Depression and what it's really like

reason to go on living? to remember things, to be with others, to do the things that you need to do.

Get some help. Do you have a therapist or doctor you can go to? A good friend? Ask for help from someone. An excellent therapist who has really become more friend was the only person/thing in my life to keep me going at times. I'm eternally grateful to her. I hope you can find a similar life raft.

Remember above all else, no matter how unlikely it may seem now, you can live through this. One day you will feel better. Make that your goal, to see that day, and you have your reason to keep on going.

I mean, listen, I am so not trying to be cold, but I've been there. I mean, good god, the night I met my fiance I went on a complete bender, and ended up sobbing on the floor trying to slash my wrists with the first knife I could find (thankfully for me now, a butter knife - I was really piss drunk. Those things do damage though, surprisingly). And there's really nothing anyone can say or tell you is good about your life that is going to stop you from feeling that way, that's the way depression is, real hardcore depression at least.

The only thing I can tell you is that it's too soon into it to judge. If you keep telling yourself hang on for another day over and over, you might eventually find for yourself your reason to keep going. You just have to take a deep breath and say, "One more day. I will pretend to be normal for just one more day". And then say that tomorrow. And the day after. So on and so forth.

This might not help you or save you or stop you from doing what you currently seem to believe is inevitable. But it might just stay you long enough to find your way out of what's going on in your head right now.

You might want to go seek some sort of help, be it professional or otherwise, but being as I always refused to, I am being hypocritical to suggest it. I do hope you can find the strength to ask someone for help though, because once you do it really DOES help.

I'm not going to give a reason why you should go on Marcello, it'll be difficult to give a reason that you won't immediately dead-bat anyway. But, of course, you must go on and I can't think of a reason why you shouldn't.
But have you spoken a bereavement councellor at all? There are people who will understand and can help you. You have a family, have you spoken to them? It sounds trite but you aren't alone and you needen't feel alone. You just need some help Marcello, and no-one could blame you for how you feel but you must try to seek and accept help.
Thing's change. They always change.

There's all schools of thought about what happens when you die. There's all schools of thought about why there's "good" and "bad" in the world. Depressed people are usually fixated on "good", "bad" and "death", basically due to desires unfulfilled or seemingly unable to be fulfilled.

There's a bunch of people that believe a "perfect" God would somehow create a perfect entity that would turn "bad" (Satan) and convince people to doubt God's perfection (namely, by eating from the tree of good and evil), and, thereby causing this world of misery... Let's think about this for a second: perfect beings, according to this old lore, choose evil.

Why would that be?

Let's talk about reality, now, not old stories:
When everything is great, people still find much to complain about, sometimes more than people who lead miserable lives of poverty. This is because this is how the mind works. For instance, how long can you concentrate on one good thing and have it remain "good"? Everything's "goodness" and newness wears off because we live from moment to moment and it is impossible to freeze one moment of goodness in time, while continuing to move forward with our lives. Our minds label a thing as "good" or "bad" and has the tendency to move on, eager to label the next thing "good" or "bad". If you make a million dollars, you will quickly get used to the idea, rather than being fixated on how "good" it is to be rich, and you will start focusing on other desires. Whether the desire is for another million dollars or for finding someone who really "loves" you is not important. You follow your desires, and are neither fulfilled before you achieve your goals or after you achieve your goals.

Why is this?

Imagine that you attained perfection. How long would it last? Only for the moment. The rest of the time you would be trying to "freeze" this perfect moment in time forever, remembering how great it is to be perfect. But, it couldn't last and it wouldn't last. This is the way the universe works: everything is in flux.

So, then, imagine you kill yourself. Is that really the end to your misery? Science has many new ideas regarding creation of life, how the universe works, etc. One thing that sticks out is the fact that the universe has proven itself to be an intelligent system. Evolution occured, most likely, not out of chance, but by intelligent choice. The fact that the universe is nonlocal proves that everything is interconnected through some mysterious and invisible force (dark matter, perhaps?)

So, then, let's say you blow your head off. You are gone, in the mind of who you are. But, the greater intelligence of the universe still exists, and, in some way, you are part of it, you return to it. There really is no escape, except maybe from your minute perspective that currently resides in the shell of your head. Better to enjoy the individual perspective your body can provide while you have the opportunity. If you are striving to be happy, you will never be happy. You will always be striving to be happy. If you simply are happy in every moment, there is nothing to strive for... and that is the difference, as trite as it seems. Each shitty moment will pass, but it is only considered "shitty" if you choose to label it as such. So, let's say you're girlfriend dumped you... or you are ugly as sin... these are things you can dwell on or use as an opportunity to explore new things... like, dating or, if nobody finds you attractive in the least, there are many things that can fill the seeming void of companionship. After all, many people are dissatisfied with the companionship they aquire, even if they're get lots of it from lots of different people every week.

