Waking up from depression

[AmZ]

All along, I have been saying that this all feels like a bad dream that I am waiting to wake up from.

Now it feels like I am waking up from the nightmare but I feel extremely fragile.

In the session with the therapist now, I couldn't stop crying, each time I talked.

It's like I'm waking up and facing reality but unfortunately the reality isn't so pretty either. I still feel very void of things in life such as friends, hobbies, interests, dreams, hopes and aspirations. (I know like I sound a broken record with this stuff).

Why is coming out of the illness and in to recovery more difficult? Is it normal to be so emotional?

 

[Daniel E.]

Why is coming out of the illness and in to recovery more difficult?

Certainly, leaving one's comfort zone isn't something people rush out to do, especially if one doesn't feel much hope that things would be better.

So even more traditional behavior therapy tends to focus on gradually expanding one's comfort zone, e.g. exposure therapy is usually done gradually in steps, doing what seems more tolerable first.

---------- Post added at 01:32 PM ---------- Previous post was at 01:15 PM ----------

http://forum.psychlinks.ca/depression/27979-the-strange-comfort-of-depression.html

---------- Post added at 01:50 PM ---------- Previous post was at 01:32 PM ----------

http://forum.psychlinks.ca/therapy-and-therapists/27340-good-riddance.html

 

[AmZ]

Very true.

Thanks for the articles.

I think I got overwhelmed in therapy and broke down because I am scared. I am scared for change, for a new life and a new me. Like the 'comfort of depression' article says, I have been so used to being in an either semi or full blown state of depression that it's difficult to make a change and get out of it. Albeit, the medications are doing a good job of taking the edge off.

I've tried on various occasions to say 'right, now AmZ, this is the time for change' but I've never managed to actually do it.

I don't want to think in bleak terms but it's hard to see my life any other way. I feel like I am needing to build myself up from scratch and it feels like a lifetime of work to do. Such is life? I've gone back to having two suitcases of stuff like I had when I emigrated here and that's it. Nothing else. I feel bare and exposed.

I have lots of worries but know that all I can do is put my trust in to people that are going to hopefully help me. Like in this rehabilitation program I'll be going in to after the hospital. I hope that I'll be given a good therapist that suits what I need. It scares me to start all over there too but I don't have any other option I guess.

Sorry. I could spill it all out but I will zip it now! That's enough.

 

[Daniel E.]

I feel like I am needing to build myself up from scratch and it feels like a lifetime of work to do.

Wayne Dyer (a former student of Maslow who went "newage") repeatedly tries to make the point that the biggest hurdle is believing that "this is going to be difficult:"

I think the most common meme is that it’s too difficult to change. It’s too risky to change. My nature doesn’t allow me to change. When you’re thinking that, you’re not understanding what your nature is.

http://forum.psychlinks.ca/cognitiv...d-automatic-negative-thoughts.html#post197102

OTOH, there is Marsha Linehan who validates that it indeed may be quite difficult -- so much so that some people never do the work to get out of "hell" and that is quite understandable. The perspective of one client, who uses Linehan's "house" metaphor of recovery:

In DBT you can think about the recovery process as a house. The basement is where you start and that is hell. It is when you are using, drinking, cutting, or whatever your self-destructive mode has been. To get out of hell to the next level you have to climb the steps (I think of these as the 12 steps of AA but that is not what Linehan says). The steps are aluminum which makes them hotter and damn it is hard to climb out of that hole. Sometimes people throw some water down to you, but you have to work to get to the first floor which is quiet desperation.

I spent a lot of time on this floor [the first floor, above the basement]. In fact, you might say, much of my life. Here you are not actively using, drinking or self-destructing but you have no kind of life. You are miserable and you know you need to change. The question is do you really want to change? It sounds easy but it is a lot of work and sometimes people (including me) just think it is easier to drop back into hell. Some people think suicide is an option at this point...

I am on the second floor now. I have used the tools of DBT and AA to get to this point. Here is where you realize that life has ups and downs. No one has the perfect life and what we do is make the best of it. It is a relief to be on this floor.

But what I really want and what I am trying to achieve by staying sober and sane is getting on the roof of the house. This is where you are at peace with what is. Very few people get to that point. I am not even close but my goal is to practice the principles of AA and DBT and at least sometimes go out on the roof. I want to see the stars and enjoy them. Live in the moment and not miss the rest of my life.

