Sunday, December 10, 2017

On the radio

Yesterday I was the guest on WGHC's "Loud and Clear" which highlights the arts. Host, Alicia Hempfling and I talked mostly about this blog, how I started it, what I write about, how I started writing as a child and topics such as depression, being part of an immigrant family and the state of American politics.

I had a great time. Alicia's show is an hour long, with musical breaks, which might seem like a long time to talk with no idea of what you're going to say, but I loved it. She said there was nothing to prepare and I should just think of it as a chat over coffee, so that's what I did. Sitting in the studio, waiting for the music to end and our cue to start, I didn't even feel nervous.

Although I feel perfectly comfortable talking about most topics on my blog, there's one that is not my forte: politics. When Alicia asked me for my opinion about things in the United States, I took my time answering, saying, "This is all going to get worse...now the rest of that phrase would normally be before it gets better, but I'm not sure about that half of it, so I just think it's all going to get worse."

Later Alicia asked me about the possibility of impeachment (the process by which the House of Representatives officially documents the crimes a president is accused of, and the Senate votes on whether or not to remove the president from office). Reluctantly I gave her my prediction about how El Idiota's term will go: "I think that impeachment is not going to happen. And I think that we are going to have our first president who was indicted and will continue to serve. And I believe that he will not leave office except on his own terms."

Alicia said my words made her sad and it hit me that I'm a terrible person to ask these questions of. But it's not because I'm a pessimist, although most Americans would call me a pessimist. It's because I lack the optimism bias most people (especially Americans) have. We Americans like to look on the bright side of things, expect the best of people and believe we're going to be okay. I don't. I'd call myself a realist and even say that depressives are the true realists.

Because I know how sexist and bigoted the United States is, I told a friend in 2015, "I'm afraid that if it comes down to President Hillary Clinton or President Crazy Town, we're going to get President Crazy Town." I believed that was extremely likely and I didn't like believing that, but it just seemed like what my country would do.

So I caution everyone (and certainly all future interviewers who might talk to me) not to ask me about politics or what I expect from the future. What I expect is that the US will just go back and forth between political lucidity (such as the passage of the civil rights act) and our worst instincts, back and forth, back and forth, with no net movement forward. Here and throughout the world, people will continue to exploit and kill each other.

In crisis, some people exhibit the worst of humanity and others the best. But the worst always dominates because that side of us is more wily, more violent and more ruthless. Our worst side has nothing to lose and that’s always the more powerful position.

People say they have hope that, given enough time, humans will achieve world peace and equality for all. I remind everyone of an inevitability we think about even less than our own death: that the human race -- like all other species in our genus -- will eventually die out. And we'll die out long before we reach world peace and equality for all.


Friday, December 08, 2017

Radio interview on Sat 9 Dec at 9:00a

Hey, all my friends:

A local radio station has a program that interviews artists in the community. For some reason, bloggers count, so I'll be on the show on Saturday, Dec. 9th at 9:00 a.m. Central Standard Time.

Legend Media, WGHC 98.3FM, broadcasts from Uptown in Chicago, Illinois USA. The show will last an hour.

It's a low-power FM radio station, so listen online. You can do this two ways:

1. Go to the organization's website and click on the WGHC radio link: www.newrhythmarts.org

2. Download the tunein.com app and search WGHC radio.

I'm not sure I recommend listening to me gab on for a full hour, but the novelty might be cool for a few minutes. Let me know if you tune in!

Wednesday, December 06, 2017

Making depression suck less

I'm proud to say that the depression support group I started through Meetup.com is going strong. As you can see in this screenshot, I started it on October 10th and we now have 111 members. Between seven and ten of us meet every Monday evening in Rogers Park and we have members who are managing monopolar depression, bipolar disorder, depression with anxiety, etc. If you know what depression feels like, you're welcome to join us. 
For years I attended a support group provided by the Chicago chapter of the Depression and Bipolar Support Alliance (DBSA). DBSA is an excellent organization that offers support to people with mental illness and their families. Mental illness is sometimes hardest on those who live with the person with the illness, so spouses, siblings, children, parents, girlfriends and boyfriends need help, too. DBSA provides support groups all over the country and they helped me a lot when I was married.

But this is a new stage of life and I need a different kind of support group. I founded the Depression: Tired of Being You Meetup (DTBY) to be a group of people who support each other in meetings and in between. I want to build friendships among people who understand depression from the inside. We have weekly meetings and have also met for a casual chat over coffee and next Monday we're meeting at a local Irish pub and grill for a nice, festive meal.

We are creating a group of friends, not just people who talk about their pain once a week and then have no contact. I want us to really be a presence in each other's lives so we're all less lonely and isolated and feeling like freaks of the universe. I want life to suck less! That could be the motto of this group: Making Life Suck Less.

