The Mental Health Thread

[Morden]

Hi Smallcleanrat, You ask some really hard questions. And I have no easy answers. I just want you to know that I hear you, and I am very pleased that you are continuing to reach out for help even though it's hard and exhausting, and some people's responses are really unhelpful. You are still strong for continuing. The treatment program you've applied for sounds interesting. When does it begin?

[polly_mer]

Why does everybody pretend they can't hear me when I ask about this?

I hear you.  Like Morden, I have no easy answers to the hard questions.

I have found reading novels from various countries and eras helpful to learn about lives that I've not gotten to observe.

I've had bouts of reading fantasy and science fiction for the same goal of trying to gather information regarding establishing a good life within my current and near-certain future constraints.

Since you've mentioned finding comfort in books, maybe more reading for targeted questions may help.

I have found much less use in reading biographies because they tend to gloss the parts that would be useful to me.

[Cheerful]

I seem to have cleared all hurdles to enter the treatment program I applied for; they think I should do partial hospitalization instead of outpatient, which is going to be intense. ACT is one of the methods they use. I've had a bit of it in the past, but was never able to get someone to help me past the "acceptance" part to the "take action" part.

Sounds like good news, smallcleanrat!  Huge credit to you for investigating this program and applying.  This could help make the next five years of your life hugely better than the last five.  A major quality in your favor is that you are smart.  You have the intellectual ability to readily grasp and apply tools, knowledge, and insights.  Fight on!

Why does everybody pretend they can't hear me when I ask about this?

Maybe it's because no one can predict the future.  If you are like me and many others, you may hate uncertainty.  The best advice I've been given for dealing with uncertainty about the future -- and it's rooted in various wise philosophies -- is to focus on the present moment/hour/day and try to find the best in that moment or ways to make the next moment better.

For example, we don't know what will happen with the pandemic and when.  For now, we cope in our  own best ways and hold fast to the promise of brighter days.

[smallcleanrat]

I seem to have cleared all hurdles to enter the treatment program I applied for; they think I should do partial hospitalization instead of outpatient, which is going to be intense. ACT is one of the methods they use. I've had a bit of it in the past, but was never able to get someone to help me past the "acceptance" part to the "take action" part.

Sounds like good news, smallcleanrat!  Huge credit to you for investigating this program and applying.  This could help make the next five years of your life hugely better than the last five.  A major quality in your favor is that you are smart.  You have the intellectual ability to readily grasp and apply tools, knowledge, and insights.  Fight on!

Why does everybody pretend they can't hear me when I ask about this?

Maybe it's because no one can predict the future.  If you are like me and many others, you may hate uncertainty.  The best advice I've been given for dealing with uncertainty about the future -- and it's rooted in various wise philosophies -- is to focus on the present moment/hour/day and try to find the best in that moment or ways to make the next moment better.

For example, we don't know what will happen with the pandemic and when.  For now, we cope in our  own best ways and hold fast to the promise of brighter days.

I'm not looking for certainty, I'm looking for contingency planning. Simply accepting as given that I will recover back to full strength would be refusing to acknowledge that the future isn't certain. Is there no room in any of the wise philosophies for thinking of possibilities and planning ahead?

Saying "I definitely will recover" would be attempting to predict the future. Saying "There are still some treatments I can try. I may be able to get better. But, given the lack of clear diagnoses and a treatment plan for many of the other debilitating symptoms, I may not recover fully in the near future." is acknowledging the reality of uncertainty.

If I knew I had alternatives, maybe things wouldn't seem so bleak.

[polly_mer]

If I knew I had alternatives, maybe things wouldn't seem so bleak.

Maybe targeted biographies would be helpful to you to give a wider range of possibilities.

Maybe actual cases studies for people who have conditions like yours might help.

[Morden]

You're right--there is no certainty. None of us knows what will happen next. To a limited extent, we can engage in contingency planning, but it's really easy to spiral into rumination, trying to control the uncontrollable. I think that's why a lot of attention has been given to approaches like mindfulness now. I don't think that means that you can't take steps to help your situation, and you have been doing that--by reaching out to people, by getting a kitten, by applying to the treatment program.

[smallcleanrat]

Thanks so much for all your feedback, everyone. It really helps to know there are people who hear me.

I'm due to start the treatment program next week. It could be a good opportunity to meet some people who are going through similar issues. It will also be isolating in its own way because it will force my lab-times to evenings and weekends when I am less likely to see my lab-mates. Thinking of asking for a Zoom social hour every once in a while.

I've been tagging lots of books on Amazon related to living with chronic illness (managing work, relationships, etc...). Based on the tables of contents, several of them specifically address topics like grieving the loss of your previous life and the future you thought you had, as well as how illness can take a toll on your self-esteem and sense of identity. This is what I could never convince anyone to discuss with me; they kept telling me not to think that way and to just believe I will get back to my old self.

I've been trying to beat back thoughts of worthlessness. It's still difficult to let go of the implication that all I've needed to do all along is change my outlook. One therapy group leader told me that lack of optimism may be the reason previous treatment methods did not work. She didn't know my situation at all. I was optimistic for four and a half years; it was only relatively recently I could no longer maintain it, even though I tried.

I've been thinking about the propensity of some to use the "other people have it worse" approach to...to what? Is this really meant to help or is it mostly meant to shut up the other person's complaints? Because when someone tells me to use willpower to be more upbeat, less withdrawn, less focused on my own pain, more active/productive, it's hard for me not to think of the times that:

1) SO was kept awake later than usual because of some noisy neighbors (probably got around 5-6 hours, instead of his usual 8). He spent the next day groggy, grumpy, and sullen. He complained of how tired he was, how the interrupted sleep made it hard to focus. He went to bed early and felt back to normal the next day.

