This time of year can be filled with fun times, special memories, and exciting events. It can also be excruciatingly difficult for those going through postpartum depression (PPD). If you're feeling exhausted, a full social calendar is the last thing you need. If you're struggling with feelings of hopelessness, the last thing you want is to be bombarded with photos of others' seemingly perfect lives. If you're feeling guilty about your parenting, seeing parents do all the things with their children isn't helpful for you. In spite of the emotional toll of the season, there are some strategies that helped me deal with postpartum depression in the thick of the holiday season.

How to Deal with Postpartum Depression During the Holidays

Take Ownership

You get to decide what your holiday season looks like, no one else. That is your decision, and you must own it. I struggled with trying to fill other people's expectations. By trying to accommodate everyone, I wasn't doing my mental health or my family any favors. I was waiting for everyone to be on the same page, and that was never going to happen. When I realized that the decision was up to me, things improved. Did I still struggle with PPD symptoms? I did, but it allowed me to regain some control. That responsibility motivated me to decide what I wanted for the holiday season, and more importantly, what I didn't want.

Set Boundaries 

This is a big one, and it's not easy. I like to say yes to obligations, which often gets me in trouble. When I had postpartum depression, I didn't have any extra energy. So, loading up my schedule with non-essential events required energy I didn't have. I had to learn the hard way to set boundaries on my time. If I wasn't going to protect time for myself, then I had to do it for my children. Sometimes this means you have to say no to things you really want to do. That decision is tough, but it's essential for feeling your best throughout the season. 

Stop the Comparison

So what if your neighbor has the perfect holiday card and you never sent one. So what if your friend bought the newest toy for their child and you bought baby wipes instead. So what if that social media account has the cutest seasonal decor, and you have nothing up at all. Does it really matter? Will it matter in five years? When you start to play the comparison game, everyone loses every time. If I compared our holiday with someone else's, I suffered. Not only that, it made me vulnerable to bitterness toward those closest to me. If you're struggling with comparison, it's time to tune out the noise and turn off the notifications. You'll feel better.

For more about postpartum depression during festive times, check out my video:

Hopefully, these simple strategies will be as helpful to you as they were to me. Postpartum depression can be difficult, but it doesn't have to ruin your holidays. Likewise, holidays don't have to make your postpartum depression worse. 

When you are trying to heal and recover from an abusive situation, one unfortunate circumstance that can result is survivor burnout. In my experience, it can sneak up without any warning and interfere with every aspect of life. 

What Is Survivor Burnout? 

Much like feeling burned out from working too hard at your job, survivor burnout is when the body is emotionally, physically, and mentally exhausted from an extended stressful situation. Survivors of verbal abuse can use a lot of energy trying to function each day and deal with pressing anxiety trying to move forward. 

Some signs of burnout I have experienced on my healing journey include: 

• Extreme fatigue
• Feeling continuously overwhelmed 
• Feeling that spending energy on myself or activities I like is a waste of time
• Every day feels like a bad day 
• Feeling unappreciated or unnecessary 
• Lacking purpose 

Many of these symptoms can go hand in hand with depression and anxiety. I have noticed after years of therapy that I cannot put everything into a nice, neat box and put a label on it. Unfortunately, the lines between survivor burnout, depression, and anxiety can overlap and get blurry sometimes. 

How to Minimize Survivor Burnout

So, if you believe that you have reached the point of burnout, what do you do now? Tackling this heavy burden is no easy task. I still have situations where it sneaks up on me even though I have been on the path to healing for years. It can be a long process, but when you stick with it, the results are well worth the work you put in to better your mental health. 

Some key ways that can help you minimize survivor burnout include: 

• Get enough rest. I have noticed that I am more apt to react to stressful situations without thinking when overtired. I ended many stressful days by going to bed early, only to find that I could face the problem better in the morning. 
• Talk to someone. Letting my partner know my struggles helped us figure out how to get the professional help I needed to heal and function better.
• Learn boundaries. I am slowly learning how to say no to things and not aim to please everyone or try to do everything on my own. 
• Find a distraction or worthwhile activity. I dabble in cross-stitch, a needlepoint craft I gave up years ago. Once I started looking for something to calm my anxiety, I found myself going back to this delicate and time-consuming art. Only a few minutes can calm my nerves, and I have something productive at the end. 
• Be kind to yourself. This element was extremely difficult for me. I am my hardest critic. I want to do everything and the best way possible. Unfortunately, I am still learning how to be kind to myself and realize I need a break from my own expectations. 