This is going to be a good support group for years to come, at least that's my intention. Unlike a therapist or DBSA facilitator, I'm making friends, emailing and texting people between meetings and inviting them to my home. I started this group because I wanted more friends who I don't have to explain depression to and now I have them.

Wednesday, October 25, 2017

Depression: Tired of Being You

It's shameful how few services there are for people with mental illness. There aren't many ongoing support group for people in Chicago with depression (besides The Depression and Bipolar Support Alliance, which is an excellent organization). So I started one.

Sometimes depression has a cause, such as divorce or job loss. Sometimes it doesn't: chronic depression just comes and goes for seemingly no reason at all. This support group is for anyone in Chicago who suffers from depression. If you have chronic depression like me, you might even feel great today, but you know the bleakness will be back.

For anyone in any of these categories, please join us. I'm no expert. I'm just a depressive woman who needs emotional support from people who know what depression feels like because they've gone through it.

We meet at the United Church of Rogers Park, where the pastors are generously letting us use their space. I'm grateful that Pastor Lindsey values mental health. Yay, Pastor Lindsey!

We meet every other week, at no cost. FREE. I'm hoping to eventually make it weekly, but we'll see. So, please pass this link to anyone in Chicago who suffers from depression. I want to spread the word far and wide! Send the link to everyone you know. Thanks.

Friday, October 20, 2017

Outpatient program, part seven

You might start with Outpatient program for depression and anxiety, Part One.

Eleventh Session (Oct. 17, 2017)
I'm bored with this program and bored with blogging about it. Usually 10-15 people show up, but today there were only eight. The first exercise was to write letters to ourselves about how we've changed and then a letter to someone in our support system. I used my letters to complain.

I'm glad my last day in IOP is Thursday. I'm tired of a program that was never a good fit for me to begin with. Today the facilitator led us through a handout on gratitude and he actually started to suggest that when we're in depression it's good to remember things we're grateful for. What? Thinking of what you're grateful for is the last thing you can do when you're in depression. Several of us spoke up and educated him on how bad gratitude is as a depression coping skill. Maybe it's good when you're in between depressions, to keep them from coming on, but not when you're in it.

Twelfth Session (Oct. 19, 2017)
For my last day in IOP, I made cupcakes (yellow with chocolate frosting). I stowed them in the staff office til the end. We split up into two groups for the first two hours. After check-in, we discussed a handout on ways to keep your mood stable (exercise, hobbies, sleep, diet, etc.). 

For the second hour we did an interesting exercise the aim of which was group cohesion. Dr. B led that one and I was very glad to see him. I'm glad he made an appearance as a facilitator on my last day, but I wish he'd been more involved all along.

Then it was the end and two of us were completing our time in the program. I passed out my cupcakes, which everyone liked. They handed us certificates, applauded us and let us say a few words. Usually people thank the facilitors and talk about how much the program helped them. I wasn't that gracious. I just thanked everyone for tolerating my presence and made one last pitch for my depression support group. Yeah...that's me.

I left feeling SO GLAD to be done! I felt so relieved and happy to be done with sitting in a room, trying to discern what facilitators are trying to get out of us and trying to build personal connections with people in an environment with no privacy. I have my mornings back, I'm back on my regular schedule and I can focus on my job! I really didn't get much at all out of IOP except that I can now say that I've done it, I'm educated on what IOPs are like and I made a few connections that I hope last.

But I must state clearly that I simply didn't belong in this program. Many people have said IOP has helped them a huge amount and they're grateful for the coping skills they've learned, the emotional support they've received and the relationships they've built with the facilitators and psychologist. There are people who adore those facilitators and are extremely glad they got to learn from them. IOP teaches critical life skills how to manage your illness through things like exercise and activities, how to best use your support system and to be honest with yourself about what really motivates and affects you. In the eyes of many, it's an excellent program. It just wasn't for me. Maybe they should add to their assessment process, "Have you spent years solidifying your coping skills such as how to assert yourself, how to set boundaries, how to build support networks..." etc. For those of us who have, this might not be the best use of our time.
My last name is actually "Rodriguez-Martin."

Thursday, October 19, 2017

Outpatient program, part six

Presence St. Joseph Hospital in Chicago, Illinois USA
You might start with Outpatient program for depression and anxiety, Part One.

Ninth Session (Oct. 13, 2017)
There's one man who consistently dozes in group and I feel for him because it sounds like he's on too strong a sleeping pill prescription. But he's not allowed to stop (or start) any prescription without talking to his doctor and his appointment isn't until next month.

Poor guy! He's struggling to reach a normal level of wakefulness. It's bullshit that he can't get in to see his doctor for weeks and bullshit that he can't reduce his sleeping medication when he nods off every day and bullshit that today he said he had to take an energy pill just to stay awake.

