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Tuesday, March 19, 2024

5 Ways To Deal With Relapse

Posted by fxckfeelings on August 9, 2018

If you live with a recurring, debilitating mental illness, you may, like our reader from earlier, be hoping to find a routine, a management plant, or just an ancient spell that will keep unpleasant, disruptive relapses at bay. Unfortunately, mental illness doesn’t reliably respect our routines—it is, for lack of a better word, crazy that way—so instead of looking for ways to prevent relapses, here are five ways to deal with a relapse if and when one does occur.

1) Don’t Confuse A Few Symptoms With Something Bigger

Beware the urge to overreact every time you find yourself dragging, getting overly anxious, feeling miserable, or generally exhibiting some of the symptoms that come with your illness, especially when they could have an easy-to-identify cause, like PMS or stress at work. Instead, force yourself to look at the bigger picture; review your list of prior symptoms and ask yourself whether these ones are occurring in the same bad combination that interferes with your work and relationships and refuses to disappear after you’ve tried to chase it away with some healthy, happy activities. Then get input from your therapist or just people who know you as you decide whether to declare an illness in progress and implement your relapse plan.

2) Put Your Relapse Plan Into Action

As described in our earlier response to our reader, you should already have prepared a list of the interventions and medications that did or did not seem to work in the past and used this experience, together with advice from clinicians and others who observed your responses, to devise a plan for stopping future relapses. Of course, you may not know for sure what worked because clinical symptoms are often slow to respond and circumstances make it hard to tell what treatment, among the many you may be trying at one time, is actually doing the trick. As such, your plan must take these uncertainties into account while offering you clear options.

3) Know What New Treatments Are Out There

After reviewing your current relapse plan with your current doctor, ask her about any new treatments that may have been developed since your last episode. While remaining open to new treatments and ideas, remember to trust your own ideas, because your doctor is less likely to remember what worked for you in the past than you do. Also, there is currently no way for doctors to make good predictions about what will or won’t work for you based on an analysis of anything but the most basic symptoms and, of course, your previous response.

4) Push Back Against Fear and Pessimism

Drawing on your previous experience with depression and anxiety, as well as any ideas you have picked up from cognitive behavioral therapy (CBT), doctors, and friends, ask yourself whether your current thinking is distorted by symptoms, e.g., whether your depression or anxiety is making you believe that nothing seems to be working, you can’t tolerate your symptoms, your health routine has failed, etc. Then use your knowledge about the facts of depression and your own experience with it to respond to those false, negative perceptions of reality that your illness is flooding your brain with.

5) Begin Treatment While Staying Both Positive And Pragmatic

Knowing, as you do, that the results of current treatments for mental illness are always hard to predict, even when a certain treatment has worked well in the past, focus on how well you do with the process rather than the quality of its results. If improvement is delayed or a particular treatment fails, remind yourself that other treatments may well succeed and that keeping your life on track and persevering with your work and relationships when you’re impaired and distracted by psychiatric symptoms is always an achievement to be proud of and feel good about, even when you feel terrible overall.

Self-Care and Chaos

Posted by fxckfeelings on July 12, 2018

After experiencing something painful and difficult, it’s natural to work hard to regain control and find ways to avoid going through the same thing again. In some cases, that means avoiding a certain kind of person, or type of dark street, or a specific hairstylist, and hoping that these better choices, combined with better luck, will keep you safe. However, when the experience involves a severe episode of what could likely become a chronic mental illness, your smart choices and allotment of good luck are fairly limited; as much as you may want to prevent a recurrence of your disease and future symptoms, no search for the best treatment or routine is guaranteed to help. And pushing yourself too hard to keep yourself safe won’t just dangerously raise your expectations but distract you from the real work of making a plan for how to deal with a relapse. So real hope should never create expectations of control, be it over your safety, heart, or bangs, but on living one’s life as fully as possible when control isn’t possible.
-Dr. Lastname

I am a person who has a mental illness! I have treatment-resistant depression and ADD and a soupçon of PTSD. I am in treatment with a psychiatrist I like very much and it’s actually pretty chill that therapy really works. I’m a much healthier person than I was five years ago! So between that and the fact that I have been in therapy long enough to throw my inner child a quinceañera, I am not asking for treatment-related advice. It’s just that sometimes, daily life is really challenging, and as a moderately successful person with a moderately growing career, I spend a lot of time worrying that my relative instability is going to just tank everything. Like I have spent the past three days in a panicky fear that I had re-entered the depression abyss when it turned out to really just be hideous PMS, which I can’t predict (really). Either way, my Depressed Self was back in action and I spent a couple days sleeping, crying, and unable to work. My goal is to build a routine, consistent life with steady work and self-care, despite the occasional, disruptive curveballs that depression throws my way.

