Category Archives: interventions

starting nardil

I just picked up my script. I’m scared. This drug is old and nasty and has terrible side effects, but apparently it really reeeally works. It seems like it’s the last line of defense, medication-wise, for depression. It’s also supposed to be really reeeally great for social anxiety.  But there’s so many food restrictions–http://www.dr-bob.org/tips/maoi.html

I have to eliminate so much from my diet. I’m vegetarian, and I can’t have soy products or protein shakes or nuts. I guess I’m going to start eating meat again.

Aside for the food restrictions, there’s, again, really reeeally bad side effects, which apparently according to my research mysteriously go away after a few months and you’re left in bliss. With my history of medication, though, I’m not feeling very hopeful.

I just want something to work. I just want to feel better. I’m not expecting a miracle or a quick fix, just a little relief.

If the ends justify the means ..

Advertisements

an example of avoidance

Yesterday my boss asked me to go downtown today to pick up some tax documents at the state’s local field office. I didn’t think they could provide the documents, but I didn’t have the nerve or desire to argue with him so I reluctantly agreed.

I’ve had to go to this field office a few times before. Each time, I’ve had to endure a rather difficult social situation because the receptionist is very attractive and socially adept. In other words, she’s beautiful and perfect, and I’m not. These thoughts happen in a split second and ensure that I will fail. Now, CBT has taught me to catch these thoughts before they happen, to counter them with positive, rational thoughts. But this never seems to happen quick enough. I sum up that she’s perfect and place her on a pedestal before my rational mind has a chance to kick in–and I’m left playing catch up.

Anyhow, earlier I started having anticipatory anxiety about the situation: Not only would I have to face this perfect being but I also don’t feel comfortable asking for the documents since I don’t think they could provide them. And so, I started coming up with ways to get out of going–

  1. I could lie to my boss by telling him that I went and that they either didn’t have the documents or couldn’t give them to me.
  2. I could call in sick.
  3. I could call the tax office to see if they could even provide the documents.

The third choice seemed the most logical, but I’m terrified of making phone calls, especially when I have time to think about what I’m going to say beforehand, so I wanted to do the first choice. Eventually though, I talked myself into calling, which was horrible in itself, but I found that I was right: They couldn’t give me the documents after all.

I’m now beating myself up, telling myself that it wasn’t that bad and I shouldn’t have been fretting about the situation at all. I’m also disappointed in myself for avoiding another social situation.

Why can’t I look at the good parts? I mean, I made the phone call even though I was terrified and obtained an answer without lying. Those are positives, I guess.

If I’m not perfect then I’m nothing at all.

three things (and four stages)

First, sometimes I cannot trust myself. Losing your capacity to reason isn’t quite as bad as thinking you can still reason when it’s clearly illogical (in retrospect, of course). I need to do my best to question my logic. Logic can be its own monster. That is, fallacies and distortions can build on one another, creating what appears to be logic–but it’s far from it. Staying connected with others and communicating more with them will help me stay on top of my own distorted thinking.

That said, I think there are instances where death makes logical sense–and suffering from mental illness(es) can be one of them. However, I owe it to others and more importantly myself to exhaust all options before even considering death. I need to grind away at each day no matter how difficult life becomes.

Second, killing myself will affect so many more people than I realized. I tried my best to push people away. But I now know that no matter how much distance I put between myself and others, they can still see me–and will be greatly affected by my loss in ways I cannot even begin to imagine. I thought I could simply die unnoticed. I was wrong.

Finally, I need structure now more than ever. In The Four Stages of Spiritual Development, the author, Scott Peck, posits that there are four stages of spiritual growth (from Wikipedia)–

  1. Stage I is chaotic, disordered, and reckless. Very young children are in Stage I. They tend to defy and disobey, and are unwilling to accept a will greater than their own. They are extremely egoistic and lack empathy for others. Many criminals are people who have never grown out of Stage I.
  2. Stage II is the stage at which a person has blind faith in authority figures and sees the world as divided simply into good and evil, right and wrong, us and them. Once children learn to obey their parents and other authority figures, often out of fear or shame, they reach Stage II. Many so-called religious people are essentially Stage II people, in the sense that they have blind faith in God, and do not question His existence. With blind faith comes humility and a willingness to obey and serve. The majority of good, law-abiding citizens never move out of Stage II.
  3. Stage III is the stage of scientific skepticism and questioning. A Stage III person does not accept things on faith but only accepts them if convinced logically. Many people working in scientific and technological research are in Stage III. They often reject the existence of spiritual or supernatural forces since these are difficult to measure or prove scientifically. Those who do retain their spiritual beliefs move away from the simple, official doctrines of fundamentalism.
  4. Stage IV is the stage where an individual starts enjoying the mystery and beauty of nature and existence. While retaining skepticism, he starts perceiving grand patterns in nature and develops a deeper understanding of good and evil, forgiveness and mercy, compassion and love. His religiousness and spirituality differ significantly from that of a Stage II person, in the sense that he does not accept things through blind faith or out of fear, but does so because of genuine belief, and he does not judge people harshly or seek to inflict punishment on them for their transgressions. This is the stage of loving others as yourself, losing your attachment to your ego, and forgiving your enemies. Stage IV people are labeled as Mystics.