Mental health services have been so drastically cut in Chicago -- and Illinois has such a crisis of too few psychiatrists -- that of course we end up having to figure out our own treatment. There are few professionals we can get in to see without having to wait one or four months, even if your health insurance is top notch. American mental health falls way behind that of other countries and it's infuriating.

But on to the program. At one point today, when the facilitator asked a general question about safe spaces, I made the following comment, "It really feels different in here when it's just us, as opposed to when therapists are in the room. So I'm wondering if I could ask, I mean, this is just a friendly suggestion, but would it be possible for therapists and interns and observers to leave the room as quickly as possible during breaks and lunch?"

He said he'd have to clear that with the director of the program, and I said, "Oh, sure. Then could you please pass that along to them?" He said he would.

During lunch (once we were alone) three women told me they were glad I said that and a couple of men sort of nodded. We agreed that it's really nice to just relax and talk among ourselves and not have a facilitator asking questions or a medical student observer peering blankly at us. (Speaking of the med students who observe us, they are so stone-faced! It's like they they're not allowed to look sympathetic or engaged in any way. I've looked them dead in the face while talking and they give no indication they even understand my words.)

As we ate (hamburgers and Sun Chips), one person said she notices when I don't attend IOP (we only go three days a week, so it's not always the same people there). She said they might be in the middle of a discussion and she'll think something like, "I wish Regina were here to make one of her comments right now." This kind of attention makes me uncomfortable. I told her, "When you think things like that, then YOU do it!"

As we all chatted up the place, I asked why people clam up when the facilitators ask questions. A couple of people said sometimes it's because they ask very specific questions and they don't have an answer. I also noticed today that when called on to speak, three people basically said that from listening to others they learn that they aren't alone and they get ideas for what to do the next time they feel bad. Listening seems to help them understand themselves. I guess maybe some people benefit from listening to us loudmouths and that's all they need.

This is consistent with remarks people made today about how IOP has helped them: they said it helped them be more honest with themselves. I guess either talking or listening in IOP has helped many people learn what really motivates them and what they're really feeling.

The second hour we had a group discussion about what we do to get through bad days, what coping skills we've learned in IOP and how we've changed since we started the program. Many others have gotten much more out of this program than I have. One man called the facilitators "incredible" and other people testified to how much they've learned and how much better they now cope. 

In the third hour people talked about how this program has changed or even saved their lives. I heard more stories of how people have benefited from it and how much the facilitators and Dr. B helped them get through bad times. It made me realize I've been a big, impatient snob because I've spent almost three decades learning the coping skills and self-scrutiny others learned in IOP for the first time. Much of my criticism and attitude has been unfair. I'm obviously not typical of their usual clientele.

So today I learned that even though this program hasn't given me what I came here for, I mustn't talk badly of it because it helps a lot of people who haven't spent almost 30 years figuring out all their mechanisms, building their boundaries and coping strategies, and tirelessly examining every single crack in their brains. That's just me.

Tenth Session (Oct. 16, 2017)
After today, just two more sessions and I'm done! By the way, the director told me last week that he had been reading my blog, which is good because I can tell that a few things have improved. The facilitators don't talk to us as much in the happy, chirpy voice, and when we're doing check-ins, they sometimes say, "I don't mean to seem like I'm being unsympathetic, but we have a lot of people today and sometimes I might have to cut you off so we can get to the next person." I appreciate that. And, of course, we've never done as many worksheets as we did that first week. I'm very impressed by how good this director is at receiving and responding to feedback, even when it comes through as informal (and obnoxious) a medium as a public blog.

Today during the second hour, we did a handout on protective factors. These are things that can help you maintain emotional balance and are basically what can help you deal with general suckiness of life. Listed were social support, coping skills, physical health, sense of purpose, self-esteem and healthy thinking. 

The facilitator had us rate how strong each of these factors is in our life and then we discussed it. One thing she asked was, "So, why do you think it's hard to be honest with ourselves about our strengths and weaknesses?" Predictably, people didn't say much and soon we had silence again. I spoke up.

"I also wonder why it's hard for people to be honest with themselves. People were talking last Friday about how IOP has helped them be honest with themselves and I'm wondering, so why weren't you honest with yourselves before?"

Another pause, then someone answered me in part by saying something like, "You say you're all aware of stuff and totally honest with yourself, but what about sugar? If you're honest with yourself and have discipline you should be able to handle that."

I said, "I have the honesty but not the discipline."

He said, "I think they go hand in hand."

He seemed to push back against my bewilderment about why people wouldn't be honest with themselves, and he sounded a little defensive, like I was judging them. Maybe I could have taken that opportunity to say that while my mental health has been a priority for me for 28 years, I don't think I'm better than anyone else the program and I regret coming off that way. Even with all my skills, I still get just as depressed as anyone else. It's just that what this program happens to teach, I happen to have already learned from countless professionals, books, videos, support groups and fellow wackos. 