WAIT! There is more to read… read on »

5 Ways To Figure Out Whether You’re Causing Your Bad Luck

Posted by fxckfeelings on March 24, 2016

As our reader from earlier this week made clear, it’s sometimes easier to blame yourself for bad luck than accept how little power we have over our luck in the first place. So before needlessly beating yourself up for false mistakes or claiming innocence and blaming fate entirely, take these five steps to evaluate whether you’re causing your bad luck or whether you’re caught being fate’s bitch.

1) Find the Facts

Do the detective work to gather any objective details that connect your actions and responsibilities with what went wrong; facts aren’t based on opinion, so if you hold yourself responsible because you were stupid or lazy, then you aren’t being a smart detective on the case, just a big jerk to yourself. Be specific about what your responsibilities were, what actually happened, when it happened, and how much damage occurred. If the facts show that your actions were, in fact, destructive, then it’s worth looking for larger patterns and help in managing your behavior.

2) Mind Your Motives

It’s easy to tell yourself something bad wouldn’t have happened if you had simply done something differently, e.g., if you’d only left the house ten minutes later or not stayed for that second cup of coffee, you could have prevented all this trouble. Before you go down the black hole of hypotheticals, however, ask yourself whether your choices were intentionally harmful or made you feel good but were thoughtless and potentially dangerous. If the answer is no, then your regrets are pointless, but if you did make knowingly bad choices, you have to work to manage negative impulses.

3) Think In the Third Person

If your friend were in the same situation and asked you whether she had done anything wrong, odds are you wouldn’t judge her as harshly as you judge yourself and blame her for being negligent, stupid or mean; even a stranger would be more willing to give you the benefit of the doubt, with only an enemy rushing to condemn you so unforgivingly. Remember, friends don’t decide whether you’re super-smart or perfect, just whether you made reasonable decisions as an imperfect-but-trying-hard human being. So be a friend to yourself and judge accordingly.

4) Spell Out Your Standards

If you can’t get over a guilty feeling simply because things turned out very badly, ask yourself what specific rule you broke. Pretend you’re writing out five rules for people who have to manage the situation that caused you problems, for posting on the wall in the office kitchen of your mind, right near the sign about labeling your food in the fridge and not putting fish in the microwave. If you can’t spell out a rule that you broke, chances are the only rule you broke was, “don’t have bad luck.”

5) Seek Out Smart Opinions

Don’t let shame stop you from telling your story to a friend or professional, like a therapist or even a lawyer, whom you can trust to be impartial. Don’t choose someone who just wants to make you feel good or someone mean, but someone who likes you but is willing to tell it like it is. Present all the facts, asking whether you should have done things differently and, if so, is there a lesson to learn other than that sometimes life sucks. If, after all your opinion seeking, you find that the blame isn’t yours, it’s your responsibility to find a way to move on. If it becomes clear that there are things you could have done differently, your path forward involves finding ways to manage that behavior so it doesn’t mess with your luck in the future.

Blame Reliever

Posted by fxckfeelings on March 22, 2016

It’s hard not to feel guilty when things go wrong, and guilty feelings may be particularly bad for just those who deserve them the least, i.e., those who are generally self-critical and insecure. If you’re someone who’s gone through a bad stretch and can’t help but feel bad and responsible for letting it happen, learn how to rely on specific information and common sense to figure out what you should really take responsibility for, if anything, and how to use your conclusions to fight a compulsive sense of having done something wrong. Instead of endless punishment, you deserve a fair assessment of the facts.

-Dr. Lastname

I often find myself on a streak of “wellbeing,” then out of nowhere I manage to fuck up whatever I had going for me, royally. Almost like I have a problem committing to something for too long. Just looking for some realistic advice as to why this may be. My goal is to figure out some realistic systems I could improvise to better cope with this dilemma.

WAIT! There is more to read… read on »

Diplomatic Lies

Posted by fxckfeelings on January 26, 2016

Avoiding conflict is an important part of making a long-term relationship work, but going too far to placate your spouse in order to avoid arguments doesn’t diffuse the conflict so much as internalize it. Not surprisingly, if you keep eating shit in order to keep your partner happy, that’s how you’re going to feel, and it’s what your marriage is going to turn into. It’s important then to know when and how to draw the line on agreeableness without being disagreeable; if you can avoid a big fight without compromising your integrity in order to do it, you can make your relationship last.

