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Goals, not wishes-- I'm a doctor, not a genie.

Saturday, May 27, 2017

Words with Amends

Posted by fxckfeelings on April 20, 2017

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If someone breaks up with you for what you perceive to be unfair or unfounded reasons, one of the ironic effects of of the unjust uncoupling is that you can become so filled with confusion, pain and resentment that you can become the very kind of negative person your ex accused you of being in the first place. While there’s no reason to like the negative person you’ve become, there’s every reason to fear the results of sharing your feelings with your ex, even if you’re desperate to share something with her to win her back. Finding something sweet, giving and positive to think about and say may then seem like a good, positive solution that could restore your self-esteem and do some good. If being with her makes you become such a bad version of yourself, however, there are reasons to think twice about offering to help your ex feel better and instead use a different approach that will make you the better person you used to be.

-Dr. Lastname

I have an ex-girlfriend that suffers from depression and also has Aspergers. When she broke up with me, she accused me of being a liar and becoming a different, uncaring person over the course of the relationship. I don’t think any of those accusations are true, or that she even believes them, and I haven’t been able to get over her. Even though she said harsh words to me, I do not think she meant them and it was just the depression and Aspergers talking, especially since she told me she’s been depressed her entire life. I know that this might sound selfish and dumb, but I want to write something that could express that to her and maybe help her in the future. I will admit that I still like her and that’s why I’m writing, but I also really want her to be happier overall. My goal is to be able to get her out of her misery and be able to have a better life. WAIT! There is more to read… read on »

5 Biggest Lies About Insomnia

Posted by fxckfeelings on February 24, 2017

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Many of us, not just our reader from earlier this week, struggle with insomnia. Of course, said struggle doesn’t just mean dealing with sleeplessness but with the false and terrifying myths about the many ways insomnia can ruin your life. If you can’t sleep and can’t stop being freaked out by the potential effects it’s having on you, please do yourself a favor and read these five biggest lies about insomnia and the sad/sleepy truths you should believe instead.

1) “Insomnia is preventable and treatable with good sleep habits.”
No illness is ever guaranteed to be preventable and treatable, especially those that are more behavioral than physical, and statements like these aren’t just false but damaging as they often create unreasonable expectations for control. Yes, good sleep habits will push you in the right direction, but life will sometimes disrupt your sleep habits in ways you can’t avoid and even the best of habits can’t always control the neurological demon inside your brain that decides it wants to play and read and have great ideas just as your body wants to collapse. So yes, always be open to treatment, but don’t despair or blame yourself when they aren’t as effective as you’d like.

2) “Insomnia is always a sign that you’ve got bigger issues that require treatment.”
Insomnia may sometimes reflect your worries or neuroses, but that doesn’t mean that logging several hours on a therapist’s couch to work out those issues is guaranteed to unclog your non-existent sleep valve and make rest possible again. If you do find yourself being kept up with anxious thoughts, then do what you can to put your worries into perspective while also accepting your insomnia as just another part of your current bad luck so it doesn’t become yet another thing to get worried about.

3) “Sleeping pills are bad for you.”
All pills are potentially both good and bad for you, from Advil to vitamins, and focusing on the bad part is a good way to let fear demoralize and immobilize you into avoiding potential treatment altogether. Instead of spooking yourself away from medication, educate yourself as to the particular risks of each type of sleeping pill, both in terms of trying it once and, if it’s helpful, taking it more often. Then weigh those risks against its benefits. Of course, always use non-medical methods first, but when insomnia doesn’t respond to non-medical methods, you have a right to research and consider plan B.

4) “If left untreated, insomnia will permanently damage your health.”
Living damages your health, period, but insomnia’s potential impact on your wellbeing is a lot less clear. It does good when it puts you on alert for danger and trouble, as when you need to stay up to watch over a sick child or are required to stay on call for important news. On the other hand, it can also weaken you, at least temporarily, when you’re so tired that it’s harder for your body to fight off an infection. Either way, if you let a fear of insomnia exaggerate its dangers then that fear will cause you far more harm than insomnia ever could.

5) “Insomnia won’t just damage your health, but your ability to do anything from your job to parenting to operating heavy machinery.”
You may not be able to perform at your highest level when you’re tired, but ask any parent what they’re able to do when they haven’t slept well and they’ll tell you that they seem able to do everything well enough since they haven’t gotten fired or wrecked their car despite not having a decent night’s sleep since having kids. Instead of letting insomnia terrify and paralyze you, use that fear to become a knowledgeable and confident manager of insomnia. Once you learn the facts about how insomnia affects you and how you can deal with it, you won’t have to let scary myths keep you up at night.

