5 paths to self-discovery

One of the primary purposes of therapy is to learn more about yourself. This process of self-discovery allows you to understand what’s going on with you, which then leads to better decisions that create a happier life. But finding out who you are doesn’t have to be limited to an hour a week. There are other ways to discover new things about yourself.

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1. Make a timeline

Using a poster board (or just lots of paper taped together), create a timeline of your life. Include major events (starting kindergarten, first boy/girlfriend, death of grandparent), but also changes in who you are (depressive episodes, discovering hobbies, learning the importance of self-care). Alternately, you can have a sheet of paper for every year of your life. If you put this in a binder, you can add to it as time goes on. You can even use pictures. As you look through your timeline, you can discover patterns in your life or connections you would not otherwise have made. For instance, did your anxiety start at the same time you switched schools? This, and the rest of your timeline, is useful information to share with your therapist.

2. Meditation/spiritual practice

We all try to get a sense of how we, as individuals, connect to the larger “whole” of humanity and the universe. Many people find this meaning in spiritual practices. No matter what your belief system is, it can help you discover purpose within your life. Meditation is one practice that can be applied across religions (or the lack thereof). The concentration required for meditation opens your mind up to new insights and ideas. Other spiritual practices – such as prayer, worship or talking to a religious leader – can also be profound ways to learn about yourself.

3. Trying new things

Remember when you were a kid and something on your plate looked gross and you didn’t want to eat it? A parent probably told you that you don’t know you don’t like it until you try it. This principle can be very widely applied. You don’t know how you’ll feel about new activities and experiences until you have actually attempted them. Finding new interests through exploration and experimentation lets you discover parts of you that you didn’t even know were there. Alternately, if something doesn’t resonate with you, that says something about you, too. Do something you would not normally do. Go see a play in the park, try your hand at tennis or go to a foreign restaurant to see if, yes, you like it because you tried it. 

4. Journaling

Writing can be a very powerful tool of self-discovery. The process of putting words on paper brings up things you didn’t know were there, allowing new information about yourself to surface. It also gives you a record throughout time, allowing you to see how you’ve progressed in your thinking and your recovery. It is a mindful and in-depth form of looking at things. Journaling can be done in many ways. You can do it freestyle where you just go with whatever comes along or you can work with prompts. A list of them can be found here. 

5. Ask questions

Children learn more content in a shorter amount of time than adults do. That is, in part, because kids ask so many questions. As we get older, we like to think we have things figured out, but embracing that you don’t know everything will ultimately make you wiser. Ask yourself questions about yourself, the people around you and larger issues. Why is your favorite color the one it is? Why do people tend to cut conversations short with you? How do you feel about sending people to prison? By actually examining yourself and the world around you, you get a fuller understanding of who you are, what matters to you, what you believe in, what your priorities are, who you want to become and so on. 

How do you learn more about yourself? Tell your self-discovery stories in the comments.

Diagnosis spotlight: depersonalization/derealization disorder

We all experience dissociation in some way or another. It can be as simple as highway hypnosis, where you suddenly realize you’ve driven for miles without noticing, and as complicated as dissociative identity disorder, formerly known as multiple personality disorder. Somewhere in-between, there is depersonalization/derealization disorder.

First of all, what are depersonalization and derealization?

Depersonalization refers to a distortion in self-awareness. You are, in a sense, unfamiliar with yourself. One typically experiences detachment from the body or the sense that it is unreal. It can even mean watching yourself from outside your body. The self just doesn’t feel real and things might seem like a part of a dream. It can also be watching yourself go about your day and making decisions, but not really feeling in control. Time might also be distorted and there can be physical and/or emotional numbing. 

Derealization is when everything else doesn’t feel real. Your surroundings might feel foggy, distorted, unreal or, again, like a dream. People, places and things that may be familiar seem strange or surreal. It’s hard to fully perceive the world around yourself and it might seem like you are watching everything through a filter of sorts. It can be like living in a bubble. What is around you is very separate from you and it can be hard to fully engage in life. 

Depersonalization/derealization disorder means having episodes of one or both of these. It can be accompanied with a feeling that you’re “going crazy.” There might also be vague physical symptoms, like tingling or lightheadedness. It is often associated with anxiety and/or depression. 

Approximately one-half of adults have had an episode of depersonalization or derealization. It happens. But when it is recurring or even constant, it can become pathological. Onset is almost always before age 25, so it’s something that can be experienced from a very young age. Childhood trauma is considered one of the causes of depersonalization and derealization, but it can happen without it. Symptoms can also be caused by physical conditions or substance use, so those need to be ruled out. Episodes are often preceded by high levels of stress, anxiety, depression, traumatic events (or reminders of them) and/or drug use.