Basically, while normal people spent decades getting married, having children, establishing careers, buying homes and spending time with family, I have spent decades being focused on me, me, me. I've spent the past almost 30 years learning my inner mechanisms, motivations, emotions and triggers. I know myself very well. While others have lived full lives, I've lived alone and focused on my own emotional health. For 28 years. Sad, but true.

Anyway, at this point Dr. B happened to be in the room and he picked up on the question of why it's hard for people to be honest with themselves. He explained to me that sometimes it's not that people are actively not being honest, but that they don't have the self-view to be able to perceive what's going on with them. He used the example of the color blind test, which is impossible for people who don't have the biology to perceive certain colors. Likewise, people who haven't learned to distinguish between motivations might just be unable to know what's really going on with them. That made sense.

I wanted to turn back to the facilitator who had originally asked the question and said, "See? Your question was too hard for us. Dr. B was the only one who could answer it. Work on your questioning skills." The facilitators often ask questions that we can't answer because we don't understand what they're asking. Most of them need work on how to ask good discussion questions. Then again, we patients need to speak up when we don't know what they're talking about. Unfortunately, most people just sit in confused silence and then things go nowhere.

This leads me to the question: why can't Dr. B spend more time with us? He's great. We need a lot more of Dr. B and less of facilitators who don't seem to have spent much time leading support groups. I think most of them are psychology students or interns and I know that means that of course they don't have a lot of experience, but we deserve better than that. It's another indicator of the state of American mental health care. I imagine St. Joseph IOP can't afford to have a psychologist like Dr. B dedicated to the 9-12:30 daily group, but man if we could, it would be so much better.

After lunch (chicken wraps and Fritos), we had a group discussion about what courage is and what kindness is. It wasn't bad. It was interesting. We talked about how courage can include still feeling afraid and how kindness includes respect for others. It was ironic to me that we were talking about kindness, when I've seen these facilitators not be too kind. I'm talking about one outpatient who tends to talk out of turn and not stay on topic who's a little difficult to manage. A couple of other facilitators ignore his mutterings or they call on him and let him speak, but when he starts rambling on, they turn away and call on someone else. Singularly, the facilitator who led this discussion on courage and kindness listens to him and responds to what he says and treats him with respect. And guess what? He doesn't talk out of turn as much! Yeah, this man is annoying and takes a lot of patience, but come on. Let's be respectful and kind.

I continued to talk about the depression support group I'm starting on Oct. 23rd and one person said he's definitely coming. Besides that, there are 20 people on Meetup.com who have signed up to come! I know they won't all be there, but other brand new Meetups often get around 10 people (or fewer) signed up at their first meeting. The only other Meetup I've personally seen get such a big response from the beginning is a recovery support group. Clearly Chicago needs emotional support groups!

And here's the final part of this series, part seven.

Outpatient program, part five

You might start with Outpatient program for depression and anxiety, part one.

Seventh session (Oct. 9, 2017)
Today was weird. It was clear that at least some of the staff had read last week's blog posts and changed their behavior accordingly (on my third day there I mentioned that I blogged about mental illness, and someone on the staff looked up this blog). One facilitator was less chirpy and friendly which was good. But the one I criticized as "nervous," was friendlier and kept addressing me by name. That felt icky. Is he trying to get a "good review?" Because of this weirdness, I'll keep writing about each session, but I won't post any more of it until my final day in IOP. 

So during check-in today, I talked about the Depression Meetup I'm starting. I also mentioned that I'd had a really good date on Friday night and was feeling better than ever. And I'm continuing my daily log that I hope will reveal a pattern that correlates to my depression symptoms (sleep, exercise, meditation, stimulant consumption, meds, weather). 

The second hour we talked about triggers and how to handle them. The now-not-so-nervous facilitator led both the second and third hours, making me wonder if the director, after reading my blog, told him to get more time in group so he can get over his nervousness. He seemed a little more relaxed.

Lunch was chicken strips over a bed of lettuce with a roll. A couple of people got a vegetarian option. 

The third hour we discussed some prayers that were variations on The Serenity Prayer. One focused on relationships, one on self-forgiveness and one on love. It was another crawling conversation where it felt like people spoke up only reluctantly. 

I wonder if the lack of participation partly comes from a lack of trust. They switch facilitators on us every day, often for all three hours. It doesn't allow us to build rapport with anyone if every hour we're starting over again to reach a level of comfort with the face that's looking earnestly at us. I imagine the staff tries to evenly assign clinic duty, but it would be better if we could at least stick to just one person per day. The hourly change of facilitators does not give a sense of stability and, for me, it's a little jarring and annoying. 

The other weird thing is that people are starting to treat me, and even talk to me, as if I were a facilitator and not an outpatient. One woman has joked about my strong personality and said that when I sat down this morning I looked ready to lead the discussion. One man asked me last Friday to push him to participate more in discussion. Today sometimes people looked at me instead of the facilitator when they talked. One woman even asked if I have a degree in psychology. 