2) SO wrenched a muscle, which led to several days of pain, foul mood, and low activity. He wasn't interested in conversation or "together time" or anything except sitting still and being left in peace. By the next week, he had recovered, pain was gone, SO's mood back to normal.

3) Former PI came down with a head cold. Complained of lack of focus, feeling "like a zombie", making mistakes with her work. Took the next two days off and came back to lab recovered.

I can think of other people, other examples, but it all comes down to the same principle: people who don't seem to practice what they preach. They don't seem particularly optimistic (even though they have every reason to expect their discomfort to be short-lived), social, or able to function at their normal levels. Why do they expect me to be? When I haven't slept through the night in months. When I've spent years feeling like a zombie far more often than I felt like a human.

Supposing they didn't recover, and they felt that way for years, to the point their careers stalled, relationships withered, their bodies aged while their minds stagnated beneath the fatigue, pain, and disconnection from the world around them. Would they be comforting themselves thinking, "At least it's not [insert worse circumstance here]?" Would they maintain their optimism for the future? If uncertainty is a major stressor, and they had no idea when to expect to feel better, how would they fare?

I can never ask this because 1) it's pointlessly combative and 2) you can't really know how it would affect you unless you've lived it. But I wonder if, were the question(s) posed to them, they would imagine themselves as never giving in to despair, never succumbing to utter exhaustion or loneliness, and getting through by sheer determination and willpower.

Am I really so much less resilient than everyone else?

[Puget]

SCR,
I'm glad to hear about the treatment program-- I hope it is helpful! It also seems like it might really help to have a therapist who specializes in clients with chronic illnesses-- health psychology is the subfield at the intersection of physical and mental health, if that helps search. In the meantime hopefully some of the books will be helpful.

I very much doubt you are less resilient than other people (you seem very resilient under the circumstances!), and I don't know why people say those things-- probably most of them think they are being helpful, and maybe for some of them thinking that way actually is helpful. Perhaps you could tell them "I know you are trying to be helpful, and I appreciate that, but this isn't actually helpful for me. What would be helpful is if you could [having a conversation about something fun, or whatever would be helpful right then]."

[polly_mer]

smallcleanrat, have you encountered the spoon analogy?  The original story is at https://butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/

The short version is everyone starts the day with some number of spoons that are then used to 'buy' daily actions.  People with long-term illnesses often start each day with fewer spoons and each activity is more expensive.

Thus, when someone runs out of spoons, they're done, even if it's only noon and more things should be done today.

People who seldom run out of spoons don't necessarily understand what it's like to run out of spoons most days.

[Morden]

As someone with chronic health problems (including depression) and a spouse with chronic health problems, I like the spoon analogy. Our lives will never be what they were before. I desperately wish things could be different for both of us, but at a certain point we both came to realize that, within certain parameters, our lives could be pretty good--even if not what we expected.

[smallcleanrat]

What do you say when people insist if you don't have enough spoons, you should just go get more?

Or who insist you miscounted your spoons and you actually have more than you say you do?

I have shown people this essay to hear something like "Well, yeah. Lupus is pretty serious; it's an actual disease. But everybody gets depressed or anxious now and then. You just have to push through it until things are better."

[polly_mer]

I hear your pain and frustration.

I have no answers for how to deal with people who deny reality other than making an effort to find better friends, colleagues, and chosen family.

[Morden]

Hi Smallcleanrat, Some people are hurtful (even if they think somehow that they are "helping" you). And that's really hard. I agree with Polly. There are better friends, colleagues, and chosen family out there. And right now, you're doing what you have to do by getting ready for the treatment program.

[Cheerful]

Shout out to smallcleanrat.  Wishing you all the best this week as you start the program.  We're here cheering you on!

[smallcleanrat]

Shout out to smallcleanrat.  Wishing you all the best this week as you start the program.  We're here cheering you on!

Thanks for thinking of me, Cheerful! Much appreciated. I have my intake session Wednesday.

I asked if they also have a psychiatrist I can talk to about meds and they assigned me to someone. Maybe they will be a better match for me than my current psychiatrist.

Been having a rough time this week obsessing over this feeling of being an "imposter" patient. I found several articles describing how people with "invisible illnesses" often feel this way when comparing themselves to people whose conditions are more disabling. Maybe I'm not sick, maybe asking for help/accommodation/moral support is inappropriate.

Been reading about people who exaggerate or even completely fabricate health issues for attention, sympathy, or relief from responsibilities. Been scrutinizing my history to see if I've been doing this at all. I don't want to be that kind of person. Am I just looking for an excuse to explain my difficulties managing my life? Because saying I have an illness would be saying that's not entirely my fault. When I feel urges to kill myself are these even serious? I haven't done it yet in all this time, and I hate myself for it; I've become reluctant to reach out when feeling suicidal because I never feel 100% certain that this is the time I'll actually do it. So I might be raising a "false alarm." Stats say most people with suicidal ideation do not actually make an attempt. And many attempts fail, raising questions of "serious" attempts versus cries for help.

Am I mistaking normal mood variations everyone has to deal with for something more extreme than the average? The chronic fatigue, the migraines, the unexplained loss of function in hands and feet...could I be doing it to myself without knowing it? Can it all be psychosomatic?

Because if that's what I'm doing, even without fully realizing or admitting it to myself, I really have just been wasting everyone's time and energy. Thinking this might be a possibility makes me loathe myself. I really need to figure this out.