If nothing is interesting to you, seek out things you can identify with, like books on existentialism. It sounds like you are reeling from the futility of existence. But, existence is not futile. That's what it does. It just keeps existing... and there really is no escape from existence, there is only different perspectives about existence. Note: I am not suggesting you will be reincarnated, but whatever comes after death (and nobody really knows), one thing the universe shows us is that everything is the same and there is no "good" and "bad". There will always be suffering, change, etc. Be glad you are not living in worse circumstances, in the filth and ignorance of the dark ages, for instance.

because death is for wussies.

okay, two.

because you'd be insulting laura.

(when alexis was taken from me...so, suddenly, with no build up, just...alive, vibrant, calling me on her cell on the way to the airport at the beginning of the week and then...cold, in a box, made up by some ghoulish mary kay girl to recapture that flush she got when she was excited or turned on or laughing or angry or...alive...but that light had now gone out...it felt as if nine years had been eradicated from my life...i spent months feeling as if i was being cotinually...raped...mentally...and...i cant count the number of times i stood in front of a mirror...and thought...very seriously...calmly...about...doing...it...the big IT...it had never seemed so...easy...to slip away...

what stopped me?

imagining her...rage...at me doing something so stupid and fucking SELFISH...you have a fucking GIFT, man...you have the years she doesnt...you better fill them...every minute...with as much LIFE as you can...cuz like a baby you're eating for two now...and even if i ever find someone to make me feel the...unfettered joy...that she brought...i'll still be living the rest of my life FOR her in so many ways.

so don't do it.

okay?)

I still think there is not point but I'm not immobilised now. I can't tell you any reason to go on, just as I can't think of one for myself - except maybe hope and because it's easier to do nothing.

And by looking at the sky or touching a tree or digging in some dirt or lying on the grass, I am reminded that, even though there is no point, I might as well hang around and have momentary pleasurable experiences.

Shiatsu massage is one of those pleasureable experiences. Despite costing $50 and only lasting for an hour or so it may well be worth going on for.

www.shiatsu.8m.com/practitioners.htm

Go on, not because there's a point, but because eventually you'll learn to enjoy living again. I've never believed there's a point to life, but when you're not enjoying it either then it seems like you're just doing time.

I stopped wanting to do anything because no activity was enjoyable, so I had no inclination to do things. the inactivity was killing me and made it worse.

Regaining interest in things takes much healing time, but soon you become human again -- WANTING to do things. something I'd forgotten i ever did.

when you want to do something, and that thing is enjoyable, that's a feeling worth living for.

Want a hug so bad and the man won't be home for three hours. Fucking THESE DAYS. These fucking days.

::HUGZ:: come to ilx chatz is a happy fam

i give abbott hug & will not stab her man tonight even tho i want to

yes! come to chatz abbott there's lotsa love there

This book has helped me a lot.

**hug**

ILX thinks yr great, Abbs. Take that for whatever it's worth to you, you can totally pwn the next three hours.

I'd give him a call but like he needs to spend 15 minutes of work hearing me in choking sobs over the phone.

Why don't you give him a call and ask him to tell you a story, instead? That way you get to hear his voice and feel closer to him but won't feel like you're dumping on him...?

Also it will prob be a better story than the one about your dad and the birds. Because THAT'S not depressing or anything.

HAHAHAHA

I've been thinking about that one for the past few days. Why?

Hope the time passes quickly for you; depression is awful - I've so been there (not too badly lately, thankfully).

Hang in there. (And yeah, I'm sure that doesn't help much from a perfect stranger, but unless you're in southern Minnesota, it will be hard for me to invite you over for brownies or something!)

what kind of brownies

megabus is only a dollar and i'd pay a dollar for brownies.

http://forum.armedassault.info/style_emoticons/default/hug.gif

See? An hour has already passed! How you doin?

Damn this accursed MACHIIIIINE!

Just plain brownies! They are kind of fudgy - no nuts - very simple, with chocolate icing (really just chocolate chips melted with some butter). I made them because I was feeling low today.

Megabus sounds like something from My Neighbor Totoro. I must find out about it!

no weed, no visitation.

just kidding, id kill for any kind of homemade brownie right now.

and how is abbott doing now?? apparently no longer at her computer surfing ilx, which means: way better off than any of us.

