with life when it was difficult. Taking a pill wouldn’t help me learn how to change my outlook and responses to be more productive and less self-injurious. Taking a pill wouldn’t help me learn how to cope when the shit hit the fan.

Let do this!

Imagine my surprise when my insurance company, happy to pay for my drugs no questions asked, balked at my getting behavioral therapy from the same (very qualified) psychiatrist who was prescribing my meds. Turns out, I had to apply for psychotherapy and the insurance company had to approve if I wanted them to pay for it. That approval took a year. A year of filing and re-filing paperwork, which they kept losing. A year of phone calls from my doctor to the insurance company giving them the information they asked for and also berating them for hindering my progress. A year of me spending thousands of euros out of pocket for my own therapy, because, well, what choice did I really have? If I wasn’t already crazy from my diagnosed depression, this rigmarole with the German insurance company guaranteed a total melt down. (Oy Mensch!)

Then, finally, the insurance demons determined that my therapy was warranted (Really?!) and approved my application, although I’d already been doing therapy without their approval. Every week I went to see my psychiatrist, who favors the Bowen Theory of Family Systems Therapy. She actually gave me homework to do, like reading from this book to have me work on emotionally and psychologically maturing myself. Every week, I did additional self-help reading. I journaled. I meditated. I even took less conventional routes, such as a guided meditation technique called Chöd, or Feeding Your Demons (a bit out there even for me), and taking prescription homeopathic medicine (not highly regarded in Western medicine but, for whatever reason, perfectly acceptable in Germany). No therapy was too new-age or too old-school for me. I embraced all therapy.

And, guess what? It worked. I’m getting better!!! It hasn’t been easy. It wasn’t immediate. And it certainly isn’t done.  But, I am slowly figuring out how to live so that I don’t relapse. Or so that if I do hit a rough patch, I have the skills necessary to deal with it. Seriously, I can’t remember the last time I had a crying jag or lay in bed all day with no desire to ever get up again. Maybe not in 2015 at all. That’s progress. Maybe even miraculous.

And I began to think, maybe, just maybe, I don’t need medication anymore.

Okay. Okay. I can hear you all screaming from your laptop, “ARE YOU FUCKING CRAZY?”

Possibly. But I talked with my psychiatrist about this, and she supported me.

Unfortunately, my husband was less enthusiastic about the idea.

“I’m not so sure about this,” he said. “You were just hospitalized last summer.”

“Yes, I know, and I was on meds at the time,” I responded. “They didn’t seem to keep me from falling down the rabbit hole. Besides, I’m doing better now. Aren’t I?”

He had to agree, but, at the same time, he’s been through 16 years of my cycles of down and downer, and he’s a bit gun shy of my “I’ve got this licked” attitude. He’s had to hold me when I cried for hours. He’s had to call from work at 2 in the afternoon to check on me and see if I’ve gotten out of bed yet. He’s had to call the ambulance to come cart me off, too.

If the person who knows me best, who is probably slightly more objective about this matter than me, who has to deal with the fallout that is me, if that person doesn’t think this is such a great idea, what should I do?

Peaceful and Perceptive

This week, I arrived in the States, at my mother’s second home in North Carolina, where I’ll stay for 4 weeks. It feels ridiculously good to be back “home” even if this place is neither where I grew up nor where I ever lived when I was in the US. It’s the comfort of the familiar, the friendly greetings everywhere I go, the ease of experience because there is no cultural and or linguistic challenge, that makes this home to me.

When I got here, my mother gave me something she’d cut out from the paper, a poem that was part of an obituary, which she thought would resonate with me. I do not know the source of this poem or when it appeared in the paper, so forgive any copyright infringement or lack of proper citing, but the words are wise and I want to share them.

If you observe with an obedient eye

A peaceful, perceptive mind, and

A love-filled soul

Then beautiful are the things seen,

Joyful are the thoughts received,

And grateful are the feelings in your soul.

 

Brilliant, isn’t it?

It really speaks to the power of your frame of mind in shaping what you experience.

When I’ve been in the throes of a major depressive episode (which has happened several times in my life and always had very serious, negative consequences), I couldn’t see anything beyond the depression. The world was gray and hopeless and lonely, and that mindset shaped everything. In that state, it’s simply impossible to say, “Okay, self, start thinking happy thoughts. Go!” That’s not how depression works.

