Category Archives: cbt

high to low and back again

I started writing this post yesterday afternoon, and it was originally called, stable .. for now, but nothing I wrote felt right, and by the evening I had abandoned it altogether. Some highlights–

I’ve been fairly stable since the wedding. That is, not depressed. I’m caught up with schoolwork again, and I’m starting to enjoy activities again, like reading, writing, running, and cooking. (I even went to a yoga class on Friday!) I’m looking forward to seeing my student on Wednesday and tutoring in general (I volunteer at an adult literacy center), as well as Thanksgiving. (I’m not delighted about being around fourteen people, but I do want to see if my mood holds up and how, or if, that will affect the outcome of the social situation. Plus, I want to test out some of my new cognitive techniques. So, it’s not so much about the social situation itself; it’s more about seeing whether I can get through it without being flooded with anxiety [an experiment, really]. And I’m actually feeling more confident that I will be able to do just that, and if I don’t–NO BIG DEAL!)

I’ve been doing lots of CBT lately. I still don’t know whether it’s working or not–whether it’s affecting deeper change–but I do know that it’s changing the way I think. I’m more positive and upbeat. I haven’t been engaging in my normal destructive behaviors of finding faults in the past and using those to ruin the present, etc. It’s a strange feeling, really. I’m not comfortable with feeling good–or, more precisely: not feeling bad. I guess I’ve just been feeling neutral lately. I look to the future and I don’t get the hopelessness that I got a week ago; it’s more like a staleness.

Finally, I’m also excited about trying a new drug. I’m not comfortable with taking Klonopin daily, so I’m going to talk to the pdoc on Tuesday about trying an MAOI–Nardil. A friend of mine who also has social anxiety is on it and I have noticed a huge difference in her behavior. Yes, MAOIs have some pretty bad side effects and you have to be on a strict diet to avoid hypertension, but maybe the ends will justify the means (for once)? I just have to talk my pdoc into it, because he had a patient die while on Nardil because s/he ate the wrong kind of cheese (aged) and didn’t seek medical attention.

Anyway, somewhere between writing and watching a football game and reading and taking a bath, my mood changed. By the end of the night, I was pretty low. Actually, I could feel my mood turning pretty much throughout the evening. My energy level dropped, and I couldn’t do the things I wanted to do. I’ve been pretty hyper (or hypomanic) this past week. I’ve bounced from activity to activity to activity. I haven’t given myself much leisure time or given myself time to think about things, which is good and bad. Sure, I didn’t think about the bad things, but I also didn’t get to process and own my negative feelings. I pretty much suppressed everything throughout the week, and maybe some of the those feelings were coming up while I was writing.

It’s a strange feeling knowing that your mood is going to turn. I started to panic a little, actually. I wanted to do everything I could to stop it from happening. I stopped writing altogether, and I tried to just sink into the feelings a little with the hopes of crying. I always feel better after I cry. I think it allows some of the feelings to release. It’s healthy. But it’s very hard for me, especially now that I’m on medication. I need to find more triggers. Last week I found a good song that brought me into tears almost immediately but I played it like ten times over the week, so when I listened to it last night, nothing happened. I need to find more triggers. What works for you?

I’m also very stressed about school and the holidays in general. I have three papers and two presentations to do in less than a month. The papers are no big deal. Sure, they’ll be a lot of work, but I’m more worried about the presentations. For those who don’t know, I’m in an online graduate program studying Library and Information Science. I’m becoming a librarian. Anyway, the presentations are done over a conference call, and even though they aren’t in person, I’m still a little upset about them. CBT is helping, though–I may have had lots of anxiety in the past, but I’m doing better. And it may not go exactly how I want it too, but I will get through it–and it will be okay. Again, I don’t know how much of that’s suppressing my feelings and how much of that is subtly dealing with the feelings but not letting them take control. I don’t know.

The holidays are another big thing. Thanksgiving is coming up. As I said before, I’m going over to my girlfriend’s brothers, where fourteen people from her family will be there. I am still hopeful that I’ll be able to get through it without getting flooded–with the help of Ativan and Propranolol, of course. I’m counting on there being a little anxiety there, just not the debilitating kind like I had at the wedding. I want to be able to converse with people and smile and not have to worry about sweating through three sets of shirts and looking like a complete idiot all the time.

I’ll address Christmas at a later date.

So, with my mood rapidly changing, and without being able to release some of the pent-up emotions through crying, I went to bed feeling like I’d wake up feeling even worse. But here I am. I feel a little down, a little stressed and depressed, but a little happy and hopeful too. Maybe I avoided a depression? I don’t know, only time will tell. But for now I am going to continue with what I’m doing: schoolwork, running, keeping myself busy.

