Feeling in an unsafe place

[Mark]

I so wish I could fix things for everyone.

all that "zen" imagery that Jimmy has been mentioning - the stuff about not pushing the river is also consistent with the idea of acceptance in psychotherapy - which is a huge theme with regard to therapy for chronic and serious mental health problems in the last decade. In DBT it shows up as self-soothing exercises; in acceptance and committment therapy (ACT) it shows up as the acceptance part of that therapy. the idea has several facets at least : 1) that struggling often makes things worse, and 2) that some things cannot be altered, so the rational coping response is to work on altering your attitude about those things.

Depression leaches all the joy out of life. It compresses the horizon so that you cannot see that things could get better, or have ever been better in the past (when you are seriously in the middle of an episode anyway). You end up sometimes feeling hopeless even with all the tools that therapy can teach. The cognitive stuff can really help, but it can also have its limits in the midst of any particular intense episode.

Often best to attack depression on multiple fronts at once. So you can work the cognitive exercises and they can be helpful. You can also make sure that you are scheduled to be around people, and/or to do something physical (such as exercise), to work it from the other end. And medications and other sorts of treatments are still another angle to approach (with some stuff that works and some that is less effective varying on an individual basis).

Mark

[Rollercoaster]

Thanks Mark

I wish someone could fix it for me too - but I kow they can't.

I am doing most of what you say, I think. Exercise is happening (yoga and the gym); I am out at work each day and interacting. I'm taking my meds appropriately, having managed not to succumb either to the urge to take them all or to stop them all. I have my therapy session tomorrow.

CBT, as you say, is a challenge in the midst of blackness. The distress tolerance / acceptance are also hard parts, though I work at them. Black is shifting slightly to grey over the last day or so - it's still tough but not as grim.

Thanks

[jimmyfay2]

I'm glad to hear you are doing all that you are doing. You are plowing the field that will someday provide the crop you seek. ( did I mention I am a musician, so I tend to speak lyrically... hope you don't mind! ) I know you want to feel 100% better right now, but that ususally doesn't happen. I have found that i typically notice I am feeling better once I've stopped looking for signs that I am feeling better. To quote a grandma " it'll stop hurting once you feel better..." Again, depression is alot like any other malady we go through in life. We contract the illness, or injury, then go through the process of healing, and often don't even notice the healing taking place until we notice that we haven't noticed the symptoms. See what I'm saying? When you are in the midst of a depressive episode, your entire focus is on the symptoms... you are defined by them in a way. Once the symptoms start to lift, and light starts to break through again, the colors start to outshine the darkness and soon, all is light again and the dark is but a memory. You can remember feeling like hell, but you can't really bring back the pain. I had a terrible motorcycle accident in 1994 in which I broke my shin, my knee, my ribs, my shoulder and ruptured the pericardial sac ( a fluid filled bag around the heart )... the pain was excruciating, and protracted. I was in pain for nearly 2 years while my body was recovering. I became so used to being in pain, that that became the norm. It wasn't until several years later that I noticed I wasn't noticing all the aches and pains because they had recovered. I find that depression works in a very similar way. Your life becomes your depression and your depression becomes your life. You become so familiar with the view through the dark filter that you cannot even remember, or in fact believe, that you were ever 'happy'. It is only through time, and effort that you come to a place where you have to remind yourself you were once depressed. Do you see where I'm going with this?

Another thing I wanted to touch on briefly is the concept of 'happiness'. I recently read an article on the idea that we in the west tend to define life's successes by how happy we are at any given moment. Perhaps embracing the ups and downs equally, and not trying to protect ourselves from the downs so much that we spend all our time running from unpleasant thoughts or experiences. It made me look at my life as a novel. If I was reading a novel that was all sunshine and light, I would get bored and put it down. It is the contrast between joy and sorrow, and in fact the struggle of the main character that makes a great novel great. So many of us are trying to write our novel with only the sunny days as the backdrop. If you can find a way to be patient and gentle with your life when it is in the doldrums, you might find that it makes for a more interesting read, so to speak. Plus, once you come through the hardships, the 'happy ending' of this chapter will be all the sweeter in comparison.

Well, not to bring you back to reality, but my 11 month old daughter is trying to deconstruct the master bathroom so I must go...

Keep writing, keep up what you are doing with your doctor, and never stop reaching for help when you need it...

-jimmyfay2

Edited November 26, 2008 by jimmyfay2

[Rollercoaster]

Your life becomes your depression and your depression becomes your life. You become so familiar with the view through the dark filter that you cannot even remember, or in fact believe, that you were ever 'happy'. It is only through time, and effort that you come to a place where you have to remind yourself you were once depressed. Do you see where I'm going with this?