But, when I’m not enmeshed in the darkness, I am able to reorganize my thinking. When I’m feeling more or less ‘normal,’ I can focus my mind on being peaceful and perceptive. I can direct my energy to being loving, joyful, and grateful. And when I do this, things start to shift. The shift is ever so slight at first but eventually becomes significant, and then it is this new frame of mind that shapes everything. It is the new frame of mind that manifests itself in my everyday life.

That’s where I am now, shifting, changing, growing, and cultivating peace and perception, love, joy, and gratitude. And the result is a more resilient, balanced, and happy self.

Awesome sauce.

 

Mantra: May my perspective (position, attitude, outlook, frame of mind) be one of peace (tranquility, calm, composure, balance) and perception (understanding, insight, intuition, thoughtfulness).

Peaceful and Perceptive

Meditating in Every Moment

Although we typically associate it with this state, meditation is not about closing yourself off from everything and everyone, sitting quietly in some yoga position, and getting your Zen on. It’s not about religion or spirituality or the Buddha. Yes, meditation can involve any of those things, but those things don’t define meditation. Meditation is what people do in order to develop a skill that they can then take off the mat, out of the Zen den, and utilize in the real world – the noisy, stressful, unpredictable real world.

So what is this skill that we practice in meditation (which is often referred to simply as “the practice”)? Well, there are many skills, but one of the most important and central ones is the cultivation of awareness. You make yourself stay in the present moment. You don’t rehash the past. You don’t worry about or plan the future. Rather, you sit and are present for what’s happening right now, both the internal and the external experiences.

Furthermore, you observe the present without analyzing it, interpreting it, or judging it, which is our nature. A thought pops up and we immediately jump on it, getting ensnared. What can I do about this? How can I change this? What does this mean? But the goal of mindful awareness is simply to observe your thoughts without over-identifying with them.

When you look at it this way, meditation is not some isolated activity you do for 30 minutes a day. Instead, it’s a state of being; it’s a way of existing in the world. When you cultivate mindful awareness, you begin to see things as they truly are, without the added layer of interpretation. And because you are observing what you feel, you begin to recognize your conditioned responses, habitual thought patterns you have, which may be unhealthy. Once you are aware of these conditioned responses, you can begin to change them. So meditation is kinda like free therapy.

Meditation is a powerful tool, backed by lots of research, which convincingly demonstrates that it can reduce stress levels, improve symptoms of depression, enhance psychological well being, improve immunity, increase cortical gray matter, and even reverse effects of aging on the brain. But the best part is that it just makes you a happier, more compassionate person.

We only live in the present, so live as fully and mindfully aware as you can.

 

NIH primer on the science behind meditation.

You Tube video produced by IFLoveScience.

Meditation is acceptance

Image courtesy of Paodoruvel (morguefile.com)

We Are What We Repeatedly Do (I Am Positive of That!)

“We are what we repeatedly do.” Aristotle

IMG_7300

One thing I have learned as I’ve been on this journey is the power of habit. Take my depression, for example. For years, I’ve had a habit of depression. What I mean is that for most of my life I’ve been entrenched in negative thought patterns and, as a result, learned unskillful behaviors that reinforced those thoughts. If someone told me, “Just smile. Just be happy,” those words were meaningless to me, because my entire repertoire was built on depression. The old me buried my sad feelings when they arose. I told myself I wasn’t good enough. I drank to numb whatever hurt I had. You can imagine how effective this was at curbing depression. Right, vicious cycle when repeated ad nauseum.

I am positive that we are what we repeatedly do, and I did depression. I did it really well.

Old Me

negative cycle

But not anymore. For many months now, I’ve been working on peeling back the layers of my depression, the ones that are my own making, in order to reveal my true self. And, check it out, y’all. I’m not actually the emotional basket case I previously thought. Or, I am, but I have the capacity to be resilient. I just didn’t know how to develop this capacity until now. Cultivating emotional resilience (or any skillful trait) means forming a new habit. No more repeating the same negative behaviors and expecting change.

