How To Have Someone Committed To A Mental Hospital

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Emily K Harrington, Author and Advocate

The best way to get someone into inpatient treatment (while not always possible), is to have a nonjudgmental and open dialogue with the person that you are trying to help.

Most people do not want to go to the hospital, especially when they’re already sick and struggling. If all of your comforting objects, habits, substances, places, and people will be suddenly removed, you logically fear that you will be left with very little capacity to cope. Being put in the hospital can be pure agony, even when you commit yourself.

Try to talk to the person who you think needs inpatient treatment (another way of saying “needs to be committed”) and set up an open understanding that you believe this would be in her best interest, and you want this to be her choice. The most important detail is that you both understand that if at any moment she decides that maybe she should go to the hospital, you guys get in the car and go that minute. Don’t stop to pack, don’t call anyone to let them know, just get in the car and go before she can change her mind. You Guitarcan pack, bring medications, find documents, buy toiletries, and let everyone know later, once she is safe in inpatient care. The best-case scenario that you’re hoping for is for her to have a moment of clarity about needing help or a moment of doubt in her plan to die, and to agree for even just a minute that the hospital is the wisest place for her to be.

To be prepared for this to work well, make sure everyone in her life who could be the person who takes her to the hospital has the name and address of the building they need to take her to and understands the “we go the minute you ask” policy. If you think that packing a go-bag with clothes, books, comfort objects, fidget toys, a small blanket, a journal, and toiletries would make her feel more comfortable with the idea that if she goes, she’ll be prepared, then encourage her to pack a bag. This can help her internalize that the hospital is a real place and she would be cared for there. Standards about what items are allowed in psychiatric inpatient care units vary between facilities, so, unfortunately, depending upon the facility, she may not be allowed to bring all of her things in. In some facilities, she would not be allowed to bring anything in at all. But it can still serve her mental health to go through an act of preparation, and it shows a willingness to go and get help, even if she is very afraid.

If she voluntarily commits herself and tells the staff that she is suicidal, most places in the United States will put her on a 72-hour hold to assess her safety, possibly start her on medication, and begin a treatment plan for her to continue once she’s out. The purpose of the hospital is to provide safety, temporary care, and the beginnings of a treatment plan. There will probably be little to no individual therapy. She will not become healthy overnight. The hope is to try the patient on initial medication, get a diagnosis, and connect them with a psychiatrist, therapist, social worker, and/or case manager who can help them build a care team once they are released. No one comes out of the hospital cured. Some people come out of the hospital way worse. The goal is to start on a path to getting better. But it takes a lot of personal research and self-edification to learn how to manage a mental illness, both for the patient and for the friends and family. Friends and family will be her first-line of support, so read up. This article covers a little bit about being a supportive family member of a mentally ill person. How To Offer Support – Mental Illness – Goldfishpainter

To find a hospital nearby, do a google search with the name of your city and the words “mental health hospital” to find all of the closest facilities to where you live. If she Abigail Paintingchooses to go before you have time to do any research, go to the nearest Emergency Room and let them know she is not safe and needs inpatient care, and they will find the nearest hospital available and make sure she is safely transported there (this is what I know about the U.S., other countries may be different). Unfortunately, this can be expensive.

If you are looking for the legal ways to commit someone involuntarily and you live in the United States, this website will give you your specific state’s requirements and policies for involuntary commitment. In most states, there are three forms of involuntary commitment: Emergency Hospitalization for Evaluation, Inpatient Civil Commitment, and Outpatient Civil Commitment. The Emergency Hospitalization often comes first, when a qualified professional (including therapists, doctors, police officers, and other officials) determines that the patient is not safe. Emergency Hospitalization for Evaluation is sometimes called a “psychiatric hold” or “pick-up.” It only lasts for a fixed period of time, often 72 hours. If the person is not safe after that, on the advice or judgment of an official, a judge may give the order for Inpatient Civil Commitment, meaning that the patient must stay in the hospital until they are no longer a danger to themselves or others. It is also possible to go straight to a judge with an appeal for Inpatient Civil Commitment without going through a psychiatric hold first. Anyone close to the patient who witnesses their behavior can appeal. In most states, a judge can also mandate outpatient treatment, sometimes referred to as “outpatient commitment,” “involuntary outpatient commitment,” or “mandated outpatient treatment.” In most states, a person close to the patient who believes that the patient is in danger has the freedom to file an appeal to a judge to ask for that person to be committed. The above website will have complete information on the legal requirements for commitment in your state.

In the U.S., a person can call the police and report that someone is a danger to themselves, and the police will send out a wellness unit to check on the individual and assess them in person to determine if care is needed. Calling the police, while sometimes necessary, is not the best way to go about things. Sometimes the sick person can talk or act their way out of being judged as a danger to themselves, and the police will leave with nothing having been accomplished to help your family member. Also, if she is assessed to be a danger and she resists the idea of going, she may be restrained, handcuffed, and taken to the nearest facility in the back of a squad car, which can be traumatic.