So I guess I'd better pipe down! I don't want to dominate, but as my depressive symptoms have disappeared, my natural desire to socialize has come out. I like to ask people their names and if this is their first day. During breaks I want to continue discussions we started during the last hour's activity. During lunch I like to get a conversation going with the group (we all stay in the same room for lunch). 

And sometimes during discussions I have questions for the facilitator or for the other people Maybe my ease with asking things instead of just answering them (or staying silent) makes me seems like some kind of leader? But dammit, I'm not a leader in that environment and don't want to be treated like one. In this third week, things just feel like they're getting weird, between me and the facilitators and between me and the other participants.

Two more days this week, three next week and I'm done!

Eighth session (Oct. 11, 2017)
Today the check-in hour was led by a facilitator who hadn't led a check-in yet. More newness. Each time a new facilitator does the check-in, I'm never sure how much information she has on me. I'd never told this one my story, but I've noticed that these therapists take very good notes. For instance, when someone tells therapist A something on Monday, therapist B follows up about it on Tuesday. So I figured this facilitator had information on my background.

I'm still feeling good with no symptoms, so I recounted to this new-to-me facilitator that my depression had lifted during the first week of IOP and mentioned my great Friday night date that had energized me and made me happy. While she had asked others about sleep, appetite, and if they have a support system, she didn't ask me any of those questions. She asked me if I have appointments with my therapist and psychiatrist, seemed satisfied with my good mood and moved on to the next person.

I didn't like that. Just because I feel good today doesn't mean I won't go right back down tomorrow. I deserved to be asked about my support system and how my sleep and appetite were, just like the others. In fact, I mentioned a couple of minutes later that I'd been awake for two and a half hours the night before.

The second hour we had a group discussion. It's really striking to me how much people clam up when we're in a group talking with the facilitators, as opposed to when we break down into pairs or small groups and just talk among ourselves. In fact, I wish they'd do more small group work because then we get to steer the conversation however we want to.

In fact, I wish they'd let us talk in small groups and then just leave the room. We really loosen up when facilitators aren't part of the conversation. For instance, in the third hour we filled out a handout with a series of statements to be completed such as:

I am most content when ______________
My greatest fear is______________
People think I am______________
My greatest joy in life is______________
If I let myself feel it, I'm angry that______________

Then we broke up into small groups and discussed. I relished sitting down with two other people and saying, "Okay, instead of going over these answers, what's more interesting to me is: what do you think the point of this exercise is?"

We didn't know the answer to that, so I moved on to, "One thing I had a really hard time with was the one about what my greatest joy is. I'm not even sure what joy means. What is joy? People always say their greatest joy is their kids, but I don't have kids. Did you answer that one? What did you put?"

The other two people told me what brought them joy and I sort of started to understand. Then we just picked the more interesting statements and talked about those. That led to a better discussion than going down the list of questions and reading off the page, which it would have been easy to do. I enjoyed our little talk.

I'm still trying to figure out why people don't talk with the facilitators in the room as much as we talk when it's just us. Is it about trust? Is it about not wanting to serve as some sort of example for the facilitator to pontificate on? Are authority figures just intimidating? I'm going to ask.

Oh and the best part of today was that lunch was cheese pizza! It wasn't bad, either.

Here's part six.

Friday, October 13, 2017

My people

One thing I like about mental illness support groups, outpatient programs and the nut house itself is that I can be myself 100%. Unlike anywhere else, I can take off my public face, express exactly what I'm feeling and say what's on my mind or stare dully into the distance and say nothing at all. There's no need to fake being normal because my weirdest behavior will be seen as part of my symptoms. It's a huge relief.

The other patients and I talk to each other about suicide attempts and hating our mothers (or loving our mothers) and feeling free to be exactly who we know we really are on the inside. There's no one to pity us or call us bad people or feel scared of us. This might sound odd, but these are my people. 

So I can't wait to get my new depression Meetup going because then I'll have that dynamic every week. I've got the kleenex ready!

Saturday, October 07, 2017

Outpatient program, part four

You might start with Outpatient program for depression and anxiety, part one.

Fifth session (Oct. 5, 2017)
This morning I found the first hour disturbing. We did the usual check-in with the facilitator asking everyone about sleep, appetite, suicidal ideation, self-care and what the goal for the day is. (My depression has gone into remission, so I've just been reporting that my mood is up and my habits are good and stable.) Two people were really in a bad place, but the protocol here just doesn't allow for truly caring for them in the moment. Each time all the usual questions got asked. Obviously, the facilitator could see these people weren't doing well, so she asked "What's going on?" Each time the person choked out an answer and got a few minutes of focused attention, but not much more than that. One person was told that the facilitator would talk to them personally later, which was good, but the other one I felt really bad for. So much emotion, but this just wasn't the place for it. There's a problem when a program that's meant to help people with mood disorders can't take extra time to care for someone who's clearly struggling.