Oh and I probably won’t be updating much until the end of the semester (12/9). I hope you are all doing well, by the way.

Finally, I’m curious how you deal with things when you know your mood is getting ready to turn. Do you just accept it, knowing you can’t change it, and try to do your best to weather the storm? Or are you more proactive about it–are there ways for you to avoid the depression altogether, or at least lesson the severity of it?

Thanks for reading, and I look forward to hearing from you. 🙂

i will fail

I’m in a bad place right now. I have to go to a wedding next Saturday. It’s actually a three-day event (Friday, Saturday, Sunday), but I think I’ve managed to find good excuses for the other two days; but even still, I’m feeling really bad about it. I dislike the groom and his family because they’re all very outgoing and seemingly don’t understand people who are shy and quiet, let alone people like me who can’t engage even in the simplest of conversations.

I tried working on some CBT earlier, but what’s the point when I’m feeling so depressed? There’s this constant voice in the back of my head saying, YOU WILL FAIL. I counter it with- “I’m going to be all right. My feelings are not always rational. I’m just going to relax, calm down, and everything will be OK” and a load of other coping statements .. but that voice is still there.

Next weekend I will fail. I’ll be flooded with anxiety and won’t be able to say anything, let alone smile. I’ll have to hide in the background, hoping no one notices me, relying solely on my girlfriend to help me through conversations.

This wedding will ruin the rest of the this week and probably the week after. I’m scared. Wish me luck.

reiteration

I want to go over something I briefly touched on earlier this week. In the post life means suffering, I said–

When I’m anxious it’s very difficult for me to smile, and as a result I look serious or angry or mean. Ironically, inside I’m terrified. I just want people to like me. The response I got from Ms. D reinforced my anxiety, and it was appropriate given my comment and how I looked. I really shouldn’t take it personally, because she’s responding to my social anxiety not my true personality, but I still do.

Essentially, I felt like I got criticized by Ms. D, my girlfriend’s half-sister, and I took it personally. But when I took a step back and analyzed it a little more objectively, I felt like she was attacking my anxiety, not my true self.

This is important because I take everything personally. When a co-worker’s having a bad day and doesn’t smile at me, it must be because I didn’t smile at him first. When a friend’s angry at someone else but he takes it out on me, it must be because I did something wrong. When a librarian is aggravated because she is busy and gets pulled from her schedule to meet me, she must not like me. When I’m with an acquaintance and there’s an awkward moment of silence between us, it’s because I’m boring and don’t know what to say. Whenever something goes wrong, it’s my fault because there’s something deeply wrong with me.

None of those are my fault, none mean there’s something wrong with me. They’re just negative situations which can be interpreted in a number of different ways, and more often than not, I find the negatives: it’s my fault and they don’t like me, personally.

Awareness is key. When someone negatively judges me, real or imagined, because of how I act when I’m flooded with anxiety, they aren’t attacking me personally–they’re attacking the anxiety.

***

Have a great weekend, and enjoy Halloween–if you have/celebrate that.

life means suffering

interview success

So, as many of you know, I had a group interview yesterday. The interview was originally scheduled for last week, but I canceled last minute because I was overwhelmed with anxiety. Fortunately, I found a good, partially true excuse and was able to reschedule for yesterday.

I already had one interview with them a few weeks back with the library director. It went well. It was very relaxed. We talked about my future and what areas I’d like to work in–nothing too formal. At the end of the interview, she mentioned that she wanted me to come back in to meet with her and the rest of the librarians. I said fine. On the way out, I asked her how many librarians worked there and she said ten, and she also said that out of those ten there are a few who aren’t receptive to interns.

That information hit me hard–not only am I going to be interviewed by ten people; not all of them want me there to begin with. And since I take everything personal, I took this personal.

This set off my hypothetical mind; I began thinking of different scenarios of what this interview would be like. Mostly I just pictured ten librarians sitting across from me, asking difficult question after difficult question. Me, barely able to breath, stumbling, blushing, sweating.

My original interview was on a Thursday, and we scheduled the next one for the following Monday. I was a mess that weekend. Actually, I think I probably wrote a post about it. Anyway, the anxiety intensified to a point where I couldn’t function. I couldn’t sleep Sunday night and had to reschedule for yesterday.

From that point until today, though, I’ve been doing great. So what’s different about this past week from the week before?

