Still Practicing

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I finished up DBT (dialectical behavior therapy) last August, but I still use my DBT skills all the time. There are days when I think I should take a refresher, but most of the time, I am just pleased to recognize that I am reflexively practicing these skills and taking advantage of my improved coping ability.

Mindfulness is number one. I feel like I should make more effort to practice mindfulness, but the moment I realize that I’m upset, or my mind is wandering, or I’m anxious, I start focusing on my breathing. It’s practically automatic. And boy, does it work! It’s amazing that something as basic and necessary as breathing, when done mindfully, can have such a powerful effect on our whole being.

Interpersonal effectiveness skills are coming to the fore more often as I start navigating my way into a new job. Demands are made of me much more frequently, asking for more all the time. It’s flattering, but I recognize now that I really can’t do everything and need to take things at a moderate pace if I’m going to make it through with any panache. I take my time about responding to requests and try to maintain good relationships. It seems more complicated every week, but something as simple as going back to the hairdresser’s to have my hair re-done after a bad cut has become easier to handle than ever.

Emotion regulation hasn’t been as difficult lately as it once was either. I can’t remember the last time I took Ativan for anxiety! I’ve had such a stable mood chart lately that it almost feels odd. And sure, I still have my lousy moments, but instead of blind rage it’s mild peevishness. Even then I realize that I’m being irrational and am quicker to recalibrate. And just letting the emotions come and go is still incredibly valuable. When I stop fighting reality and just allow painful emotions to be what they are, they dissipate quickly. There is no stewing and ruminating anymore. There is no getting worked up into a frenzy. I recognize my emotions, acknowledge and experience them, and they’re gone before I realize it.

The big one in recent history has been distress tolerance. It’s been very stressful to look for housing while waiting for our current house to sell, dealing with all kinds of pressures from all kinds of people. Feeling a bit lousy while traveling, I self-soothed with a piece of chocolate peanut butter cake (though I would have been better off with fresh pineapple or something less sugary…) Realizing I was feeling frayed, I decided to spend some down time by myself, catching up on work. Noticing some nervous energy, I went for a walk outdoors where I could be mindful of nature and relax.

And of course, there’s plenty more; I notice little ways that practicing DBT has helped me almost every day. I see in others a need for the same lessons and practice, and I almost feel sorry for them because they probably won’t ever learn to cope as well as they could, and they will suffer for it. But me, I’m grateful that I stuck it out and really made an effort to learn and practice DBT. And it’s not too late for the rest of you!

Dog for Mental Health

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Apologies to Lulu for the title. Her call for bloggers about mental health issues inspires a lot of good work and discussion at Canvas of the Minds, and we’re lucky to have her driving the conversation.

This post is based on an off-hand comment I made a while back:

I think you should get a dog (I think everyone should get a dog). A dog will not allow one to lie abed; he requires attention, every day–and gives back unconditional love. Before I met DeeDee, my dog was sometimes the only reason I even bothered to eat–he needed me, and that was reason enough to take care of myself.

I won’t go into the sad, sordid story of before I met DeeDee, but I will admit that my most fervent prayer is to be more dog-like, because dog is love. I want to expand on that comment, though, because I believe that owning a dog has real benefits–beyond having a designated dishwasher to clean the plates. The first and most important of these, of course, is unconditional love.

Dog = unconditional love

A dog will always be happy to see you. A dog loves unconditionally, and helps us learn to do the same, which can help us let go of resentment, accept flaws, and embrace joy. Dogs will show this love in several ways: by wagging, licking, playing, smiling… it’s hard to feel bad when you’re petting a happy, playful dog. But if you do, a dog will recognize that you’re not feeling well and will try to comfort you.

Dog = responsibility

Of course, as every kid who ever begged for a puppy knows, owning a dog is a big responsibility. But sometimes, responsibility is exactly what we need. I’m not talking about taking responsibility for your mental health—you know that no one else can make sure you get the care you need—but the benefits that come from caring for something outside yourself. The resolution to care for something else, something that can’t care for itself, provides a purpose, a reason to get out of bed even when you don’t want to. A dog does not care that you feel depressed or anxious; the dog recognizes your state, but still needs to go outside, still needs you to provide food and water. A dog cannot do these things without you. You MUST care for the dog, regardless of how you feel.

And, in so doing, you might realized that, having gotten out of bed, you can do other things, too. And doing something may, in turn, help you feel better—or at least distract you from feeling so poorly for a while.

And ignoring the dog (and feeling guilty about ignoring the dog) isn’t an option—the dog will bark, eat your shoes, and shit on the floor if you ignore him. The dog needs his exercise, which leads to another benefit.