-Dr. Lastname

Early on in my relationship with my wife I fell into a pattern where almost every time we got into a big fight, I’d end up apologizing and admitting total fault, even if I didn’t feel that it was all my fault, basically because I didn’t want to continue the argument. She can be a dirty fighter who is great at playing on my guilt, but also, I’m not very good at being assertive and dealing with conflict. And now, as we have had more complex problems to sort through in our life, and the stakes have gotten higher (kids, in-laws issues, mortgage, etc.), it’s even harder to break this habit, which has resulted in me feeling resentful towards her and emotionally withdrawing at times, which is not something I want to continue. I do get her to “compromise” at times but often those compromises are still tilted strongly in her favor. I’m not a total doormat, but I’d like to stand a little more upright. My goal is to be more assertive, and not fear the outcome of being more assertive with her, which I imagine (based on many past experiences) is her losing her temper (rage, blame, etc.), sometimes making threats (divorce) and making me the bad guy, until I play by her rules.

WAIT! There is more to read… read on »

Fix or Forget It?

Posted by fxckfeelings on September 8, 2015

Deciding whether to continue a marriage and how you feel about your marriage are two very different things; you may feel miserable in a marriage that has the potential to make you happy in the long run, or you may feel ambivalent enough about your union that you tough it out, even though doing so may be the wrong choice looking forward. Making the decision is hard, but if you can be honest about your priorities, you can make the best choice for you, your marriage, and your future.

-Dr. Lastname

After too many years of passive aggressiveness by both myself and my wife of several years, we finally admitted that we do not love each other anymore. Despite that, she agreed to give it a go again, though she will not attend counseling where she thinks all her mistakes will be highlighted. She wants to begin “dating” each other again. I’m going along with this but will also be seeing a psychologist to sort out the anger I have for the wasted time. The thing is, even with all of this counseling, I don’t see myself falling back in love with her. I think separating and eventually dissolving the marriage would make me much happier; as a healthy man in my 60s, I feel I have a lot of great years left and want to spend them with someone I can really love. My older kids would probably accept the separation, so…f*ck happiness? Yield to the stupor of reality? My goal is to figure out what the f*ck is going on.

Fix it or Forget it, Should I Stay In My Marriage? F*ck Feelings

When we have to make important decisions for ourselves that also affect someone we care about, we tend to make the mistake of allowing them an equal or more important voice in our thought process. It’s a little like the old notion of having a devil and an angel on each shoulder, except in this case, you have the other person voicing their needs on one shoulder and you’re sitting cowering down by the elbow, hoping to eventually get a word in edgewise.

Considering the feelings of someone you’re strongly connected to as if they were your own is a natural habit to get into, but if you want to do the right thing by both of you, it’s a habit that must be broken. It might sound selfish at first, but when you think about it, it’s the smarter approach.

That’s because, if you over-regard someone else’s feelings when making decisions, you may well make the decision they want and then blame them for it. That’s not fair, of course, because it’s your decision to make. It’s not fair to either one of you in the long run.

So re-edit your description of your problem; you feel you don’t love your wife and have a negative, angry chemistry that doesn’t change, even when you’re not arguing. Given her age and lack of interest in treatment, you can’t expect her to change. You haven’t presented any reason of your own for staying married to her. Instead, you’ve presented her wishes as if they’re as important as your own, even though they’re completely contradictory.

Give more thought to your own reasons for staying together. Review your incomes and retirement opportunities, and consider the possible shared pleasures and interests of spending retirement time together. Ask yourself whether you enjoy your time together with your kids. Do your own arithmetic so you don’t demean your own judgment by substituting hers for yours.

As long as you make your own decision, you won’t be a marriage victim; you’ll either stay because you think you’re better off as partners through the next stage of your lives, or you’ll leave because there are too many advantages to moving on.

No matter what you decide, it should be your choice based more heavily on your priorities, not shoulder commentary, so it’s a choice you can respect.

STATEMENT

“I feel torn by my wife’s desires versus my own, but I can discover my own mind even if I’ve been married forever. I will not disregard my marriage, but I will protect my right to a better life if I determine that this marriage is fundamentally harmful to my well-being.”

How to MOVE ON.

Posted by fxckfeelings on August 25, 2015

What to say when you can’t let go!

Not surprisingly, ending an important relationship—be it with a person or even a job—usually stirs up negative feelings because the circumstances requiring the relationship to end are rarely pleasant, agreeable to all parties, or completely without alternatives and drawbacks. The way to make the best of moving on is to do your own assessment of whether it’s necessary and whether you lived up to your obligations and kept your promises before walking away. Then prepare a statement of your thoughts about the ending, omitting any mention of anger, doubt, or guilt.

