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When I spent three months in residential treatment back in 2010, the clinicians would frequently encourage the other patients and me to communicate and honor our needs. This practice was meant to teach us how to separate our own inner voices from the control and influence of an eating disorder. As well-intentioned as these clinicians were, however, I remember asking myself: "How can I learn to express my needs if I'm not sure what they are?"
One of the best pieces of advice I've ever received was to stop trusting my emotions, which means, don't trust my gut. I had gone to see an acupuncturist with a strained back and an abundance of curiosity. He palpated my ovaries, eyelids, and the like for a half minute before diagnosing my issue as one of emotional over-indulgence. He stuck a couple of dozen needles in me, left me alone for 20 minutes, and returned with his treatment plan. "You shouldn't trust your gut so much," he suggested and sent me on my way.
One of the hardest things about any mental health condition is that they are unpredictable. The same thing is true at my job. Some days are very difficult because of the anxiety and depression I feel at work. However, several activities make it easier to get through my shifts. Here are six strategies that help me overcome anxiety and depression during my job.
As soon as puberty kicks in, many of us lose self-esteem. Many physical, emotional, and psychological changes begin to take shape during this time, leaving us confused and extremely sensitive. As our bodies change, so does our self-esteem, leaving us vulnerable. Even fully understanding that this is a perfectly normal part of life that everyone goes through didn’t make it any easier for me. Puberty was a time in my life I think back to and wonder whether anyone handles it any better than I did.
I talk about eating disorder recovery all the time. You might call them healing conversations. I unpack the layers and nuances of it with my therapist. I excitedly share these revelations with my partner once the session is over. I journal about what I'm learning in the process. Then I pass on those lessons to the younger women I mentor, who deal with similar experiences of their own.
Every hello ends in a goodbye, but every ending is also the beginning of something new. This will be my last post for "Speaking Out About Self-Injury." What will life be like after writing for this blog?
If your childhood included kids teasing you, an adult might have explained that they teased you because they liked you. I'm not sure when affectionate teasing and verbal abuse evolved into a well-known sign that someone likes you, but it should stop.
The transgender experience can be lonely. When I first began hormone replacement therapy, my doctor asked me if I had a good support system. I lied and said I did because I didn't have the time or energy to join a support group and didn't want to cause worry. Now, I think about all the hands that have reached out to me in the past that I brushed off. I believe loneliness was caused by my self-imposed social isolation. 
I’m still struggling with the negative self-talk that often comes with depression. Many of you have probably experienced this in some form or other—a nagging voice in the back of your mind that fixates on all things negative, constantly reminding you of your failures and flaws. For me, this voice is especially frustrating because I know it isn’t logical. I have, overall, a happy and fortunate life. Yet sometimes, I can’t help feeling defeated or worthless over a relatively minor event, like forgetting to run an errand or even burning the toast. When depression rears its ugly head, my negative self-talk magnifies the smallest perceived failures a hundredfold. 
It helps to know the difference between paranoia and anxiety. If I am experiencing paranoia, it involves delusions like someone is out to get me (suspicion and distrust) or has betrayed me. I frequently battle the delusion that someone is poisoning my food. My paranoia can cause anxiety, but the two do not have to be present together. My anxiety attacks often have ties to worry (like health concerns, the health of a loved one, public speaking, etc.), but not always. I can have an anxiety attack where I can't identify a triggering cause.