Sleepless in A Battle

Posted by fxckfeelings on February 6, 2017

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Good sleep, along with YouTube videos of porcupines eating and fresh mozzarella cheese, is one of life’s simplest pleasures. Unlike those other things, however, it’s not just a joy but also something of a necessity. A life without hungry porcupines or good cheese of any kind of unfortunate, but one without sleep can feel excruciating, so it’s not surprising that those who just can’t shut themselves down at a reasonable hour are so eager to figure out what’s wrong with them and so quick to blame themselves for their sleeplessness. While we now have clinical sleep specialists and a bunch of helpful theories, suggestions, and treatments, we don’t, of course, have any solid answers or cures. The answer then isn’t seeking complete control over your insomnia, but learning to manage it and find pleasure in life despite it.
-Dr. Lastname

In short, I cannot sleep. I mean, theoretically I can (because, well, biology), but practically I can’t, and I know it’s all in my head— the fact that I feel that “I have insomnia” makes it so much harder, because, obviously I don’t have any clinical disease that it’s a symptom of, just some mental block that makes sleep impossible. I really, really want to sleep and get back control over this one thing without depending on anything (drugs, diets, etc.) or anyone to fix the problem for me. My goal is to get to the bottom of whatever’s causing this insomnia and get rid of it.

WAIT! There is more to read… read on »

5 Better Goals for Controlling Your Illness

Posted by fxckfeelings on March 31, 2016

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There are no surefire ways to cure, let alone control, mental illness, so, if like our reader from earlier this week, you find yourself yearning for a way to get your sick brain well, then you should stop torturing yourself and start redirecting your energies elsewhere. Here are five better goals for controlling your illness.

1) Assess Your Own Symptoms

Make your own list about the things that bother you most about your illness, paying more attention to your own experiences than the descriptions from doctors or textbooks, or whether you fit one specific diagnosis or another. Give priority to the symptoms or problems that endanger your safety, cause you pain, make it hard to work, or interfere with being a good friend. Only you know what symptoms are worth keeping an eye on and making an effort to manage.

2) Keep Track of Trouble

Until doctors develop a blood test or breathalyzer for measuring mental illness, you’re the one who knows best how you’re doing from day to day. So keep a log or diary of your symptoms and status, reviewing the list of problems that bother you and putting a number from 1 to 5 next to each one representing how bad it is on that given day. That’s the only way you can tell whether whatever you’re doing to get better is having a good effect or not.

3) Adjust Your Expectations

While you should of course work to get better, you should never expect to achieve total recovery. Some people do get better and never have symptoms again, but it isn’t necessarily because they’re good patients and know how to do the right thing (though that helps). It happens, mainly, because they’re luckier and their illness is not as bad. So instead of expecting to get better, get real about the work you have ahead of you and what the realistic rewards are.

4) Punishment Hinders Progress

If you try too hard to make yourself better and become too obsessed with your illness you’ll spend all your time looking for treatment and be too busy to spend time with friends, enjoy a fine meal, or generally go about your usual business. As hard as you should try to explore treatments that might work and pursue methods that you think are helping, you shouldn’t keep going with a treatment that isn’t working, nor so focus on treatment that you forget to live your life.

5) Remember the Real Goal

The fact is, you don’t beat an incurable disease by making it go away but by going about your business in spite of all the trouble that the mental pain, fatigue, doctor visits, medication side effects, and general chaos of your illness throws in your way. When you can tolerate all that shit, stick to your values, and try to live a life that matters, you’re accomplishing something incredible.

Runaway Brain

Posted by fxckfeelings on March 29, 2016

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Some people assume that “fuck feelings,” aside from an excellent book title, is a statement intended to devalue or eliminate feelings, like an emotional “shazam.” In reality, of course, feelings have their own way of telling you that they’re very important, no matter what you chant at them, and that the only way to feel better is to air or obey them. Your best tactic then isn’t to look for a magic word or pill to keep your thoughts or feelings in check but to constantly remind yourself that they aren’t as important as your values and knowledge of right and wrong. Even though you can’t control your feelings, you shouldn’t always believe what they tell you or do what they want you to do (but you should buy and believe books that give advice like this).

-Dr. Lastname

I’ve been reading your book and I’ve made some very positive strides towards accepting myself. However, I have Schizoaffective and Bipolar Disorder and I am wondering why I continue to do weird wacky things, even after I accept that I should f*ck my feelings, they don’t totally go away. My goal is to eventually get better control of my behavior by coming to terms with my illness.

WAIT! There is more to read… read on »

5 Advantages To Having A Touch of The ‘Tism

Posted by fxckfeelings on March 3, 2016

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As we often say in our family, everybody has at least a touch of the ’tism, but if you find yourself dealing with a new diagnosis of a spectrum disorder, like our reader from earlier this week, it can feel like the time for jokey phrases, along with your life as you knew it, is over. It’s important to remember, however, that you’re life hasn’t changed, just your classification, and that having an actual touch of the ’tism t’isn’t the worst thing. Here are five advantages to having an autistic spectrum personality style.