I for one believe that no one person is totally in only one stage at a time–we fluctuate across many stages throughout our  lifetimes, often residing in more than one stage at a given time and between stages as well. At this point, I find myself mostly in stage one. I still carry with me pieces from the other stages, but, for the most part, I unraveled, tried to kill myself, and now am left vulnerable, disordered, and reckless.

Now, I don’t believe that organized religion is the only means of finding structure in Stage II. I’ve decided to focus more on my job, as well as to start studying for an Enrolled Agent exam so I can move up in my company and get a raise. I’d also like to spend more time writing and connecting with others through my blog. Reading, exercising, and cooking are also on the agenda.

Sorting through the pieces of what’s left from my suicide attempt is all I can do at this point, and I need to take it slow, one day at a time.

does your mother know?

So, on the way home from therapy on Tuesday I took an overdose of Ativan. The session itself was difficult, as we discussed my recent suicide attempt and the fact that I found a new therapist and would like to start seeing him next month. I also tried to ensure my therapist that the events are mutually exclusive. ( I thought this was very important.) In other words, I’ve been contemplating a change in therapists for some time now (which is true).

Furthermore, I was dreadfully scared of having to go back to work yesterday, so instead of addressing it proactively–by either talking to my therapist or boss, trying to go on disability or something, etc.–I felt it best to OD. That will grab attention, I thought; and it sure did.

Without doing much damage I skipped the emergency room and went right to my psychiatrist’s office. He suggested I spend the night somewhere safe at a urgent care clinic, which I did (which wasn’t so bad), and then possibly go on disability leave from my job. There’s also plenty of options for low-cost inpatient care treatment here in San Francisco (we love our social services here!), so that’s an option. But to be honest, I really think I just want to switch anti-depressants–to Nardil–and go back to my normal routine.

I’m proud of myself because I told both my parents what’s been going on with me over the phone, and they were both very supportive. I also texted my boss. I haven’t given him all the details yet–I just told him I couldn’t come in because I had a psychiatric emergency. He’s provided support, and he wants me to call him–and I will as soon as I get up the courage.

I am feeling loads better. I see my psychiatrist again today to hopefully get on Nardil. I am also no longer feeling suicidal. Yay!

a little down

I’ve been feeling a bit low the past few days. I really miss Kansas City and my family. Talking on the phone with them just isn’t the same.

I’ve been running a lot. I signed up for the San Francisco Marathon. Running has become something to live for. I love it. I can’t explain it. I’ve never felt like I had any true hobbies or anything I’ve really loved in this world, but I do think I’ve found something–and it’s actually healthy.

I’m still waiting to hear back about the eight jobs I applied for at the public library. I’m already starting to lose hope. I applied for some teaching English jobs abroad for after I graduate in August.

Nothing much is happening right now, really.

I am thinking about ending therapy and just seeing my hypnotherapist and continue doing CBT with her. CBT has made such a tremendous difference in my life. It’s great! I know my hypnotherapist isn’t formally qualified to be working on CBT with me, but she’s recovering from social anxiety herself and has used CBT extensively–so I feel like she’s more qualified than my therapist.

I’m also thinking of getting off the Lamictal. I do not think I have Cyclothymia. I think my deep depressions happen within the context of social anxiety.

I am starting to accept myself more. I am who I am inside–and I am starting to be okay with that. I do have limitations, but I do have many positives as well–like all people. Most days I am happy and feel good about the future. I am excited (well, most of the time) about starting my internship in a few weeks, and I am just overall liking the direction I am going.

Finally, I want to give a shout out to Nick over at The Social Phobic. He’s been away for a while but now he’s back. He inspired me to start my blog and writing about my day-to-day experiences with social anxiety.

Thanks Nick. I hope all is well.

back in san francisco

I got back yesterday. Honestly, I miss Kansas City and my family. Even though we didn’t get to talk about the letter, I think a lot was accomplished, and I had a lot of fun with my family. My relationship to them is different. On the surface, we’re the same, but deeper down, I think there’s more understanding between all of us. It’s strange being back. I feel like a part of me is still in Missouri. I feel like I could walk out of my apartment right now and be back there.

