How Anxiety Affects Bipolar Disorder

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Bipolar disorders and anxiety are frequent bedfellows. In fact, anxiety and anxiety disorders occur in more than half of those with bipolar type I, according to the paper, "The Importance of Anxiety States in Bipolar Disorder."1 And I am one of those who experience anxiety in bipolar disorder. Whether your anxiety comes in the form of a specific disorder, or it's just symptoms of anxiety, I can attest to the fact that anxiety affects bipolar disorder, and it's not in good ways.

How Anxiety Affects My Bipolar Disorder

I suppose I should say that anxiety affects bipolar disorder, and bipolar disorder affects anxiety. Both sides of that relationship are difficult to live with. I find that anxiety tends to be the worst during bipolar mixed moods, and it makes those mixed moods worse. A mixed mood is when you have symptoms of mania or hypomania at the same time as symptoms of depression. And when you have anxiety with a mixed mood, it seems to turn up the symptoms of that mixed mood. Anxiety seems to increase my physical and cognitive agitation (known as psychomotor agitation, a depression symptom) a lot and, well, makes me want to rip strips of my skin off using my fingernails -- while pacing rapidly, back and forth,

The anxiety in bipolar also seems to interact with racing thoughts (a symptom of hypomania or mania) such that my racing thoughts become almost exclusively anxious ones.

All in all, anxiety does not have a positive effect on bipolar and bipolar disorder doesn't have anxiety either. I find the combination very difficult to live with.

How Rest Affects my Bipolar and Anxiety

Rest, sleep, is universally helpful in whatever ails you, in my opinion. And I know that for me, sleep is critical to bipolar disorder wellness. I have to prioritize over almost everything.

That said, my experiences with sleep and anxiety are different. Watch this video for information on how rest affects my anxiety:

How Anxiety Affects Bipolar Disorder and Suicidality

And while we're talking about anxiety and bipolar disorder, I think it's important to point out that anxiety in bipolar disorder can actually increase suicidality and risk of suicide, although the specific relationship is unclear. One paper states:2

Lifetime anxiety disorders were associated with a more than doubling of the odds of a past suicide attempt, and current anxiety comorbidity was associated with a more than doubling of the odds of current suicidal ideation. Individuals with current anxiety disorders had more severe suicidal ideation, a greater belief suicide would provide relief, and a higher expectancy of future suicidal behaviors. However, some of these associations appeared to be better accounted for by measures of bipolar severity including an earlier age at bipolar onset and a lack of current bipolar recovery. Comorbid anxiety disorders may play a role in characteristics of bipolar disorder that then elevate risk for suicidal ideation and attempts [bold mine].

Of course, I don't care if anxiety makes bipolar worse and the worsened bipolar then increases suicidality, or the anxiety increases suicidality directly. The point is, if you have anxiety with your bipolar disorder, you may be at a higher risk of suicide.

How to Treat Anxiety in Bipolar Disorder

Naturally, if you suffer from anxiety and bipolar disorder, your treatment considerations become more complex. And it's important to know that anxiety actually worsens treatment outcomes in bipolar disorder, so ignoring it just isn't an option.

The typical treatment for anxiety is certain antidepressants. However, those may not be an option in bipolar disorder as antidepressants can induce mood-switching, and, of course, this is always to be avoided. Additionally, doctors generally want to avoid dependence on benzodiazepines as they are considered addictive.3

That leaves us with, yup, atypical antipsychotics and anticonvulsants. One 2013 paper notes that there is emerging evidence for olanzapine (Zyprexa) and lamotrigine (Lamictal) in the treatment of anxiety in bipolar disorder.3

Additionally, therapies like cognitive behavioral therapy (CBT) and psychoeducation also appear to help.

No matter what, though, if you're experiencing anxiety with bipolar disorder, make sure to discuss it with your doctor. It is a big deal, can hugely affect you, and absolutely needs treatment.