As you heal from abuse, burnout can happen again and again. The important thing to remember is that you can overcome it and continue on each day. Many resources are available to help you in your community, and virtually, so you do not have to face these hard days alone. 

I’ve gone for a really long time without hearing schizoaffective voices. In fact, I’ve gone over four months without this disruptive schizoaffective symptom. I credit it to a psychiatric medication change.

A Mishap with Medication for My Schizoaffective Disorder Brought on Voices

A few years ago, my blood work showed that the levels of my mood stabilizer were really low. I called my psychopharmacologist at the time, and she suggested I raise the dosage of my mood stabilizer. More blood work was done until I reached a therapeutic range.

I did notice a difference with the raised dosage. The difference was that I stopped hearing voices. I didn’t hear voices again until I had a new round of blood work one morning and accidentally took my morning dosage of the mood stabilizer right before I got the blood tests. My levels were suddenly really high, and my psychopharmacologist recommended I lower the dosage of my medication.

I was worried from the start that a mistake had been made because I took the medication right before I got the tests done, but my psychopharmacologist advised the change. The mood stabilizer I’m on can be toxic if it’s at too high a dosage. So I think she figured it was better that I occasionally hear voices than lose a kidney.

Correcting a Mistake in Schizoaffective Medication Stopped the Voices

A nurse practitioner I began seeing earlier this year when my psychopharmacologist retired came highly recommended by my therapist. I explained my situation with my mood stabilizer and the voices to my nurse practitioner, and she had me get another set of blood tests done. It showed that my levels were very low, lower than a therapeutic dose.

So, my nurse practitioner increased the dosage of the mood stabilizer. I haven’t heard voices since. My nurse practitioner was surprised since, usually, the antipsychotic medications affect voices and hallucinations. But I wasn’t surprised because I have schizoaffective disorder, bipolar type, so my condition is a mood disorder.

I had been heartbroken when the voices came back, and I knew it was from lowering the dosage of that particular medication. In turn, I’m elated that got straightened out and that I haven’t heard voices for four months. I hope to never hear them again.

For years, the voices were a signal that I needed a “time out.” I would have a schizoaffective voices episode when I was extremely frazzled, stressed out, or overwhelmed. But I don’t need the voices anymore. I’ve learned to know without the schizoaffective voices when I need a time out. I’m glad they’re gone, and I hope they stay away. The message this time was that it never hurts to get a second opinion.

For some people, journaling can be a useful tool with which to process emotions and experiences related to self-injury and recovery. These tips for keeping a self-harm diary will help you create a helpful habit that you can use to support your healing process.

Maintaining a Self-Harm Recovery Diary

I've been journaling since I was five, but that doesn't mean I was always "good" at it. Keeping a diary, self-harm-related or otherwise, is a habit many find difficult to maintain on a regular basis. To be fair, creative writing isn't for everyone, but if you think journaling might be a good outlet for you, here are some tips for writing more regularly.

First, choose the form that speaks to you. Some people prefer handwriting, while others like to type. You may also want to try voice memos or even a video diary if you have an easily accessible, safe, private setting in which to record your entries. If you're not sure which to use, play around with different options until you discover which feels most comfortable and natural.

Whatever form it takes, try to keep your diary handy. Smaller format journals can easily be tucked into travel bags, backpacks, purses, and pockets. Similarly, you can store a digital diary online or in cloud storage; that way, you'll be able to access it from multiple devices, including your phone as well as tablets or computers. Keeping your diary within arm's reach means you'll be able to update it whenever you need to, even when you're out and about. (Use this tip with discretion, however; if you have reason to worry about someone accessing your diary while you are out—at school or work, for example—it might be safer to leave it in a secure location at home.)

If you don't want to carry the whole diary with you, consider using a type of journal to which you can easily add extra pages (such as a binder) and just keep some blank paper with you instead. For electronic diaries, you can simply type something into a memo and copy it over to the main file later.

If you're having trouble remembering to update your self-harm diary (if, for example, your goal is to write in it on a set schedule, such as every day), try setting an alarm as a reminder. Or, if you have someone with whom you are comfortable speaking about this, ask this person to check in with you now and again to keep you accountable.

If, when you sit down to write or record an entry, you feel absolutely unmotivated to do so, consider whether the way in which you're journaling is right for you. Don't force yourself to stick to a format that doesn't suit you. If regular "Dear Diary" entries aren't working for you, consider a different approach, such as using fiction to reframe your experiences or poetry to work through different emotions. You can even draw or paint instead of writing if you choose.

It's your diary; it's up to you how you want to use it.