Moving on is hard. Don’t make it harder by expressing all you feel. Make it easier for yourself and others by celebrating the positive and accepting what can’t be helped.

Life is Unfair.

Breaking up with a boyfriend after not getting along for far too long

You must be able to assure yourself that:

  • you can’t make the fighting go away by talking about issues with him, a shrink, or anyone else
  • major, possible steps to make things better between you two, like cutting back on your hours at work or moving house, aren’t likely to be worth the hassle
  • his good character traits and ability to function as a partner don’t outweigh the bad chemistry

Script: “You know how much I value our relationship and the many good things about you as a person, but after everything we’ve tried, I can’t see a way to stop the fighting, and I think it’s better for both of us to admit defeat and move on.”

Leaving a hated boss on not-hateful terms

You must be able to assure yourself that:

  • you’ve done everything possible to make the relationship work well enough to make working there bearable.
  • there’s no possible way to stay at the company under different management
  • you’ve got a better opportunity or can survive unemployment

Script: “I’ve learned a great deal from this job and your leadership, and I’m sure what you’ve taught me will be of great help in my new position [without mentioning that what you’ve learned is how to survive a bad boss].”

Breaking up with a girlfriend who expects commitment you can’t deliver

You must be able to assure yourself that:

  • her good character traits and ability to function as a partner don’t outweigh your belief you can’t give her what she needs in the foreseeable future
  • you aren’t just panicking in the face of a possible (and terrifying) life-long commitment
  • you will be strong enough to resist the urge to still see her occasionally and string her along

Script: “I know how happy we are together, but you’re looking for the kind of commitment that, sadly, I can’t provide, and I’d rather end things now before you get more invested and a separation would be even more painful.”

Distancing yourself from an alcoholic parent or sibling

You must be able to assure yourself that:

  • providing him or her with close support doesn’t have enough positive impact on his or her health and welfare to justify the amount of pain and distress the relationship causes you
  • you have made every reasonable attempt to get him or her to consider getting sober
  • there is nothing you can do to change him or her, period

Script: There is no script at first you because you just have to distance yourself without declaring that you’re doing it or apologizing for it. Then, if he or she’s upset, say, “I know we’ve had so many good times together, but I need to focus more on my own well-being now by spending more time with kids/job/baking hobby, and I look forward to you getting more involved in those aspects of my life once you become sober and more independent.”

Distancing yourself from a friend who has gradually become someone you don’t like

You must be able to assure yourself that:

  • there’s nothing positive or helpful you haven’t already said
  • you’ve been a good friend and done your share; otherwise, try to even the scales
  • s/he’s not going to change and that whatever you like about this friendship does not outweigh the dislike

Script: Again, forego an announcement in favor of just returning calls and messages less and gradually fading away. If challenged, say, “I think you’ve been a great friend, but chemistry sometimes changes, no matter what you or I might want, and I think right now we’re both better off spending more time apart.”

Get the Book - FxckFeelings

Disorder Form, Part 1

Posted by fxckfeelings on August 10, 2015

Despite all of our attempts to make our lives secure—wearing protective gear, creating a savings account, building a Y2K+X shelter—we’re all subject to nature’s whims. Most of the time, we’re just scrambling to maintain life’s delicate balance between order and chaos. Of course, there are certain, non-weather related natural disasters that can create disorder; namely, those we’re naturally related to. That’s why, in particularly unstable families, any interaction must be planned with a map of the likely fallout and that Y2K+X shelter stocked to the gills. Later this week, we’ll see how shaking things up can sometimes make the family balance stronger.
Dr. Lastname

Even though most of my family are crazy and a pain in the ass to be around, I still love them and have found a way to keep them in my life without letting their bullshit make me miserable. I’m worried though that, if they come to my wedding, then our relationship is going to fall apart. I can’t not invite them, because they know it’s happening and will show up with or without an invitation, but if they do show up, it’s going to be a shitshow. My father is a nice guy but a mean drunk, and there’s no way he’ll be sober. My oldest sister is a compulsive klepto who would probably disappear the wedding gifts, and another sister is well along in following our father’s staggering footsteps (my brother moved far away to get away from them, and I can’t blame him). I’ve told my fiancée I don’t want to spoil the event for her parents, who are very nice, but I’m afraid of what my family will do to create chaos and ruin what we’ve paid for. My goal is to have a wedding that doesn’t blow up on me and hurt innocent bystanders like my wife and her family.