Dog = exercise

A dog requires exercise, and the link between exercise and improved mental health seems to be real. According to the National Institute of Health, “Exercise improves mental health by reducing anxiety, depression, and negative mood and by improving self-esteem and cognitive function. Exercise has also been found to alleviate symptoms such as low self-esteem and social withdrawal.” There are other benefits, too:

  • Improved sleep
  • Increased interest in sex
  • Better endurance
  • Stress relief
  • Improvement in mood
  • Increased energy and stamina
  • Reduced tiredness that can increase mental alertness
  • Weight reduction
  • Reduced cholesterol and improved cardiovascular fitness

All of these help us feel better, physically, and that also helps. A dog requires walking at least twice a day, making it easy to get enough exercise for these benefits. And as a bonus, starting to exercise makes it easier to get more exercise, which increases the benefits of exercise.

There are other reasons to get a dog, of course. You can train and show a dog, maybe even go on to win at Westminster, if that’s your thing. A dog will guard your house, give you reasons for social interaction, and might even attract members of the opposite sex (ask DeeDee how we first met). For any of these reasons, or all of them, I think you should get a dog. I think everyone should get a dog.

The Perfect (Medication) Cocktail

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DeeDee:

Hey, look! I finally got my meds right!
Well, mostly. The sinus meds are making my heart rate skyrocket, so they need some adjustment. But the rest of it is finally A-OK. Hurray!

Originally posted on A Canvas Of The Minds:

click to read DeeDee's bio

click to read DeeDee’s bio

It seems like almost everyone who has been under long-term psychiatric care has embarked on a quest for the Holy Grail: the perfect medication cocktail. And it also seems like a lot of people never find it.

But I’m pleased to discover–my therapist and psych nurse both concur–that I’ve finally found mine. It treats a biological failure to produce enough of a couple critical substances: dopamine and progesterone.

My perfect cocktail includes medicated sinus rinses, nasal spray, a slew of vitamins and supplements, and a couple of prescriptions.

My perfect cocktail includes sinus treatments, a slew of vitamins and supplements, a couple of psychoactive drugs, low-dose naltrexone, and progesterone (not pictured).

I’ve known for years that dopamine was to blame for my mood and attention issues because only dopaminergic drugs ever helped. But there’s no “dopamine deficiency disorder” in the DSM, so they’ve labeled me with ADHD and Major Depressive Disorder. Although Wellbutrin XL and Adderall XR is a bad combo for most people–it makes…

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All The Things Are Happening, Again

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Been awhile, hasn’t it? That’s because life has been a nonstop action-packed adventure flick for the last few weeks.

After chewing my nails for weeks waiting to find out about jobs, I got not one, but two job offers! It came down to choosing between Midwestern State University and University of Mid-Atlantic, Flagship. My preference was clear; I used the offers to negotiate a slightly better package (and my offer was already pretty stellar) and then sealed the deal at Mid-Atlantic. In a few months, we’ll be moving our nest south of the Mason-Dixon, where I’m pretty sure they eat Yankees like me, to a sprawling metro area. In August, I’ll officially become an assistant professor.

It’s both terrifying and exhilarating. I haven’t had enough down time for terror to really sink in, though. As soon as I signed the offer letter, we started the mad race to get our house ready to sell.

If you’ve never prepared a house to list, you probably have no idea what kind of horrific endurance test I’m talking about. For nearly a month, every day, evening, and weekend has been filled with scraping, scrubbing, painting, repairing, upgrading, and facelifting our 86-year-old bungalow. In the process, I’ve triggered a carpal tunnel flare-up that requires me to wear a brace at night (minimum) if I want to sleep.

Last weekend I installed a new metal tile backsplash because the Formica was gross and burned.

Last weekend I installed a new metal tile backsplash and it looks damn fine.

In addition to overhauling the kitchen, touching up all the things, disposing of tons of stuff we don’t plan to move, and packing away everything we could possibly live without, we shelled out for a staging consultant and a pre-listing home inspection. There’s nothing for the ego quite like getting multiple professional opinions on the deficiencies of your home.

As a result, we still have a to-do list for repairs after the inspection, and we pretty much completely rearranged our house. Only 2 or 3 pieces of furniture remain where they were before. It’s disorienting and frustrating to live in a space that feels so foreign and temporary. It’s also nerve-wracking to try to keep everything spotless, depersonalized, and perfectly orderly for unknown visitors who may descend with minimal notice at any time.

But that’s just the beginning. The really stressful thing, which I try to ignore, is that we need to sell our house fast so that we have a down payment for new living quarters. And boy oh boy is housing expensive in our new neighborhood. Like, three to six times higher cost than we currently pay. Ouch.

So despite a 50% raise in my pay, Mr. Chickadee hasn’t yet had time to secure a job, and we have very little buying power. We can only finance about double the house we have now, and you can’t touch a house like ours in the new locale for less than five times the value of our current property. What that means for us, because renting is even more absurd, is shopping for condos and townhouses instead of traditional single-family homes. But it looks like we’ve found a decent area for our needs, so we’re planning to take that university-funded house-hunting trip later this month.