I went and got a baked potato at Wendy's. Some good songs came on the radio that made me nostalgic. The nostalgia took me places I shouldn't have gone, but the potato was good. And, uh, pulling through, You guys 'r' swell.

megbus.

the bacon cheddar baked potato is the only baked potato worth having

you're crazy deeznuts. the bacon cheddar may be at the top of the baked potato hierarchy but by no means is it "the only baked potato worth having".

I am actually a fan of the potato skins with cheddar and bacon, with a side of sour cream and chives. Hit all the bases that way.

ok, fine. excuse me for being hyperbolic. the sour cream & chive is a delicious steal, & i would recommend it to anyone short of $2.49.

xp i didnt know this was possible?? i dont have a wendy's within 45 mins of me anymore tho

i know admitting it is like admitting that i enjoy the slaughter of kittens, but i have to say that i find baked potatos fairly nasty

Oh, not at Wendy's. They're awesome in diners or at home, though.

theyre mainly a starchy delivery device for cheese/sour cream/butter/etc

remy, do you eat them with like, stuff on them? cuz baked potatoes are disgusting, which is why you coat them w/ butter & sour cream & cheese & bacon, all of which are wonderful things that i fail to understand how anyone could not love.

xp tru!

fighting w/ my fiancee because i do what the psychiatrist + therapist tell me to do and she stubbornly fights them every inch of the way (we have different psychiatrists + therapists).

sucks.

Remy has v cultivated tastes, he probably likes more imaginative potato forms. I'm a simple person, though, and I like mine with lots and lots of salt and dairy product.

glad you saw what i did there dmac, because i didn’t!

ah the joy of picking up going into therapy again.

i've passed the first stage, which is trawl round the aggregator sites looking at people with indistinct qualifications, who list all forms of therapy in their biogs, and where it's clearly impossible to distinguish between them or get any sense of quality in any way. there was one nearby who looked good in terms of their experience. they were full up (obv), but did recommend me a couple of other names, which I was v pleased about, as any sort of thread through this field is welcome. One of the names got back to me, and although they haven't got any spaces right now, expects to in the next month or so, which, fine, it's not urgent and part of me is just pleased i'm moving this on a bit.

we had a initial chat and it was good. they did say they practice a 'holistic' approach, where the body is seen to be as much a part of the process of therapy as the various ways of making the mind and feelings more legible. in theory this makes total sense and would be foolish to deny; it's seems to me as reasonably clear as it can be that as an organism our emotions, memories, and thoughts - cognitions generally - are embodied and nervous and physical experiences and conditions are intrinsically psychological. i see this in myself as i recognise it in others.

However (obviously), I'm also slightly resistant: I sense 'mindfulness', and I'm wary of it, partly because I saw it appear and develop as a secularised excrescence of spiritual and religious systems (themselves complicated in terms of 'authenticity' and meaning), and meld with that recent popular form of secular humanism that's so unappealing, to me anyway.

So, some objection on broad principles that I don't like the word or what i believe to be the concept, not explicitly stated by the therapist but to me apparent. Seems a bit weak put like that tbh.

It feels like the process will necessarily be also about cognitive states and the recognition and let's say 'management' of them. Now, I've nothing against either CBT or other forms of examining mental states and responses to triggers, which may be causing... let's call it unhappiness or whatever. The identification and exploration of maladaptive cognitions.

And yet, and yet. Is it just a desire for melodrama, self-dramatisation and maybe a form of vanity that makes me feel going back and forth over the ground of how one's memories and representations - a more literary approach - is more appealing to me? Part of it, I think, is that the approach that identifies the areas of fear, tension, anxiety in my existing state may well be efficacious, and to be welcomed for that reason, but that it doesn't end up aligning with my life (put very broadly), that it lacks explanatory force, even if that explanatory force is fictional or synthetic (again, to put one objection to more literary forms of psychotherapy very broadly indeed). Or to put it another way, it seems to me that you can play whack-a-mole with the demons in your head - mole-demons - but that at some point you need to untangle and delve into the tangled roots. in which the mole-demons live. i may be oversimplifying. i'll check when ask the therapist whether they believe they can describe their method as 'whack-a-mole'. see what they say.

The therapist did say 'there's increasing evidence that we need to consider the body in terms of treatment of the mind,' which got my back up slightly. I mean, as I say, it seems more or less axiomatic in one sense, and in another, choosing your methodology may not purely be about evidence of this sort. (i obviously didn't say, well yes, physical explanations for psychic and behavioural states goes back to the dawn of time, but here let me fetch my copy of Burton). i do also realise that understanding of anxiety has improved significantly, and especially in its more extreme forms cognitive approaches have helped people crippled by specific or general forms of anxiety to improve their lives in a way that wouldn't have been possible even fifty years ago.

