Sometimes, even when you are no longer the victim of verbal abuse, the lasting effects can hinder your mental health. Finding ways to deal with the possible symptoms of verbal abuse like anxiety and depression are critical for your path to healing if these symptoms prevent you from living a full and happy life. Box breathing may be able to help.

I have years of therapy experience, and I still struggle with using the coping tools I need when I feel triggered or overwhelmed with a situation. My logical brain tells me that I should be doing this or that, but when I am in a heightened state of anxiety or panic, that part of my brain shuts down and the fight, flight, freeze, or appease mode takes over. 

Fight, Flight, Freeze, or Appease

While many people know about fight or flight, I did not know about the freeze or appease mode that may accompany individuals who have posttraumatic stress disorder (PTSD) until I started regular therapy¹. Many people will fight back or run away from the stressor when facing a tense or stressful situation, which is a typical response. 

The freeze or appease modes are prevalent for other people, especially those with PTSD because of abuse. Freezing makes the individual do nothing at all. They will freeze because they are terrified of the outcomes of their actions from the situation. Appeasing happens when the victim goes along with the abuse hoping to minimize the situation or avoid prolonging the circumstances. 

Use Box Breathing to Break Out 

It can be challenging to break out of the fight, flight, freeze, or appease mode if you do not know you are responding this way. Unfortunately, after many years of therapy, I still sometimes have difficulty recognizing my emotions until deep anxiety or panic sets in. But it is possible to break out of this cycle with some helpful tools. 

Not every coping mechanism will work for everyone, unfortunately. I had years of therapy where I tried so many different things, only not to have them work or help my mental health. Thankfully, I kept seeking out new methods until I found a couple of local therapists who could provide some tips on how to regulate my emotional state. 

How I Use Box Breathing

On one occasion, I was in full panic mode and tearful without any valid reason or situation. I could not pinpoint any outside circumstance that triggered me, only that I felt like crying and my body was shaking. My logical brain told me that I had to get groceries, and it was a needed task. So, I got in my car in my heightened state of anxiety and headed to the grocery store. 

At this time, I remembered what one of my therapists had me practice to help calm my anxiety. He called it box breathing. I would take four seconds to breathe in slowly, hold my breath for four seconds, exhale slowly for four seconds, then hold my breath for four seconds. This systematic breathing helps regulate my body and focuses my brain on counting rather than feeling panicked. 

Although it is not a quick fix, I found it does help me. After 15 minutes of my box breathing technique, I noticed that I was calmer and more focused than when I left my house. 

Finding What Works Best for You 

The box breathing technique may not work for you or someone else who suffers from adverse symptoms stemming from verbal abuse. Part of the healing process is finding what works best for your situation. You can try this method or leave a comment below on what techniques you use that have been productive in your life. 

I would love to hear other ways you use to help combat those stormy days where there is anxiety. Leave a comment below on some tools that work for you or someone you love. Maybe your story will help someone else in a similar situation. 

Source

1. D'Anniballe, J. and The National Childhood Trauma Stress Network, "Neurobiology of Trauma." The Care Center, adapted from Building Cultures of Care, November 2016.

A self-harm tracker can be a useful tool in helping you begin the recovery process and maintain a self-harm sober streak over the long term. Let's take a look at how you can use a self-harm tracker in your own recovery journey and what information you might want to include in your own version.

What Is a Self-Harm Tracker?

A self-harm tracker usually tracks one of two things: either instances of self-harm, or how much time has passed since your last episode.

The first type of tracker is perhaps most helpful for people in the early stages of recovery. Tracking when you self-harm can give you insight into temporal triggers such as:

• Time of day—For some people (myself included), being awake late at night by yourself can make self-harm all too tempting.
• Day of the week—For example, you might be more prone to self-harm at the end of the week when you're feeling tired and stressed.
• Time of the year—Certain holidays, changes in weather, or seasonal disorders (such as seasonal affective disorder) can exacerbate self-harm urges.

Tracking other potential triggers (such as who you spent time with, what activities you were engaged in, or what stressors you were experiencing prior to an episode) can also be incredibly useful information you can use to create a self-harm prevention plan, either on your own or with the help of a therapist.

Tracking "days clean," meanwhile, can be a motivational tool that will shine a spotlight on the progress you've made as you walk the road of recovery. A tracker like this helps you quantify certain recovery goals, and can also be helpful in setting up rewards for certain milestones (e.g., treating yourself to a new book or video game once you reach the 30-day mark).