Then, funny enough, we finished the check-ins early and had extra time! The facilitator asked if anyone had anything else they wanted to talk about. No one said anything. She asked again a few minutes later if anyone had anything else to talk about or if we should take an early break. Still no one said anything, so I spoke up.

"I think it's really lucky that I pulled out of my depression during my first week here because if I had been coming to this program while in depression, this really wouldn't have gone well. I would have felt angry about how things go here and every time you gave us one of those handouts I would have wanted to hit someone and every time we worked on these skills I would have wanted to punch a wall. And I wouldn't have understood why we can't just talk about how we feel, especially when someone clearly wants to just burst into tears or just wants to kill themselves. So it's really lucky that I'm not in a depression or this just really wouldn't have gone well."

I don't remember exactly what the facilitator said, but it was something about how they're working on incorporating more discussion. Then we took our break.

One thing that was really nice was that after the break, the facilitator led us through some breathing exercises. One was called 4-7-8 breathing: you inhale to a count of four, hold the breath for a count of seven and exhale for a count of eight. We also did belly breathing and morning breathing, which involved standing up and bending over. These breathing exercises were great. They gave us actual, practical techniques for managing our emotions during the day and helping us fall asleep at night, plus we all just felt better after doing them. Many of us have trouble with sleep, so this was valuable. The facilitator looked surprised and happy that they went so well.

After the break we did a handout on assertiveness. Clearly I don't need any help with that, so this was another activity that I didn't get much out of, except to learn how many of my colleagues have trouble with ideas like "you have a right to put yourself first sometimes" and "you have a right to have your own opinions and convictions." 

I'm realizing that over the past 28 years, I've done a hundred tons of work on my inner mechanisms and behaviors, mastering assertiveness, confidence, honesty and boundaries, and yet I still suffer from horrible depressive episodes. This program's cognitive behavioral therapy (CBT) approach is good, but it doesn't offer much to someone like me who needs hands-on techniques for managing sadness, rage, despair and hopelessness in the moment when I'm experiencing them. The limitations of this program still disappoint me, but I have to accept them. 

Sixth session (Oct. 6, 2017)
Today I had a little extra to say in the check-in. I said again that my depression went away last week and I'm feeling good, but that I'm baffled by what makes it come and go, although sugar consumption seems to be part of it. So, like a detective on the case, I'm starting a daily log of how much sleep I get, how much sugar and caffeine I have, exercise and other things. (I've since decided to include the weather, although I'll leave out planetary movements.). I said I hope this will reveal some pattern I can use to manage my depression.

The facilitator said, "That's great. I think that's a really good approach. So you're going write down each day how much you slept and how much you exercised and things like that and then that will give you a nice amount of data you can work with. And then you can use that to try to see if you can find out any ways to help your depression."

I said, "You don't have to repeat everything I just said."
She said, "I'm just making sure I heard you correctly and that I understand."
I said, "Yeah, I know, but it just doesn't work for me. You don't have to do it. I think you've got it."

She repeated that it's part of having clear communication and I just looked at her with exasperation. There's really only one facilitator I like. The rest of them just chirp too much. Instead of saying, "Okay, good," they say, "Okay! Good!" They talk to us like we're children and it feels patronizing. I wonder if any of them have mental illness themselves because they don't seem to have any idea that the more cheerful you are the angrier it can make someone who's already suffering from anger and alienation. I sense little empathy coming from them. Or maybe they're people for whom being in a bad mood is helped by cheerful people and they have no idea that such an approach does not work for everyone.

In fact, when I tell a friend I'm depressed and part of their response is to smile or try to joke, it makes me want to hit them. If they try to lighten my mood in any way, I want to say, "Fuck you!" Their behavior suggests to me that they aren't taking me seriously or they live on a planet where things are never very bad. I feel a canyon of space between our worlds which makes me feel even more isolated, helpless and alone.

Again: it's really lucky that my depression didn't last after that first week. I imagine the staff thinks I'm enough trouble in a good mood.

The second hour we did the hole-in-the-road exercise. You know that story that starts with the person falling in a hole and taking a long time to climb out, etc? We read through it and talked about where we feel we are in that story, which is to say, where we think we are in our recovery. I said I'm still on chapter one because I have no idea what brings on the depression or makes it leave and I feel overwhelmed and bewildered by it. 

We also discussed what strength is and how feeling your emotions and/or falling apart still means you're strong. That's always an important message because I know many people think being emotional is weak and that's bullshit.
hospital orange

After lunch (turkey sandwich and an orange), a facilitator who seemed nervous led the session: he spoke with a lot of "um" and "uh," and struggled to find words. It seemed to me that he didn't have as much of the other facilitators' ease. We filled out a worksheet that led us to imagine our future selves: how they look, how they act, how they handle problems, etc. It was an okay exercise, but either it or the counselor didn't inspire people to talk and the hour dragged. 

