Tag Archives: Partial

Resource: On What beliefs are your house built?

24 Jun

 

On what beliefs is your house built?

FOUNDATION: The house’s foundation is your foundation as a person.  List and label the values, beliefs and traditions that direct your life.  Do you put family above all else?  Do you think that being financially successful is paramount?

OUTER WALLS: The walls represent your supports.  Are you struggling to name supports?  Remember that supports can be people, places, and things.  Who have you interacted with in the last weeks?  What did you do and where did you go to feel better and find assistance?  Supports can also be professionals in your life.

THE ROOF: What gives you shelter?  Who protects you?  Like supports, these can be people or things.  Do you feel like your parents/family/friends encourage you unconditionally?  If so, include the on your roof.

THE DOOR: The door keeps things hidden and others out.  What things do you hide? Are you ashamed of things or do aspects of your past?  List these in the door.

FIRST/GROUND FLOOR: Behaviors you are trying to gain control over, or areas of your life you want to change.

SECOND FLOOR: Emotions you want to experience more often, more fully or in a more healthy way.

THIRD FLOOR: List all the things you are happy about or you want to feel happy about OR list the things you are grateful for and/or that you have right now.

FOURTH FLOOR/ATTIC: What would a life “worth living” look like for you?

CHIMNEY SMOKE: Ways you blow off steam.  Possible coping tools.  Things you do to get your mind off things.

BILLBOARD: Things you are proud of and want others to see.

I fall apart fast or do I

14 Jul

Things have been rough for awhile, real bad depression wise for at least a couple months and more like 6-9 months with a few small breaks in between.  Some people wonder how you can consider suicide, but a lot of people understand the feeling of what it is like to want to die but being able to overcome it in some way.  I can’t get that overcoming part down… the bad outweigh the good by so much it’s ridiculous, there is not enough pleasure to even slightly offset the immense emotional pain I am in.  I don’t have kids to take care of.  People would miss me but most of them I think would get over it with time.  I don’t see me contributing to the world and I don’t see the pain ending enough to have any sort of quality of life.  My “good days” are probably other people’s “okay days.”  I just wake up with this sense of dread of another day, more pain, more pretense, more survival, and hopefully some distraction.  Distraction has been the only thing that’s been helping lately while it is totally false that you can “fake it till you make it” it does give you something to do and put energy into.  Plastic fantastic.  My condition is chronic, this is a life long thing that is all I have ever really known and escape is so appealing.  I don’t have much faith in my psychiatrist or medication.  The work I do to stay alive is work I do and I’m terrified I’m about ready to give that up.

I’ve been falling apart since last fall, unraveling slowly at first.  I remember when it got so bad (just the depression not suicidal) that I went to the ER with the knowledge that I could spend my 31st b-day in the hospital.  It’s been a slow drag and then after the last hospitalization there was a weird transition time.  Adjusting to no constant voices and just a weird state that I don’t ever recall being in that lasted for a month or so.  Then the depression hit full force again, this time with major self harm urges.  I spent a month in Partial which did practically nothing.  A few weeks ago a set of the voices that are intermittent came back, I call them the back 2s.  I think they just may be parts of me I don’t want to acknowledge or can’t or whatever.  But they have been coming and going since.  I’ve been extremely suicidal and self harm urges.  I took apart that razor the other day.  I took 25mg Valium just to stop the pain.  I’ve been trying to blast the voices out with music, reason with them.  Some part of me or the back 2s or whatever you want to call it, REALLY wants to die.  And I’m scared.  This morning I had it all figured out I don’t want to go into it because of giving other peoples ideas but part of it was that I turned off my phone.  This may seem really stupid to a lot of people but when I’m really down I lay down with my phone next to me hoping someone calls/texts/comments on a blog or I check my e-mail and Facebook.  There is still that hope and sometimes I can reach out to others. Not only was I not capable of reaching out to others this morning (busy planning my demise) I made it so they couldn’t help.  My sister thinks that’s dumb because there is the house phone and obviously people live here and all but to me it shows my mindset.

So now I’m scared of myself.  I have an appointment with the therapist on Tuesday and will have her put me in the hospital if I can’t get in to see my case manager tomorrow to have her do it.  Pray I can make it till Tuesday and this part that has some hope can stay in the front because I’m afraid the suicidal part can come out and act quick and it will all be over.