1) Extra Intellectual Ability

Dr. Asperger himself used to refer to kids with his namesake syndrome as “little professors,” and they often grew up to be big professors, or, at the very least, big thinkers in important fields. For people on the spectrum, the tendency to express intellectual interests may have made you a dweeb as a kid, but as an adult, it can help you make a good living.

2) Success Thanks to Social Insensitivity

A lack of awareness of social cues may handicap your ability to make small talk and get dates, which can feel devastating, especially during adolescence. On the other hand, it can also free you to ignore the need to be popular so you can focus on pursuing the things that truly interest you. And as an adult, especially in a world where spectrum disorders are more accepted, it’s easier to find and befriend people who find connecting as hard as you do.

3) Handicapped Communication

It’s not just hard for people with spectrum disorders to read other people’s emotions, but to understand and communicate their own feelings clearly. While it can sometimes be tough to have difficultly conveying how you feel, your intellectual style of communication can help you discuss and clarify abstract ideas that emotionally fluent folks often can’t.

4) Challenged by Change

In school, it drives people with Asperger’s crazy to stop mid-activity and start a new one when the bell rings or have to abandon one class schedule and learn a new one every year or semester. Out of school and into adulthood, the ability to focus for a long time on a single problem without the limits of a bell or class schedule helps those on the spectrum to solve problems that others can’t.

5) Opposition

When you’re young, open opposition to stupid statements may win you few friends and bog you down in painful struggles with the parental or educational authorities. Once you’re older, however, and know what you’re doing, it may help you stand up for yourself, negotiate cleverly, and prevent anyone from compromising your basic principles because you need to be liked.

The Great Aspy

Posted by fxckfeelings on March 1, 2016

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Unlike severe autism, autism spectrum disorder is more a collection of differences than a disease. True, there are disabilities and moments of feeling alienated, but some abilities are enhanced, so it’s less like being broken and more like being Batman. So if you have Asperger traits, don’t make it your goal to be “normal.” Recognizing your weaknesses does not oblige you to eliminate them, but to learn how to use your strengths to manage them and be the person you are (and perhaps save Gotham, if you’re so inclined).

-Dr. Lastname

I’m over 60 and have just discovered/realized I am on the autism spectrum (what they used to call Asperger’s). I’ve spent my life trying to fit in to a neurotypical world. I’m also a little over a year divorced from someone who emotionally abused me for almost 20 years. Between these two things, I’m kind of reinventing myself. I’m already saying f*ck to ‘normal’ (neurotypical) and to society’s dictates for women my age, but that doesn’t mean I’m totally comfortable with what’s happening. My goal is to figure out how f*cked I am, and what can I do about it. 

WAIT! There is more to read… read on »

5 Truths To Correct Your Depressive Thoughts

Posted by fxckfeelings on February 4, 2016

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As exemplified by our reader from earlier this week, depressive thoughts can be powerful, persistent, and, above all destructive. Despite that, it’s possible to defuse these thoughts by responding to them and not letting them have the last work. Here are five common depressive thoughts and how to correct them with the truth.

1) “I used to be able to get things done, and now I’m so tired and miserable that I’m just useless.”

Even truly useless items, like VCRs and rollerblades, are only useless to those who aren’t grandpas or capable of shame. Respond to this thought with the following: “I’m doing a lot, given the fact that I can’t help feeling shitty, my brain isn’t working quite right, and all I want to do is stay in bed and think of more reasons to hate myself. As such, I’m actually proud of all that I’m getting done, and I’m not going to waste time putting myself down.”

2) “I still can’t figure out what I did to make her dump me, except be the worst person who ever lived.”

Depression loves to tell you you’re the worst person, and even though you can clear up that accusation with a quick Google search, it’s easy to believe after a particularly tough rejection. Until Google invents an inter-cranial app, however, tell yourself the following: “If I can’t figure out why she dumped me—and Christ have I tried—it’s not because ‘I deserved it’ because of who I am or something stupid I did. I did nothing terribly wrong other than choosing a girlfriend who’s not a steady, faithful friend, and the worst thing about me is that I didn’t know better, which is no longer true.”

3) “I can’t now and will never find anyone to love a turd like me.”

Donald Trump, Billy Cosby, and multiple guilty death row inmates have found true love, so even if you were a turd, it wouldn’t necessary doom you to a life of solitude. Respond to your sad solitude with the following: “Most people find it hard to find a good partner, no matter how hard they try, so I don’t deserve criticism if I’m doing a reasonably good job of trying to date the available candidates, especially given how hard it is to leave the house or even shower or get out of these sweatpants.”

4) “My job (thus, my life) is going nowhere.”

