My new skill

If anyone read my posts last May or whenever I began writing for Depressed Academics, you would know I was having a really hard time emotionally. Here I am a year later and I have to congratulate myself on something in particular: my new skill of sitting with uncomfortable feelings without being destructive or resorting to some form of escapism.

Truth be told, I am having a pretty hard day today. I've been experiencing mixed states-- a combination of an elevated/anxious mood and symptoms of depression: crying, isolation, etc. Mixed states are probably my least favorite mood state(s) because they can be so unpredictable. The last several days, I was in a hypomanic state-- which was pleasant initially. However, underlying the pleasantness was the knowledge that at any time, I could tip into a more severe manic form. I had been monitoring my moods carefully, ensuring not to get too overstimulated either by drinking too much caffeine or being around too many people as these things can definitely heighten my mood. Making sure I got my sleep, doing my deep breathing. The basics.

I noticed my mood shifting earlier today, however, due to family stuff, I had to keep myself composed. Be strong. Be the rock. After all, some members of my family are having their own issues-- whether its financial or emotional. So I was there for them as they had been for me when I was going through my breakdown last spring and summer. The problem with "being strong" when you feel like crumbling is that at some point, you have to release those feelings. Alternately, you can avoid them or overeat or oversleep or drink a beer or a lot of beer and forget. These things are what constitute escapism.

I released my mania last spring when I went crazy in the city of 2. I was in a similar situation I as I am now. Living at home with family and in a hypomanic state. I have a tendency to "let loose" emotionally in environments and people I'm most familiar with. So when I was invited to visit my friends in the city of 2-- a place I had lived for several years before moving in with family -- I decided to go even though I had a feeling it might disrupt my moods. In fact, I went because it would disrupt my mood. Let me explain. Physically, I felt I had to release all the built up energy and neglected emotions. This wasn't my cognitive process- but rather something like muscle memory. In other words, I knew (somewhere inside of me) I was about to go crazy and I needed a safe space to do so. So I chose my safe space to be with my two closest friends at the time. However, since this wasn't a cognitive process, I didn't think that they might not be equipped to handle my emotional state. And that's when things got complicated.

Back to my new skill. I am feeling really shaky in the sense that at any moment I could teeter on over to mania's side or worse, a severe mixed episode. But instead of indulging in that drink or another destructive behavior, I've been sitting with my feelings. Figuratively and literally. For instance, I've been communicating with my family and being assertive about my needs. Earlier I told them I needed to stay home to unwind, relax. When I was back at the house, I ended up calling a friend and talking out what's been bothering me. But instead of completely "letting loose" with my friend, I kept the conversation to a specified length and told her that if she had to go at any time, to let me know. By establishing those boundaries, I didn't overwhelm my friend. Additionally, I have been invited to visit the city of 2 recently--invitations I've rejected for the simple reason that I actually do not want to disrupt my moods this time, intentionally or not.

The good news in all of this is that I see my psych doctor later today. The other day I wrote out a list of all my questions relating to my my anxiety, irritability and elevated mood. I do have some speculation as to what triggered this emotional state so I'll be bringing up those concerns and issues as well. Just knowing I see my psych doc is comforting and reassuring. Because I've gone through this before, I know the drill and I'm prepared. Despite this difficult and painful state to deal with, at least I know that I do have resources here to help.

Before signing off, there's an adage that just seems too fitting not to reiterate. I feel like people with a mood disorder know this one best: this too shall pass. If I had a penny for every time I heard someone say that in response to a difficult situation! But what I'm trying to say is that if I could sum up all my lessons into one remark about the malleable nature of moods, that adage would be it.

I'll keep you updated.

You know, the usual: mood swings, self-improvement and questions

I feel like March has been one big self improvement month yet when I look back at my emoods app with the record of my highs and lows, this month has seen the most mood fluctuation. The emoods app I use is pretty basic. It tracks my hours of sleep, whether I've taken my medications and what degree I've experienced depression, irritability, mania or anxiety. I like mood tracking because it can lead to seeing patterns I normally wouldn't if I just went day by day. The pattern that recurs most frequently is the correlation of higher hours of sleep with either depression or irritability. In the beginning of March, I was sleeping on average 10 hours a night or more. I've been trying to get my sleep down with some success. But I feel like I really have to make an effort to manage less hours.

The last couple of weeks I've been exercising more. I've even started jogging about a mile a day. I also made a schedule for listening to my mindfulness/relaxation exercises, which I've been following semi-regularly. This past week I've done acupuncture twice- though not so much for my mood but to aid with smoking cessation. Finally, I bought a lovely little lavender eye pillow to chill in the freezer and put over my eyes when I meditate. I guess my goal for all these things is to get in to relaxing and self-soothing habits for when I eventually begin to experience higher levels of stress. Right now, my stress levels are pretty low with not being enrolled in a university and all.

I am pretty sure I posted this link in another one of my posts, but here it is again:

http://www.dartmouth.edu/~healthed/relax/downloads.html

(Those are some of the guided relaxation exercises I've been using.)