Before I started to work on cultivating emotional resilience, I did lots of things that ultimately made the transition to forming a new habit much easier. I started going to therapy. Religiously. I started taking meds. Religiously. I started meditating. I read a ton of self-help books. I took a 3 month online Science of Happiness course. I did a 21-day meditation class with Deepak and Oprah. I joined the 100 Days of Happiness Facebook page and posted for 100 days in a row. I emailed and texted my friends back home almost daily. I did groundwork that set the stage for me to be successful. And with all that under my belt, I was ready to do the real work. And, trust me, it’s been hard work. It’s taken practice, lots and lots of practice, to change my bad habit.

I’m using the following hierarchy to drive my change. Thoughts become words. Words become actions. Actions become habits. Habits become character. Character becomes destiny. When I feel sadness coming on, I now use a mindful approach to deal with it. I simply sit with the feeling instead of repressing it. I don’t try to complicate it with projection and judgment. I just let it be, accepting it without letting it take control. In addition, I start each day with a mantra that I come back to throughout the day. One mantra that cultivates emotional resilience is, “May I abide in loving-kindess.” It’s a phrase that enhances self-compassion and compassion for others. It reminds me that I am worthy and deserving of love. Finally, I perform little acts that demonstrate loving-kindess. I smile more. I am kinder to others. Nothing major, just subtle behavioral shifts, again and again and again, because we are what we repeatedly do.

New Me:

positive cycle
The whole point of this is what science is now bearing out. Developing and being able to access positive emotions improve quality of life. Barbara Fredrickson of the University of North Carolina at Chapel Hill has shown that nurturing positive emotions (her Big 10 are joy, gratitude, serenity, interest, hope, pride, amusement, inspiration, awe, and love) is associated with short- and long-term changes in personal resources including competence, meaning, optimism, resilience, self-acceptance, positive relationships, and health. This growth in personal resources can reduce symptoms of depression and increase life satisfaction. We are what we repeatedly do. Frederickson theorizes that these positive emotions expand one’s mental and behavioral repertoire, essentially promoting rather than limiting adaptation.

The bottom line is that over time, small changes, daily changes, in life can lay the foundation upon which anyone can develop a new habit. My goal is to replace my unskillful habit of depression with the more skillful habit of emotional resilience, and I’m using positivity to cultivate this habit. Every day, through my thoughts, words, and actions, I am taking incremental and necessary steps. Every day, I am getting closer to being the person I truly am, someone who can withstand the challenges of life without falling apart. I set this intention; I repeat an affirming mantra, and I’m mindful to act on my intention and mantra.

I am what I repeatedly do. We are what we repeatedly do, and I am positive of that y’all.

 

References

Catalino LI & Fredrickson BL. Tuesdays in the lives of flourishers: The role of positive emotional reactivity in optimal mental health. Emotion. 2011 Aug 1(4):938-950.

Cohn MA & Fredrickson BL. In search of durable positive psychology interventions: Predictors and consequences of long-term positive behavior change. J Posit Psychol. 2010 Sep 1;5(5):355-366.

Cohn MA, Fredrickson BL, Brown SL, Mikels JA, & Conway AM. Happiness unpacked: positive emotions increase life satisfaction by building resilience. Emotion. 2009 Jun 9(3):361-8.

Fredrickson BL. Updated Thinking on Positivity Ratios. American Psychologist, 2013 Dec 68(9):814-822.

 

my feet carry me

For much of my adulthood, I have been a runner. For years, I belonged to a training group. I had a coach. There were paces, distances, track workouts, hill repeats, races. I distracted myself from the physical pain that comes with this level of training so that I could just do the work I needed to do and run faster or longer or whatever the end goal was.

When my life began to unravel, I ran more. I remember the nights during my worst depressive episode. My marriage was crumbling, and I was unable to sleep. A barrage of negative self-talk played on a continuous loop in my head. 3am and the spotlight was on in my mind

‘You’re unlovable. Something is inherently wrong with you. You’ll never be happy. You’ve ruined everything good you’ve ever had.’ This was the background noise of my inner self.

Not knowing how to quiet the thoughts, I would get out of bed and put on my running shoes. The whirlwind in my head powered my legs to go for miles. Running gave my mental energy a physical release. Often, I didn’t even know where I was headed when I left my house in the middle of the night, but it didn’t matter. Nothing mattered, but throwing myself into the darkness and running away from the voices, from my thoughts, and from my life.

People say that running is a metaphor for life, because what you put into it is what you get out of it. I think most people take this to mean that with harder work comes a greater benefit. But, for me, harder work meant greater repression. Running became my escape route in the same way that alcohol did. I ran and I drank to actively avoid my reality, to get away from it. Drinking dulled the ache of depression, buoyed the weight that was constantly on my shoulders, and running relieved the pent up angst.