Both therapy and medication are used to treat depersonalization/derealization disorder. In particular, cognitive behavioral therapy allows people to reinterpret the symptoms and psychodynamic therapy can look at unresolved and suppressed internal conflicts. Medication-wise, nothing has been approved specifically for the treatment of this disorder, but anxiety medication and anti-depressants have shown some success. There is also research supporting the use of lamotrigine, an anti-convulsant typically used to treat epilepsy. Using grounding techniques can also be very helpful.

Having the experiences of depersonalization and derealization can be very frightening. But it is a recognized mental health condition and a notable amount of people experience it. If you feel like the symptoms described apply to you, please talk to a doctor or therapist. It is possible to gain control over it enough to where it is not interfering with your life, if it doesn’t go away altogether. 

Have you experienced depersonalization or derealization? What was it like for you? Share your experience in the comments.

Vignette 5: What Would You Do?

Annie, a suicidal student

Background: Annie is a sophomore with a psychiatric history dating to age 12. She has had multiple depressive episodes and was hospitalized at 16 after a suicide attempt by overdose. She has been in some form of treatment off and on since she started high school. Annie engages in cutting but that is a coping measure and not suicidal in intent, though she frequently thinks about suicide.

Scene: Annie answers questions in class which alarm her instructor and classmates.

Dr. Hokumba: So, can you recall an experience in your life which is evoked by your reading this week? Yes, Annie?

Annie: (Raising her hand) Well, when I was sixteen I was sent to a hospital after I tried to kill myself. Let me tell ya, it was exactly like what Kafka said.

(Other students quickly turn around to look at Annie.)

Dr. Hokumba: I see. In what way?

Annie: (Holding up both wrists, which reveal very red marks on the wrists.) See? People freak out over this but I went because I overdosed. The hospital was like a maze just like Kafka spoke about. I never did figure out what was supposed to happen or what I was supposed to do. It just seemed like whatever I did was the wrong thing, but when I tried to do what they wanted it just made it worse, ya know?

(There is obvious discomfort among the students.)

Dr. Hokumba: (nervously) Anyone else?

Annie: But I’m used to it. I still think the way I used to. After all, suicide would have solved Kafka’s problem. My shrink says I am stubborn that way.

Dr. Hokumba: Annie, let’s talk more about that after class, OK?

(After class, Annie approaches Dr. Hokumba.)

Suggestions: First, if you plan on having class exercises which involve personal history, creative projections of fantasy, or stream of consciousness thinking, you need to be prepared to field and respond to disturbing material.  This means being familiar with sources of support, referral, and immediate crisis response.  In this vignette the student reveals her thinking is current and not just in the past, and the fact that she is in treatment already.  Make sure others in your area are aware of your meeting and consider having your campus police nearby for support if needed.  In your discussion encourage her to continue in treatment and make every effort to refer her for follow up that same day, either to the campus counseling service or her current therapist if she is being seen off campus.  Either way the situation warrants timely follow up in order to determine her current level of distress.  If in doubt, ask your campus counseling service to send a counselor to your office in order to make a literal handoff to those services.  There may be many other considerations involved which cannot be covered here, so follow the recommendations of the counselor as they are provided during your discussions.

25 reasons to recover

On tough days, it’s important to remember why you are working on your recovery at all. When steeped in negativity, it’s hard to think of what you have to gain. But it is important that you do. Motivation and hope can get people through a lot. 

So what keeps you going? I suggest that you make a list of reasons why you want to recover. There is always something. Even if your list has a single item, you can turn to that one reason you have when you are feeling discouraged. You can do your list all at once and add to it as you think of new ones, or you can decide to write down one a day for as long as you can. To get started, here are 25 examples.

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1. So you can feel confident in your own skin.
2. To truly be there for your loved ones.
3. To understand yourself better.
4. So you don’t have to worry about keeping up appearances. 
5. To think more clearly.
6. So you don’t have to be scared of going outside.
7. To be a more empathetic person.
8. So you can get out of bed in the morning with a smile on your face.
9. So you’re not afraid of food.
10. Because you deserve the best life you can live.
11. To be honest when you say, “Fine,” when others ask how you are.
12. So you can wear whatever you want without being uncomfortable.
13. To show your loved ones that you care about them.
14. So you don’t always compare yourself to others.
15. To concentrate better.
16. So you can actually enjoy celebrations. 
17. To feel motivated and inspired.
18. To improve your physical health.
19. To become a more accepting person.
20. So your dreams can become realities.
21. To show others that it is possible.
22. To feel like life is worthwhile.
23. Because you believe in second chances.
24. To show that you love yourself.
25. Simply do it because you can.