Sources

  1. Goes, F., "The Importance of Anxiety States in Bipolar Disorder." Current Psychiatry Reports, Feb. 2015.
  2. Simon, N., et al., "The association of Comorbid Anxiety Disorders with Suicide Attempts and Suicidal Ideation in
    Outpatients with Bipolar Disorder
    ." Journal of Psychiatric Research, Apr-Jun. 2007.
  3. Cazard, F., Ferreri, F., "[Bipolar Disorders and Comorbid Anxiety: Prognostic Impact and Therapeutic Challenges]." L'Encephale, Feb. 2013.

Mental Health Crises Are Not Spectacles

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Mental health crises can happen anywhere at any moment, such as in a public place. Time and time again, I've seen those public moments captured in photos and videos online, turning a moment of pain into a show that people seem to feel entitled to gawk at and criticize. This needs to stop because mental health crises are not spectacles. Making them into such is stigmatizing and potentially harmful to the individual struggling.

How Mental Health Crises Are Made into Spectacles and Why They Shouldn't Be

This happened recently in my community (unfortunately, it's not the first time). A person had climbed to the top of a vertical-lift bridge in a state of crisis. While there were those advising others to steer clear and allow emergency responders to help this person, there were others who flocked to the scene. The news article about the incident cited that hundreds of people crowded around1, and I saw posts on social media noting there were pictures and videos of the scene shared online. Some posts said there were people taking their children to the scene and taking photos with them. It was rumoured that people were coordinating where they could park to get a view of the scene or be within walking distance.

It all made me feel incredibly disappointed by people. Disgusted, even. It also raises the question: what purpose does any of that serve?

Again, mental health crises are not spectacles and they shouldn't be made into them. This is not a performance for you to watch. Not fiction on a streaming service. It's someone's life and someone's pain

I know if I were in that position, I sure wouldn't want my distressful situation to become a show for the masses. It is not helpful, could impede first responders, and have a largely negative impact on the situation overall. I can only imagine the feeling afterward of feeling like your darkest moment was under the magnifying glass and the ripple effect that could have on mental health from there on out.

I see this as being a product of mental health stigma. Those going to watch don't seem to understand the severity of mental health struggles, or they almost seem to dissociate themselves from it being a real life in the mix. It's just a performance for them to observe so they can tell others later that they were there. Then there are those who say the person was only doing it for attention. I saw one commenter say that if the person didn't want attention, then the person shouldn't have done what they did. As if it were that simple. ("Breaking Down the Stigma of Attention-Seeking Behavior")

3 Tips to Stop a Mental Health Crisis from Becoming a Spectacle

I recently wrote about the ways we're making some progress combatting mental health stigma, but this kind of situation is a glaring representation of how bad things still are. In light of that, here is a video with tips for stopping someone's mental health crisis from becoming a spectacle.

 

If you feel that you may hurt yourself or someone else, call 9-1-1 immediately.

For more information on suicide, see our suicide information, resources and support section. For additional mental health help, please see our mental health hotline numbers and referral information section.

 

Source

1. The Welland Tribune, "Police negotiator talks woman in distress down from Main Street Bridge tower in Welland." The Welland Tribune, September 13, 2020.

Is it Selfish to Try for a Baby if You Have Had Depression?

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The decision to try for a baby is one of the most difficult you will ever make. However you choose to do it, there are about a million things to consider: am I the right age? Mature enough? Financially ready? Am I prepared for the toll this will take on my body, my relationship, my finances, my career? Am I ready to give my heart and soul to this person I haven't even met yet? And for me, there was the big one: is it selfish of me to bring a child into the world given my history of depression and mental illness?

When is the "Right Time" to Try for a Baby?

In many ways, my circumstances read like a textbook on first-time parenthood: I was in my mid-late twenties, healthy, married, and financially secure. To an outsider, the decision to have a baby seemed almost obvious. Not that we cared about any of that: we decided to start trying for a baby because we wanted one, not because our situation seemed to warrant it. We loved each other and wanted to share that love with a child. (At this point I should say that I am in NO WAY suggesting there is a right way to have a child — I am just recalling my circumstances, and almost laughing at how cliched they were in a 1950s, And Baby Makes Three kind of way.) 

Is it Selfish to Try for a Baby when you Have a History of Depression?