As we always say, there’s a reason they call it work, which is to say, it’s rarely enjoyable, fair, or as rewarding as it should be. If you hate your job, that’s normal, not the end of the world, and a good time to remind yourself of the following: “Since the Constitution doesn’t promise happy employment, the only question is whether I’m doing a good job with the work I’ve got while I make a reasonable effort to pursue something better.”

5) “I can’t see the point in being alive.”

Only very sick depressed people may act on this notion, but odds are, if you’re feeling really down on yourself, the thought at least crosses your mind. Even if you never take it seriously, there’s no reason to take this bullshit, period. When depression questions your very existence, remember the following: “No matter how hard I try to be a good person, life can hurt. It sucks that the world is unfair, but it’s worth remembering that my pain is caused by bad luck and unfairness, not my own shortcomings. And if I can still get out of bed everyday and try to be a good person and make the world a better place that way, then that’s meaningful, no matter what depression says. I deserve to be here as much as anyone else, and I prove my worth everyday by trying to be the kind of person I admire.”

Career Wrath

Posted by fxckfeelings on February 2, 2016

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It’s very hard to determine whether you’re successful, lovable, or just a worthwhile human being when your thoughts are distorted by the shit-colored lens of depression. Even if you’re making good efforts and getting reasonable results, you’ll see nothing but could-haves, should-haves, and don’t-bothers. That’s why it’s important to recognize when you’re depressed, how depression distorts your thinking, and what to do to be more objective and positive about your achievements. If you can see the effect depression is having on your mind, you can see past the filter to the truth.

-Dr. Lastname

A couple of months ago I was miserable because I worked 12 hours a day for little money and also had to juggle school. While working at this job, my girlfriend for five years left me. I quit the job but never really recovered. In part because I felt I’d disappointed my teachers, because I didn’t perform at school like I used to. Also, I’ve stranded myself from my friends and colleagues because of some internal school politics, plus I rebounded with one of the girls from my class that everybody seemed to want, so now there’s lots of resentment. Since quitting/everything going south at school I can’t concentrate properly, always feel depressed, emotional and anxious around people, and have little interest for things that I used to love. Either something makes me not give a shit about it or makes me cry. I even found a new job where I could make good money in a couple of years and maybe be set for life, but I still feel like shit because the job’s not the field I’m going to school for, so I’m so conflicted. It’s seems like I either try to do what I love/thought I loved but probably will make little money OR make some money doing a job I don’t really love and get to do all the things you couldn’t do before because I was kinda poor. My goal is to get out of the dumps and choose the right career for the right reasons.

WAIT! There is more to read… read on »

5 Ways To Address Partner Flaws

Posted by fxckfeelings on November 19, 2015

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Sometimes, when you add up everything good about your spouse and subtract the stuff that drives you nuts, the marital math shows you that they’re not equal to (e)X, i.e., that they’re worth keeping around, despite their less attractive behavior. If, like our reader from earlier this week, you’re trying to stay together despite some behavior you can’t stand, here are five ways to positively address the issue without going positively nuts.

1. Be Calm and Clarify

With as much clinical distance as possible, identify a grouch-related behavior that is simple, easily defined, and well worth reducing. Possible examples include a raised voice (that can be heard clearly in the next room, or next town), swearing, or personal criticism that is more cruel than part of a constructive conversation.

2. Frank but Fair

Before beginning the discussion, announce your intentions by first describing your pleasure in your spouse’s company when he’s being nice/not doing that one jerky thing. Assert your belief that it hurts your relationship for you to hang out and engage in conversation when he’s not being his normal, nice self. Then define the behavior you don’t like without sounding critical or arguing about whether or not it’s bad; slinging insults is objectively bad, no matter who’s slinging them.

3. Brace Yourself

Even if your spouse agrees with your goals, he or she may complain that your new rules are destroying his spontaneity and causing him to second-guess himself and feel perpetually self-conscious. Don’t argue, but express confidence in your observations and the long-term benefits of change. Show no guilt and offer no explanation when you implement your plan, just support and assurance that this transition period will soon pass.

4. Extend the Experiment

Whether you try withdrawing in response to negative behaviors or lavishing praise on ones that are positive or both, refine your methods as you observe how they work. Don’t expect to get your husband to see what he’s doing wrong or agree to change. Remember, your goal is to protect yourself, even if you can’t reduce his inappropriate behavior.

5. Embrace an Exit Strategy

If you’ve done your best to alert your spouse to his bad habits and he still can’t reign them in, then your next best strategy is to avoid being in the presence of that behavior altogether. Put together an escape plan that will protect you from having to listen to further grouchiness while also discouraging it. For example, you can leave the room, put in ear plugs, or go for a walk. Because if s/he can’t keep bad behavior under wraps, you can always keep up good methods for getting around it or, if you really can’t take it, getting a good lawyer to get out of the marriage entirely.

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