No one wants to go to the hospital. It’s scary and uncomfortable. She may resent and distrust you for a long time afterward if you involuntarily commit her.

However…

People go to the hospital to get better. That’s what it’s there for. She won’t come out happy, but hopefully, she will be kept safe for a few days and come out with a diagnosis at the very least. Diagnoses are crucial.  A correct diagnosis is your family’s first big clue as to how to help her get better. Once you have a diagnosis, you can start researching treatments and get her started with a psychiatrist and therapist. You can learn coping skills for your own mental health and point her in the direction of learning skills herself. You can join support groups that are appropriate to her situation and diagnosis. If she has a substance abuse problem, for example, you can join AlAnon and she can join Alcoholics Anonymous or Narcotics Anonymous. NAMI, the National Alliance on Mental Health, has offices all over the U.S. and offers services that can help build her support system. The more people who actively help or love her, the better her chances of recovery. Her emotions and problems are her responsibility because she is the one who will experience them firsthand (responsibility and fault are different things), but other people are often (but not always) capable of helping. Remember that you can’t save her from herself. But if you take care of your own mental health, you have the potential to help her in some pretty huge ways.

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Should We Have Labels?

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by Emily Harrington

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Should We Have Labels?

Would it be better to believe you were normal than know you are sick? Does having a label make your life worse?

Anything classified as a mental illness or mental disorder is, by its nature, problematic. It’s almost always distressing or painful. A person with a mental illness can usually identify that their feelings are not average or the same as their peers’. The ill person will also probably be able to identify that they are in pain or struggling in some way.

But, for the sake of argument, let’s say hypothetically that “Larry” is suffering from mental illness, specifically borderline personality disorder, but has not identified that there is anything problematic with his thoughts or behaviors.

What Larry does know is that he can’t keep a girlfriend, everyone makes him angry, he can go from laughing to crying in a matter of minutes, he frequently feels guilty and hates himself, and if he starts thinking bad things he spirals out. He has a contentious relationship with his boss and his coworkers hurt his feelings all the time, so his job is miserable. At night, when he’s driving, he gets very anxious because he always sees cats dart across the road right in front of his car. Sometimes when he gets stressed he “zones out” (dissociates), and sometimes feels like he’s outside of his body, watching himself. All of these problems make his life harder, less stable, less safe, and more painful. All of these problems cause suffering. And all of these problems could be treated effectively if he saw a therapist.

If Larry never gets a diagnosis or finds out that the problems he has are all related, that they have a name, and that other people have had them, too, he is likely to lose hope. He may just settle into the idea that life is awful and there is no point. This makes him much more likely to attempt suicide. If he doesn’t know that he is mentally ill, there’s no reason to not believe that the world is as awful as it seems to be. He’s missing a key piece of information that could lead him to treatment, personal research, introspection, and hope. He could feel better; it’s possible. But if he believes there is nothing wrong with his thinking, then suicide is clearly a wise choice in his own eyes. Without identifying a problem, there is no hope of fixing it.

A diagnosis is the biggest clue a mentally ill person can receive in their treatment. Once you know what your illness is called, you can start learning potentially life-saving information. You learn about what thoughts and behaviors are typically problematic for people with your diagnosis and then learn how others cope with them. You can read first-person accounts of other people with your same diagnosis and learn how they survive or even thrive. You can derive a lot of hope from other survivors.

Knowing that something is wrong is usually necessary to lead people to receiving treatment. If you don’t know it’s broken, why try to fix it? Learning your diagnosis is empowering; it allows you to move forward and try to improve the areas of your mental health that need attention and care.

I believe that it is safer, wiser, and more helpful to know your diagnosis than to be oblivious to it. Ignorance of a disorder only leads to increased suffering.

 

For the Strong Who Feel Weak

You:

If you’ve ever been suicidal and you didn’t attempt suicide, you are strong. If you attempted suicide and failed, you are stronger. If you attempted suicide, failed, became suicidal again, and didn’t make an attempt, you’re even stronger. And so on.Co Earth from a Distance

If you live with an ice-cold knife in your chest. If you’ve ever felt your soul catch on fire. If you’ve had bugs crawl under your skin. If your body has ever felt so tight you felt your physical form contracting… you’re my people.

If you have lost all hope or had none to begin with, I’ve been there. If you’ve tried therapy and coping skills and it didn’t help, I’ve been there. If the medications you’ve been prescribed made you worse instead of better… I’ve been there. But where I am now is beautiful and meaningful, and I started exactly where you are. And I didn’t get better on my own. I’ll never be cured, but I can live a life in which I am willing to occupy my body.