And yet something was stopping me from throwing out my birth control pills. It was the niggling sensation that it was wrong of me to try for a baby when just two years earlier I'd had a complete breakdown as a result of depression and lifelong OCD. I worried that the process of "trying" would cause a spike in my symptoms, especially if we had difficulty conceiving. But more than anything, I worried that if we were successful, I would be condemning an innocent child to a life of misery — watching its mother fall in and out of depression, having to raise itself because its mother was too wrapped up in her own problems to be a real parent. On top of that I worried that I would be passing on a genetic predisposition for mental illness, and effectively handing my child a life sentence of pain, rejection, and struggle. What kind of monster would do that?

Then I remembered something I had read years ago: I am more than my illness. I might be someone who has a history of depression, but I am also someone who has overcome depression. Overcoming depression is not just a matter of "cheering up" — it takes unbelievable strength, patience, and commitment. And what better qualities are there for a new parent to have? Moreover, people who have experienced mental health issues tend to have a greater capacity for empathy and understanding — both virtues in a parent caring for a developing child. 

A History of Depression Should Not Stop you from Becoming a Parent

In the end, I realized I was denying myself something wonderful for no reason. One of the cruelest things that depression does is make you doubt yourself and your abilities. I forced myself to remember who I was beyond my illness: I was a strong, capable person who had proven time and time again that she could overcome whatever life threw at her. Most importantly, though, I was someone who would love her child more than anything in the universe, and do everything in her power to ensure that child's happiness.

So I did it, and I am now the mother of the most perfect, kind, hilarious, vivacious little girl, who is — as you would expect — my entire universe. Now, I would not for a moment suggest that having a child is a "solution" to mental illness, and I didn't even consider getting pregnant until I was healthy and stable, but I would urge those of you who have experienced depression to not let that experience make you feel as though you don't deserve to be a parent. You deserve to be happy, and if you believe that having a child would make you happy, I say go for it. I did it, and I've never looked back. In fact, the next one is due in December.

See Also:

Decisions About Parenthood and Depression

Anxiety About Your College-Age Kid? How Not to Worry

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Parenting anxiety doesn't end when a child goes off to college. In fact, experiencing anxiety about college-age kids (young adults) is common. I've had many conversations recently about worries and anxiety around kids going off to college, and I just dropped off my own son at his school for his freshman year. Here's a look at why sending a young adult child can cause anxiety and how not to be consumed with worry despite all of the causes. 

Anxiety About College-Age Kids Can Seem Boundless

Whether or not this is the first time you've sent a young adult child to college, it's the first time you've sent this child to college. Therefore, the experience is full of unknowns. Unknowns and uncertainty are key causes of anxiety. The human mind doesn't like not having answers, so when in new territory, it's great at imagining problems to fill in the gap and making up all sorts of possible negative outcomes, which in turn cause new worries and fears. Common uncertainties that can make life miserable for parents of college-age kids include such thoughts as these. Will my child:

  • Fit in and find friends or be lonely?
  • Make too many friends and party all the time? 
  • Wake up on their own and get to class?
  • Handle the intense workload?
  • Be homesick?
  • Not be homesick and be glad to be gone?
  • Get sick, including COVID-19?
  • Struggle with their mental health?
  • Eat well?
  • Know what to do in the face of problems?
  • Fail?

For perhaps the first time in your child's life--almost two decades--you aren't there to help things go smoothly. That can be unsettling and anxiety-provoking. 

These anxious thoughts and feelings are a normal part of your transition into this new stage of parenting, but you don't have to give in to your worries. 

How Not to Be Consumed by Worry: Create Anxiety Boundaries

As I write this, my son has been at school for less than a week. Even though this is still very new, I am calm about the whole thing. I'm not experiencing anxiety because I've created anxiety boundaries, a fence, if you will, with myself on one side and worries on the other. Use these tips to create boundaries:

  • Visualize. Imagine being able to think about your young adult and smile rather than frown with worry. Imagine feeling calm and peaceful about where they are and where you are. Fully picture this and describe what that will be like for you. This creates the foundation for the boundary you're building around anxiety because what you visualize is what you focus on, and what you focus on is what grows. Knowing what you do want to have and how you do want to feel and be is more effective than thinking about the anxiety you don't want to have. 
  • Notice. To be sure, I'm not denying any automatic negative thoughts, worries, and emotions that come up. Denial and avoidance serve to increase, rather than decrease, worry because they allow thoughts and feelings to lurk and linger. Therefore, an important step in creating anxiety boundaries so you're not consumed by worry about your college kid is to use the mindfulness skills of awareness and acceptance. Notice your anxious thoughts, and simply allow them to be there. They'll come and go naturally. But you don't have to let them invade your personal space (after all, your child just moved out and you certainly don't want this uninvited guest to move in in their place).
  • Introduce fresh thoughts. To stop ruminating (repeatedly thinking about your worries), use mindfulness to focus your attention on something real and tangible in your present moment. Also, when you catch a worry, use a defusion technique from acceptance and commitment therapy. Remind yourself, "I'm having the thought that (fill in the blank with your specific worry)" to remind yourself that the worry is only a thought and isn't necessarily real. 
  • Identify why you're proud of your college-age kid. In the below video, I discuss what this involves and why it is one of the most important things you can do to reduce your anxiety about your young adult child. I invite you to tune in.

Remember, too, to acknowledge your parenting strengths. After all, you've been raising them their whole life to prepare them for independence. Thanks in large part to you, they've got this. And so do you. 

Baby Step Your Way to Strong Self-Esteem

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Having a well-crafted set of life goals helps me on my journey to build self-esteem, but it's the baby steps that lead to those goals that make me feel successful. Completing a life goal's final steps may be years away and focusing on that can be detrimental to healthy self-esteem. Changing my focus to the baby steps I take improved my self-esteem.

When I was suffering daily from poor self-esteem, I had a set of goals that was like the one I have now, but my attitude was completely different. I felt dissatisfied with myself because my to-do list contained all these huge goals and I never got to mark them as complete. Now my list contains only the next couple of baby steps for any of my goals. Changing my viewpoint to focus on progress instead of perfection keeps my self-esteem strong.

I want to share the struggle my self-esteem is going through today and how I am using baby steps to try to win the battle du jour. I hope that you will find some inspiration on how you can use this change of focus on your own journey.

Building My Self-Esteem with Baby Steps Is Important

My self-esteem is facing new challenges that makes baby steps important. Right now, I'm dealing with the mess that is my physical health. When I get depressed, it's difficult for me to do the cooking and exercise that keep me feeling well. The pandemic has caused me to be depressed more than usual, and I can't visit my favorite healthy restaurants or go to my gym, which make it even harder to break the cycle and begin to recover.

In the last two years I've worked hard to improve my health. Now I find myself again barely able to walk and breathe, and I feel like I'm starting all over. It's been crushing me, and I find myself reverting to the old patterns of negative self-talk, telling myself I will never accomplish my goal of remaining independent as I age despite my chronic illnesses.

Sometimes it's hard to keep trying the same things again and again, even if they have worked in the past. With the help of my therapist and a couple of close friends, I am choosing some new baby steps to try to revitalize my self-esteem.

  • I found a 21-day challenge starting next month offered by one of the whole food experts I follow. My baby step for this week is reading the instructions for the challenge and preparing my mind and my kitchen to fully participate. I will treat each day of the challenge as another baby step and celebrate every day's completion.
  • Exercise is also part of this challenge, and my baby steps to prepare are to have my old VCR hooked up to my TV and finding my favorite workout videos in the back of the closet from my days when I had neither the time nor the money for a gym.
  • My last new baby step is to focus on all the doctor visits I've been putting off because of the pandemic. They aren't critical, but they are part of my regular health maintenance. They will help me stay on top of my status by providing objective feedback from blood work and other tests. Each appointment I set is another baby step to celebrate.

Focus on Baby Steps to Build Self-Esteem

My own journey to stronger self-esteem is defined by continuing to look for new paths to try when I feel blocked by obstacles, and by breaking down every goal into tiny baby steps that improve my self-esteem because I know I can complete them. There are many paths that can lead you in the direction of your goals. If one isn't working right now, find another, and practice looking only at the next few baby steps rather than overwhelming yourself with the big picture.

Change your focus to taking a baby step each day to build healthier self-esteem.

What challenges are you facing today that seem insurmountable? How can you break it down into baby steps to help you succeed? Share your stories in the comments.