On the brink

28 May

I made it through partial without being hospitalized. Yet, I still feel on the brink. I guess I need to accept this is my life.

Update and randomness

27 May

I was discharged from Partial today, first I was told they might keep me, then I was told go home or inpatient (they used different words, but that was the gist). funny how people keep throwing around inpatient and needing to be in the hospital, it was like that at last appt with therapist.

My paperwork is ridiculous and entertaining. They left one of my medications off completely, and another they had the dosage incorrect. So they got half right. My current diagnosis (per the psychiatrist I saw while in this program) is schizoaffective disorder DEPRESSIVE type, that’s a first along with the lack of the Borderline Personality Disorder diagnosis (which would be really cool if it was accurate.). Also on axis IV it says “coping skills.”

I canceled the Disneyland trip. I’m too unstable to know if I’ll enjoy it and I don’t need a guilt trip if I don’t. The Disney trip was suppose to be to celebrate a year and a half of no self harming. Yesterday I was so down, it didn’t (still doesn’t) feel like much of an accomplishment. Maybe I’ll do something to recognize it…

My mood has really been affected lately by my interpretations of social interactions. Today we talked about addiction to adrenaline, growing up in a dysfunctional home, and codependency. (Maybe I’ll do a post on that, it was interesting). Kinda clicked home that my “people addiction” is worse now that I’m not self harming; though it’s been the most intense since my mind cleared up with this Latuda. Guess my mind needs incessant worry to keep it company now that the voices are gone.

I managed to set and keep a boundary with my dad. I was extremely surprised he listened.

Right now I’m laughing at things that earlier nearly had me in tears. I’ll probably be back to tears, later tonight. I think I’ll put my contacts on, maybe that will stop them. yup I really am crazy.

3 days ago was my 4 year anniversary with WordPress, blogging.

Losing my grip

26 May

I’m sinking and I’m starting not to care. It’s been about a month of this last bout of depression. I’ve been doing all the “right” things yet I still feel like shit. I went and saw the therapist on Thursday and she said I sounded like her clients that deal with chronic depression, I don’t know if she doesn’t know my history or was just stating the obvious or what. I’m getting tired of trying. I’m trying to go about life like nothing is wrong, when all I want to do is crawl under the covers and cease to exist. I’m doing the things that normally give me pleasure despite the fact that they currently don’t. For the most part I’m eating, staying out of bed, and being social. I went to the partial program for practically a month. I haven’t self harmed and have been trying my hardest to distract myself and not make suicide plans. I know I can’t keep this up much longer, I’m running out of whatever keeps me holding on and fighting.
The thing is majority of the time I don’t think I’m worth fighting for. I don’t think I’m worthy of life. I think I’m not worth anything. I truly believe this, and no one wants to hear it so I keep my mouth closed. I keep living because I’m suppose to, because apparently one day things won’t be this painful, because there are some people who would miss me. When you don’t have the will inside yourself to live, you hang on to outside reasons. I’m losing my grip.

Double Awareness

15 May

bpd awareness

May you are wearing me out and I am already worn thin!!!  So let’s see here it is Mental Health Awareness Month all May (Post), NAMI Walk Northern California May 3rd, Children’s Mental Health Awareness Week May 4-10 (Post), I’m Blogging for Mental Health May 14th (Post), Borderline Personality Awareness Month all May, and I’ve been in a Partial Hospitalization Program since May 2nd.

For this post I am going to share a handout sheet I did on Emotional Regulation while in the Partial program I am in.  Emotional Regulation is one of the key concepts of Dialectical Behavioral Therapy (DBT) that was initially founded to help treat those with Borderline Personality Disorder (BPD) though it is now commonly used to treat many mental health issues and some of the concept such as mindfulness are common in mental health and spiritual health practices.

First a blank worksheet if you would like to fill out:

er hmwk 1 blank

Mine filled out:

er hmwk 1 5.9.14

Most of the worksheet is self explanatory.  The emotion generally derives from anger, sadness, fear, or shame.  My emotion hopelessness was a form of sadness.  The prompting event is just the facts, exactly what happened to trigger the emotion.  The interpretation, body changes and language, and action urges fall under the category of experiencing the emotion.  At one point I want to type up a few handouts we received that have examples of all these for each main emotion.  The what I said or did is expressing and acting on the emotion.  The secondary emotion (which there can be multiple, a single one, or none) is how the first emotion made you feel example: I felt angry that I kept going to treatment only to get hopeless again and again.