Creating Your Own Self-Harm Tracker

If you work with a therapist, they might offer you a pre-made template for your self-harm tracker. You can also easily find a wide variety of tracker templates online (some free, some not). But since everyone's recovery journey is different, and we all need different things to help us move forward with healing, it might be worthwhile to create your own self-harm tracker.

Luckily, this is easy to do. You can write one up yourself with good old pen and paper, or you can create a simple table or two on your computer and print out what you need as you go.

But what, exactly, should you track? Here are some ideas; feel free to cherry pick the information you believe will be most helpful for you:

• How many days it's been since you last self-harmed
• Self-harm episode dates and times
• Instances of self-harm urges that you did not act on
• Potential triggers for each episode/urge
• Intensity/duration of each episode/urge
• Coping methods used and how effective they were
• What specific thoughts and emotions you experienced during each episode/urge
• Milestones you've passed, and ones you want to reach
• Potential rewards for achieving certain recovery goals or milestones

The most important thing, especially when you're just trying this out for the first time, is to avoid overwhelming yourself. It is often helpful to start with a very simple tracker and only worry about tracking one or two of the items above at first. (Usually, tracking one or both of the first two items on the list will be most useful.)

Keeping things simple at the beginning will make it easier to form this new habit and stick with it. You can always change your format later and add extra details once you're more used to using your self-harm tracker consistently.

Do you use, or have you used, a self-harm tracker of your own? What information have you found most helpful to track? Please share your ideas and thoughts in the blog comments if you feel comfortable doing so.

When you are depressed, it might feel like a waste of time, money, and energy to go on a vacation. You are probably going to be depressed wherever you go because traveling is not going to cure you of depression. And in case you can't or don't want to travel, relaxing at home is unlikely to make your depression go away either. This begs the question: should you even take time off from work in the first place?

You Need to Rest to Cope with Depression

Of course, you should take a vacation because your mind needs a break from the "rise and grind" way of life. Going on a holiday will not make your depression disappear, but it will help reduce its intensity. I can personally vouch for the healing powers of a change of scenery. Back in 2018, when I was going through a severe depressive episode, I went on a short trip with my family. Even though I thought it was a bad idea at the time (and that I should be working instead), I felt better during and after the trip.

Note that there were many moments when I was extremely depressed and even suicidal, but there were also moments when I felt glad to be immersed in a new culture and far away from my desk. It is for small but significant moments like these that depressed people like us should take a holiday. Rest is important for your mental health, and the world has grown to accept that over the past year. What's more, a healthy rest ethic is great for your productivity as well. 

Take Time Off from Work Even If You Cannot Travel 

If you can't afford to travel or are afraid to because of the ongoing pandemic, this doesn't mean you should keep working. I am in the same boat as you, and I will be taking a staycation this year. In fact, I have taken far more staycations than I have taken vacations, and they have been equally relaxing. As long as you don't work on vacation, you are doing a good thing. 

Check out the video below for some tips on how you can take a vacation at home. I intend to take mine in the last two weeks of December, and here's how I plan to do it.

How are you planning to spend your end-of-year vacation? Let me know in the comments section below. 

In many cases, eating disorder behaviors can be fueled by cognitive distortions. These irrational thought patterns could influence you to latch onto a negative and inaccurate view of yourself, a situation, a relationship, or life as a whole. But cognitive distortions only have power if you allow them to take root, which means that you can learn to spot cognitive distortions—and ultimately combat them—in eating disorder recovery. 

What to Know About Eating Disorders and Cognitive Distortions

Are you aware the human mind can process more than 6,000 thoughts over the course of just one day? Neuroscience researchers from Queen's University in Ontario arrived at this estimate in 2020 when they measured how the brain moves from one thought to the next.¹ But, how much of this continual thought loop is actually helpful and constructive—or even true, for that matter? Do you choose to believe your own thoughts at sheer face value, then respond to them on automatic impulse? Or do you pause to interrogate whether or not those thoughts have a place in your commitment to eating disorder recovery?   

The reality is, some thoughts will help you, while others have the potential to harm you. Cognitive distortions fall into the latter category—but with some careful attention, as well as decisive action, you can learn to spot these cognitive distortions in eating disorder recovery. Then, once you're in the practice of identifying them, you can intercept those thoughts and refocus them in a healthier direction, rather than allowing them to spiral into an intrusive belief or reckless behavior. The next time a thought which feels like it could be a cognitive distortion crosses your mind, here are some questions to examine before you act.  