Logistically and philosophically, things can only get worse to the point at which you die. It can’t get worse than that. It isn’t always possible for things to get worse. But it is always possible for things to get better. Things can always get better. This is true. So, wherever you are, with whatever lack of hope you have, it is unequivocally true that it is possible for your life to improve.

You’re strong. You’re in pain. You’re out of answers. You’ve lost hope.

And all I can offer is words. At the end of the day, you’re the only one who lives inside your head and gets to make decisions about your life.

If you’re struggling, you’re not alone, and there are literally hundreds of millions of other people online who have had your same symptoms and some version of your experiences. No two humans are exactly alike, but none of us are really that different, either. We’ve all got the same chemicals in our brains, just different balances. So reach out. (Themighty.com is a great place to read other people’s stories or just comments on daily life with any one of many health problems, mental and physical. The Mighty is a loving community, and if you have a story to tell, you can submit it to them to potentially get published. Your story could reach many people, so if you have something to offer (and everyone does), write your story and get your helpful information out into the world to help others.)

You are so strong. You’re having a bad day or month or year. You may have terrible, repetitive thoughts, but you are not created out of those thoughts. Thoughts come and go, and even if some come back over and over, that repetition doesn’t make them true. You are a human with inherent worth and lovability. Even if it feels like no one loves you, you’re worthy of love. Even if you feel weak, you’re carrying a burden that takes tremendous strength to bear. Even when there’s no one to talk to, you still have options for expressing your feelings.

You are actually pretty great. You deserve love. You deserve happiness. You deserve meaning. You deserve safety. You deserve respect. You deserve to express all of your feelings, positive or negative. You deserve to live in less pain.

There is hope out there. There are doctors and therapists and blogs and communities and self-help groups and books on how to feel better. There are concrete things you can do to minimize your pain.

This is your journey. For good or for ill, it’s yours. So stand up and fight. Life is an adventure, and adventures are dangerous and scary sometimes, and can be exhausting. This adventure is yours, alone.

At the end of your life, you will not be on your deathbed saying “I wish I had spent less time helping and loving people.” Give a hug. Hold a door. Text your mom to say you love her. Pick up a piece of trash from the ground and throw it away properly. Give blood. Give that homeless vet a little bit of money. Compliment the cashier at the grocery store. Smile at a child. Spread love in the world. It will help you every time.

Stop guilting yourself. Stop blaming yourself. Stop berating yourself for things you have no control over. Stop calling yourself names. You are not worthless, weak, a burden, unlovable, broken, ugly, stupid, or a loser. If you just started crying, it’s probably because you think one or more of those words is true about you. It’s not. No more self-hate. For a moment, imagine what it would look like (in terms of your actions) for you to love yourself. What would you do to show yourself love? pause to think Do one of those things today.

There is always hope, but you won’t always be able to believe it. You’re always worthy of love, but that won’t always feel true. Continue to allow your thoughts to come and go, to simply be things that happen in your mind that are then replaced with other happenings. You won’t always see clearly: such is the nature of mental illness. But you’ll come back. You always come back.

I know we don’t know each other; all I know is that you’re reading about mental health online right now, which means you’re seeking to understand yourself or others. For that, I am very proud of you, and you have permission to be proud of yourself, too.

Love and empathy forever.

 

 

 

 

 

Not My Fault. Still My Responsibility.

We are each completely responsible for every single decision we ever make. We have to live with the consequences of all situations and decisions, even ones that are not our fault. “Living with consequences of your decisions” is another way of saying “being responsible for your life”.

I do believe that some decisions we make are not completely voluntary, in the sense that sometimes the mind allows us to believe things that are incorrect, especially during psychotic episodes. Other times, there are decisions of inaction caused by severe depression. But no matter where in your brain the decision came from, no matter how impaired you were when you made the decision, even if it was not your fault, you are still completely responsible for what happens afterward. Many common situations in mental illness will not be your fault at all, but you’re still responsible for how you decide to react.

If you’re mad right now, then you’re not listening. Calm down, and I’ll explain.

There are tons of things that are not our fault but are still our responsibility. Mental illness is not your fault at all. But how you respond to it is still completely your responsibility. If I have a panic attack in a grocery store, that panic attack is not my fault. But I will still have to take responsibility by deciding what to do about it. I could decide to leave. I could decide to do a breathing exercise. I could strip naked, wear my underwear as a hat, and run through the store screaming the lyrics to “I Will Survive”. I could even decide to ask someone else what to do, and yes, even for that decision I am responsible.

Deciding to delegate to a stable person or choosing inaction are also still decisions. I know all too well that deep depression can keep me inert. I may not be able to get out of bed some days. Just like with the panic attack, this is not my fault. But making decisions is still always my responsibility, which means I will be directly affected by any action or inaction that I choose. Whatever decision I make, I am responsible for how I respond to that situation, and I will be responsible for the next situation that my decision brings me to. Making a decision about anything is taking responsibility.