The goal of filling out the worksheet is to slow you down and help you realize where everything fits.  In my case most of my emotion, hopelessness, was based on my interpretation of what was going on.  It helps to identify all the urges and then to see the difference in what you do do, it generally makes me feel a little better to know I didn’t do my action urges or at least not all of them.  Also it helps to see the after effects, which can be immediate or awhile later.  Another way filling out this worksheet is helpful is because it helps separate the primary emotion (the one you do the worksheet on) from any secondary emotions; which if you want you can do another worksheet on that emotion.

 

2014 I’m Blogging for Mental Health: Treatment Program

14 May

APA-BlogDayBadge-2014

 

 

I can’t believe I almost missed it but today is mental health blog day.  This year I am going to blog about treatment programs specifically the Partial Hospitalization Program I am currently in.  Years Past: 2013, 2012.

I have a specific section under my menu about different treatment options where I briefly describe the treatment and the pros and cons of it and then my experience with it.  This post will be more specific but if you want more general information on different treatment options, and there are quite a few, check out that topic under the menu bar.

I am in a Partial Hospitalization Program, it meets from 9 am-2:30 pm Monday through Friday includes 5 different groups and lunch.  All partial programs that I have been to take place on the site of the hospital, usually in an adjoining building, and this one is no different.  We  eat at the hospital, yeah yuck hospital food, but not with any of the inpatients.

People usually attend a Partial program in an effort to prevent hospitalization or as an adjustment after being hospitalized.  When I did my orientation the program I am attending says they have a 70% success rate with people graduating the program and not needing hospitalization or re-hospitalization.

This particular program focuses on a DBT (Dialectical Behavioral Therapy) Approach.

The program I go to also has an IOP (Intensive outpatient program) aspect with people who are attending that program go home at noon, or only attend 3 groups and they only go 3 times a week.  The first group is a check in group where we all fill out a morning report.  Here re rate our anxiety, depression, irritation, and pain.  The form asks about what we’ve done since the last time we were in program, how long we have been sober for, if we have appointments ready (with an outside psychiatrist and therapist) after program ends, sleep, questions regarding self harm urges, and questions regarding medication issues.  We fill out the form and the leader goes over what’s in the form and asks us what we would like to work on that day.  This first group is the same every day!

After the first group we usually split up into two separate groups, in two separate rooms.  The people are split up by what they want to work on or similar issues.  It is very rare that the groups are split in the same exact way each day.  One usual division in the program that I am currently in is that those who have had substance abuse problems are generally all in one group sometimes with non-substance people depending on the number of people.  Some days, like today, we don’t split up because there was only 10 people.

Our 2nd Group was on “Learned Optimism.”  It was an educational type group, but time for participation.  Each group is about an hour long. The group was about cognitive restructuring or turning learned helplessness into learned optimism.  One of my key “take-aways” was that pessimism has three characteristics: pervasive, permanent, and personal. “It’s not just this, it’s everything.”  “It’s not just now, it’s forever” and “It’s all because of me and my personal failings.”  So a way to restructure those thoughts and put a more optimistic twist is to think of it as specific, temporary, and having multiple causes.

Our 3rd Group was on Grief and I have been requesting this group and was honestly disappointed.  The group again had an educational type and the handout repeatedly referred to death.  My grief is not related to a death but is a loss none the less, so I kept feeling invalidated and had to ask for clarification on how this applied to me and my situation.  We also didn’t get all the way through the group, the handout was on 7 stages and typically there are 5 stages of grief, and the handouts also kept referring to using drugs and alcohol to deal with grief.  So I didn’t get much out of this group.

After this group the IOP people went home and there were only 6 of us left, which is about the usual number in Partial.

Our 4th group was a continuation of a group we had prior in the week.  The topic was interpersonal effectiveness and it was a myths and challenges sheet.  I didn’t care for the group this time or prior in the week.  The sheet just had statements that are myths and we are suppose to write a challenge to them.  The statements were things like: “I don’t deserve to get what I want or need.”  “I can’t stand it if someone gets upset with me.”  “Obviously, the problem is just in my head.  If I would just think differently I wouldn’t have to bother everybody else.”  It is clear to see that these statements don’t have an absolute truth to them but just writing a “challenge” to it does not help me and it’s a waste of time.