In a race, as in life, there are times when everything hurts. To go on even one more step feels impossible. When this happened to me in life, I didn’t acknowledge that it was a natural result of accumulated trauma or that the hurt would eventually change. Instead, I used up all my physical resources for the sole purpose of not being with the hurt.  I literally ran away from the pain. I ran until my emotional tanks were completely empty, and that’s when the pain finally caught up to me. At that point, I had nowhere to go and nothing left to save myself. At that point, I broke.

I’d like to say that I figured it all out after that breaking point. But, I didn’t. It took many more years of running away from my problems and a few more breakdowns before I finally reached the place where I stopped running away from my emotional pain. It’s only happened in the last 6 months, as I’ve focused intently on my well-being. In doing so, I’ve changed my approach to running, and I’ve changed my approach to life. I have given up my GPS watch and no longer track pace or distance. When I run, I don’t look at the ground in an attempt to avoid pitfalls. I’ve stopped running as a means to an end, and I’ve started running with mindfulness. I run with a keen awareness of my surroundings. I don’t look at my watch. I look at the trees overhead. I listen to the birds singing and the snow crunching underfoot. The same is true for my life. I am learning to stop being focused on the end result and to be okay with what’s happening right now. I’m learning to be okay with the pitfalls, because they inevitably happen. Life is about living; it’s not about the final outcome. And in the living we do, there are moments of pain, which I am learning to acknowledge rather than distance myself from. In the living we do, there are also moments of beauty, and I am choosing to slow down and experience the beauty.

I run because my feet carry me. They support me as I make my way through the miles of life.

Thank you, feet.

 

Here is some beauty from my recent runs.

 IMG_7253     IMG_7172

IMG_7250      IMG_7287

 

 

 

I’d Be Laughing, If I Weren’t Crying

 

I now have the dubious distinction of having been a patient at a psychiatric hospital on 2 different continents. Try to top that one, peeps! Actually, don’t try to top that, because, let’s be honest, that is not something to aspire to in life.

My stay in the German loony bin happened when I had a melt down last summer. This melt down was not of unprecedented proportion, if you’ve been witness to my crazy spells, but let’s just say it had been over a decade since the last one, which was truly a total come apart (see Tuesday’s post). I had been depressed for months. I was angry. I was drinking. And I had a bottle of Xanax. The combination resulted in a 36-hour (semi-comatose) stay in the ICU of the University Hospital followed by transport to the psych ward.DI arrived on the ward around 1am on a Monday morning and was literally dumped by the emergency technicians (for some reason I was transferred by an ambulance from the ICU to the psych ward, although they were the same hospital) in a bed in a patient room with 3 other beds. Roommate 1 was sleeping in one of these beds. The other 2 beds were empty, but it was obvious that I had 2 other roommates; who knows where they were. After this unceremonious, middle of the night arrival, I was on my own. No one came to check me in (‘Welcome. I’m Nurse Birgitte’). No one came to provide me information. (‘Breakfast is served in the kitchen at 8. Group therapy is at 10. Medication is dispensed before bed.’) No problem. I was still in a Xanax stupor so fell asleep immediately.

The next day I woke up when someone in a German National team soccer uniform – it was the summer of the World Cup – bounded into the room screaming, “Mittagessen!” Lunch. It wasn’t casual Friday. It was Monday. So I guess they had a lax dress code at this hospital. Honestly, you would be hard pressed to differentiate the nurses from the patients, especially when they’re all huddled together in the smoking room that was adjacent to the kitchen. Yes, there was a smoking room. Inside the hospital. Oy.

Despite the invitation to partake in Mittagessen! I went back to sleep. Apparently, it takes some serious work to sleep off a bottle of Xanax, even if the prescription is expired. When the doctor on duty showed up that afternoon, however, I had to get up and talk.

“I see you suffer from depression. Do you take medication for this?” he asked.

“Yes,” I told him, “but my meds are at home.”

“Well, have someone bring them in so you can take them while you’re here.”

Wait, what did he just tell me? I didn’t mean to question his professional judgment but I was in a psych ward. For an intentional overdose. But, in an attempt to be a good patient, I called my husband and told him to bring in my anti-depressants.