Everything in your life affects you in some way, and your reaction to each situation directly affects you with its outcome. You are already responsible for yourself and your decisions, so actively recognizing the power you have always had is a tool that can vastly and rapidly change the way you see yourself and your personal power to affect change. People who can correctly identify the times in which they can choose between different outcomes have a higher sense of stability and self-worth.

Whether we actually have free will or not, we still are forced by our own brains to live as though we do have free will. Taking responsibility for every single decision you make, plus the consequences of each of those decisions, is the single most empowering thing you can do with your mind (I’d rank mindfulness as the second most empowering). Once you take complete responsibility for everything in your life, regardless of whose fault it is, you realize that you contain immeasurable power, including the power to change yourself and your life through the decisions you make every day.

 

In Crisis; What To Do When You Have No One To Talk To

When you are alone and in crisis, the crushing loneliness you feel is overwhelming. Wanting to talk to someone you love about your thoughts and feelings is natural, but it’s also unfortunately not always an option. In these situations, you can use your coping skills, including writing or calling a warmline or hotline.

If you are alone and what you need at the moment is to verbalize your experience, I suggest writing down your feelings first. I find this is best done when you just write freestyle, with no regard to sentence structure, punctuation, or continuity of thoughts: just let it all pour out however it wants to. It may make you cry, but you will find a little bit of peace when you finish writing, and your thoughts won’t be as tangled. Writing is a good way to calm yourself down, even when the act of writing makes you upset. You’re getting the poison out on paper, where you can see it and realize that these thoughts are not who you are: they are something that is happening to you right now, and you will have different thoughts after these. Thoughts are happenings, and you are not made up of your thoughts. They do not have to rule your world. Thoughts come and go, and are impermanent, even though some of them are repetitive, commonly like “I’d feel better dead.” Or “I’m worthless.”

Hotlines and Warmlines

Warmlines are for less severe situations than feeling suicidal, so you don’t have to worry about taking someone’s time away from suicidal people. This is actually an unproductive and problematic thought: the thought that you don’t deserve help. However, I know this kind of thinking happens often when you feel worthless and undeserving of love or help, so I want to encourage you to make yourself call.

You are the person most likely to save your life, and any time you consider death as your only option, your thinking is not perfectly crystal clear. This is always a good time to call the National Suicide Prevention Hotline. You get to talk to a real person who can help you sort out your feelings and situation, and will talk to you as long as you need. If you feel you may commit suicide, call this number: 1-800–273–8255. Or if you would rather text, try this Crisis Text Line: Text HOME to 741741.

You deserve help, and help is available at any time, day or night. Seize any tiny moment of doubt in your plan to die, and call. These people are trained at calming you down. They are often people who have been suicidal themselves and will relate in a very visceral way to your feelings and situation. They will most likely make you feel better enough to call off your plan to die.

I know there are people and situations in which suicide is a good solution, but this is a tiny minority, mostly reserved for people already dying soon in a painful way. You are most likely not one of these people, even though death seems completely appealing in the moment. Some people need suicide, and I’m not going to pretend that it’s never appropriate. But again, this is a tiny minority of situations, and most situations and people do not qualify for the “good idea” group. This means you. If you’re not already dying, your suicide would do more much more harm than you are currently feeling. It sucks to feel guilty about the idea of hurting people with your death, but no matter how you address it, suicide is devastating, and yours may be devastating to many people. Think of your parents, siblings, grandparents, aunts, uncles, cousins, classmates, friends in real life, friends on twitter, friends on Facebook, people you’ve dated in the past, people who grew up with you, your employer, your coworkers, every close confidant you’ve had in your life, and all the adults who formed you.

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When you die, you just switch off. No more anything. It’s not relief, it’s non-being. It’s nothing. And while nothingness is sort of the reward you get for living, a suicide is harder on your friends and loved ones than a natural death because everyone feels they should have done something. Everyone feels guilty, like they failed you. That regret will follow them for years, possibly their lifetime. Many parents of suicide victims even commit suicide themselves because they simply cannot bear the feeling that they failed their child. They naturally, though often unfairly, feel responsible for the preventable death of their own offspring. Even if your parents are failing you currently and you think they would be better off if you were dead, that’s not true. Even parents who are blase, indifferent, or mean to their children would be devastated in a way that you cannot imagine unless you’ve experienced a suicide of someone you loved and felt responsible for. Continue reading

Humiliated

I know way more about my brain than most people know about theirs because my brain is the key to what’s wrong with me. My life’s work is coping with it. I am obligated to learn as much about my brain as I can. I have to pay attention to detail. I study my thoughts, actions, and behavior to live with minimal suffering. My brain is what I study.