At the same time, I just had an article in the crème de la crème scientific publication, got invited to facilitate a workshop in Italy (yes! yes! yes!), and got sucked into heading up Mid-Atlantic’s end of an NSF proposal with only a week to write the grant. My travel schedule for the next few months is off the charts: six trips before we move, and a few more after that. It’s stressful and exciting, and it’s really all good, so long as I can keep my wits about me.

It’s been mind-boggling, kids. Wish me luck! I’ll try to check in again soon.

Job Search Crazy Times

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I haven’t been keeping up because I’ve been trying to get a job. Big deal, you might say, but unless you’re in academia (and therefore already pitying me) then you’re probably underestimating the level of torture involved in the professorial job search.

The academic job search goes like this:

  1. Apply for jobs from September through November. Application materials: cover letter (2 pgs), CV (mine’s 10 pgs), research statement (2 pgs), teaching statement (1 pg), 3–4 carefully selected references, and 1–3 writing samples of published papers. Each item must be painstakingly crafted to demonstrate superior abilities. 200 other people will apply for each job; I applied for 6.5 jobs.
  2. Wait.
  3. Get phone/Skype interviews in December and January. Spend about 3 days per interview preparing for a 20–45 minute screening call. For each position, a search committee will interview around 12–20 people. I got 4 phone interviews.
  4. Wait.
  5. Do “flyouts”, “campus visits”, or “campus interviews” in January–February. Spend about a week per visit preparing for an intense 2-day gauntlet during which every moment is scheduled, aside from 10 PM to 8 AM; you’ll be lucky if they remember to offer bathroom breaks. Meet up to 20+ faculty each time, either in group meetings that feel like firing squads or endless back-to-back half hour meetings where you must impress each person individually. Give a 35-60 minute “job talk”, then meet with graduate students/deans/department chairs, tour the campus, and literally talk yourself hoarse while charming everyone at every moment. Each position will have 3–4 candidates visit. I got 2 campus visits.
  6. Write thank-you notes to every individual that you met at each visit.
  7. Wait.
  8. Wait.
  9. Get paranoid and drunk a lot.
  10. Wait.
  11. Sometime in March, if you’re very lucky, get an offer or two.
  12. Negotiate.
  13. Wait.
  14. Negotiate.
  15. Wait.
  16. Sign a contract.
  17. Pack up your whole life and move.

I’m somewhere around step 9 and it’s driving me (and Mr. Chickadee) crazy. I can’t think about anything except this impending transition. I search for places to live in each city I’ve visited, increasingly horrified by cost of living and suburban banality, and then second-guess every interaction along the way. From all accounts, I performed brilliantly at the interviews, and the fact that 1/3 of my applications yielded campus visits is actually quite good.

This week I attended my favorite annual conference. I thought it would be a great distraction, but faculty from both schools I visited were there and everyone asked how the job search is going, over and over. Instead of being fun like usual, it was a pressure cooker. I cried myself to sleep but barely slept, ending up so exhausted that I could hardly pay attention to content or conversations. Worst of all, I co-organized a workshop with two people who are on the search committee for one of the jobs I’m up for. I couldn’t get drunk fast enough at the end of that day.

I was constantly under scrutiny and trying to maintain a good show, but the stress was killer. I resorted to avoiding people, leaving events early, taking breaks to be outside by myself where no one could judge me, and drinking heavily. Which may not have been terribly wise, but my coping skills just couldn’t overcome that much stress.

I tried (and failed) to put on a brave face, and all my friends heard the truth: I’m terrified. I can’t draw good comparisons between the schools because they’re so very different, and despite excellent feedback, I don’t know if I’ll get job offers. Although there’s nothing I can do and it’s like picking at a scab until the wound becomes infected, I just can’t let it go. And I still have at least two more weeks to wait.

Miss Diagnoses

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DeeDee:

I don’t even know how many times I’ve been misdiagnosed at this point. But the hits just keep on coming…

Originally posted on A Canvas Of The Minds:

DeeDee newAnyone who has ever looked up a “serious mental illness” like bipolar disorder has been smacked in the face with dire warnings and frightening statistics about misdiagnosis. If you google my lifelong companion ADD, you’ll see lots and lots of dire warnings and hand-wringing about overdiagnosis. But you won’t run into are dire warnings, frightening statistics, and hand-wringing about repeated, compounded misdiagnoses.

It’s really bad for people with mental health issues to get the wrong diagnosis and treatment. But it’s just as bad for those with somatic health issues to get the wrong diagnosis and treatment.

And it’s very, very easy to get misdiagnosed. Consistently. Repeatedly.

How does it happen? The biggest problem is that myriad conditions can cause psychological symptoms: vitamin deficiencies, endocrine imbalances, chronic stress, and many more. But the main problem, from what I’ve seen, is cost-control driven negligence: major psychiatric diagnoses made on the first 15-to-30-minute…

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