What are your reasons? Add to the list in the comments.

Have hope – it will change

  

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Mental illness has a way of trapping you into thinking that you are stuck in it forever. A depressed person doesn’t lay in bed for three weeks and say, “Two more and I’m good.” Someone doesn’t think, “I’ll have five more panic attacks and then I’m done.” It’s pervasive. And even if you can logically convince yourself that it isn’t going to last forever, it’s hard to believe it enough to get the accompanying feeling of relief. It’s like a kid the week before Christmas. It drags on forever. 

The point is, though, that it isn’t forever. Like I said, it’s hard to believe. Really hard. But it’s true. There is an end to it. Even if you are suffering from a lifelong condition, the way it manifests will change. There will be variation. The pain you are feeling won’t feel the same way for the rest of your days. 

There is always change. If you aren’t changing, the world around you is. You might not be capable of changing yourself at the moment. That’s okay. Some days/weeks/months/years/decades are like that. But others aren’t. An acquaintance might transform into a good friend. A family member might have a burst of inspiration that results in him being more helpful. Your therapist can learn something new about your diagnosis and apply it to your treatment. You have to believe in change.

Change happens on larger scales, too. Psychologists do studies to find out which treatments are more effective and why. Scientists invent new medications. People learn to become more sensitive to mental health issues. You never know when the next breakthrough is around the corner.

That is why you have to believe that change is possible. It’s happening around you all the time. But it is possible for change to happen to you as well. It might take a really long time, but it does happen. I tried several different medications of a certain class before we found one that worked. Did it suck until we found it? Yeah. Did some of them make me worse? Yes. But when we did find it, it made my life easier. I was in therapy for seven years before I decided to take a chance on a new treatment approach and it transformed my life. I’ve had bad relationships. If I had given up on people, I would not have a boyfriend that makes me better every single day.

You never know how long it will take to change and that’s scary. It really is. I spent over a decade almost constantly fighting with a certain terrible feeling before it subsided. If you’d told me at the start that that’s how long it would take, I might have given up before even trying to get better. That amount of time is overwhelming. But it is a lot shorter than the rest of my life.

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I’ve asked myself if it was worth it. How long can you endure misery before the chance of getting better is no longer worth it? There were times when I would have said not another day. Sometimes, I would have said that ridiculously many days in a row. But part of me didn’t let go. And eventually, things did turn around. 

It seems easy to say that, well, in retrospect it might be worth it. When you’re not in the midst of it, you can say it was possible to overcome. But my life is still affected by mental illness every single day. There are things I want to do that I can’t. Sometimes, I still get set off and have to spend a few days under the covers. But I have also found many things that are worth it. I have found relationships I could not have been healthy enough to manage before. I have come across new interests and started new hobbies that I would not have had the energy or concentration to learn about before. Even running this blog gives my life some sense of meaning. 

No one was more annoyed with the whole, “It gets better,” attitude than me. I felt like an exception. But the fact is that despite feeling hopeless, I still kept trying to get better. That effort pays off eventually. It will be small victories at first. It might be forgetting you’re suicidal for an hour or going a single day without drinking. But every bit of progress is still progress and it’s moving you forward. It might take you a thousand steps to get to somewhere when it takes someone else only 10, but you can still get there. 

With time, those steps do add up. Every day that you do your best matters. Everything is constantly in motion and you are becoming a new person minute by minute. Making the choice to recover helps you become a happier and healthier person. So love yourself for trying. That is one thing I always hold on to: I never stop trying. Knowing that alone has a powerful impact.

What gives you hope? Share stories in the comments.

5 habits that promote mental health

Mental health is not something you are born with or without. It is something that can be impacted by as many different things as your physical health can. We might take vitamins and get flu shots to protect our bodies, but do we offer the same level of care to our mind? Here are some habits that can help your mental and emotional health.

1. Take care of your body

Your mind and your body interact on a constant basis. What you do to one will surely affect the other. That’s why taking care of your body is essential. Consult your doctor to find out what is best for you, but here are some general guidelines. Eat appropriate amounts of healthy food on a regular basis. Ideally, you should do moderate exercise for half an hour five times a week. But anything helps, even five minutes of stretching. Work your way up to it. And make sure you get enough sleep. Every body is different, but some research indicates that 7 hours is optimal.