Keeping Your Self-Harm Diary Private

One barrier that may be keeping you from starting a self-harm diary is the issue of privacy. If you have family members who you don't trust to respect your boundaries or are worried about fellow students or coworkers discovering your journal (and maybe even using it against you), it may seem safer not to try.

But there are ways to keep your diary private if it's important to you to try keeping one as part of your recovery process. Consider the following tactics:

• Hide your diary in a secure location or keep it under lock and key (if it is a physical journal).
• Disguise your diary as something else with a fake file name (if it is digital) or a false book cover (if it is physical).
• Set a password and change it regularly (if it is a digital journal).
• Use a secret pen name or username no one will recognize (for online journals).
• Make sure to log out and clear your cache and history after every session (for online journals).
• Keep the first page blank or include a warning asking the reader not to continue reading.
• Write in a code only you know.
• Destroy your entries after creating them.

That last point should be considered a last resort. Reviewing your entries later on in your self-injury recovery journey can yield helpful insights into the progress you've made and can even help you identify triggers you may be overlooking. However, if you feel you must delete your entries to maintain your privacy, do so—destroying them does not reduce the value of creating them in the first place. For some people, destroying them may even be cathartic—a symbolic way of "letting go" of difficult past experiences.

If you have any additional tips to share that will help others maintain their self-harm diaries, or if you have questions or concerns about maintaining your own, please feel free to leave a comment below.

Eating disorder recovery during life transitions can present a real challenge. As this final stretch of 2021 rounds the corner and another new year looms on the horizon, the inevitability of transition is at the forefront of my mind. But while this idea of change can often bear a negative connotation and cause stress levels to escalate, the change itself doesn't always have to bring chaos, fear, anxiety, or upheaval into your actual lived experience.

If you can create a buffer of mental and emotional resilience around the changes and life transitions on your own personal horizon, you'll have a steadier, more balanced outlook on how to manage stress as it comes. However, in order to achieve this, you also need to prioritize your eating disorder recovery in the midst of those life transitions.    

The Impact of Life Transitions on Eating Disorder Recovery  

Life is not static, nor should it be. The human experience is in constant, dynamic motion—and, in my humble opinion, that's the adventure of being alive on this planet. However, I would be remiss (not to mention, dishonest) if I glossed over the reality that change can push me to the anxious brink when I don't prioritize my eating disorder recovery in the midst of life transitions. Here is a real-world example to illustrate what I mean:

Last week, my husband and I spent the majority of our free time moving into a new apartment with much less room than we previously had. Later on this week, he will also start working for a new company on a remote basis, and since I already work from home, this will be quite a transition for both of us—learning how to adjust to one another's professional rhythms in a limited amount of space.

While both of these changes are positive, they can still cause tension to surface. This is why I must be intentional about coping mechanisms and self-care practices that continually remind me to prioritize eating disorder recovery. I will discuss some of the strategies I use to accomplish this goal in the video below:  

How I Prioritize My Eating Disorder Recovery in Life Transitions

What particular changes are you faced with currently? How do you prioritize your own eating disorder recovery in the midst of these life transitions? What are the coping mechanisms or self-care practices that you use to manage stress and look after your mental, emotional, and physical wellbeing? Please share your feedback in the comment section below.  

I think one of the most difficult aspects of coping with anxiety is dealing with the fear that is inherent to this experience. While fear and anxiety are not necessarily the same thing, they typically walk alongside one another, and that is why it can be helpful to analyze one in order to understand the other. 

The Relationship Between Anxiety and Fear

According to NAMI, fear is our reaction to immediate threats in our environment, while anxiety is a reaction to our emotions.¹ NAMI also states that anxiety results from the effort to push aside emotions so that we don't have to experience them. But, the physical reaction of both is very similar, and that is why it can sometimes be difficult to figure out what you are experiencing.

Why is it so important to identify what you are experiencing? For myself, I have found that identifying whether the symptoms are a result of fear or anxiety helps me to figure out how to cope. If I am feeling anxious, but there is no immediate threat around me, it is usually safe to say that I am dealing with anxiety, and I need to take a close look at what has triggered the reaction and what my current situation is.