It's also interesting to me that I'm resistant ofc, and just going along and seeing how I get on is the obvious answer. intellectually i'm not necessarily a dualist, personally there might as well be a 12ft high prison fence between body and mind so, again, maybe it's worth exploring.

anyway, i wanted to set my thoughts down and see if it resonated for anyone. or if the general approach is fgs stop overthinking just go along and see how it is. if you want to pay to be the hero of your own story i'm sure there are places you can do that if this person doesn't provide it.

and if this is not the appopriate thread for what may be a slightly abstract discussion - i've come here before to vent and seek support and it's been a very welcome place to do so - please do let me know and i'll find another or start a new one and leave this one free for more immediate discussions.

'uh sir, is there a question here?'

i guess i'm just asking if anyone has any experience of this 'holistic'* approach and how did you find it.

*i'm not at all clear on the various disciplinary categories and definitions. as i say the self-descriptions always seem to be 'i do everything all the words below'

I think a psychotherapist might be the specific kind of therapist that’ll suit what you’re looking for?

what i'm really looking for is something that will help with underlying anxiety. what i want and what will help may not be the same thing!

Is the tl;dr version of your post that you want to do that thing of delving into your own memories and mind and just talking through stuff?

Wrt physical aspect, psychosomatic and I guess just physical symptoms are a huge component of anxiety, at least for me.

few thoughts take or leave or discuss over a pint sometime as you like

i) you really gonna get anything out of the "explanatory" method?

ii) /abstract/ does one need to feel their therapist/guide/advisor/travelling companion through a journey like this can add something they cannot themselves in order for it to not be a doomed enterprise- to bring it back to the non-abstract youd be a hard man to get and stay ahead of in that sense, is the problem then clarifying into one of having to relax into a process where you dont need to have the other party in that position but they can help anyway

iii) quite genuine, if the above might possibly be serving as some kind of block for you, one wonders if you mightnt get more out of serving in this capacity for others?

i) ime from doing psychodynamic therapy it unlocked stuff that was really important to me later on, though I didn’t realise it at the time. It set things in place for me that had been disrupted and out of sync for decades.

im irrationally annoyed youve gone back to i) there

Is the tl;dr version of your post that you want to do that thing of delving into your own memories and mind and just talking through stuff?

Yes, as just1n3 pointed out, that's what I'm saying really, isn't it. though as i say, what i want and what works may not be the same thing, in fact you *might* argue that what you want and what works probably aren't the same thing given that you're in here in the first place.

i think i massively underestimate the physical impact, gyac. see my immediate response was 'not such a huge component of anxiety for me', but then who occasionally wakes up in the night with their fists clenched? (not in anger, i should stress, at least afaict, but like my body is trying to process more stuff than it as an organism its capable).

darragh:
i) yeah, that's the question isn't it. i'm not sure - practically possibly not?
ii) hang on, i'm struggling to parse this slightly.... yes, ok, i think i've got it. my approach makes it tough for any potential therapist to contribute to my wellbeing. why not instead allow them to contribute and see what happens.
iii) it's an interesting point - i mean in a sense if that were the case, it's not a terrible idea to look around at different things, a tour d'horizon so to speak.

gyac
i) yeah, this is what i'm getting at i think when i used the word 'alignment'.

this is helpful, thanks both - helping me articulate my view of it all a bit better, and also, yes, maybe relax a bit about it.

lol. xpost

im irrationally annoyed youve gone back to i) there

"The therapist did say 'there's increasing evidence that we need to consider the body in terms of treatment of the mind,' which got my back up slightly."

I've come across this in yoga being spoken of as a holistic path to health, where it's talked about how the work on the body has an effect upon the mind. But -- even if in a yoga practice you are effectively learning to do many stressful things without any hint of strain, and part of that is adjusting your mindset -- I find the evidence of wider effects to be very anecdotal, and whenever I hear of studies on this v thing I feel scepticism rise up. But that's me trying to not read about it too much and to just do.

You can only try things. If they work you will just want to carry on doing it, where it will just feel right for you. Good luck!

i don't think i grind my teeth in sleep, though I have been on-off sleeping terribly for some time now. no headaches.

thanks xyzzzz - agreed on the generally open minded exploration being the best approach! it'll be interesting at the very least. and expensive. we'll see. once it's started i'll report back.