The House of DBT with the steps of AA

http://forum.psychlinks.ca/psycholo...ds-to-pain-and-disappointment.html#post167318

 

[AmZ]

Thanks for the links to the articles Daniel.

I feel like I am 'levelling off' to some degree. I wonder if that is normal to happen when someone comes out of a depression. I felt tons better for a week or so and now I am starting to feel a little down. Don't get me wrong, I am still feeling a lot better, but I just feel like I'm coming off of that initial 'high', as such.

 

[Retired]

I felt tons better for a week or so and now I am starting to feel a little down.

How about getting yourself a calendar, you know, one of those calendars where each day has a box for notes...or a little diary book..anything to keep track of the days. Each day, make a note of when you are having a good day....not the bad days, only the good days.

Make a "positive reinforcement" diary for yourself, to see the progress you are making.

You may discover that you are having more and more good days over time!

 

[Daniel E.]

Another trick is to predict the night before if you are going to have a good day or bad day tomorrow. It's related to the idea of self-fulfulling prophecies and sometimes gets people to rethink about how their behavior influences their mood.

 

[AmZ]

I hope so. To have more good days than bad days.

That's a good idea. Thank you.

Now it feels like I am facing the true process of recovery. The medication has taken off a big edge of the depression but I am left with facing reality and all of the continuing hard work that I need to put in.

I'm pretty worried but am trying to have faith in the process.

---------- Post added at 07:30 PM ---------- Previous post was at 07:25 PM ----------

Another trick is to predict the night before if you are going to have a good day or bad day tomorrow. It's related to the idea of self-fulfulling prophecies and gets people to rethink about how their behavior influences their mood.

For sure. Thats a good one too. Even last night, I was dreading today as we have Psychodrama group therapy and various other things I dislike about Tuesday's - I preempted that today was going to suck and it put me in a bad mood last night and I woke up at 4am (that's still ongoing) and couldn't get back to sleep. But luckilly today wasn't so bad after all.

 

[Retired]

I'm pretty worried but am trying to have faith in the process.

Let the doctors be concerned with the process; just have faith in yourself, the good days to come and the goal of taking back control of your life.

 

[AmZ]

Thanks Steve. I appreciate it.

Tomorrow I am leaving the hospital to go to the local mall for a couple of hours. It's the first time I'm leaving the hospital in 5 weeks asides from the one time I went out a few weeks back which went very badly.

I hope that this time, there will be no triggers like being in my apartment etc and I'll enjoy myself and the short time out of the hospital. I want to buy my niece a gift and plan to treat myself to some nice lunch.

 

[Retired]

I want to buy my niece a gift and plan to treat myself to some nice lunch.

Well deserved, indeed. Bon Apetit!

(b'tayavon) בתיאבו ...Is this correct?

 

[AmZ]

Hehe. That is perfect Hebrew Steve!! Many many thanks.

Btw. I am really proud of myself. I put on 17 kilos in 10 months since being in the hospital. I've been on a diet for the last month or so and got weighed today. I've gone from 79 kilos to 74 kilos. That's in a month. Perhaps a little too quickly so I'll make up for it by having mc Donald's tomorrow maybe!!! I am going to treat myself. I haven't had mc Donald's in a couple of years. I crave the badness!

---------- Post added December 21st, 2011 at 04:54 PM ---------- Previous post was December 20th, 2011 at 08:37 PM ----------

My trip out to the local mall went well. I only went for 2 hours and felt quite calm. I bought my niece some really cute clothes for the holidays and bought myself some trainers/sneakers, really cool ones, so now I can properly do brisk walks around the hospital grounds.

As I was falling asleep last night, I however had awful anxiety. It was the most anxious 2 minutes of my life. I was drifting off to sleep and had a semi dream that I was strapped down to a bed in the closed ward because I had gone totally crazy. I 'dreamt' the whole event, me smashing things and pulling the nurses hair. And I couldn't stop myself. In real life, I'd stopped breathing and my heartbeat and breathing had increased. I woke up and had to catch my breath to start breathing again.

I keep having these fears when I am even awake that I am going to 'lose it' and burst out in a crazy fit. I've seen other patients do it and in a way, I want to do it. But I am terrified that I am going to burst one day and lose control. I wonder why I am having these thoughts?