How to Cope with Fear and Anxiety

Unfortunately, many times, there isn't a specific trigger, and I find that the anxiety I am experiencing is related to anticipation of a potential threat, even if I have no idea with that threat is, and even if, rationally, there doesn't seem to be an imminent threat. Therefore, sometimes anxiety can be hard to figure out. And while anxiety isn't always debilitating for everyone, it can be difficult to manage if the lines seem to be blurred between fear and anxiety, resulting in a constant state of worry, panic, and fearfulness with no end in sight. Here are some of the things that can be done to help in the face of these physical symptoms of anxiety:

1. Identify what you are feeling. It can be helpful, as I mentioned, to first identify whether it is fear or anxiety, or even whether it has now become fearfulness of being anxious. This can be done by paying close attention to your symptoms and even journaling your experiences and symptoms.
2. Find ways to relax. This is so important for me. I exercise, watch a funny movie, do a meditative activity, even cook, and this can put me in a more relaxed state that calms the physical symptoms. Sometimes, this can help me to revisit the anxious thoughts later on, to put things into perspective.
3. Talk it out. This is also vital for me. If I talk it out, I can process the symptoms, feelings, thoughts, and behaviors to help me see, logically, whether there is an imminent threat or I am feeling the result of chronic stress that I have been going through. If it is the latter, then I know I need to work on this. But it also helps to become calming because, by processing what I am feeling, I am able to regain a sense of control.

Try these steps to help you face your anxiety. If there are steps you take to help you differentiate between anxiety and fear in order to help you cope, share them in the comments below.

Source

1. Hendel, H., "Anxiety and Fear: What's the Difference?" NAMI, May 2021.

During the holiday season, one of the most talked-about topics is holiday shopping. Many people who struggle with anxiety find it to be overwhelming. Before I started my holiday shopping, I feared that some people would not like my gifts. I also worried about how much money I would spend. Now that I have shopped for two people, I do not feel as anxious. Here are some tips that helped me start my holiday shopping.

5 Ways I Reduced My Holiday Shopping Anxiety

1. I made a list of people to shop for. Having a list of everyone I will be shopping for allows me to plan my shopping time wisely. This year, my list consists of 10 people. Since Christmas is less than three weeks away, I can shop for two people every day this week. That will give me plenty of time to receive online orders in the mail.
2. I came up with a budget. Most years, I try to limit my gifts to $20 per person. Usually, I spend a total of $160 to $200 on gifts. Since I do not have a full-time job right now, I will try to stay closer to $160. Some of my gifts will be sale products, or I will use coupons. The prices do not matter as much as the thought and quality of the gifts.
3. I wrote down two gift ideas for every person. So far, I have a rough idea about what I will be buying each person. Two of my siblings love new clothes. My niece always uses nail accessories. My mom enjoys doing crafts and lighting Eucalyptus candles. Two of my friends enjoy dining out. One of my friends goes to the movies often. I have created a list of potential gifts based on people's interests and hobbies.
4. I spent a few minutes researching products online. When I shopped for a friend and my mom, I found my gifts on Amazon. Since budget and quality were important, I used the price and rating filters. After reading a few product reviews, it took about an hour to select my first two gifts. Even though it might not be that easy to shop for everyone else, I am off to a good start.
5. I decided to shop more mindfully. When I shopped at Walmart and Target last month, I occasionally found products that would interest my loved ones. At the time, I did not buy gifts because the holiday seemed far away. But now that it is getting closer, I will go back to Walmart and Target to find the products again. I will shop with the intention of finding gifts.

At this point, I am feeling excited to continue my holiday shopping. I know that as long as my gifts come from the heart, that's what matters the most. Do you have any tips to relieve holiday shopping anxiety? Please share in the comments.

See Also

• "7 Thoughtful Self-Harm Recovery Gift Ideas"
• "Give Your Mentally Ill Loved One this Gift for Christmas"
• "Giving a Gift to Someone With Mental Illness Means a Lot"
• "Thoughtful Gifts for Depressed People"

Content warning: This blog contains a discussion of suicide and suicidal ideation.

Surviving Mental Health Stigma Blog — that’s the name of this blog full of tips and advice to get through moments of stigma, overcome it, and so on. Often, that’s how I approach writing for this blog: what tips can I share? What have I gone through that might be useful to others? But then it struck me. Dealing with mental health stigma can quite literally be an act of survival. It’s not hyperbole. It’s not dramatics. Mental health stigma could literally lead to someone dying. I’ll elaborate.

What Does It Mean to Have to Literally Survive Mental Health Stigma?

We all know how stigma can prevent people from speaking up, prevent them from getting help, and prevent them from getting better. When mental health conditions are untreated, it can lead to risk-taking behavior. That, of course, could potentially lead to death.

For me, it’s a matter of stigma fueling thoughts of suicide. That’s right, it’s not just thoughts of suicide that I contend with, but mental health stigma coming in to give those thoughts a boost.