Yes, I do. I *see* it (perhaps I am starting to find shades of grey rather than pure black). Feeling happy sometimes seems impossible. I liken it to a cave - that's the image I have of my depression; that i am stuck inside a cave, in the bowels of the earth. At the worst times I can't even believe there could be a way out - even if there were, I couldn't find the energy to move towards it. Just now I am starting to see there are tunnels leading away from this cave, but I am still not sure I have the ability to make my way throughone of them.

Another thing I wanted to touch on briefly is the concept of 'happiness'. ... It is the contrast between joy and sorrow, and in fact the struggle of the main character that makes a great novel great. So many of us are trying to write our novel with only the sunny days as the backdrop. If you can find a way to be patient and gentle with your life when it is in the doldrums, you might find that it makes for a more interesting read, so to speak. Plus, once you come through the hardships, the 'happy ending' of this chapter will be all the sweeter in comparison.

Tolerating the distress, in fact. That's a hard one for me; the distress throws me back so vividly into my childhood experiences. dissociation is a very real experience for me, particularly in therapy sessions, and I am too readily flooded by re-experiencing things. It's something my therapist and I are about to begin new work on - finding a way to process traumas without re-experiencing them.

Thank you.

I'm starting to move a little now. Starting to feel less hopeless. Maybe at some point it will shift to hopeful.

[jimmyfay2]

From where I'm sitting, you are sounding more optimistic than you might realize. Of course, sounding and feeling are TOTALLY different, so I'm sure you aren't feeling it yet, but you will. I am glad to hear you are working on new things with your therapist. The problem I had growing up ( I started seeing doctors at age 7 for anxiety and depression ) was that no matter what doctor I went to they all seemed to do the same thing. By the time I was 20, I was usually teaching each new doctor something new. I should've been getting paid for the sessions! It wasn't until I found a doctor when I was 20, and at my worst, that I started to feel like things were actually changing for the better. He made me do alot of work, but the rewards were phenomenal! Slow, but phenomenal...

Let me know how things go with the dissociation. That has been a big part of my life... if you need to 'talk' about that part of your depression with someone who gets it, this is the place for it for sure.

Take it easy...

-jimmyfay2

[Nise122]

I'm new here and reading how you are a handling things is so encouraging to me! You have real tools to use in times of need. I don't know if it's appropriate to ask on this page but I want to know where to begin. I am severely depressed but pretend I'm not. I've been in therapy for over 20 years on and off. I tell myself, and my family tells me, that everyone needs a little help now and then but I'm perfectly normal. My family dr put me on effexor for depression during my divorce 10 years ago and I've been taking it sin e then. But recently I'm more depressed than ever and my family is attributing it to premenopause even though my periods are still regular. I'm 52 so they think it's time. The fact is that I've suffered with depression on and off as far back as I can remember into childhood. It comes and goes. I need real treatment. Where do begin to get the tools you seem to have? I am feeling so badly right now that I would love to be able to do some kind of residential treatment and get proper diagnosis, medicine and therapy. I k ow there is hope. I just can't get out of bed and do anything because I don't know what to do.

[muffinmule]

Hi Rollercoaster

Please believe me when I say you do matter and as my daughter said today to me when you get those thoughts it is not you but the Black Dog Barking.You sound so alone ...but we are here for you so please stay safe.out here in NZ we have a brilliant place called IRIS it cares for women with depression no matter age ethnicity or finance.Do you have something like that in the US.Are there any independent groups that could help you in the interim like church,or community places.i am not very up on what is available in the US only that we seem to have a number of resources that can help.Have you tried your University many of the bigger ones have staff available to help listen and stay with you through the worst parts.Most of all the world would be a sadder place without you so hang in there

[Rollercoaster]

I am glad to hear you are working on new things with your therapist.

Indeed. For years I have had a diet of CBT - which got me "so far but no further". Then I did some work on Schema therapy and that helped, gave me more understanding of why I am as I am and some ideas about how I might change things. Now I am working with someone who understands that the childhood issues, and the dissociation, need looking at. She's giving me a lot of input to help me feel safe in that relationship, to give me security that she is not going to go away because of anything I say, and seems to have a massive range of techniques to draw on.

Let me know how things go with the dissociation. That has been a big part of my life... if you need to 'talk' about that part of your depression with someone who gets it, this is the place for it for sure.