I maybe sound a bit silly saying this but they are genuine worries.

 

[Daniel E.]

My trip out to the local mall went well. I only went for 2 hours and felt quite calm

So are you thinking about hanging out at the mall more often?

I wonder why I am having these thoughts?

A great way to start any session of ruminating

Such thoughts rarely have end points, they do not lead to effective problem solving, and the thoughts recur repeatedly. The consequence is a self-perpetuating process that keeps the individual stuck in his or her thoughts, less likely to find a positive, active solution, and more likely to be disengaged from other activities. Such sustained focus on internal feeling states may decrease any pleasure that can be derived from activities and may perpetuate depression by preventing goal attainment.

http://forum.psychlinks.ca/resource...o-be-more-active-in-your-life.html#post177105

 

[AmZ]

So are you thinking about hanging out at the mall more often?

A great way to start any session of ruminating

I won't be hanging out in the mall too often unless it's for window shopping! It's the first time I've been unemployed in 10 years, since I was 16 years old and it was legal for me to work. My sister joked but it's true, I am now 'skint auntie'. No more regular treats and nice things for my sister and niece.

The thoughts are not ruminating thoughts though. They're impulsive ones that come in a flash.

 

[Daniel E.]

The thoughts are not ruminating thoughts though. They're impulsive ones that come in a flash.

So how do you cope with them? The ideal is often to ignore/accept them and move on.

 

[AmZ]

So how do you cope with them? The ideal is often to ignore/accept them and move on.

That's easier said than done. It's tough. Especially when it comes with physical anxiety too.

What if I should have reason to worry?

---------- Post added at 06:34 PM ---------- Previous post was at 06:09 PM ----------

That's easier said than done. It's tough. Especially when it comes with physical anxiety too.

What if I should have reason to worry?

I know that sounds dramatic? What, I'm really going to go on some anger rampage? I don't know. I feel like I have it in me. In the past when I was a teenager and got picked on for my religion, I really lost my temper a couple of times.
I've heard such awful stories about people being tied down to beds in the closed ward for not even big reasons.
I feel like something could trigger me off.

 

[battleworn]

Thanks AmZ for stimulating this thread. Like a good meal, each course had a tasty applicable contribution. I very much appreciated the article on "Waiting".

 

[Daniel E.]

I know that sounds dramatic? What, I'm really going to go on some anger rampage? I don't know. I feel like I have it in me.

Well, you know, people with anxiety will worry/awfulize so much about things that they forget that they are basically paralyzing themselves in the long term with their anxiety. At least in retrospect, I find it easy to see in myself. I find also find it easier to spot during and after a therapy session.

And it's pretty easy to spot the related avoidance behavior. But if you just focus on thoughts and feelings, it's easy to get lost in a quagmire of rumination. So I personally try to focus on behavior in the here-and-now, e.g. behavioral activation.

Especially when it comes with physical anxiety too.

Regarding the sensations of physical anxiety, those can be normalized, too, such as by noticing similar sensations when exercising:

Cognitive Therapy of Anxiety ... - David A. Clark, Aaron T. Beck - Google Books

 

[AmZ]

What should I do for example with my current anxious state?

I feel the tension so much in the air in the ward here. 3 bad things have happened in the last 1-2 weeks, more than has happened in the last 10 months. I now can't stand to be in the day room and around people because I think that something bad is going to happen again.

So I end up avoiding being around people and always find a quiet place to just pace up and down (even though I'm feeling OK) and listen to my music on my headphones.

But then I end up isolating myself and it's not healthy. On the other hand, a majority of the patients here are middle aged men and I have no desire in speaking to them as it always ends up in them flirting. I'm trying to make the best of what I have with my American roommate but she is very trigger happy also so it's like walking on eggshells with her.

Shall I do exposure therapy and just force myself to be around others? Even though I'm in a psychiatric hospital and this s*** it messed up!?

 

[Daniel E.]

You could always plan your next getaway How often do they let you venture into town?

There's also "occupational therapy" in the sense of doing things that you would normally do at home or work, e.g. learning a new computer skill. Have you mastered the Hebrew language yet? (Since Hebrew is much harder to pronounce than Romantic languages like French or Spanish, I would find it very frustrasting/challenging.)