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.
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.
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Posted by fxckfeelings on May 17, 2018
Just as mental illnesses are harder for people to accept because they lack the visible symptoms of physical illnesses, cognitive disabilities are much more misunderstood than physical ones. After all, you wouldn’t tell someone paralyzed to just try getting out of their wheelchair, but people often assume that they can help someone who, like our reader from a previous post, has a legitimate cognitive impairment like ADHD by encouraging him to just work harder or focus. And of course, as well intentioned as that kind of advice may be, it’s also ignorant, which means it hurts more than it helps. Here are five common, incorrect ways to avoid when trying to help people with ADHD and what you should do instead.
1) Loading Up Their ADHD Library
Some books on ADD are quite good and filled with helpful information, but expecting someone with ADHD to read them, no matter how beneficial the books are, is bound to backfire. If someone struggles with accomplishing tasks, giving them another task to fulfill, no matter how much it may benefit them, is only going to further frustrate them and disappoint you. Besides, trying to change someone, rather than helping them manage who they are, is always going to be met with resistance and resentment. So give them your own synopsis of whatever you liked about the book and offer positive reinforcement if and when they seem to put those ideas into action.
2) Nagging with Negative Reinforcement
You may think that someone with ADHD would appreciate frequent reminders about tasks; after all, if they have trouble focusing, any effort to help them stay focused should be a good thing. Unfortunately, people with ADHD are also still people, and there is no human being on earth who responds well to constant nagging, especially when it culminates in an angry scolding for not listening to the nagging and getting the task done. Don’t then assume that someone who lacks the ability to remind themselves to do things is eager to outsource the constant reminders to you or anyone else. Instead, urge them once to think about a way to set up reminders for themselves, like on their phone, or to feel free to ask for your help in providing such reminders if that would be better.
3) Echoing Others/Past Achievements
Encouraging someone with ADHD to believe in himself by comparing current failures to past achievements, or the achievements of others, is intended to give that person confidence by showing him that he can perform better now because he once did, or because someone who isn’t smarter/just as flakey once did. But there may be good reasons why he can’t repeat an earlier success or equal the performance of someone who may be similar but isn’t his equal in other ways. So, without meaning to, you’re making him responsible for a failure he may not be able to help, and that won’t have a good effect on his mood, self-esteem, or performance (and certainly not on his relationship with you). Better to focus on his efforts, regardless of whether he gets good results, and, if the results suck, to find methods that manage his attention better.
4) Giving Them Goals
As with providing constant reminders (a.k.a. nagging), giving someone with ADHD very specific and quantitative performance goals also seems like a good way to help since you think you’re stepping up where their brain can’t. In reality, giving someone a goal, let alone reminding them about it and rewarding them for meeting it, isn’t really the same as giving them the techniques to wrangle their mind enough to meet it. Since inventing and pushing someone towards a finish line will probably just make them more flustered and frustrated, ask them to create and share goals for themselves. Then congratulate them on their efforts, regardless of results, while supporting successful approaches and encouraging the search for better ones if a goal isn’t met.
5) Figuring Out Why They Fuck Up
Whether the problem is a cognitive issue like ADHD or an everyday issue like drinking or infidelity, most people assume the best way to solve is to get to its source or cause. So you may think you’re helping someone with ADHD by getting her to explore her emotional reasons for failing, e.g., that she’s performing badly because she’s secretly really angry at you and trying to defeat you out of spite, or because she’s afraid that succeeding will set her up for future shame, humiliation, or rejection when she eventually fails again. In reality, finding the source of a behavioral problem gives you an explanation, not a cure; being abused might be the reason you started drinking, but admitting that causation won’t be the reason you stop. With ADHD, the cause isn’t anything someone has done or feels, but the bad luck and/or genes they were cursed with. So trying to help someone find out why they have ADHD is in fact only pushing them to needlessly blame themselves for a problem they didn’t create. Instead, stop trying to fix or change them, period; you don’t get rid of or overcome ADHD, you manage it, so as soon as you accept them for who they are, it’ll be easier for them to do the same and work towards making the best of the brain they’ve got.
Posted by fxckfeelings on May 3, 2018
ADHD, like any cognitive disability, can be misdiagnosed as a personality flaw; seeing your problems as due to your character, not a disorder, can make you self-critical and vulnerable to the criticism of others at a time when you should be self-motivated and eager to find outside encouragement. Blaming yourself for everything you can’t achieve will just make you depressed, which just makes it harder to do well, which of course makes you feel even worse and more responsible, further impairing your ability to perform. So before you let your depression and/or critical audience bring you down entirely, push yourself to recognize that you aren’t a bad or worthless person, just a good person with the bad luck to have a quirky brain. Then develop standards that are realistic and respectful of good efforts rather than competitive results so you’ll be able to give yourself, and demand from others, the respect you deserve.