My brain is the reason I’m humble. I’m not better than anyone else. I am significantly weaker than most people, and sometimes that slaps my ego in the face. Humiliation becomes humility.

There are a number of ways in which my brain humbles me. If I measure myself and my abilities against an imaginary “average” person, I come up short. No such person exists, by the way. We make that person up to compare ourselves and determine our own worth by comparison. Right now, I can plainly recognize that. But the next time I’m put in a position that makes me feel weak, small, childlike, vulnerable, or less-than, my first instinct will be to measure myself by unrealistic standards and berate myself for failing to meet them.

I am aware of how wrong I can be while being sure I’m right.

You can talk with a person who thinks they’re aware of their own brain’s shortcomings. This person may talk about how first-person accounts of events, given as evidence in trials, are hogwash. They may talk about how memory changes over time. Then, you can tell them something true that they misremember, and they will insist that they are right, that they know they’re right, and they remember it clear as day. If there’s a solid memory of something, almost everyone will believe their own memories over someone else’s

I don’t have that privilege. I am wrong all the time, and cannot trust my memory, regardless of how true something feels. For a few years, I would even confuse my memories with my dreams. Now, I have flat-out false memories that are crystal clear, and I am positive that they happened. That’s the natural reaction for us humans. But when someone else tells me I’m wrong about something, I am forced to admit that I can never be sure, and more often than not, I have to take the word of the other person and incorporate the new, correct information into my reality, discarding my incorrect memory.

I’m sure many of you already see the problem here: I can’t know for sure if the other person is correct, either. This makes it easy for people to accidentally gaslight me. I may be correct, be told I’m incorrect, and then believe my brain is lying to me and the other person knows what’s real. Because I’m the only person in the equation, who is (forced to be) self-aware enough to recognize that my memory is faulty, my memory will always lose the argument, regardless of who is right. I can’t even fault anyone for this. I know what being sure of something feels like. This is another example of healthy, neurotypical privilege; believing you are right about something with absolute certainty.

My brain also limits my practical skills, like running errands.

My brain’s limitations make something as normal and boring as going to the store a high-stakes event. I hate stores. Overstimulation is dramatically negative for me. It’s not fun. Grocery stores and big-box stores have fluorescent lighting, rows and rows of endless information to ingest and lots of people threatening my personal space. I walk out of a grocery store with less than half the mental capacity I walked in with, and I don’t mean just emotionally. I’m also unable to process some information and complete ordinary tasks, even if they’re simple (like making coffee). I tremble and have jerking motions in my body. It’s a lot to deal with. Being actively respectful of this limitation of mine humbles me. On some days, I tell my partner that I’m not strong enough to go to the store, and man, that hurts my ego. Most people take something so simple for granted, leaving me humiliated by my limitations when I compare them to an imaginary average person. I feel weak, or childlike, or vulnerable. I feel like I cannot protect myself. Sometimes I thought-spiral when I’m confronted with these feelings. Then there’s the double-edged sword of thought spirals. It’s easy to feel sorry for myself, but it hurts like hell.

Knowing my brain well comes with the price and privilege of understanding how fragile a person’s understanding of the world is. Most people “know” that they’re right and take simple tasks for granted, often even going on autopilot to complete them. But each of these people could be thrown off of reality without knowing it. False memories are a thing.

If you never know you’re wrong, you feel pretty good about yourself. If you can move easily through the world, you feel even better. I’m not someone to be pitied: not at all. I still love my life. But I am humbled by my knowledge of my limitations and the ways in which my brain functions. Humiliation conquers me during episodes and thought spirals, but when I’m steady, I’m left with humility, not humiliation. I am grateful that I know how small and fragile I am compared to a neurotypical person. I can see my place in the universe; I know I am impossibly tiny, just like you. Just like the earth. Just like the Milky Way.

Again, I am not someone to be pitied. I am incredibly grateful for my life, including my disorders. I even had one phenomenally positive change in my brain because of a seizure. That was an unexpected but greatly appreciated gift. I love my house, my husband, my stepson, my parents, my family, and my cat. I love that I’ve never gone hungry. I love that sometimes, in mindful moments, I can completely connect to the present. I love my life.

I am often humiliated, through no fault of my own. I hate it. But sometimes I am in a healthy place, and I have the forced gift of humility. It allows me to let the people around me be right, which makes them feel good. I am no better and no worse than any other human, and I don’t look down on many people. We are all completely controlled by the chemicals and electricity bouncing around the insides of our heads.