Trying to Do Too Many Things at One Time

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I’m the kind of person that has a lot of hobbies. As such, I’m constantly coming up with ideas for creative projects related to those hobbies. The amount that I’ve been able to devote to those projects because of my anxiety, however, is nowhere near what I sometimes envision it to be. Oftentimes I am guilty of trying to do too many things at one time, and I need to be better about that.

Anxiety Worsens When Trying to Do too Many Things at One Time

One of the ways my anxiety works is I am often unable to do a lot of things at one time. Furthermore, if I do a lot, I’ll need to take frequent breaks to help my mind relax. I’ve always been this way, and I don’t see that ever changing.

This isn’t bad in itself. What makes it bad is how I will sometimes respond to it. I’ll often feel like there isn’t enough time in the day to do all the things I want to do, and because of that, I’ll push myself to do more that would normally do. This only lasts for a short time, as after a while I will hit a wall and just have to stop completely. This isn’t a good way to treat myself – it’s as though I’m using a worn out machine well past its breaking point, knowing that it’ll fall apart at any second, but ignoring the warning signs because I just want to.

This has the counterproductive effect of making me dislike whatever it is that I’m doing. If, for instance, I’m trying to get a bunch of reading done to research something for a project, I’ll hit that wall and end up feeling negatively about whatever it is I’m reading about. Sometimes this bleeds over and makes me feel negatively about the very act of reading itself. As someone who loves reading, this is tragic, but it’s a mistake I seem to keep making.

How to Be OK With Not Doing A Lot

I know I’m not the only person who tries to do too many things at one time. So I want to try and give advice so this doesn’t happen. It isn’t fun, and it causes you to look negatively on things you may genuinely love. I wouldn’t wish that on anyone.

The most important thing to remember is that your well being is the most important thing. If it takes cutting out all but the essentials so that you feel alright, then let it be done. Nothing is worse than driving yourself to overload. There is never a good reason for that.

It sounds silly, but following your heart is the best way to handle such situations. Devote your time only to what your heart tells you it wants to do. That will make you happy, and will make you feel the most satisfied and productive when the day ends. If you don’t end up getting around to a lot of other things, forget about it. There will always be more time. You should always come first when it comes to your mental health.

Do you find yourself trying to do too many things at one time? What happens when you do that? Share your thoughts in the comments.

My Eating Disorder Makes It Hard to Heal from Sexual Assault

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As a young woman, I am unfortunately no stranger to crude—and sometimes coercive—innuendos aimed in my direction. Like countless other women, I have been taught to use car keys as weapons of self-defense, and I know all the tactics designed to repel an attacker. However, not until I was sexually assaulted in 2017 did I recognize the full impact of this violation and the residual trauma it causes. Nor was I ready for how this would further exacerbate and complicate my eating disorder. But three years later, the truth remains: my eating disorder makes it difficult to heal from sexual assault. 

An Eating Disorder Can Add to the Pain of Sexual Assault

In my case, the eating disorder was not a response to sexual assault—in fact, I had been in the throes of anorexia for 15 years before I even crossed paths with the man who harmed me. With that said, however, it would be dishonest to claim a fierce commitment to eating disorder recovery in the aftermath of my sexual assault. For months after this incident took place, I numbed the confusion, disgust, fear, and shame with any eating disorder behaviors that would repress my true emotions.

I consumed the bare minimum amount of food, then I ran for miles until my chest burned, my stomach heaved, and my brain could not form a thought. In the midst of this reckless, furious crusade not to feel, I allowed my eating disorder to make it difficult to heal from sexual assault. There is nothing unique or remarkable about this story, I have since come to learn. As researchers in 2018 found, 91 percent of women and girls who are sexually assaulted will be at risk for posttraumatic stress behaviors1.

This comorbidity can include depression, anxiety, and other mood-related issues, as well as eating disorders. In fact, evidence of posttraumatic stress is around 25 percent higher in those with eating disorders than in the broader population2. Because the shame and violation of sexual assault are often just what eating disorder behaviors need to intensify, these two conditions can be deeply enmeshed. I know this firsthand since my own eating disorder makes it difficult to heal from sexual assault—in spite of all the recovery work I do. But it is not impossible, as I will share in the video below.    