-Dr. Lastname
So my husband and I have had a very bad run over the last few years of our marriage, after we had our first child and made the mistake of getting into business together. We do things VERY differently; he’s always on time, organized and knows his mind, and I’m the opposite on all fronts. The cash flow and our available time kept dwindling while our family grew. And I caused a lot of damage—in our relationship and in our business—so that we had to shut the business down. He kept telling me what I needed to do to change my ways, buying me books and sending me links to articles, all along believing that I would and wanted to change, until at some point he realized that I was uninterested in the work. He also concluded that I am the most selfish person he’s known, and that I have been lying, thieving, and not investing in our relationship a fraction of what he has. He stopped helping around the house and with the child. I now had baby, house AND work to do up to his standards in order to redeem myself. So from here it goes like this; I’m constantly in a frame of mind that I don’t have enough time so I don’t do anything significant to address things, then wait ’till the last minute and then throw up my hands saying that, well, I did not have enough time to do it (when in truth, I had a lot). He then turns into a nag, waiting to catch my every slip-up and make a mountain out of it. Now the house and the child also start getting short shrift, up until the point where EVERYTHING lies around incomplete or half done and I have no motivation to do even the things I loved doing. I don’t groom myself anymore. He’s so nasty with me that he’s recently become short with our child and physically abusive to me. My goal is to understand why I don’t do things I know I should be doing so I can overcome both my inertia to change and this hellish situation.
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Posted by fxckfeelings on October 12, 2017
If you’re dealing with ADHD, as the son of our earlier reader is, sitting down and poring over what having ADHD means and your options for dealing with it—or really, sitting down and poring over anything for more than five minutes—can seem totally daunting if not downright impossible. Here are five steps you can take to figure out how and what to do with an ADHD diagnosis, and while they do include some research and consultation with experts, the main expert they direct you to consult about your symptoms and needs isn’t found through lots of painstaking research, but in the mirror.
1) Assess Whether Your Improved Attention Is Worth It
While there may be a loud chorus of voices—including your parents, teachers, doctors, friends, fellow drivers screaming at you to pay attention before calling you an asshole—telling you that your ability to focus needs work, you need to ignore the urge to do something to shut those voices up and do your own needs assessment instead. Based on your experience so far, ask whether you need to be more focused or attentive in order to survive, i.e., to make a living or accomplish a task that’s important to you. Of course, you should look for ways of learning and making a living that exploit your natural spontaneity and don’t require too much reading or sitting, and certainly not in large doses. In the end, however, if what you want in life requires a kind of attention that doesn’t come naturally to you, prepare to work harder than others to achieve the same results and to draw on motivation that must come from your own sense of priorities, not from the urging of those around you.
2) Take Stock of Tricks To Use As Tools
Don’t let your shame of current classroom performance or intimidation of learning in general prevent you from looking for and studying other ways of absorbing information. Researching such techniques may be daunting, but some teachers are gifted at helping you find your own style and the learning techniques that would be work for you. Neuropsychologists, who measure the methods your brain uses to acquire and process information, can also steer you in the right direction (and are often even partially covered by health insurance).Yes, learning and applying tricks to help you focus will take some effort and push your abilities to focus, but they’ll save you a lot of work and misery in the long run.
3) Consider Meds if You Must
If and only if you can’t find any successful learning tricks, focusing exercises, witchcraft, or any other non-medical methods to help with the kind and amount of learning you’ve decided is necessary, then it’s time to look at the risks of trying stimulant medication like methylphenidate and amphetamines. It turns out that the risk of trying a stimulant is very, very low (although there are a few people who find it enticingly addictive) and, because it can take less than an hour to see results, the entire trial period, like your own attention span, is unusually short. Yes, there may be additional risks if you take the medication regularly for years, but there’s no point in examining those risks until you know what the medication has to offer, and you won’t know unless you take the low-risk chance.
4) Evaluate End
In order to run an effective trial, take a stimulant 30 minutes or so before trying an intellectual task that you believe is necessary but difficult. You may need to repeat the experiment several times to evaluate the effect of three or four different doses or their impact on different kinds of learning, but you’ll know pretty quickly if there’s any potential benefit. You can measure your results, not by whether your test scores and/or the impression you make on teachers improves, but whether you feel a stimulant makes learning substantially easier. Then weigh that benefit against what you know about the trouble of obtaining the medication (e.g., cost, MD visits, the various that come with filling a prescription for a controlled substance) as well as whatever information you can gather about its possible longterm risks. Remember, you’re the ultimate judge of whether the benefits to your ability to learn outweigh the hassle and low risk of addiction, then taking these meds makes sense.