My brain forces me into humility during healthy times, but shame during episodes. The tasks I can’t complete leave me asking for help, and there is no more humble position than asking someone for help. Situations I can’t handle mean I am relying on someone else to keep me safe. Feeling childlike without being humiliated is something I still have to work on, and I’m not very good at it. But if I can breathe and let go of my terror and humiliation, I can (sometimes) just be a person who someone is helping. Whether they’re providing a correct memory or pulling me out of the way of a car, I always know I am not as able as they are, and I hope I can someday consistently turn that shame into humility. I have work to do. The easiest path for me is letting go of all attempts at control of the situation and just flow where life takes me. Life and my brain make my world. I am humbled daily by that knowledge.

 

The Coping Skills You Didn’t Know You Needed

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There Is Always Hope Of Reducing Your Pain

You can calm and soothe yourself when you hurt.

It takes a long time, some training, and a lot of practice, but by using coping skills, you can learn how to calm yourself during a depressive episode, an anxiety attack, a panic attack, a bipolar episode, or something similar.

When I have a situation that causes me pain, the first thing I need to do is figure out how to feel better. After that, I can try to resolve the situation. This is where my coping skills come in. My coping skills are anything I can think or do to make me feel better. They range from meditation and mindfulness to re-watching comedy specials on Netflix and cuddling with my husband. Some are extremely simple, like reading or cleaning when I’m on the manic side. Others are just statements I reread that I originally had physically written down on index cards kept in my “toolbox”, which is the box I keep made out of a re-purposed shoe box. Now I use this article to “thumb through” my tools at a glance.

Actions

I have many soothing or calming actions I can take to feel better. Here are the actions from my toolbox:

  • Read a book if manic.
  • Call a friend if you need compassion or to be heard by someone.
  • Lay down, close your eyes, and relax from toes to scalp if you are tense.
  • Play guitar if you need a distraction.
  • Listen to an affirming Spotify playlist if you need to center yourself or re-establish your personality.
  • Do the big/medium/small ears centering meditation. (This is where you sit silently with your eyes closed and imagine your ears are getting bigger. When they are very large, listen for all the sounds you can hear outside of the room you are in. Once you can hear all the sounds, shrink your ears to half their previous size, and listen to everything you can hear inside the room you are in. Imagine your ears going back to normal, and listen carefully for all the sounds inside your body. This helps to ground you in the present moment, and it also helps with fear and anxiety. It is a very quick and easy meditation, and only takes a few minutes.)
  • Meditate freestyle. Let thoughts occur inside of imaginary helium balloons in your mind, and then let each balloon go up and away as your thoughts come up. Have a thought, but then let it float away.
  • Drink cold water.
  • Sing until you are distracted.
  • Exercise.
  • Hold ice cubes in both hands and feel them melt. This is good for distracting your brain from your anxiety, which calms you down for a little bit. It’s good for panic attacks, but the relief doesn’t always last, so have another skill prepared for after.
  • Walk. Thinking while walking helps you process emotion, due to the bi-lateral communication between the two hemispheres of your brain.
  • Go outside and ground yourself. You ground yourself by noticing something near you and trying to take in as much information about it as you can. Use sight, smell, touch, color, lines, your emotional response to it, its history and where it originated. You can do this with anything. I recommend a tree or a plant.
  • Meditate any way you like.
  • Splash cold water in your face.
  • Watch something comforting you’ve seen before on Netflix. This one is great for depressive and dissociative episodes, especially comedy specials. They have no plot to follow, it’s okay if you tune out sometimes, they have the same volume all the way through (which is good if you are tense, anxious, or agitated), and if you’ve seen it before, you’re not being challenged by trying to take in new information at a time when you already can’t process things you usually know.
  • Write about all of your feelings.
  • Talk to someone in your family. It is highly likely that they want to help you.
  • Paint.
  • Draw.
  • Think about science.
  • Color in your coloring book.
  • Yoga.
  • Do crunches or lift weights.
  • Find the present moment. Become completely present. Not worrying about the future or the past, just noticing exactly what is happening right now.
  • Warm up like you would before a voice lesson (or any instrument).
  • Make sure you’ve eaten. If you haven’t, have fruit. This one is a good solution for when I don’t want to eat anything at all.
  • Meditate by watching your breath.
  • Cuddle with a loved one.
  • Give attention and kindness to your pet. Take your time. Be present with them. They are always in the moment.
  • Take a hydroxyzine or Benadryl (or whatever you are prescribed for an as-needed anxiety med). I only name hydroxizine and Benadryl because both of them are non-addictive anti-anxiety medicines to be used as-needed for anxiety attacks and episodes. You have options when it comes to psychiatric medication, so keep your doctor informed if something doesn’t work or causes problems. Please note that lorazepam, alprazolam, clonazepam, and diazepam all have the potential for abuse and addiction because they work so well and make you numb if you abuse them, so discuss any addictive tendencies you have with your doctor. Like I said, you have options.