I have a bunch of thoughts and not many words right now

Personally, of late, I'm thinking that the processes that help me look after my day to day existence and what I might want to do to explore my underlying distress are quite different, and concentrating on the former seems to help me live much better right now

few thoughts take or leave or discuss over a pint an ayahuasca retreat sometime as you like

(i) if the underlying anxiety seems to be fairly clearly linked to some thoughts or feeling that you keep returning to, then I'd be inclined to seek out someone who works on shorter term issues and try to resolve it, and wouldn't rule out 'holistic' methods;

(ii) if's it's free-floating anxiety of origin not easily traced, then I might be inclined to seek a deeper psychotherapeutic treatment, but I'd research and 'shop around' before committing to a long-term relationship with a therapist.

xpost to NV.

that makes a lot of sense, NV. in fact i was just this second thinking anxiety from eg work, or other day to day matters may need to be separated from being middle aged and often irretrievable sad. i recognise that obviously these can be connected, but resolving the former probably gives more space for the latter, and may even resolve more of the supposedly 'profound' stuff than we may realise. at least i'm coming to this conclusion. which in part is why i'm broadly ok with an approach with which i'm not entirely in sympathy.

what was interesting to me was in the initial phone conversation with this therapist, which was very neutral, just seeing whether their approach and my needs were aligned etc, i was again in the most neutral way explaining why i wanted to pick therapy up again, and it was extraordinary how rapidly i felt myself becoming extremely upset. in an abstract sense it was really interesting. obviously in a direct way it suggest there is some stuff i need to do, to say the least.

Thanks Bob Six - that's helpfully clear thinking and makes a lot of sense, even if when I try to explore what's i and what's ii it can get quite unclear again, so that I have a iii or a i.5.

hmmm, fizzles... i haven't read this whole thread, i recommend reading "the body keeps the score" by besser van der kolk. that's the source of a lot of the recent upswing in "holistic" approaches to therapy - a growing recognition of the somatic component of psychological issues. it is in fact, at its root, an evidence-based approach and not a bunch of pseudoreligious "woo".

what i did read, fizzles, is your last post, which i think is really... i mean, honestly, i think you're in a good headspace. when you say "in an abstract sense it was really interesting", that's actually what's referred to by mindfulness. it's non-attachment. you're observed your emotions without making an intellectual judgement on them or giving in entirely to those emotions. i kind of hate saying that because it sounds like one of those stupid gotchas, "you're doing mindfulness already!", but it just resonates _so hard_ with my experience of practicing mindfulness - which, i do want to note, is _not a religious practice_ for me. i'm doing it entirely as an empirical practice.

so if you're looking for recommendations i'd say... continuing along that path for yourself. observing your feelings, your behaviors, and what causes them, and, after taking time to reflect on the evidence, acting based on that evidence. whether you call that "mindfulness" or not (i do), i think that's a good way of approaching things... figuring out what makes you upset and anxious and figuring out what approaches are most effective against the distress you experience.

I am worried about what mindfulness is turning into as it becomes embraced by psy- instititions and capitalism ... I can see a version of it being very compatible with the neoliberal bootstrap approach to mental health and being prescribed as a cure all much like CBT has (it's also "evidence based" and probably even cheaper) and also like CBT in that you can just blame the patient for not engaging properly if it doesn't take

that's my cynicism and anxiety but all that aside a lot of things under that umbrella have really helped me a lot esp the breathing exercises (which are probably as old as anxiety) and my belated realisation that mind-wandering is not "doing it wrong" and is just part of the practice. something to return to is always good to have ready when that happens whether it's breath, feet/body on the ground, mantra, whatever feels most grounding... I try not to get hung up on the religious / non-religious aspect since religion is a concept we apply pretty arbitrarily in this allegedly secular age

as far as body/mind idk what category this falls into but I recently had what I thought was a depressive episode that turned out to be a strong reaction to the clonidine (blood pressure meds) I was prescribed as a newish treatment for insomnia... they worked much too well so I'm reducing dosage but the fact that I thought I was just depressed (I probably am but not usually in a totally catatonic bedbound way) says... something. idk what

I really feel the short term treatment / coping mechanism being different from what might help in the medium/long term thing but I don't know the answer to that

Again, a lot of thoughts and insufficient patience to express them but absolutely Left, the language of mindfulness and self-awareness in general has been poisoned by a capitalist ethos that's jumped on it to justify individuation and the denial of our collective life. And it sucks

my bad mental health has always felt intensely physical btw

same which i thought was an autistic thing but maybe it's the same for everyone and that binary just forces us to separate the symptoms conceptually in a very artifical way? idk

The language of mental health is very badly conceptualised on many levels I think. Social construct innit?