    

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2. Learn new things

If you don’t stretch your mind, how do you expect to keep it in shape? Your brain needs the occasional challenge and learning is a great way to do this. Learning new things promotes qualities such as confidence, happiness, self-efficacy, independence and wisdom. Keeping the mind active can stave off some of the effects of age-related cognitive problems. While it’s fun and comforting to do things you already enjoy, learning something new has an even greater effect on your mind. Learn to cook Thai food, paint with watercolors, restore cars, woodwork or take on a new language. This last one is especially great for mental growth.

3. Reduce stress

Stress is unavoidable. Some amount of it is healthy because it helps us get things done, but having too much can have negative consequences for your mental health. There are many studies supporting this. So find ways to reduce the load. If your child is having a birthday party and you’re trying to clean the house, decorate, make treat bags and bake a cake, maybe you should just buy a cake at the store. If you have overwhelming work responsibilities, see if you can delegate some duties to someone else. For some tips on managing stress, read this.

4. Engage in self-care

Life is so full of demands that sometimes we forget to just slow down and assess what we actually need. When you feel scared, overwhelmed, frustrated, in pain or otherwise having a difficult time, stop and ask yourself what you actually need. Commit to act on it. If you need to slow things down, try some grounding techniques. If you are hungry, grab a snack. If you feel lonely, call up a friend. Something inside of you always knows what you need and you need to learn to listen to that part of you. It’s best to take care of how you’re feeling before it develops into something bigger.

5. Ask for help

Sometimes we think that we should be able to handle everything life throws at us. But the truth is, humans are social creatures for a reason. We need each other. So when you are depressed, overwhelmed, anxious, distracted or otherwise having problems, it’s okay to ask for help. This can involve anything from going to therapy to having a neighborhood kid mow your lawn for you. What matters is that you’re not going through your struggles alone. Besides, connecting with other people is good in and of itself. And you never know when you might be helping someone else simply by being in touch.

What healthy mental health habits do you have? Leave other suggestions in the comments.

Thoughts to make you feel better

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Mental illness can be very discouraging. Sometimes, you just need a little boost of positivity to help you get through a challenging time. So if you are having one of those days, here are some thoughts that might make things seem a little more okay.

You deserve help

A sense of worthlessness often accompanies mental illness. When your ability to function and be productive is compromised, you can feel like you aren’t earning your place in the world. If you can’t give, then why should you receive? Alternately, if your problems are minimal, what makes you deserve help when it seems like others need it more?

The truth is, everyone deserves help. Everyone. No matter what. Help is not a limited resource. It is not something that is carefully allocated to whoever has earned it or is the most needy. Getting help can take so many forms, from having a cup of coffee with a neighbor to spending time in in-patient treatment. And even when you are receiving help, you might be giving it, too. A friend who listed to you might feel wanted and like her life has some purpose because you chose to open up to her. Your therapist could become a better clinician because he is working with you, furthering his ability to help others. You can’t make yourself an exception to everyone. You are a human being. You deserve help, no matter what you are or aren’t giving back.

You are not your struggles

Mental illness is not your identity. The way you handle it says more about you than the fact that you have it in the first place. Mental illness can happen to anyone at any time. You are not a flawed person for struggling with it. That’s just your particular battle at this point in time. When we admire someone, we don’t look up to her because of the odds she faced. We admire her because of what she did despite them. 

There are so many things that are more important and interesting about you than what your diagnosis is. What matters the most to you? What makes you passionate? Who do you love? What makes you laugh? Why do you keep trying? These are who you are. Having a name for a disorder can help a clinician get a general sense of what he’s dealing with, but it doesn’t mean much beyond that. Who you are has a larger impact on your life that what you are up against.

Trying means you are strong

The work it takes to recover can be astounding. It’s flat-out overwhelming at times. You might not be able to fix everything, but the fact that you are trying – even if it’s just a little bit – is an incredible feat of courage. Mental illness will try to make you succumb to it. It will tell you whatever it needs to in order to gain control over your life. But if you are putting forth effort, you are saying that you’re not giving in. Even if you slip up, the strength it takes to say you’ll try again anyway outweighs that mistake. And that is amazing. 

The smallest bit of effort can be a large victory because you aren’t on neutral ground. You’re not getting out of bed when you have a wonderful day to look forward to. You’re getting out of bed when everything inside of you is screaming at you to stay. You are going outside when you are crippled by fear. You take a chance by saying, “I’ll get through another day,” even when as far back as you can recall, all the days were miserable. It doesn’t look like much from the outside, but your determination to keep trying is an incredible feat.

What do you tell yourself when you get discouraged? Share your motivators in the comments.