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Paula
I have a lifetime of trauma and BPD and depression & anxiety and i can really identify with everything you have said chronic low self esteem and believing i nothing worthwhile to contribute to any conversations in social situations, iv grown up believing i was a bad evil person who doesn’t deserve anything good that life has to offer, even when im with my family i again feel like im an outsider and all the above caused me to isolate for 16 years and this made my situation a million times worse when i came back into society only months ago, im absolutely filled with Paranoia and i dont feel safe around humans unless im with 2 people that i can sort of connect with but its not often this happens and on any given day im that terrible or feel unable to have a conversation with people i can retreat to isolation again which again makes me worse everytime, i feel like i suffer if im out with people and i suffer if i isolate, im just constantly in a state of anxiety and terror and it paralyzes me and makes me brain shut down where i cant even think of a sentence to strike up a conversation with people, it’s absolutely horrendous and all the negative things my head tells me about myself it’s disturbing! I wouldn’t talk to anyone else the way i talk to myself but i just dont know how to stop it its been so ingrained in me for at least 4 decades now and im 45 years old.. i keep hoping one day it will get easier, but my heads such a mess, honestly and im not a bad person, iv just had a lifetime of trauma since i was a little girl that it completely changed me, that I don’t even recognise myself and neither does my family or anyone who knew me, but i might have more serious mental health iv just never been able to get out the house to go to mental health assessments.. but i wish you all luck!
Anonymous
Hi I'm 15 and I have severe anger issues that I can't control. I don't know why I am like this but when I am super mad I like to punch myself in the head repeatedly until I pass out and I sometimes slam my head against the wall. I used to cut but I try not to. I would just take scissors and you know, snip snip. I think this started when I was younger- around 12 years old. I always thought about sh but now I actually do it. I wish I had never started because once you start you can't go back. It's like a one-way road. There is no way you are going back to where you started.
anon
I do not have a BPD diagnosis (or think I should), but I can relate to much of what you're saying. I had a parent who was bipolar and struggled with addiction and who ultimately died when I was in my twenties. My other parent was extremely religious and I was raised in a controlling and punitive environment. I am extremely codependent on my intimate partners but can simultaneously hold others at a distance when I feel overstimulated or just want to be alone. I too am very triggered by perceived abandonment and really struggle to communicate with others because I feel too much too intensely and cannot make others understand it..I don't always understand it. Despite all of this, I feel very triggered by this post?? I have a friend who also struggles in the same ways I do, but I suspect it is much worse for them. I notice they ALWAYS have plans even when they feel burned out because they are terrified of being alone. We used to be very codependent on one another but now I find myself keeping my distance. And sometimes for unrelated reasons, I have to cancel plans. OR I will state upfront that I tentatively agree to the plans but reserve the right to cancel if I don't feel up to it. I don't know if that makes me a bad friend or not; I have been in counseling for years learning how to hold space for both myself and others. And sometimes that looks like cancelling or rescheduling. I know that this is a trigger for my friend- they not so casually mention other "flaky" friends in conversation- but at what point am I supposed to cater to someone else's (sometimes irrational) needs at the expense of my own peace? Why do I have to give you a play by play of my thought process (and maybe a doctor's note) to get out of doing something? What's an acceptable reason to cancel? This friend recently encourages me to just say I don't want to do something (almost aggressively mind you), but when I do, I feel like I get the silent treatment or otherwise passive aggressive responses. And I am constantly hearing stories about this person's disappointment in other friends who cancel or are perceived as flaky. I want to give them space to process their feelings about cancelled plans, but sometimes I feel annoyed and overlooked. Like their pain is more valid or important than my own. I have not had the courage to talk to my friend about this but feel I need to soon or else I will continue to harbor resentment. Anyway, I know there's room for all of us to feel our feelings but it's so hard to navigate right now. I have been a caretaker in one form or another my entire life. I really need to take care of myself and not feel guilty about it. The end!
Mj. Bean
You're definitely not alone. My boyfriend has DID and more often times than not, we dont get throiugh the day without arguing or disagreeing at least once. I'm head over heels in love with "Super Max" which is who he basically is when he reaches this sort of "peak performance" and the "lesser" maxs' are the ones that can get downright insane. One talks like an 8 year old, another one acts like he's around 20 years old. I didn't have any idea he had this until we were 3 months in and i had already fallen hard for him. Most days he's in "annoyed/angry max mode" where he is literally the biggest control freak on the planet. Obsesses over silly things like "spilling" things and such. It can be exhausting but the violent max is the one that, while i rarely see him, he's still the only one i dread and have only seen a handful of times.

My point being, I'm right there with you. I hate the rollercoaster. I just want to live life without being in a state of constant fight or flight mode, only for his character to change and de-escalate and I fall for the person I fell for all over again.
Exhausting is a horrible word. The understatement of all understatements, if you will.

I wish there were better support groups for this kind of mental health condition.
midnightvibes
I’m so sorry that you’re going through this. It sounds so difficult and I can’t imagine what it must feel like. I know what it’s like to feel like no one in the world cares, that they’re all just caught up in their lives, and I’m so sorry that you’re feeling that way. I would just say stay strong and seek the help you deserve. You deserve to be alive in this world. Even if it feels like you don’t, you 100% do. I don’t know you but I can tell from this post it’s seems like you are resilient and care about others and have some hopes for the future. Stay strong friend, seek help if you are able to, and have hope if you can. I believe in you so much <3