How I Prioritize Eating Disorder and Sexual Assault Recovery  

   

Sources

  1. Khadr, S., et al, "Mental and Sexual Health Outcomes Following Sexual Assault in Adolescents." The Lancet. July 2018.  
  2. Brewerton, T., "Eating Disorders, Trauma, and Comorbidity: Focus on PTSD." ResearchGate. August 2007.

Surviving a Loved One's Death by Suicide

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Trigger warning: this post involves frank discussion of suicide and coping skills for people who have lost loved ones by suicide.

In all of its forms, grief is excruciating, but surprise-grief is the worst of all, and the "surprise" of a loved one's death by suicide can cause you to wonder if you, yourself, will be able to survive. There are many factors, such as your relationship to the person or your mental health, that influence how you react and cope.

I have lost a handful of people in my life to death by suicide. Each death struck me differently. I realized that while there is no roadmap to successfully navigate the labyrinth of loss and grief, understanding the following principles helped me learn to cope.

My Roadmap to Recovery from a Loved One's Death by Suicide

Experiencing Unexpected Emotions

When someone that you know or love dies by suicide, you may experience unexpected emotions. You may feel despair due to their untimely death, anger at them for leaving, or self-loathing for not recognizing the signs of suicide that may or may not have been there (or all three of these together). Maybe you are shocked at the news because they seemed healthy in your eyes. Even if they are only your acquaintance, their suicide might still impact you. You might find yourself shuffling through your memories, trying to remember what you said to them the last time you saw them. Maybe you feel inclined to contact their family, but you don't know what to say.

Or you may feel none of these things--you may just feel numb for a little while.

Learning to Cope with a Loved One's Death by Suicide Is a Process

Learning to cope with a loved one's death by suicide is a patient process that looks different for everyone. It starts with recognizing and accepting what you are feeling. Someone that you care about has died--no reaction is off-base. These feelings can vary in both breadth and intensity, but they tend to worsen as you avoid confronting them. Pretending to be okay might numb you for a moment, but pain festers the more that you hide it. Sharing how you're feeling with a trusted friend, family member, or therapist can help solidify what you're experiencing.

You are not weak for feeling like you can't survive. It is not a mark of cowardice that you want to hide under the covers forever. Leaning into life without your loved one is overwhelming, and it doesn't happen overnight. You don't have to be an expert at dealing with an unexpected loss. Take things one day, even one moment, at a time. Feel what you feel, and be gentle with yourself.

It Gets Better

The path to healing from a loved one's death by suicide does not require blotting out all of your memories of your loved one. You don't have to forget about them to feel peace. I don't believe that time is the ultimate remedy for loss, but I do believe that you will get better at coping as you practice. As you crawl your way into a new life without them, you will gradually feel better.

Death doesn't minimize your love for someone else; in fact, I've found that it often fleshes out that love in a very unique way. There will be days where the loss feels deeper, the shock sharper, the grief thicker. Don't flinch at those moments when they come. When you allow those feelings of loss of a loved one to death by suicide to pass through you, you can come out of them feeling increased fondness for the loved one that you've lost.

If you feel that you may have hurt yourself or someone else, call 9-1-1 immediately. 

For more information on suicide, see our suicide information, resources and support section. For additional mental health help, please see our mental health hotline numbers and referral information section.

Learning to Stay Grounded While Living with DID

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If you know someone who is living with a mental illness, such as dissociative identity disorder (DID), you may hear the word “grounding” used in regards to managing the condition. What does this mean, and how does it impact those living with DID?

Addressing Dissociation

In order to understand grounding and what it means to be grounded, it’s first important to grasp the concept of dissociation. When an individual DID is feeling dissociated, it means that he or she may feel “out of body.” Dissociation is a mechanism that the mind uses to escape perceived danger in a particular environment.

I often assimilate dissociation with being in a dream-like state. My mind is entirely elsewhere, seeking safety from a threat that may not actually pose any harm, but simply arise due to past trauma. A certain sound may trigger me, for example, and signal to my brain that it’s time to seek safety in the form of dissociation.