Dissociation - it's making the therapy harder just now, as I am so quickly triggered into it and back into then. Finding a way to stay grounded is eluding me at present. I'm going to start some new work with my T using "lifeline cues" - have you come across it? I think it is aimed at trying to help my separate parts recognise that we are all one, all connected. J has said she is going to find some "metamusic" which will help me stay grounded while I do it. I'm terrified, to be honest - just writing out a cue for each year of my life is proving very difficult. Part of the trouble is that the cues are distressing; another part is that I have no clear sense of memories tied in with particular ages. There is so much that I just don't remember. There are general memories - the colour of curtains in my room - but no sense of how old I was then. There seem to be very few clearly recalled events from childhood.

fact is that I've suffered with depression on and off as far back as I can remember into childhood. It comes and goes. I need real treatment. Where do begin to get the tools you seem to have? I am feeling so badly right now that I would love to be able to do some kind of residential treatment and get proper diagnosis, medicine and therapy. I k ow there is hope. I just can't get out of bed and do anything because I don't know what to do.

I wish I had the answers. I've struggled since childhood too. Some of what has helped me is reading, some is taking the plunge and doing things, some is accepting that there are things I can do to help myself (though I can't do all of them all of the time,a nd at the lowest points it is really hard to do anything). One of my starting points was exercise - I began with swimming - and although it is something you so do NOT want to do when depressed, it does help. Getting a friend to go with me, to encourage me to go, really helped.

Hi Rollercoaster

Please believe me when I say you do matter and as my daughter said today to me when you get those thoughts it is not you but the Black Dog Barking.You sound so alone ...but we are here for you so please stay safe.out here in NZ we have a brilliant place called IRIS it cares for women with depression no matter age ethnicity or finance.Do you have something like that in the US.Are there any independent groups that could help you in the interim like church,or community places.i am not very up on what is available in the US only that we seem to have a number of resources that can help.Have you tried your University many of the bigger ones have staff available to help listen and stay with you through the worst parts.Most of all the world would be a sadder place without you so hang in there

Thank you muffin.

I'm in the UK. The nhs may be a wonderful institution, but mental health care is definitely the Cinderella of the service. I'm not at Uni - I am a teacher. I have accessed counselling through my employer, and through my GP, and through referral to secondary services - but it is all short term (usually 6-8 sessions) which is not ideal. I now pay for a private counsellor, digging myself further into debt. Fortunately my sessions are subsidised by a Christian charity.

Thanks for all your responses. The support here is helping.

[Mark]

Nise122,

The place to start is to educate yourself regarding the various different treatments that are out there. Our Depression topic center anchor article goes over most stuff, so it is a reasonable place to begin. I'd supplement that also with some of the material in our Psychological Self-Tools self-help book, which goes over some self help techniques that can be applied to working through depression, and also our stress management topic center anchor article which describes stress coping skills. When you have a sense of whats out there, you can start to figure out what seems to you most compatible and helpful for your issue. At that point it is a matter of finding a professional helper you can click with (if that is the way you're going to go), which is a combination of luck and resources and persistence (unfortunately, often stuff in short supply when you are not feeling well). But one thing at a time. there is definitely ore quality treatment out there than simple antidepressant medications. If you want the cliff notes, look into Cognitive Therapy for Depression, and develop a regular robust physical exercise program (provided you are healthy enough to do so), and those two things can do wonders, and they are compatible with antidepressant medication treatment as well.

Rollercoaster, Jimmy,

This is a hopeful discussion. I'm remembering times when it was evident to myself and to group members that another group member was feeling better - not quite in the pit of depression anymore - but he could not perceive that - he felt as black as ever, but it was plain as day that he had more energy, was more motivated, etc. Not that this is necessarily the case here, but it is a good thing to mention, becuase it can be the case that you are doing better than you were and you don't notice yourself but others do.

Dissociation is a hard one. It's one of those frontiers still where there aren't established protocols for working it through - at least not that I am aware of. I think it helps to think of it as a coping reaction that trips off when people feel unsafe, and one of the ways to work it through is to develop a safe rapport in which it becomes unnecessary to dissociate - the need doesn't arise as much. And to work on ways to come back from times when you do dissociate. It's not either/or - if you can learn to come back a little faster and not dissociate so frequently or intensely as in the past, that is real progress. Not sure if this is a helpful comment, but I just want to say that dissociation is a hard problem.

Mark

[jimmyfay2]

I have a tendency to ramble, so instead of rambling anew, I stole this old ramble because I thought it might help here... I hope it does! I wrote this to someone else on another thread:

"Dissociation is absolutely the worst part of anxiety for me. I live with it for 90% of my day, each day. It starts when I leave my house to drop off my kids and lasts until I pick up my wife at 7pm. It really, REALLY sucks... but, I do understand what it is and how it works, so that has really helped me deal with it. The first time it happened to me I was 7 years old. I was waiting for the bus and all of a sudden I had this wave of terror wash over me and I felt like nothing was real, like I was in some horrible nightmare world where there was no safety and no proof that the world was real. Sounds crazy, right? I was too young to adequately express what was wrong, plus, I didn't want anyone the think I was insane, so I just kept living with it. Long story short, it wasn't until my most recent episode of anxiety and stress that I found some answers. My wife and I just had our 3rd child and for some reason, it pushed me over the edge and back into panic and anxiety mode. I started having panic attacks on the freeway, then at work, then at home, then eventually everywhere I went. It was particularly frustrating because I'd been through all this and thought I was done with anxiety, but it turns out, it's just something I have to be aware of and deal with for the rest of my life. I have been able to deal with all of my symptoms, except for the dissociation... so I kept searching through books and the internet, and eventually found an article that explained the physiology behind this particularly disturbing symptom. I won't bore you with the details, but here's a brief rundown of what happens. When you get anxious, your body goes into defense mode, the fight or flight response, and a whole bunch of systems kick in to get your body prepared to protect itself: The heart beats faster to get blood to your large muscles so you can run away or fight off the danger; Your adrenal glands pump adrenaline into your system to give you more energy, and so on, but the dissociation comes from a couple of systems firing at once. The blood rushing to your large muscle pulls blood away from your brain making you feel light headed and surreal. Also, the blood vessels in your brain constrict which causes those unreal feelings, as if you're out of your body, or not in touch with your mind. It's the same thing that happens during a car accident when people say " it's as if the whole world slowed down and everything felt like a dream ". How is this a defense mechanism you may ask? It is simply a side effect of all the other systems working to protect your body. If you were really in danger, and not simply driving down the freeway for example, your logical mind would make sense of those weird feelings by attaching them to an actual danger, such as a car accident, or an attack of some kind, but when they just hit you out of the blue, they produce more feelings of anxiety. You start to think things like "what the hell is wrong with me?" or "why can't I make this go away?". When you think things like that, your mind attaches meaning to the thoughts and they themselves become the danger. Does that make sense? Now, your frightening thoughts, or simply the anticipation of having those feelings again become your threat, and your body reacts to them, even if you aren't aware of it. So as far as what you can do to stop the feelings? Simply start letting them come, knowing full well you are in no danger. I know that sounds counter intuitive, but trust me it works. I've stopped fighting the sensations and in fact have been putting myself into situations that bring them on, because, for me, the only way to get over anxiety is to go through it. Not around it, over it, beyond it, just through it. I found a great website with tons of information about anxiety at paniccure.com. I suggest you look the site over and keep researching dissociation or depersonalizaion. I've also seen it called disassociation, so try several sites based on those titles. Also, take a look at a book by Barlow and Craske called Mastering your Panic and Anxiety ( I'm guessing at the title because it's in my baby's room right now! ). Most importantly, know that dissociation is completely normal, not at all dangerous, and it will go away."

There are answers out there, they are just hard to find. If you have any more questions, please keep asking them. Keep in mind this is just my experience and my take on this aspect of anxiety. I am certainly not a doctor, just someone who relates to what you're going through and who wants to help if I can.

-Jimmyfay2

[Rollercoaster]

Dissociation is a hard one. It's one of those frontiers still where there aren't established protocols for working it through - at least not that I am aware of. I think it helps to think of it as a coping reaction that trips off when people feel unsafe, and one of the ways to work it through is to develop a safe rapport in which it becomes unnecessary to dissociate - the need doesn't arise as much. And to work on ways to come back from times when you do dissociate. It's not either/or - if you can learn to come back a little faster and not dissociate so frequently or intensely as in the past, that is real progress. Not sure if this is a helpful comment, but I just want to say that dissociation is a hard problem.

Thanks Mark. It is helpful. I know that dissociation is, for me, a coping mechanism - and one of the ways I "escape" from situations which feel too challenging or scary emotionally. My T and I are working on safety - I'm getting closer to feeling safe - and also on returning. That is still hard. We have some new work planned and I am anxious about that, but hoping I can manage to stay with it. There are lots of things my T is doing that are helping me to return after dissociating, but it is still very hard. I do like your comments about progress - that helps.

Jimmy - your experience of dissociation sounds like what I experience as panic. For me, dissociation is when I am not fully aware of what is going on in the present time. As a child I used to "fly away with the birds" - and my experience is a bit like that; voices become muted, sensory perception also so, and I don't recall fully what has happened while I have been "away".

[valarie]

here in the usa it is just as hard to get help. my son has been without work for over a year. there is just no jobs here. and with no jobs no insurance. he went to the local mental heatlh clinic. they said they would help after 3 days of taking his info the said sorry they couldnt help him. he ended up in the hosptial they kept him 24 hrs after that ask him how he felt and sent him home and told him to go back to the same local mental heatlh place that wouldn't help him the first time. i feel just so helpless. now i am getting depressed. there is no help out there. he even said to me "what do i have to do go to the er and cut my throat in front of them before i will get help!!" I had no answer for him. as a mother i feel worthless.