“Bring some clothes, too,” I said since all I had was the Victoria’s Secret slip in which I’d been admitted and the hospital scrubs ICU dressed me in for the transfer.

My husband showed up that afternoon with some clothes, my meds, my iPhone, and a Sudoku book. Without work or a child, I was practically on vacation. The rest of that day, I laid on my bed playing Words with Friends and Sudoku.

The next day, I finally went to the bathroom. I won’t go into details here, but suffice it to say that they must have given me a lot of activated charcoal in the ICU.

Roommate 1 left the hospital that morning to spend the day with her boyfriend, but, in her absence, Roommate 2 showed up. She introduced herself and announced that she was going to therapy.

“What kind of therapy?” I asked since no one had bothered to inform me of my options.

“It’s one where you make things with paper and cardboard,” she said in her broken English.

“And how exactly does that help?” I asked.

“It’s better to have something to do than to sit around here,” she said, casting me a certain look.

Did she mean something by this, like I was just sitting around doing nothing? I mean, I was sitting around doing nothing, but only because (1) I didn’t even know about arts and crafts therapy until right now, and (2) I couldn’t see how cutting and pasting would help me.

Roommate 2 sighed heavily and left. I laid face down on the bed and proceeded to sob. Maybe I should have gone with her. Maybe making a half ass piñata would have provided me with an emotional outlet when I ultimately destroyed it.

My wallowing was interrupted when the entire staff of resident psychiatrists came in to evaluate me. The Head Professor of Psychiatry introduced himself to me and began to ask me questions while his posse stood around and stared.

“Miss M, was this was a suicide attempt?” he asked.

“I don’t think so,” I said. “It was more of a screaming message that I hate my life right now.”

“Why would you hate it?” the Professor asked.

“Because I hate living here.”

“And why is that,” he asked.

“No offense, but look at yourselves.”

Yes, I actually said this to 6 psychiatrists who were all standing there staring at me while I sat on my waterproof-sheeted bed, crying like a baby.

I continued, “No one smiles here. It’s unfriendly here in general. I’m from the South. It may be fake to wish someone you don’t know ‘Good Morning’ or say ‘Hello’ to a stranger, but there’s a reason that whole happiness movement is going on in the States. Because it works.”

One doctor in the entourage smiled, stifling a laugh.

“See. That’s all I need,” I said. “I am a human being, and I need a human connection. Really, you guys should work on your bedside manner.”

The Professor wrote down some stuff. The one doctor continued to smile, and the other doctors continued to stare at me. Then they all left, and I returned to my wallowing.

That afternoon the lunatic left the asylum. My husband came to get me, and we took the subway home. I carted my ICU scrubs and Sudoku book in a garbage bag, like a homeless person. Crazy and back on the streets.

A few days later, I went to see my psychiatrist. She wrote the paperwork for me to take medical leave for the rest of the month, which meant I could stay in bed and cry all day if I wanted. Except that I couldn’t because I have a daughter, and it turns out my daughter had just gotten her first case of head lice. Friends, remember that overnight farm trip she went on with her kindergarten the previous week? Well, her roommates were the 3 kids who had lice at school (that same week) plus the one kid who’d had strep throat the week before. I should have asked the damn kindergarten teachers to see if they could find a kid with chicken pox to throw in the mix. You know, just get it all done at once. Luckily, we live above an Apotheke, and all I had to do was buy some shampoo that treats lice in one wash. So the second I finished my mama chimp head grooming routine, I got the shampoo and nit comb and went to town.

And just when I thought it couldn’t get more challenging, that same day, as I’m nit picking, my husband came home diagnosed with pneumonia. Yes, pneumonia. Now he had a stay-at-home-for-2-weeks medical leave pass, too.

Friends, I wish I could say that the worse was over. But, of course, it wasn’t. (Damn you, life!) That very night, I shit you not, my daughter complained of an itchy bottom, which, when I played doctor on Web MD, meant she had pinworms. What?! I’d never even heard of them before. I could confirm this internet diagnosis by waiting until my daughter fell asleep, spreading her little ass cheeks, and shining a flashlight to look for “moving threads”, because the female pin worm only comes out at night to lay eggs in the anus of the child. Sigh.

I considered checking myself back in to the loony bin at this point. Seriously. This shit is my life. Oh. My. God.