In short, dissociation is a coping mechanism, and while it doesn’t necessarily cause harm, there can be negative consequences. When I am dissociated, for instance, I feel out of my body and mind simultaneously. This means that if I am engaged in a conversation, I may not remember it later on because I was mentally absent while it was occurring.

Memory lapses are not uncommon in people living with DID, and dissociation in general can quickly become a way of life if it is not addressed through means, such as grounding.

Becoming Grounded with DID

Being grounded is the opposite of being dissociated. In short, it means that you are living in the present, and your mind is entirely aware of its surroundings. You haven’t been triggered, and your brain is not searching for a way to escape perceived danger.

For those living with DID, becoming grounded is much easier than it sounds. When you have a trauma history and are used to feeling threatened, dissociation is more familiar than feeling grounded. That being said, being grounded is essential to the healing process. It is in this state that those with DID are able to converse with their different personalities, and more importantly, interact with others in everyday life.

Grounding Techniques for DID

To get grounded, I use a few different techniques. Deep breathing is one of my favorites because it’s easy to do virtually anywhere at any time, and it quickly provides results. If I have the opportunity to go the extra mile, I try to squeeze in a meditation session instead.

Another method I use to get grounded is to look around the room and pick three objects of the same color. I repeat the process until my mind regains an understanding of its surroundings, and the fact that there is no actual danger in the environment.

Sometimes, my mind has become dissociated to the point that I need the help of a prescribed medication to calm down. It’s in these moments that I try to focus less on the stigma behind the medication and more on the fact that it is providing me with the help I need to become present.

Dissociation looks different for everyone, as does being grounded. It’s important to explore different ways to get grounded and find what works best for you.

See Also:

Top 21 Anxiety Grounding Techniques

Coping with My Eating Disorder During Pregnancy

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Eating disorders during pregnancy are serious. When I found I was pregnant with my son over 10 years ago, I was still firmly in the grip of my eating disorder. I had what was known as eating disorder not otherwise specified (EDNOS), now referred to as other specified feeding or eating disorder (OSFED). As my doctor explained it, this is a name used to describe people who did not categorically check all the boxes of anorexia nervosa or bulimia, but still had a high-risk eating disorder

In my case, I'd starve myself for short periods, do my best to eat normally for short periods, and then binge and purge for short periods. These periods typically lasted anywhere from a day to four days. 

Pregnancy with An Eating Disorder: A Wake-Up Call

I hadn't planned to get pregnant when I did, but at that point, I had been trying to eek my way into recovery for a few months. Seeing those two lines on the pregnancy test shoved me into it. I mention this timeline, so it's clear that I was ready to seriously try to get better when I became pregnant. This is in contrast to women who find out they are pregnant and have not thought seriously about their recovery. I cannot speak to this experience, though I know it must be extremely stressful and even cause dissociation

Here's what I mean by that: even as someone who was willing and ready to get better for the sake of myself and my child, my disease still had me in its grip, and it was still a main focus of my life. Logically, I understood I was pregnant, but emotionally, my child may as well have been on Mars. I didn't feel that instant connection that many women talk about feeling. To be honest, I didn't get that feeling until months after my child was born. I was shell-shocked by the whole experience--"shock" being the operative word. 

So did I stop the bulimic behavior and starving myself as soon as I found out I was pregnant? I am lucky to be able to say yes, but again, I'd made headway toward that end before becoming pregnant. I'd gone weeks without purging and had been trying to consistently listen to my body's cues for hunger. 

I am not going to say it was easy, though. There were many times I had to talk myself down off a ledge, and keep myself away from the bathroom after eating a big meal. There were lots of times I had to remind myself not to fight my growing belly, and to welcome it. 

As I already mentioned, connecting with my child and the experience of being pregnant was difficult during this first pregnancy. My subsequent pregnancies would give me the space I needed from my disease to really feel that connection. However, if it weren't for that first, unexpected pregnancy during my eating disorder, I am not sure I would have had the motivation to get better.  

Next week, I'll be talking about the strategies I used to get through my pregnancy with an eating disorder. In the meantime, I invite you to share your experiences.

Do you have experience with eating disorders during pregnancy? Share in the comments.