6 Questions that Can Teach You How to Spot Cognitive Distortions 

1. What does this thought ask me to believe? For instance, let's assume your thought is, "I am worthless if I eat all the food on my plate without being able to exercise immediately after the meal." In this case, the thought asks you to believe that your human worth is tied to the number of calories you burn or restrict. 
2. Does this thought make me feel empowered? To use the same example, this belief that your worth hinges on compulsive exercise and caloric restriction does not cultivate feelings of personal empowerment. Rather, that belief is much more likely to cause insecurities, self-flagellation, and ultimately, disempowerment.  
3. Is this thought in line with factual reality? Now it's time to consider the level of accuracy in this belief. Just because you perceive a connection between your worth and the amount of food you consume or exercise you perform, that does not mean a connection exists. Perception and reality are two different scenarios.
4. Will this thought serve the life I want to create? If your commitment is to recover from an eating disorder, the choice to believe your worth is linked to caloric restriction will not help you achieve this goal. You cannot build a life of freedom, healing, and wholeness if you are still ruled by a negative impression of yourself.
5. If I act on this thought, what will I lose or gain? All actions result in either productive or destructive consequences. So think about which outcome will take place if a belief turns into a behavior. If you restrict or over-exercise, you might feel temporary satisfaction, but you won't have the energy and nutrients to function.
6. What new thought can I reframe this into? As a sentient being, you have control of your own brain. That means you can redirect a harmful belief, instead of falling victim to it. For instance, shift the message from, "I am worthless," to, "My eating disorder wants me to think I am worthless, but my value has nothing to do with how much I exercise or restrict my food intake. I will not listen to this deception anymore."  

Don't Let Cognitive Distortions Affect Your Eating Disorder Recovery

When you learn to spot cognitive distortions in eating disorder recovery, this awareness will give you both the confidence and competence to intentionally build healthier thought patterns. Just because a cognitive distortion enters your brain does not mean it's true or that you should act on it. Quite the opposite, in fact—you can choose to halt the cognitive distortion in its tracks and prioritize your own mental, emotional, and physical wellbeing instead. 

Source

1. Tseng, J., et al., "Brain Meta-State Transitions Demarcate Thoughts Across Task Contexts Exposing the Mental Noise of Trait Neuroticism." Nature Communications, July 13, 2020.  

Bipolar is usually medicated to a manageable level. In other words, people with bipolar disorder who are on medication are not "back to normal," rather, they still exhibit some bipolar traits but at a manageable amount. This is completely different from what I was told for years after diagnosis, and it's also different from what people see in the media. People seem to think that a pill will make the person back to who they were before the bipolar disorder. I'm sorry to say, this just isn't true for the vast majority of us. 

Misunderstandings of Medicating Bipolar

People seem to think one of two things when it comes to medicating bipolar. They either think that there are no treatments that will work for bipolar and we'll always be hugely unstable, or people think that popping a pill will correct bipolar entirely. Both of these things are completely wrong. As we know, medicating bipolar is possible and is effective -- even if it's not 100 percent effective.

Medicating Bipolar Is Hard

What people need to understand is that it's not easy to treat bipolar disorder. Even when a person takes medication and attends therapy, and invokes lifestyle changes, bipolar disorder is still a very hard disorder to treat. Looking at medication alone, the difficulty is clear. There has been no medication specifically for bipolar disorder save one -- lithium -- which has been around for decades. We know that lithium effectively treats the symptoms of bipolar disorder for some, but not for all. 

When lithium doesn't work for a person, they are then stuck with repurposed drugs: anticonvulsants and antipsychotics, mostly. It has been determined that many in those categories, while not designed for bipolar disorder, do work to treat bipolar disorder for many.

But it gets more complicated than that. It's rarely the case that a person is on only one medication. Many people require several drugs at the same time to achieve the best result. According to a chart review, upon hospital admission, people with bipolar took on average 3.3 psychotropic medications and 5.94 medications in total.¹

And even with all of these medications, the best result is not typically a "pre-bipolar" state.

What Does Medicating Bipolar Do?

So, if medicating bipolar doesn't bring you back to a pre-bipolar state, then why do it? That's simple: it will keep you alive. It will keep you going. It will give you a life. Medicating bipolar makes bipolar manageable; it doesn't make it disappear.