I am worried about what mindfulness is turning into as it becomes embraced by psy- instititions and capitalism ... I can see a version of it being very compatible with the neoliberal bootstrap approach to mental health and being prescribed as a cure all much like CBT has (it's also "evidence based" and probably even cheaper) and also like CBT in that you can just blame the patient for not engaging properly if it doesn't take

mmmmm, sort of? the thing about a lot of this mindfulness stuff is that a lot of it comes out of the framework of Dialectical Behavior Therapy, developed by Marsha Linehan in the '80s and '90s... I don't think the dialectics in question are explicitly Marxist dialectics but they're not _not_ Marxist dialectics, iykwim? and what's happening with DBT is sort of the thing that happened with CBT, that people take this entire clinical approach and reduce it to photocopied worksheets, because the full approach is really expensive. to me that's not a question of deliberate _perversion_ but simply the _inadequacy_ of capitalism to deal with the reality of the mental health problems caused by oppressive institutions like, uh, capitalism.

i actually don't know much about marxist dialectics but to me dialectics is important because it's a way of reconciling opposite forces that _doesn't_ rely on the neoliberal approach of compromise and centrism. but it's a real struggle, it's a real struggle to do therapy within the context of capitalism because you are dealing with systemic oppression that's affecting _everyone_ and an individual response is never going to be adequate, there is not individual liberation from the forces of oppression. that said at least in the therapy circles i run in there's an implicit understanding that people in therapy _are_ dealing with systemic forces of oppression and that those forces of oppression are outside the scope of the individual, or any individual-focused therapeutic system, to resolve. that's where a lot of what's called "radical acceptance" comes in. radical acceptance, again, speaking as someone who's done a lot of DBT it's not "and that's OK" or whatever. it is sort of the 21st century version of the serenity prayer (the one that in its trans version goes "Lord, give me HRT to change the things I can and THC to accept the things I can't") but more in the original historical sense, in that reinhold niebuhr was responding to systemic fascist oppression and economic injustice.

the thing about "evidence based" is for me it's not a buzzword, it's another way of saying "material conditions". for me as someone who works in healthcare "evidence based" means doing things like acknowledging the racial disparities in health outcomes, the systemic bias inherent in things, and looking for ways to address those issues.

as far as body/mind idk what category this falls into but I recently had what I thought was a depressive episode that turned out to be a strong reaction to the clonidine (blood pressure meds) I was prescribed as a newish treatment for insomnia... they worked much too well so I'm reducing dosage but the fact that I thought I was just depressed (I probably am but not usually in a totally catatonic bedbound way) says... something. idk what

personally a lot of where my ideas of mindfulness and somatic practice come from stems from my lived experience... like my gender dysphoria manifested as dissociation and depersonalization (as well as lots of depression, anxiety, etc.), and that did inflict long-term trauma on me, and HRT changed things completely to where my body now feels like _my body_, i have this persistent sense of embodiment. for myself, as a trans person, HRT was the single most effective thing i've done in terms of mental health treatment. of course not everybody has access to that through official medical channels, but at this point i do think DIYing can possibly be a net positive choice. if anyone here has questions about that side of things my DMs are open.

I really feel the short term treatment / coping mechanism being different from what might help in the medium/long term thing but I don't know the answer to that

― Left

most of the mental health peeps i know when talking what will help in the medium/long term do have a pretty good idea of the answer, and it's "communism". but, again, systemic forces, etc, etc, i'm not personally going to make that happen, but hey, we're all doing our part.

Incredible insights regarding DBT and mindfulness, Kate, thank you, and also I love the trans serenity prayer omg

My big annoyance in doing CBT for over a year was running into the inevitable "final problem" with the approach: there comes a point where CBT, which has spent all its time attempting to convince you that all your anxieties are illusory, and distortions of actual-reality, falls short in addressing "the brutal truths of one's existence". That's where DBT and mindfulness come in... training your brain and body to accept the brutal truths.

Personally, I think mindful meditation should be taught in schools, as part of phys. ed., that even the most entry-level understanding of what-it-entails can change the way one walks a block, or swims, or runs, or rides the bus, or engages in any moments of solitude (where the mind may have a tendency to ruminate). A friend who was highly-invested in her own mindful meditative practice told me that in certain languages, the terms for "meditation" are virtually interchangeable with "exercise", that its as important a component of one's daily upkeep as eating, sleeping, exercise, relaxation, etc.