In the previous hour, during the discussion of strength, the facilitator had offered her view of what strength is. I appreciated that. She and Dr. B are the only two who seem comfortable adding their own opinions to a discussion. Everyone else keeps the focus fixed relentlessly on us, with phrases like, "What do you think?" and "Does anyone else...?" and "How does that sound?"

When people stopped talking, the nervous facilitator switched from the handout in front of us to the subject of strength versus courage. Things continued to drag, so I asked him, "What do you think the difference is between strength and courage?"

He said, "That's what I'm asking you."
I said, "Right, and I'm asking you what you think."

He stammered through a response that didn't tell me much. Dr. B sometimes floats in and out during the last hour of the day and this was the hour he did that. At this point, he stepped in and presented us with another way of looking at the question and the discussion picked up.

I have a part-time job, and on the days when I go to the program, it's a long day for me. To spend the morning at the hospital and the afternoon working feels like a lot, even though I only go three days a week. I'm glad I now have two weeks of IOP (Intensive Outpatient Program) under my belt and only two weeks to go. 

When it's someone's last day in the program, they get a certificate of completion and everyone applauds. When this happened earlier this week, someone joked, "Where's the cake?" So I've decided to bring cupcakes on my last day.

And here's part five.

Thursday, October 05, 2017

Outpatient program, part three

You might start with Outpatient program for depression and anxiety, part one.

Fourth Session (Oct. 3, 2017)
The St. Joseph Hospital outpatient program did get better this week. It's like they really heard our criticisms of the heavy focus on handouts and the non-interactive reading of what we'd written, and started doing more group discussion (once I spoke up about the focus on handouts, so did others).

This is good for two reasons. One: the sessions feel more useful. Two: it shows that the staff are capable of accepting and acting on feedback. That feels RARE and responsible for any program staff and I'm very impressed. Psychology professionals aren't any less driven by ego than the rest of us, so I appreciate how postively these therapists and managers (and Dr. B) responded.

This week my first day was Tuesday. At check-in, I was able to say that my depression had lifted and I was feeling fine again. I mentioned that the previous week, I'd made the decidion to stop the sugar roller coaster I had been on in September and it had made a big difference. Within 24 hours of stopping the almost hourly candy, cookies and soda, my mood improved. But besides getting off the heavy sugar use, I said I hadn't changed anything, so I didn't fully know why I felt so much better. Someone joked that it could be because I'd been coming to the program, and I just smiled at him.

The second hour we did a handout on negative thinking. We went over the language of negative thinking, which can include words like never, always, can't and don't. We looked at words that are more neutral like often, sometimes, choose not to and will not. Then we wrote down a negative belief and re-wrote it in a better way.

I wrote, "No one will ever want to be in a long-term relationship with me." There were sections on the handout that asked me write the pros (keeps me from rejection) and cons (loneliness) of believing that. In the part of the worksheet that asked for the origins of that belief, I wrote, "My ex-husband divorced me because of my depression." Then I changed the statement to "I might meet someone who wants to be in a long-term relationship with me." Again, no great revelations or lessons there for me.

But when we talked about what we'd written and I read mine, a discussion started that did help. The facilitator asked me what I'd want to change about myself to help me believe I can meet someone. I said, "I'd change my brain, so I could have one that works right, and my body."

Everyone was giving me input about that, and in the process, surprisingly, it sank in for me: I actually MIGHT meet someone who wants to have a relationship with me. That is within the realm of possibility. As the discussion moved on to the next person, I stayed with my new statement. I wrote it down on the paper. I even threw in some parameters: "I might meet someone who wants to stay in a relationship with me, even after he gets to know me very well, even with the depression."

I felt a little lighter. I sat with that feeling. It felt good.

After lunch (breaded chicken sandwich and fruit cup. Mmm...fruit cup), we did some work in pairs. It gave me a chance to get to know the person sitting to my right, who seemed like a cool guy I could connect with. I was glad I got a chance to confirm that. We talked about what's challenging us right now, then the whole group got back together and shared a little of what we'd talked about.

So, things have gotten better. The outpatient program surprised me. I'd still like techniques for managing my emotions when I'm in the worst of a depression, but that's not what this program offers. That disappoints me, but if things continue in this direction, staying in it for two and a half more weeks won't be as painful as I was expecting.

Next post: Outpatient program, part four.

Wednesday, October 04, 2017

Gun control debate is OVER

Look, people, this is the United States. Mass murder by gunfire isn't going to stop and Congress is not going to pass legislation to restrict access to guns. Gun control is a dead issue, no matter how much we might hope it's still up for discussion.