5) Shake the Stigma
Some people—Tom Cruise, for example—may always look down on you for taking ADHD meds, but doing your due diligence comes with the added bonus of not having to give a shit about what anyone else thinks. You’ve done the work, you’ve made smart assessments, and you’re confident that medication gives you an intellectual boost that you really need and can’t get in other ways. You’re the one who bears the burden and risk because you’re committed to learning something difficult. Yes, you’re different and, of course, your difference sometimes gives you advantages, but when it doesn’t, be proud of the way you manage it and confident, no matter what Xenu says, that you’re doing the right thing.
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Filed Under: ADHD
Posted by fxckfeelings on September 28, 2017
It’s hard to watch your child struggle in school, even when your child is old enough to rent a car and the school work that’s giving him trouble is for his master’s degree. Your parental reflexes tell you that you’re responsible for alleviating his pain and, when you can’t, you still can’t help but feel like a failure. Remember, however, that the pressure shouldn’t be on you to absorb his pain, but on him to absorb your values so he knows how to persevere and do tough things when he decides they’re worthwhile. You can never fix your kid’s problems, but if you teach him how to approach problems with the right ethics and expectations as his guide, he’ll have a set of tools he can use to help himself for a lifetime.
-Dr. Lastname
I have a son who has continually struggled in high school and now in college. He is very bright but has difficulty keeping organized and completing his work. The doctor prescribed him medication which he doesn’t like taking because he doesn’t like how it makes him feel, but when he does take it he does do better at getting his work completed. He’s now in his third year of college and is still struggling. He feels that there is a stigma attached to medication… that it’s a drug and he’s cheating by taking something. It also prevents him from getting a good night’s sleep. But he’s otherwise so slow at completing tasks it takes him nearly an hour to eat his dinner when I cook a meal. My goal is to get any suggestions that you might have to make his life easier.
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Posted by fxckfeelings on September 18, 2017
Android-ish/Aspberger-y people, like the one described recently by a reader, can often be jerks by accident; because reading social cues or facial expressions isn’t in their programming, they can unwittingly do or say things that most humans would recognize or rude or hurtful. That’s why it’s sometimes easy to confuse an android for an Asshole™, which is dangerous for the android (who may unwittingly lose a would-be friends) and for you (who, due to getting entangled with an Asshole™, may lose your mind). So, if you meet a guy and can’t tell if he’s obnoxious or just oblivious, here are five ways to distinguish an android from an Asshole™.
1) Apologetic or Apoplectic?
A person’s response to gentle criticism often reveals a lot about his character, but it’s especially telling where androids andAsshole™s are involved. If, for example, you find a neutral way of describing this guy’s rude rough edges and ask him about their possible negative impact on others, his reaction will speak volumes. If he’s confused and even contrite, then he’s an android who’s just had trouble computing. If he’s incensed and then blames you for being too sensitive and stupid to understand him, Asshole™ ahoy.
2) Sample His Anger
Androids don’t tend to hold individual grudges—they can get frustrated when they have to make transitions or changes to a plan, but their anger is usually circumstantial. Assholes™, on the other hand, explode with personal fury and hold ironclad grudges about emotional betrayal. So if he barely reacts to or is merely baffled by a slight but has a strong, angry respond to an illogical criticism, he’s an android. If he responds to any insult by turning into a Hulked-out Alec Baldwin, that’s an Asshole™.
3) See What Giving Him Space Gets You
Withhold your attention for a bit and note how he reacts. If he’s mortally offended by your rudeness, that’s an Asshole™, because an Asshole™’s ego doesn’t just dictate that your every action is directed at him but that he’s deserving of every last ounce of your attention and anything less is an unreasonable insult. If instead he doesn’t notice your absence, or really appreciates the alone time and break from interpersonal demands, then you’re safely in android territory.
4) Evaluate His Interests
Androids tend to enjoy activities that allow them to exercising their private gifts in a solo setting, like manipulating numbers, rebuilding machines, or memorizing obscure baseball stats. Asshole™s, on the other hand, need to socialize, not just to bask in the attention and adoration that is as vital to them as food and water, but to find new relationships to replace the selfish, hurtful, disappointing ones that they’ve lost. So if he prefers less social, more skill-based activities, he’s probably android, whereas a preference for doing anything that could likely foster close, rapid contact and intense communication, he’s more likely an Asshole™.