One way that stigma sticks with me is by becoming internalized. Every time I’ve ever been told that I’m a downer or buzzkill has sunk in, and when I’m feeling the grips of depression and treading into suicidal territory, they’re usually along for the ride. Instead of arguing against the darkness, my thoughts turn to those comments and lead to considerations about how it’d be better if I weren’t here because I’m just so negative. Why should I stick around when I’m bringing others down?

And thus, in those moments, surviving the stigma literally becomes a survival effort. It’s not just about tolerating the stigma or hardening myself against it. It becomes a matter of not giving in to those thoughts and staying afloat long enough until they quiet down again.

Mental Health Stigma Doesn’t Just Hurt Superficially

I don’t think people realize that mental health stigma truly impacts people in this way. More likely, people see stigma as just hurting someone’s feelings in a superficial way or as someone unable to handle the “facts” (also known as their hurtful and unhelpful words, perceptions, or opinions).

Even with what I wrote above, I imagine people will brush it off as “not their problem” or me just being too sensitive. Maybe some will learn from stories like mine.

If you’re in the same position as me, feeling like dealing with mental health stigma means having to survive it, I get it. I’m shoulder-to-shoulder with you, fighting it on a regular basis. Let’s keep striving to survive together, okay?

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.

I find pain destroys my ability to think. I find that once pain reaches a certain level, I can no long formulate rational thoughts, and all I can think about is the pain. I short, pain kills my brain. This feels like a curse for someone who uses her brain for a living. However, pain's penchant for affecting one's ability to think is hardly limited to me.

I have lots of experience with pain between bipolar disorder and daily headaches/migraines. Pain is woven into the fiber of my days. I despise it but have learned to work with the complexities of it out of necessity.

Pain and One's Ability to Think Relates to the Amount of Pain

One of the things you learn about with pain is the pain scale. The pain scale is a rating of your pain from zero to 10, where zero is no pain and 10 is pain that is so bad you're going to pass out. There's a sort of devilish torture to having to rate your pain all the time, trust me.

And while people have many different definitions of each number of the pain scale, what is clear is that there is a turning point from where you think about pain occasionally, to sometimes, to exclusively. Believe me, as you move up the pain scale, this absolutely happens. By the time you are at a nine, you can't think of a single thing but your pain. It is overwhelming. It is soul-destroying.

It's sort of like this example. You stub your toe really hard, and it's exquisitely painful. At the moment it happens, anything you were doing ceases to exist. Anything you were thinking runs from your psyche. In fact, you might even drop anything you were carrying if the pain in your toe is severe enough. Luckily, that toe pain calms down pretty quickly, and you gain the ability to deal with other things. This is a completely normal experience.

But if that toe-pain -- that extreme, shocking, psyche-consuming pain -- were to continue, you would find it very hard to focus on something else. The pain and making it stop would be the only thing about which you would by thinking. This is what people with chronic pain deal with. They deal with that severity of pain, often on a daily basis. Bipolar disorder can do this to you. Migraines can do this to you. It's just luck if you don't happen to have those or another chronic pain condition.

My Ability to Think with Pain and Bipolar

And bipolar may even be a bit more sinister. If you're in an extreme bipolar depression, the pain you feel may affect your ability to think, as I've outlined above. But even in other mood states, bipolar tends to take the wheel of your thoughts. Hypomania may have you thinking of sex nonstop. A more minor depression may have you hating yourself nonstop. A mood with mixed bipolar characteristics may have you thinking aggressively nonstop. So, bipolar pain can affect your ability to think, but so can other parts of bipolar disorder too. 

What to Do When Pain Destroys One's Ability to Think

This is the tricky part. I find I can't think in a straight line when the pain is too severe. I find that I can't think along a logical line without that pain interrupting and cutting that line. It is very, very difficult.

The only thing I can really think to do is to admit to what's happening to myself and deal with reality. 

• "I'm in extreme pain right now. I'm having trouble thinking."

I think anything less than absolute honesty when dealing with severe pain just doesn't help. 

And then I breathe. I breathe into the pain. I breathe through the pain. I breathe around the pain. I do anything I can to focus on deep breathing and realize that I will survive this moment.

Pain and suffering are horrific, and this level of pain and suffering is torture, but it won't kill you. It won't kill me. (Yes, there's the issue of suicide, but we'll just put that aside for a moment as that's for another post.) So pain may take over my brain and body but not my spark of existence. That is mine. Does that knowledge help my ability to think with pain? Maybe it doesn't. But what it does is keep me alive, and that's the biggest win you can ask for in that situation.