After our 4th group we take a break and go to lunch at the hospital.  Today’s lunch was Teriyaki Chicken and Rice, I went to Subway and Jamba Juice instead because most time I don’t like the hospital food and won’t eat it.  Also between each group we get a 10 minute break.

Our 5th group and last group of the day was an extension of the 4th group.  We received a handout on cheerleading statements (another thing that isn’t effective for me!)  This group turned more into a process group that focused on me :/ A process group is different in that it when you take information and process it and relate it to you, probably the typical thing when you think of support groups or group therapy.  We had the majority of our 6 were non-talkers and so the leader called on me and I said these statements don’t work for me.  I gave an example of “If I say no to people and they get angry, that doesn’t mean that I should have said yes.”  I explained that sometimes it’s more effective to just say yes (even if I don’t want to do it) to spare the anger and all the effects it will have on me.  This turned the last group, which is usually shorter because of getting back from lunch, mostly about me which made me uncomfortable.

So today specifically wasn’t a very helpful day in the program, only one group really resonated with me and I felt I learned something and I could apply it.  However, going to Partial has other benefits such as having to stay out of bed for 5 hours, needing to get dressed, need to eat, and needing to interact with other people.  So even if I don’t always get something out every group, and it’s impossible that every time the group will apply to me, I still get at least one or two things and the structure the program provides.  Plus there is always tomorrow!  The groups range anywhere from 2-4 weeks and I am not sure how long I will be in this Partial Program.

The battle wages on

5 May

battle

9am- I just want to give up.  I’ve been fighting this for nearly 2 decades.  I’m tired.  I’m losing hope.  I want to take something and just sleep.  It’s just the same thing over and over, with small breaks of okayness.  I’m not worth fighting for.  I could go on and on about all the bad things about me, why I don’t like me and why I think no one else does/should either.  About being sad and a burden, who would want to be around that?  Desiring connection, but too scared and hopeless to pursue anything.  Thinking about not signing up for summer classes, fading away and then when there is nothing to keep me anymore, I won’t have guilt.  I don’t even want to go to Disneyland, I think I will be let down and a waste of time and money and I’ll just feel bad.  I’m trying to hope and make plans and just hope these feelings go away; but I don’t believe it.  It’s hard to keep this up.  Losing hope and the motivation.  The depression gets bigger and stomps out what little hope is left.  The battle wages on.

3pm- Partial is over for the day.  I woke up not even wanting to go, thinking about how I wish I had their number so I could call and say I was sick.  Suicidal, hopeless, and feeling some sort of desperation.  I got up and went anyways, because that is what I do.  I will not give up half halfheartedly, when I am done I will be done.  As you can tell by my prior writing what sort of mind set I was in.  We mostly talked about communication today, I will post at least one resource a little later.  While my main issue right now is more with emotions than communication I got some hope out of today.  Like I mentioned prior I’ve been fighting this for 2 decades, so I have heard a lot of the same stuff.  A very common topic taught is assertiveness and I messages or I statements… the “I feel…  When you…. Because… And I want…” I swear nearly every program I have every been in has taught some form of this at least once.  The plus side was today we learned that was the “feelings oriented” version of the I statement and there is an “action oriented” version which is good to use for people who don’t care about your feelings.  While, like I said, I’m not struggling so much with communication it was refreshing to learn that I haven’t heard it all and it made me feel a little better.  Still extremely depressed but now there is a small reason to not give up and continue with treatment. A huge impulse right now is to cut off contact and support, which includes treatment and other things, so I could give up entirely and permanently without guilt; this was thwarted by the learning of “action oriented” I statements.  A small victory in the continuing war.  The battle wages on.

Partial Day 1

2 May

I started the Partial Hospitalization Program (referred to as PHP or Partial from here on out.)  They called me at 6 am to start today so I did. This partial program is from 9 am-2:20 pm Mon-Fri, in the past I have always been in it for 2 weeks but my estimated discharge day is 5/31 which is a Saturday :/   I might have plans for the week my parents are gone to Mexico so I hope I am out by then.  I also have 2 appointments that week that are on the same day.  I doubt my insurance will keep me all month.  It has been 3 1/2 years since I’ve been in Partial, wow; but I have been hospitalized like 4 or 5 times since.