As I said before, not only is owning guns a core American value, it's a core part of our identity. To quote myself, we Americans pride ourselves on being "independent, highly capable, have-gun-will-travel people who aren't afraid of anything, as long as we're armed." In the 1770s we founded the United States of America with guns, and our belief that we must stay vigilant against attack continues.

So what if it's delusional to think any single person needs weapons appropriate for war? So what if the constitution was written when American guns could only fire one bullet before re-loading? So what if statistics show that the fewer guns available to the population of a country, the fewer incidents of mass murder? Those arguments are nothing compared to our concept of "freedom," which includes the freedom to have the ability to kill anyone at any time.

Bill O'Reilly articulates what millions of Americans believe about massacre by gun: "This is the price of freedom." End of discussion.

When a gunman slaughtered twenty little white children at Sandy Hook elementary school in 2012 and we didn't pass gun control legislation, the debate was over. When white America is willing to sacrifice its own little white children for their freedom to access weapons, we're fools to think we can take up the discussion ever again. At least, we can't until another gunman slaughters twenty-one little white children.

So stop your hand waving and "We have to do something!" Sit down and shut up because this is the land of random violence and murder and that's all there is to it.

Friday, September 29, 2017

Outpatient program, part two

First you might read: Outpatient program part one.

Third Session (Sept. 29, 2017)
Today was better. The first hour of checking in was conducted by a facilitator I'd actually seen before. I've finally made it to the repeats! One woman said she'd had a hard time making a stressful phone call, but she finally did it. She started to say that it had made her feel anxious and afraid, but the facilitator pulled her attention to her success in getting it done. She assured the woman that anyone would have felt anxious in that situation, but she handled it and that's great.

That's the general tone of this program. They don't have time to hold your hand through whatever fear or anger you're feeling. They want to lead you straight to the bright side, the better way to look at it, the possibility of success. I guess this strategy works a lot of the time.

I also got the feeling that the facilitator wanted to normalize the woman's anxiety. Her attitude seemed to be, "You're fine. You're just like everyone else. You're normal."  It's like they're trying to hypnotize us into believing we're not depressed or anxious.

When the facilitator got to me, I told her that I was feeling so-so. She asked why. I told her I was really looking for more group therapy with everyone taking part in a conversation and so far this program hadn't provided that. I said this made me feel disappointed. She said, "You wanted more time to process?" I wasn't sure what that meant, but it sounded about right so I said yes. She said maybe they'd try to do some more of that kind of activity. 

Maybe it was a coincidence, but after the break, we spent the second hour having more of a conversation, and it was led by an actual psychologist. Finally! Dr. B had somone pull a slip of paper from a pile, read aloud the challenge described on it, and say what they'd do in that situation. For instance, one described being at a family reunion and sitting next to a family member who was drunk and talking badly about people with mood disorders. We only had time for about five of these challenges, but each time people said what they'd do, or how they've faced that challenge, or how they're facing it now and don't know what to do. It was almost like group therapy! 

I pulled out a slip that described being on the bus and having someone harass you. I said I'd just ignore them. Dr. B asked if it would invoke any emotions for me. I said, not really because I'm very good at boundaries and I'm very good at not engaging if that's what I've decided. He said, "So this is within your skill set." I said yes, it was. So he turned to the others who said they'd have different responses.

In fact, every challenge we discussed wasn't anything that I'd have trouble with, so while I was glad to finally have some group discussion, I still didn't feel like I was learning any new coping skills.

After lunch (fried fish sandwiches with regular potato chips), Dr. B led the last activity. Not only did the same person lead two exercises on the same day, but it was a psychologist! I was impressed. We had a discussion about how we feel about the stigma attached to having a mental illness, with Dr. B answering our questions about how many people have mental illness and why some psychiatric wards operate as they do. He was a good source of information.

The last part of the morning was a handout. Oh, well. Not having to do any handouts would have been too much to hope for. We wrote down how we'd respond to someone asking about our symptoms/illness in different contexts, such as at a party, in a therapy session, on a first date, in a job interview, at work, with friends. Then we discussed our answers in pairs. It was another exercise that didn't tell me anything new about myself.


At the end a facilitator asked how we thought the day had gone. I said I really appreciated the group interactions and thought the day had gone well. I also said that doing handouts and then reading aloud what we wrote puts people to sleep. Another woman backed me up, saying she thinks filling out worksheets and then reading them doesn't get us anywhere. I tried not to smirk, but had to nod in agreement. Most of the others said the day had gone really well and they liked all the exercises.

So I have a little more hope that I might get some of the group dynamic and emotional support I'm looking for. But the level of skills that this program teaches doesn't feel like the level I need. So far nothing has challenged me (although plenty has challenge my patience). Plus today someone smelled like urine, so I left the room to eat lunch.
The next post is Outpatient program, part three.