***

I’ve been thinking more about this blog and decided that I want to spend less time on it–and the “blogsphere” as a whole. I’m getting a lot out of writing about my issues, and I am so grateful for all the support I’ve received. I cannot thank you all enough. I am going to probably spend one day a week posting, answering comments, and reading other blogs.

That said, I am feeling a lot better about life in general. I’m doing more, engaging more, and, for the most part, I’m happy. There are days where I feel down, but, at the end of the day, all feels right. I think it’s a combination of all my interventions–and, again, your support. Also, over the holidays, I think I finally realized that social anxiety is my choice. That is, it’s my choice how much of my soul I put into social anxiety. I am the one in control. Social anxiety is not who I am. It’s not my friend, it’s not my child–it’s a part of me, but it’s not me.

Finally, I got runner up for Best Neurotic, Stress-Related and Somatorm Disorders Blog over at Mental Nurse for the 2010 TWIM Awards. I’m surprised, especially considering how new my blog is. Anyway, I just wanted to say thanks to them and to those who voted for me.

I hope everyone is well. I’m looking forward to catching up on my favorite blogs later today. And Happy New Year!

phone therapy

Three posts in as many days! I don’t know what’s come over me. 🙂

***

So, since my therapist is out of town this week we arranged to have our regular session over the phone yesterday. I was dreading the session most of the day, even more than usual actually because I don’t like talking on phones. I don’t like checking voice mail. I don’t like seeing/hearing others talk on their phones. I don’t like hearing them ring (or vibrate, in my case). I cringe when I hear other people’s phones ring. I’d get rid of mine, but that probably wouldn’t be smart for someone with social anxiety.

It must have something to do with the fact that there are no distractions over the phone. It’s me and the other caller–that’s it. There is no one else to take the spotlight off me. There are no external distractions either, like television or eating or music or a movie, etc. But there are no distractions like that in therapy anyway, so I don’t know what I was so afraid of.

Anyhow, about thirty minutes before the session started, tension, nervousness, and anxiety hit. I just wanted to get it started (or over with). My stomach hurt, and I began sweating a little under my arms. I felt like I was getting ready to go to a large social gathering or something. I think it must have been the combination of the phone and pre-therapy jitters.

I’m probably freaking out about nothing, I told myself. So I’m going to stop  indulging in my negative thoughts. Once I became aware of what was happening and told myself to stop, I felt better.

***

The session started like all our other sessions. We talked a little about how this–therapy over the phone–is new territory for us and what not. I wish we would have explored my phone-phobia a little more. I brought it up, but we quickly turned to other things.

I told him about how I was feeling anxious about Christmas, about how I’d be seeing my relatives. I told him how anxious I felt as soon as I found that out. We spoke about this for a while (mostly about how I’m afraid of interacting with my cousins’ children) before he said–

“You can push back if you want but what I think it all comes back to is self-acceptance. It’s okay to be introverted and reserved. It’s okay to be soft-spoken. But these things are not okay for you.”

He went on and on, and yet I was still stuck on his words push back. It had a negative connotation to it. To me, the words said–

Now you can push back, but if you do, you will be wrong because I am the therapist and I am right.

After he got done talking about self-acceptance, we were both silent.

“Where are you?” he asked, finally breaking the silence.

I told him the truth. I told him how I didn’t hear much of what he said because I was still stuck on him saying push back. I told him how I’m uber sensitive to his wording sometimes and how I’m afraid to stop him because I’m afraid he’ll say I’m just avoiding things (like he’s done in the past). We had a good discussion about that, and I feel a little better about it, actually. I think he understands better that when I do stop him, sometimes it’s not that I’m avoiding–it’s just that I want to say something and that should be okay. I don’t think there has to be a hidden/deeper meaning in everything.

One thing interesting that he did mention is that therapy is the one place where I can–and should–feel comfortable pushing back. A lot of times in life, I want to do that, but I just don’t have the self-esteem.

We then went on and talked more about the letter (part 1, part 2) I sent to my parents and how I can use that to start more discussions. I’m scared to talk more about it, yet I do want a closer relationship with my parents. I know my relationship with them hasn’t changed because of one letter. I have to keep moving forward, and I feel a lot of pressure to do that.

Finally, at the end of the session, I started getting flooded with anxiety, as I always do, and I checked out by browsing Facebook. When we finally said goodbye, I found myself looking at pictures of someone from high school who used to pick on me. Whenever I get on Facebook I’m unconsciously brought to the people who did me harm. I should probably bring that up in a future session, among other things. I’ll add it to the list.