5) Look For Lingering Relationships
Androids may not have a lot of close, intense friends, but they do frequently have longterm relationships with fellow bots, often with optional face-to-face contact, who share their interests in stuff like games/computers, obscure topics, or specialized tools. Assholes™, on the other hand, have a lot of ex-friends (and shunned family members, and pending lawsuits), so take note if he has a lot of lost friends who have turned into lingering enemies. Unless you can identify Assholes™ (and differentiate them from their more harmless android cousins), you may find yourself on that enemies list next.
Posted by fxckfeelings on November 19, 2015
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.
Posted by fxckfeelings on November 17, 2015
You’d think that people would want to stop doing things that are irrational and painful, but it’s because they’re uncontrollable that they’re doing them in the first place without being able to stop. In any case, don’t let your allergy to irritability control your partnership decisions. Look at the whole person before making up your mind about the value of preserving your relationship. Then, if you decide it’s worthwhile, we’ll have tips later this week for using your acceptance as a tool in negotiating a better relationship that any (mostly) rational person could agree to.
-Dr. Lastname
My husband has been diagnosed with ADHD, takes meds for ADHD, and sees a psychiatrist twice a month. A couple times a week (sometimes more) he gets angry/irritated with me for the tiniest of missteps. I’m usually surprised and I never know what will set him off. I’ve been seeing a therapist who helps me to maneuver around it and not take it personally, etc., but it always stings when he gets pissed at me. It seems kind of human to flinch when anger comes at you out of the blue. Plus, he denies that it’s anger, even though if any human were to overhear his voice and see his face, they would say, “wow, he’s pissed at her.” He’s really wonderful in many ways (which is why I’m trying to find a solution), but I don’t know if this is something that can be resolved. I have a metaphor for the situation: its like we have this lovely glass of water, but he keeps pissing in it, then says, “just drink it, it’s just a little piss.” Well, no thanks. I know sometimes bad and unfair things happen and when they do, by all means, get angry…but his anger is way out of proportion. My goal is to have peace and harmony in our marriage.
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Posted by fxckfeelings on August 21, 2015
Back-to-school time can bring emotional issues bubbling up to the surface as personality conflicts and intense power dynamics pop up and throw you and your family off-kilter.
Here are five all-too-common back-to-school issues and our advice for dealing with them.
1) Your Kid Hates His Teacher
It’s terrible to imagine your child feeling miserable for an entire school year, but as your kid’s number one teacher (tenured in perpetuity), you’re the one to help him manage frustrations and make the best of them. So take time, gather facts, and see if there’s something you can do to improve teacher-child communication or their attitudes towards one another, or have a positive talk with the principal about finding a better match for your son. Otherwise, do your best to teach him that learning is more important than any single teacher, that surviving the year is more important than showing your teacher he can’t get away with being a jerk, and that he can get through tough times like these with his family’s support.
2) You Hate His Teacher
Of course, if you hate your kid’s teacher as much as he does then you can at least validate his views, although it will take a lot more discipline and self-restraint to get through the year. If your kid is fine with his teacher but you aren’t, then you’re stuck keeping your feelings to yourself, at least at home. You could try having another positive pow-wow with the principal, listing reasons why a different match would be more successful. If your kid seems happy in the class, however, then you’re probably better off following common logic and avoiding the principal’s office entirely. If your kid can survive a year with this jerk, so can you.
3) You Hate The Other Parents
If you don’t like the values or characters of other parents in your neighborhood—and, given how passionate some parents can be about their specific choices and yours, this is not an uncommon scenario—school can be more alienating for you than for your kid. Your job is to keep your frustration to yourself and help him feel he belongs in class, whether or not you feel you belong. Your hope is that the kids are better than their parents and that your kid will find friends he likes in his class, even if you can’t.
4) The Other Kids Hate Your Kid
If your child is being picked on, definitely try to work with the school and other parents to stop bullying, but be prepared to get a lot of defensive responses because no parent wants to admit that they’ve spawned a bully and schools often lack the resources to really tackle the problem. Coach your child on how to handle bullies or just avoid them, but be sure to let your child know that you think he’s fine, even if he’s a social outcast for the time being. There may currently be no friends at school, but there are always friends at home.
5) You Hate Your Kid
Every parent fears having a kid s/he really doesn’t like, so commend yourself on surviving this living nightmare. You can see a therapist or ask yourself whether you’re overly irritable with everyone and need to improve your behavior and/or try medication for improving your mood, but if the answer is that it’s just your kid that’s a jerk, then you’re stuck. So if you’re burdened with unavoidable negative feelings, build up your ability to be a true professional, regardless of how you feel. Teachers have to spend huge amounts of time with kids they hate, so you can, too.