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Why Now Is The Best Time To Be Mentally Ill

This is the best time in the history of the world to be mentally ill. We have psychiatrists, drugs, psychologists, scientific researchers, therapists, hospitals, and we are working toward public knowledge of mental health as a legitimate concern. Many people know what depression or anxiety mean, and can list names of other psychiatric conditions as well, even though they may not be able to name the symptoms.

Modern life also allows us to be connected to communities online, with social media sites, mental health support sites, and many blogs that try to spread awareness and understanding of mental illness. If your family or friends don’t “get it”, you still have people to communicate with who understand what you’re experiencing. Having a social support network can save your life, even if it’s made up of people online who you never meet in person (or friends you talk to on the phone who you never see in person anymore). Talking to others who are fighting the same battle you are makes you feel much less alone or abnormal, which is tremendously helpful for your sense of self as a human with inherent worth. In other words, having a community is good for your self-esteem, and the internet allows anyone to reach out if they choose.

The digital age revolutionized my care. I use a pharmacy that is open every day for 24 hours, and I can manage and order refills through an app on my phone. My doctor’s office uses a system called MyChart, through which I can contact my doctor online with any questions or concerns, and he gets back to me in just a few days. This level of treatment is radically different from what I had for most of the duration my illness previously. Because things were so difficult before, with problems like not being able to speak to my psychiatrist directly, not being able to change dosages without an appointment, missing refills after I had run out, the pharmacy being closed every day at 6 and closed on weekends, having to call my prescriptions in and wait on hold for up to forty minutes, and then having to call and wait again to confirm that they are ready (or find out that they’re not), I count myself incredibly, unbelievably, undeservedly lucky that I am getting such amazing care. That’s largely due to the fact that everything in the world is turning electronic. The internet is helping keep me alive, and I am grateful for that.

Depression in the modern age still exists in a gray area of public understanding. Many people know what it is and can validate it, many others do not and cannot. Any individual who wants to help fight the stigma against mental illness can do so by educating people one at a time, teaching the origins and symptoms of their disorder to people and showing at the same time that they (the sufferer) are a decent, regular person. With Facebook and Twitter, we can even display our conditions to large groups of people as part of the fight against the stigmatization of mental illness.

Because of the advancements we have achieved as a world, we as a world society are in the best position to support people with mental illnesses that we have ever been in. There are elements to our care that are still severely lacking (and it varies widely based on country), and many people do still die by suicide due to mental illness, both treated and untreated. We need to teach emotional intelligence and coping skills to our children, all of them. There are many things that still need fixing in our system. But there are also many things that have already been fixed. For that, I am indescribably grateful.

 

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Fact-checking. What’s Real?

I’ve had doctors who were surprised that I can distinguish most of my hallucinations from reality, so I’m led to believe it’s not common, but I am not a professional.

I know when I’m in a psychotic episode and I can use logic to detect most hallucinations. I call it “fact checking”.

adult automotive blur car

Photo by JESHOOTS.com on Pexels.com

If I’m in the car and I hear the driver (I don’t drive. I have a license, but it scares my family. It’s disheartening at times.) singing along with the radio, I look at the driver’s mouth to see if it’s moving. Sometimes it is, and I’m hearing them singing. Sometimes it isn’t, and then I realize I’m just hallucinating them singing.

sunglasses girl swimming pool swimming

Photo by Juan Salamanca on Pexels.com

Once, I saw a young, blonde-haired boy in a blue and orange swimsuit floating motionlessly near me at the bottom of the pool. I panicked, yelled “Help!” and dove down to grab him and bring him to the surface. When I reached out to grab him, he disappeared. I returned to the surface with a pounding heart and told the lifeguard that I was mistaken, nothing was wrong and thanked him for coming to help. My whole body was shaking for the next hour. Finding out you’ve had a hallucination is comforting in that the problem it presented is not really there, but your adrenal system will continue to flood you with panic chemicals long after you’ve found out.

I frequently have visual disturbances, the most common of which is smoke or bent light in the air. Imagine billowing smoke, and then take the same curves and lines you would see and turn that into light. It’s a lot like the reflection of light at the bottom of a swimming pool. It doesn’t obscure my vision, it just passes over it. This is usually the first sign I’m having psychosis.

Following the billowing light, I usually become very frightened, with the cause being some vague danger, a threat to my loved ones’ or my safety. I frequently ask if we’re safe (anyone in my life knows to expect this, and fortunately the answer is always “yes”) and sometimes need my fiance to search the house for strangers on my behalf. This fear is paranoia. I actually consider myself lucky for not having more specific fears. The more specific the fear I’ve had in the past, the more intimidating it was. Sometimes, if I’m in public during a psychotic episode, I will believe that I can hear everyone’s thoughts and that they can hear mine. I’m afraid I’ll think the wrong thing and everyone will hear me and get upset. That’s a great example of a paranoid delusion. In this state, I know I’m in an episode, which allows me to continue to move through the world looking a little bit normal (with the guidance of a loved one) even though I’m inside of an absolutely insane situation. I can experience it as real, the way I’m being forced to experience it, but pretend that nothing is happening and just do the things I’m told to do, like walk next to someone, get in the car, or stand in a line. This level of coping with psychosis is ninja-level. I cannot express how hard I have worked to get to the point where I can actively fear for my life and stand in line at the grocery store at the same time.