yeah i like that last post Kate and i agree with what i *think* you're saying about the need to be thoughtful about he we react to things that have been corrupted by capitalism because, yes, capitalism corrupts everything. it made me think about how Deleuze & Guattari talk about concepts as tools, which seems to me like a way of trying to remove ideas from the ownership of ideology - ties in to how they reject the concept of ideology i guess

a mindful approach to mindfulness gods help me but yes, i don't want to reject any of those ideas out of hand no matter how much the language of corporate self-idealization makes my gut grumble

This is just my experience and what I’ve seen happen with a couple of people close to me but: anxiety is exhausting, and often doing the work to try and manage it is also exhausting and then you become so exhausted that you can’t hold the fort against the anxiety and it just gets worse and worse, and the mental work to manage it gets harder and then the exhaustion increases and the cycle continues, round and round until you feel like you’re gonna die - especially if your anxiety manifests as loss of appetite and insomnia. If you can find the right medication that works for you (which tbh can also be an exhausting process) it can interrupt that cycle and give you the space to do the mental work.

I have done that occasionally but never on purpose and I haven't found a repeatable formula for it

which isn't to say there aren't interventions that could make that more or less likely to happen but they're probably different for everyone (or even for the same person next time round)

too much to respond to immediately, but i did want to pick up on this

what i did read, fizzles, is your last post, which i think is really... i mean, honestly, i think you're in a good headspace. when you say "in an abstract sense it was really interesting", that's actually what's referred to by mindfulness.

thank you, first of all, for your thoughtful post(s). second, yes, i should stress that my mental state right now is not terrible. you do come up against the edge of things sometimes though. and i’m guilty of only paying attention to my mental health when it’s bad or when i’m over that edge. i want to contribute to it when i’m not in a hole and corner situation. hence this process and thinking through things now. hopefully shoring things up against harder times.

"hmmm, fizzles... i haven't read this whole thread, i recommend reading "the body keeps the score" by besser van der kolk. that's the source of a lot of the recent upswing in "holistic" approaches to therapy - a growing recognition of the somatic component of psychological issues. it is in fact, at its root, an evidence-based approach and not a bunch of pseudoreligious "woo"."

I read this feature about it last year and I got the sense that it's a pretty contested notion.

https://nymag.com/intelligencer/article/trauma-bessel-van-der-kolk-the-body-keeps-the-score-profile.html

The language of mental health is very badly conceptualised on many levels I think. Social construct innit?

what field of professionals exists where the vast majority of practitioners arent in it performing the role as handed out to them in a safely approved guidance manual reviewed every five years by deloitte tho

im not crying out for the robin williams mouldbreaker therapist lord forbid but 8 times outta ten your gonna get a template applier right? in most fields?

is my feeling yes. i think the framework is very lacking in mental health.

if - peers at screen - i’ve understood you correctly anyway.

I acknowledge no peers

as far as the profession internationally is informed by the successive editions of the DSM, i'd say it's an unusually labile framework compared to the majority of technical professions

psychotherapy as a field is something broader than that tho, and certainly doesn't belong wholly to the world of the medical

as far as the profession internationally is informed by the successive editions of the DSM, i'd say it's an unusually labile framework compared to the majority of technical professions

psychotherapy as a field is something broader than that tho, and certainly doesn't belong wholly to the world of the medical

― wang mang band (Noodle Vague)

the main way it belongs to the world of the medical is when it comes to getting paid... the thing that makes the MH field interesting, from a US-based perspective, is that the majority of the field is solo practitioners. you go to see a doctor, even if they're a solo practitioner they have an office staff who take care of billing insurance and making appointments and all that stuff. MH professionals are doing all that stuff themselves, most of the time.

which means that the ability of something like the DSM or whatever to enforce hegemonic MH standards is kind of limited. first off the DSM isn't a billing standard... like it can set up whatever diagnoses it likes but for someone to get paid they're gonna be billing, in the US it's probably gonna be CPT codes, and these are a standard set of CPT codes for therapy. honestly one code, really, you're just gonna submit 90834 probably, and then the insurance company is gonna want a diagnosis, and that comes from a _different_ set of standards, that's the ICD-10. this is where it gets tricky because american healthcare is fucked, right? this is why it's hard when therapists bill their own codes. so say you're treating someone with gender dysphoria, and you're in, like, tennessee or texas or something. see, where i'm at, here in oregon, it's probably fine to bill F64.0... that's not actually "gender dysphoria", there's no billing diagnosis for "gender dysphoria". gender dysphoria is in the DSM-5, but you have these list of codes from this standard that they came up with in, i don't know, probably the early 2000s, and so the diagnosis code they're gonna bill for me is "transsexualism". and you know what, fine, they're working on a draft standard for the ICD-11 which the AMA will spend another 20 years fighting because it makes it harder for their doctors to get paid, in the meantime you use what you have available. except, i mean, if you're a therapist treating someone in texas maybe you wanna use a generic F32 ("depression") code. because maybe there's some fucking law in place that makes it illegal to pay for it, or maybe some insurance company has some policy in place saying that they don't pay for gender affirming treatment, or whatever the fuck. it's a fucking pain in the ass, billing insurance, which is why most providers don't do it themselves, they hire somebody else to do that bit for them. therapists, though, they don't have the resources that an MD does so they're stuck doing it all themselves. i'm not a therapist, but part of me thinks dealing with the insurance companies might be harder in some ways than dealing with the clients. i mean you're treating somebody for mental health issues and at least they mean well, you can't really say that about insurance companies.