Well, for starters, my thoughts haven’t controlled me. The negative thoughts were still there–they just didn’t dominate my consciousness. Part of this is attributed to CBT, the other part mindfulness. By becoming aware of my thoughts, before they took control, I could use cognitive techniques to ensure that they wouldn’t take control.

Next, I began to use meditation to help me relax. Two hours before the interview, I was laying in the bath, listening to a meditation. Once I got out I felt at peace. This feeling carried me into the interview.

Finally, I hashed out the situation with my hypnotherapist on Friday, meaning: we tried to look at my hypothetical scenarios in a different light.

“What’s your worst fear?” she asked me.

“To get up at the end and have to go down a line of ten librarians, shaking each of their hands,” I said. “They’ll see how much I’m sweating.”

“Do you really think it will be like that?” she asked.

As soon as she said that it was clear: there’s no way it would be like that. I may have to wave goodbye, but shaking hands with ten people sounds absurd, and it certainly wouldn’t all be in one line. I always feel so much better after playing out scenarios in my head. Seeing just how absurd my thinking can be, reminds me that my logic can be irrational at times.

The interview, itself, went well. I met only with the library director and one other librarian–no biggie, especially since I was expecting ten people. I did have to engage in a formal interview, but it went well. The director called one of my references earlier today. I think I got. Hurray!

on binging

I haven’t felt well the past few days. I’ve experience several ups and downs, including one period of depression where I thought I’d have to binge in order to bring myself back up again. Fortunately, I kept control and didn’t binge, and eventually my mood brightened and I began to function again.

It’s really strange that something so destructive (my binges) can make me feel whole again. I like to call it a release while my therapist calls it avoidance or suppression … regardless, I feel so much better after I binge. Actually, I want to step back: I want look a little closer at what happens before, during, and after a binge (because I just love breaking things down into tiny, manageable pieces). Without going into too much detail, before a binge I’m low–really low, obviously. My body, my mind, everything aches. There’s tension, there’s stress, there’s negative thoughts. Usually, I’ve stirred up some feelings or memories that I haven’t touched in a while. My brain feels mushy; there’s no other way to describe it.

When the actual decision is made (most of the time I feel like it’s already made for me beforehand) to go out to get food or alcohol–whatever I’m feeling like at the time, depending on the time of day (I never drink during the day, except maybe on the weekends or some holidays … ), etc–shame and guilt hit me. Before I even go to get the food, there’s guilt for what I’m about to do. But not enough guilt to stop me from doing it in the first place. At the store, when I’m picking up the ice cream or burrito or beer, the shame only increases. I feel like the cashiers know me by now. When they’re all together at some bar after work, they talk about me, referring to me as the “binger” or “loser”, that sort of thing. They know exactly how sad and depressed I am, because I wear my feelings on the outside. Everybody knows, for that matter.

After the food is obtained, my heart starts racing and my mood begins to lift. I have to get home as soon as possible. I race back, running up the stairs two at a time, and then consume … and consume … and consume. In all, it probably takes me less than thirty minutes to eat a burrito and a pint or quart of ice cream (my staples). If I’m drinking, though, I like to spread out six beers over a period of three or four hours. I hate getting drunk. My only goal is to get rid of the feelings.

The actual consuming is all done unconsciously. I usually plop myself in front of my computer, watching an episode of Star Trek or Seinfeld while shoving the food down my throat. There are no thoughts, the feelings disperse. Sometimes I’ll catch my reflection in the computer screen which causes me to pull back a little and assess the situation. I begin to feel shame, regret, remorse, anxiety … but before the feelings can take a hold of me I return to the food, unconscious once again.

When I’m done, the feelings begin to return little by little, but they’re different. Less tangible, and more abstract. They’re probably deeper in my body, too. Then, they start to grow again and I feel worse and worse, but, again, they’re still different. I’m not depressed or hopeless, but I just feel so much shame and regret. Eventually, those feelings disperse and I’m left with just a sense of contention. What’s done is done, my mind says. Pull yourself together. You have a future, you have worth. It’s like I have to hit some sort of rock bottom to see things clearly. When you’re down, the only place to go is up.

On Thursday I really felt giving into the temptation. The triggers were there, the environment was just right. But rather than giving in, I pushed through using a combination of awareness and cognitive techniques. I caught the thoughts before they could take control of me. I then distracted myself, and, finally, I replaced my negative thoughts with positive one’s.

It was a minor victory, but I learned something extremely valuable–I learned how to take back control. In the end, though, it’s not about controlling my thoughts or feelings or urges, because they may always be there; instead, it’s about not letting them control me.