Whatever you decide to do about inviting your family to your wedding, it’s clear that you accept them for who they are, but that acceptance is dependent on certain factors, i.e., where they are, and for how long. When it comes to family, especially awful relatives, better living through boundaries is often the rule.

Even if you’re not interested in punishing, hiding, or changing them, and you can talk about them honestly with your wife-to-be (who is not asking you to disown them), you’re also not interested in inflicting them on the public or your new in-laws. WAIT! There is more to read… read on »

Instability Insurance, Pt. 2

Posted by fxckfeelings on August 7, 2015

On Monday, we discussed how stress can change people and turn a strong, intelligent woman into a bad-boyfriend addict. While stress can push you to pick up bad habits, it can also push you away from good ones. Whichever happens to you, regaining control begins with an acceptance of the fact that you’ve lost it, but that you’re still the same old person inside. Then invite help from friends, build new habits and be patient, and you’ll eventually bring your behavior into line with your character. Just because stress changes you doesn’t mean careful management can’t change you back.
Dr. Lastname

I worry about the way my daughter stops contacting me for months at a time when she gets depressed. At least when she was in high school, she lived with me, so I could keep an eye on her and force her to stay on top of her work and get out of bed. Now she’s out of school and won’t even answer my texts. I worry, but I don’t want to antagonize her or undermine her independence by barging in on her. Meanwhile, I understand from her brother that she has trouble getting out of bed or even checking her mailbox, so it seems like she needs me now as much as she did when she was a kid. My goal is to help her without making her feel that I’m trying to take over her life.

It’s true that actions speak louder than words when it comes to expressing affection or commitment, but some people’s behavior is really impaired, even when their affection and commitment are genuine. Depression notoriously can prevent people from checking their mail, answering their phones, or even showering or leaving the house. No wonder they get more isolated and depressed.

What you’ve learned from watching your daughter endure prior bouts of depression is that her withdrawal doesn’t reflect specific negative feelings or a lack of independence; just a neurological shutdown. WAIT! There is more to read… read on »

Instability Insurance, Pt. 1

Posted by fxckfeelings on August 3, 2015

Dear Readers,

As you might have noticed, the site’s been going through some changes in the past week or so as we prepare for the release of our book, F*ck Feelings (see pre-order links to the right, it makes an excellent Labor Day gift).

This week, we debut our biggest change—instead of doing two cases per post, we’re going to do two per week. New posts will still go up on Mondays and Thursdays, but those posts will contain just one case, and it’ll be the Monday case and the Thursday case that have a unique and insightful connection, as opposed to two cases within each entry.

We hope you approve of these changes, and we appreciate your patience as we revamp the site and drag it from the WordPress dark ages.

In conclusion, please enjoy FF 2.0, and also, please buy our book. These A/C-bolstered electric bills aren’t going to pay for themselves.
-Dr. Lastname

 

When people are under stress, they sometimes become different people. While nobody aside from Bruce Banner experiences a physical transformation, stress does make some people repeatedly do things they know they shouldn’t. If stress sucks you into a bad habit, learn to accept your loss of control, put shame aside and have faith that the real you is still there and will come back from your mental-Hulk state. Next time, we’ll discuss the strange flipside of stress-induced compulsion.
-Dr. Lastname

I pride myself on being a pretty independent woman, so when I realized I had to give up on a relationship that was going nowhere with a guy I liked, I barely let it phase me. Six months later, however, I fell hard for someone else and, when he dumped me, it seriously messed me up and made me miserable. That’s when I was horrified to find myself calling my previous, going-nowhere boyfriend again. Since then, I can’t seem to stop calling him, even though I feel the same old vague emptiness after we spend time together. I’ve never seen myself as weak, but I feel like an addict every time I get sad and find myself picking up the phone. My goal is to figure out what went wrong with me to make me become someone who can’t stop calling someone whom I know will leave me feeling worse.

 

Experiencing the urge to do something destructive, be it calling a crappy ex, eating your weight in Oreos, or returning to the vodka trough, isn’t always a sign of overall weakness, weirdness, or creepiness. More often, it’s a sign that a part of your brain is possessed, and Oreo-loving demons don’t get up and leave on their own.

That’s because these compulsions often have a life of their own, and sometimes independent people who are proud of their self-control find themselves struggling with the urge to do something they really don’t want to do, whether it’s drinking, eating, or over-connecting. Nobody’s immune to bad habits, not even good people. WAIT! There is more to read… read on »

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