It was good I went today so I had something to do.  My social worker is a person I know from inpatient and I like her so that is good.  They have a new program manager and he actually leads groups, so that is different. I met with the psychiatrist today and he didn’t change any of my meds or anything so I am happy with that.  The whole Partial program uses a DBT Approach and that is cool as I am familiar with it and some of the skills actually work.  I have homework too, which I like it’s on emotional regulation so if this week is anything like last I should have plenty of opportunity, hopefully just the motivation.

tobTomorrow is the NAMI Walk I am pretty proud of myself I have a team of 14, including children and dogs.  I made the shirts yesterday and here is a picture of our team mascot.  I had 4 other people going but unfortunately they couldn’t get the time off work.  Afterwards we are having a swim/BBQ.

Awards: Learning more about me

30 Apr

 

I was just nominated for the Liebster Award from Tess’ of the d’amned and though I don’t participate in the passing on of the blog awards (because so many people have them and I’m tired as can be)  I will answer the questions so you can learn more about me.  I would also suggest checking out the blog that awarded me it’s new but seems interesting.

liebsterblogaward

11 Random facts or statements:

  1. I wore my contacts all winter and the day I switched over to glasses, it starts raining!  California has been in a drought and we have had very little rain this winter so I thought that was ironic and put it on my personal Facebook page.
  2. I am starting a Partial Hospitalization Program (PHP) at the end of the week.  I am not jazzed about it but I probably need it right now.
  3. I have more friends and support now (if you add them up) than I had in all my 20’s put together.
  4. I still have an iPhone 4, not the 4s or anything after so I don’t have Siri.
  5. I have a headache from crying too much today, but I’ll probably sleep good tonight.
  6. I am going to go to Mickey’s Halloween Party for my birthday this year and will be Kowalski from The Penguins of Madagascar, I’m really excited about this.
  7. In the late 20’s of next month it will be a year and a half since I have self harmed.
  8. I’ve been writing a book for about 10 years now, and work on it enthusiastically (usually during manic phases) and then later delete or re-write all I have worked on.
  9. I just picked up all my prescriptions other than my birth control pills and my insurance saved me nearly $3000 dollars, that’s about 3 months worth of medication.
  10. I have two sisters but no nieces or nephews, though lil sis has her dog Tobias.
  11. I can communicate in English, Spanish, American Sign Language, and Italian.

Her 11 questions answered.

  1. Has there ever been a time that you considered yourself truly happy and at peace? There have been  moments but I wouldn’t consider there to be a time period longer than a few days.
  2. What is your worst memory? – only if you are comfortable to share. My worst memory is probably my first memory which was a suicide attempt at age 10.  It was after a family argument and I had decided that my family (and the world) would be much better off without me and that all I did was cause pain and problems.  I cried for a little bit and then tried to suffocate myself with a pillow.
  3. Have you been diagnosed with a mental disorder? Yeah, all the different disorders I have been diagnosed with are under the DSM-IV tab on the menu.  My current diagnosis are Schizoaffective Disorder Bipolar Type and Borderline Personality Disorder.
  4. What famous figure inspires you and why? I don’t really have one.
  5. What is your favourite book or/and author? Why? My favorite book is The Hitchhikers Guide to the Galaxy (series) because it is funny and I didn’t have high expectations going in so it totally exceeded anything I thought.
  6. What would be the most important thing you would try to teach your child? Love themselves just the way they are.
  7. What’s the one thing you could not live without? My case manager
  8. Have you ever been on a diet? If yes, why? I’ve never put myself on a diet.  While in the hospital they put me on a low cholesterol diet because I have high cholesterol.  I’m a picky eater with GI issues and medications that affect what I can/n’t and should/n’t eat but I don’t follow a specific diet.
  9. What is your hobby/passion/talent? Scrapbooking, journaling, writing/blogging, poetry, and crafts in general.
  10. What’s your favourite guilty pleasure? Ice cream.
  11. Name one misconception about your disorder or mental health in general that annoys you. People with voices (or psychosis) are not intelligent and/or violent.  That’s two.