Being 12 years into my treatment for bipolar, nothing now is nearly as scary as it used to be. I used to be completely entranced by horrific hallucinations and believed completely that they were real. I once sat next to Satan on an American Airlines flight (I really was on an airplane). He had a little boy in his lap, and I was trying to figure out how to signal to the stewardess that the boy needed help, but I was nearly paralyzed by fear. I looked down between my feet so he couldn’t see me crying, and the floor of the aircraft had disappeared. I was sitting 40,000 feet above the earth with nothing between me and the tiny lights below but air. That was real to me.

By 3 years ago, I’d come around to being aware of almost all my hallucinations. I once saw a flock of black angels/bird people flying over the car I was riding in. I knew it was a hallucination, but it still mattered to me. I wasn’t at all afraid. It was beautiful. I watched them swoop and dive around each other. They were fast and graceful. I watched until they disappeared. That memory is still special to me. That experience was only mine. No one else in the world can possibly have that memory, not even the people that were there.

Knowing I’m having hallucinations is much easier than knowing I’m having paranoia or delusions. Paranoia and delusions are less tangible. Seeing something is easy to disprove, especially if it disappears while I’m watching it, which is frequent with my visual hallucinations. If the person is singing in the car, I can watch their mouth. But if I believe I’m not “safe”, for whatever vague, paranoid reason, it is very hard, and sometimes impossible, not to trust my gut. Instead, I have to trust someone else’s gut. My fiance is my partner in life, and we have been through enough episodes together to have each other trained in what to do. If he’s the person I’m with, which is usually the case, I have to ask him questions, sometimes repeatedly, about the nature of actual reality as he is experiencing it. I use him to check what is real. I ask him about the validity of things I see, hear, and think. I will ask him if we’re safe, and he’ll say yes. If I don’t calm down, he will describe why we are safe. If I’m far enough gone that I can’t calm down, it’s probably all terror-crying from that point on anyway, so he just takes me home, stays with me and reiterates that we are safe. I much prefer hallucinations, as you can imagine. They, at least, can sometimes be fun. Paranoia, so far, has never been fun for me.

I am self-aware enough now that I know when I’m in an episode most of the time. Sometimes someone else will point it out before I’ve figured out what’s happening, but as soon as I realize it, I am able to stay grounded in that knowledge. Knowing that I’m in an episode and that I can’t stop it sometimes feels like falling, only I never land. It just goes and goes, without my permission, and I can’t change it. The intensity of it can be ridiculous. Humans shouldn’t be able to manufacture that level of intensity, especially with no external source. It can be quite incredible, in the original meaning of the word. In fact, that incredibility is part of why fewer people understand or validate mental illness. It sounds made-up.

Knowing I’m experiencing psychosis keeps me grounded and safe during episodes. I know to alert my fiance or family, and I follow their lead, at least until I get out of public. At home, I am better able to cope with whatever counter-reality comes my way.

Read More About Psychosis

Read More Personal Experiences

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“How Can People On The Internet Help Me With Severe Depression?”

All people on the internet can do for you is to listen and respond. We can offer our support through words and remind you that you are not alone. We will be here in the middle of the night. We will hear you, and we will try to help.

 

Move forward with the hope of treatment and remission. You need to be seeing a psychiatrist and a therapist. Depression is hard, and you may not have much energy or functionality today. That’s okay. Make your one task for the day “Make an appointment with a psychiatrist”, and even if there is a long waiting list, set the appointment and put it on your calendar so that you will have help in the future. Do the same thing tomorrow, only with a therapist.

 

If you already have a psychiatrist and therapist, stay vigilant in keeping your appointments and taking your medicine. Start to build your toolbox of coping strategies,(that link is to a list of all of my coping tools) and use it when you’re in pain, even if that Sunflower CCmeans you are using it all day, every day. You cannot be cured, but your pain can be managed. For your next appointment, take any notes you can on your symptoms, triggers, medicine effects/side-effects, sleep problems, eating problems, and daily moods. There is no wrong way to take these notes, just write down information every couple of days about things you experience in your illness. The important thing is that you have everything written down for the doctor. The doctor will only be as good as the information you give them, and you are your best and only advocate as the patient. Don’t rely on only your memory to communicate with your doctor, because memory is fickle and fallible, and doubly so with Continue reading