this is kind of a... i'm kind of into the weeds here on this, and i'm not doing it from a clinical perspective because i'm not a clinician. this just happens to be my professional background, figuring out how the hell providers can get insurance companies to pay them for the work they do. and i think that's important because it comes back to something that is kind of unavoidable when talking about any kind of health care in the US, which is to say that the whole thing is completely and utterly fucked. the idea of anything in american healthcare being done based on a safely approved guidance manual reviewed every 5 years, that's just so far removed from the reality of things here. it's really hard to follow a system when the system you're supposed to follow is completely unworkable, you know? you kinda have to just improvise things sometimes.

which makes it in theory high-risk because you never know when you might run into a dr. eugene landy, but usually? usually those providers aren't therapists. usually they're the ones doing the prescribing. i've had therapists that worked out well and therapists that didn't, but when in terms of going through medical abuse, which i have gone through, that wasn't something i ever got from therapists.

idk i guess that's kind of a ramble, i got a... lot of experience with mental health, and mostly it's as a patient, but shit, you spend a long enough time around these kinds of places you sort of pick up a thing or two. particularly since i do have some professional understanding of how the donuts get made.

now, how that all plays out in Canada or the UK or whatever, i don't have any idea. really my only experience is within the US.

That was a great post Kate! I totally appreciate the “code compliance” issues.

Most days I’m good at just suppressing it and “carrying on”, as it were, but then it sneaks up on me and hits me all at once to be reminded of how much it sucks to not have any good friends.

I’ve written a much longer post about 8 times, but it all feels kind of futile and doesn’t get the point across well. I’d kill to even have one of those text groups I’ve heard about where friends bullshit with each other. Sounds cool.

Hell, I’ve been posting here for the better part of two decades and I don’t have a single one of you I interact with outside ilx (I mean, considering how often my threads sink to the bottom, it’s not like I actually “interact” with many of you on here either lol). Yet I stubbornly persist.

sorry man

I'm glad you're here jon. I don't actively post on many threads and I lurk on maybe a couple dozen, but your posts on the annoying coworker threads get me smiling and shaking my head in recognition and commiseration every time.

Most days I’m good at just suppressing it and “carrying on”, as it were, but then it sneaks up on me and hits me all at once to be reminded … Hell, I’ve been posting here for the better part of two decades and I don’t have a single one of you I interact with outside ilx (I mean, considering how often my threads sink to the bottom, it’s not like I actually “interact” with many of you on here either lol). Yet I stubbornly persist.

Jon, I hear you. I often think to myself who I would call if I were in trouble or needed someone and the answer is always "shit, no-one". Then I get depressed and this is exacerbated by remembering how I don't have anyone to call when I'm howling and crying and then I howl and cry more. Then I fall asleep and I wake up and it doesn't matter until I start remembering it again hours or days or weeks later. It just sneaks up.

Sorry, didn't see this had been bumped. Appreciate the thoughts.

It's just been hard, as my son has gotten older and is spending more time with friends and I've found a little more free time, the lack of friends has become more glaring. I keep thinking, "hey, it would be cool to go see that band with someone" and then remembering there are absolutely zero people I could reach out to for that sort of thing. Not that I'm afraid to go to shows solo, I do it a lot, just would be nice from time to time to go with someone to talk about it with afterwards or w/e.

Part of the challenge, beyond just how hard it is to make friends as an adult, is that most of my interests don't alight with chances to get to know more people, even those who share said interests.

Not going to most of the gigs I'd like to go to is a thing I accept nowadays to the extent I mostly forget that I could even go on my own. I just...don't do stuff.

^^^
i used to buy advance tickets in an effort to make myself go, but soon realized it was just a waste of money

hey jon, i just wanted to say that i really appreciate the breadth of your knowledge and your generosity on ilm, and all the times i make a post about a random harder rock band and see an enthusiastic response from you it raises my spirits. you rule!