Anyways, I'm not really sure of what to make with my moods fluctuating as they are. I do seem to "bounce back" easier than before. They aren't severe mood swings, definitely more mild than I've seen. Probably due to experiencing less stress. I see my psych doc in May, and I've been toying with the idea of proposing we begin to lower the Abilify. Of course, being mindful of my (mild) mood swings, I wonder if I should postpone my proposal. My reason for wanting to taper off the Abilify is related to the weight gain/maintenance issue. I'm off the Depakote. I saw a dip in my weight and now it's creeping up again. I dislike feeling so vain about the weight issue, but it is very important to me. My BMI is 29, which falls in the overweight category. GRR!!

In regards to returning to my PhD, I still become very anxious and worried when I think about it. There is some lingering uncertainty. Nevertheless, I am happy I've been returning to my skills in order to help ease the present emotions as well as prepare me for whatever happens next.

Now to some questions to my fellow contributors of Depressed Academics and/or readers of this blog:

1. Are you currently therapy and what type? Does you feel it helps? I ask because I've kind of dismissed the whole therapy thing this year. I feel like I've learned what I can learn from therapy and now it's up to me to be my own therapist...

2. Do you use mood tracking? If so, what kind? Maybe we can get a running list in the comments. I did once do the paper mood tracking but I much prefer apps with the ability to see a graph from my input. I do, however, feel like my mood tracker doesn't account for other variables that would affect mood.

3. Finally, for those on meds, how do you determine whether it's a "good" time to change medications? Of course, I understand this is deeply personal and to be discussed thoroughly with a healthcare provider. I'm just curious to see what intuitions and approaches other people use.

As a concluding tangent, I want to acknowledge all those out there who are currently in a degree program- whether it's a BA, MA or higher and who are currently dealing with emotional issues. I look back at my academic performance and career and I wonder how the heck I did it. But even more so, I wonder how I am going to continue doing it. Right now, I feel scared and uncertain. My fear is deeply rooted in my health concerns. It's also weird because so rarely people in one's program acknowledges mental health concerns. So thanks again, Depressed Academics, for reminding that depressed people do exist in the university sitting. Moreover, that they are rocking at it too.

Til next time!

[LINK] Academia Is Killing My Friends

http://academiaiskillingmyfriends.tumblr.com/

Gathering anonymous stories of issues in academia — including harassment and mental health.

Decisions, decisions, decisions

It's been almost two months since my last post. I did make the switch to Tegretol and am now completely off the Depakote. I would say the transition has been successful. No strange side effects. No major setbacks. Moreover, my mood has been fairly consistent.

Since taking a medical withdrawal, I kept in touch with my advisor from the University. In mid March, I will be coordinating with faculty and my doctors to get my documentation together for the readmission process. A couple months ago, the thought to return was scary and brought much stress. In order to sort my thoughts out on returning I took up a suggestion of a previous therapist to create a CBT grid listing the disadvantages and advantages of going back to my PhD versus not returning. I won't reproduce the whole list but this was kind of the gist:

Advantages of returning to my PhD:

• Tuition covered plus stipend 
• Support from doctor, therapist and program
• Many opportunities I wouldn't otherwise have
• Passionate about the field of study
• Job opportunities
• The possibility to travel and do research
• Strong program and responsive and dedicated faculty

Disadvantages of returning:

• PhD programs are high stress and have high expectations, which could be a strain on my health
• Worry that I'm unprepared and/or made a bad first impression
• Might have to go back on a higher dose of medications or even make a medication change
• My current support won't be there

After writing up the list, I didn't look at it for sometime. Lately though, I've been reading and rereading it daily. Whereas there is a variety of advantages to going back, the core of the disadvantages centers around my health. I have never ever felt like my emotional dysregulation disabled me. It never felt like a crutch. Or something which held me back. But it's pretty obvious from looking at my list that my health concerns are a factor in whether or not I return to my PhD. 

It's crazy to think what this list might look like had I not had these health issues. But then again, I wouldn't have taken a medical withdrawal if it wasn't for my health. I could wonder what life would be like if it were only a little different but I don't think that kind of thinking would help my current situation much. For now, I'm clinging to my list. And taking it day by day.

The three difficulties; and self-esteem

I went out with friends tonight, mid-conference, to a pub I like here.

About three beers down, the conversation turned to mental health, and coping strategies, and related subjects. I started talking about my issues in the past, and present, and how I am now in the habit of consciously reminding myself that whatever my internal commentary track is telling me might not be the ground truth.

At this point, a (buddhist) good friend of mine interrupted me and told me about the Slogans of Lojong, and specifically about this one:

Train in the three difficulties

The first difficulty is to even see a neurosis for what it is. The second is to be able to deal with the neurosis, and the third is to deal permanently with the neurosis

(paraphrased from my friend's explanation)

He pointed out that my even being able to recognize my mood spirals for what they were, and able to try to tell myself to temper my trust in my intuitions based on my impression of my depression talking over my more sensible thoughts was already achieving the first of the Three Difficulties, and for him an ability well worth respect.

It is very helpful, at times, to be reminded that as far as I may feel I have yet to travel to some sort of sensible, workable, harmonious end-state in my relationship to my depression; where I am now is significantly further along than where I started.

 

Link: On Depression, and the Toll Academia Exacts

Jacqui Shine writes on depression in academia

Here's the thing, though: Graduate school doesn't make me depressed. Depression makes me depressed. 

Researcher Development assistance

http://www.theguardian.com/higher-education-network/blog/2014/mar/01/mental-health-issue-phd-research-university

The Guardian writes about mental health support system in universities for PhD students and academics; and the culture they need to overcome just to even reach the academics they could help.