I mention this so we all can take a moment and recognize how hard medicating bipolar is and, even with all the help in the world, how hard people with bipolar have to work. Medications work, they do; they just aren't perfect. We aren't at a place in medical history where we understand enough about the brain to really treat bipolar in the most effective way. That means the person with bipolar has to pick up the slack. Not being medicated isn't an option for 99 percent of people -- most of us would die or blow up our lives without medication. But being medicated still isn't the easy option -- it tends to just be the only option. 

So, my medication brings my bipolar symptoms down to a manageable level. Does that mean I'm still sick every day? It does. But it also means I'm alive. It also means I have a life. That's what medicating bipolar does. 

Source

1. Weinstock, :L. et al., "Medication Burden in Bipolar Disorder: A Chart Review of Patients at Psychiatric Hospital Admission." Psychiatry Research, April 2014.

Among tinsel and twinkling lights and cheer, it’s not something people want to hear, but it’s true: the holidays negatively impact my mental health. Whereas others find cheer in the music and gift-wrapping, I find discomfort, anxiety, and darkness. The even more difficult thing is there’s really no safe, stigma-free space to talk about it.

Holiday Magic Doesn’t Cure Mental Health Struggles

I’m sorry. Holiday magic is not a cure for mental health struggles. This isn’t a Hallmark movie where the main character learns the Christmas spirit. This is life, where, for me, the struggle continues, even increases.

But saying that often means being met with comments about being a Grinch, which I’ve written about at length. I’m not here to talk about that again. Rather, I want to talk about having a space to be honest about mental health struggles during the holiday season.

Talking About the Negative Impacts of the Holidays Can Help Ease the Struggle of Mental Health

Having a space to talk about not liking the holiday season honestly would be more helpful than I think people understand. The fear of smothering the joy leads to shaming and stigmatizing people like me who are negatively impacted by the holiday, which actually makes things worse because it just fosters more negativity. I discuss this in the video below.

It’s Not About Ruining the Holidays; It’s About Trying to Survive

At the risk of sounding like a broken record, how the holidays negatively impact mental health is something I’m probably going to keep talking about each year. I’m likely to keep going on this conversation until people realize this isn’t an attempt to ruin the holidays, but a reality that we—I’m—trying to survive.

Is the gift of a safe space to acknowledge that holidays can negatively impact mental health a gift you can give this season?

Thanksgiving is not my favorite holiday—not even close, in fact. As someone who was raised in a large, boisterous, Italian American family, I understand the importance of seasonal traditions, quality time with loved ones, and communal expressions of gratitude. But as someone who is also in eating disorder (ED) recovery, the overt emphasis on food this time of year can still cause ripples of anxiety to surface. So, as another holiday season rounds the corner, I want to share with you a list of ED recovery affirmations to remember on Thanksgiving. I often repeat them to myself when I feel overwhelmed or anxious during the festivities, and I hope these affirmations calm and re-center you as well. 

5 Affirmations to Support Your ED Recovery this Thanksgiving

1. You deserve to fuel yourself with foods that offer both nourishment and pleasure. You do not have to earn the right to eat or punish yourself after the meal. You can taste, savor, and enjoy without feelings of shame to ruin the experience.  
2. You can carve out alone time to pause, breathe, and rejuvenate when you start to feel those undercurrents or anxiety or emotional depletion near the surface. Do not apologize when you need a timeout—it's a valuable form of self-care.  
3. You are empowered to either change the subject or leave the discussion if any negative talk about food, weight, calories, or body image circulates at the dinner table. Protect your mind from toxic messages that can lead to unhealthy behaviors. 
4. You have so much intrinsic worth beyond the amount of food you consume at Thanksgiving—or any other event on the calendar. Eating is not an indication of weakness or an epic moral failure. Your human value cannot be measured in calories.  
5. You matter at this table, in this moment, during this season, and on this earth. So, claim your space and commit to doing whatever feels the most restorative in times of stress. Your body requires gentle, tender care. Your mind requires intentional, positive thoughts. Your spirit requires nurturing, compassionate love. Be kind to yourself.

As you take a few deep, conscious breaths and steel yourself to enter the fracas that is Thanksgiving, I hope those affirmations will soothe your fears, calm your emotions, and bring you a measure of peace. I know firsthand just how tough this holiday can be with an eating disorder voice in the back of your mind. So, these ED recovery affirmations are for you to remember on Thanksgiving—because I believe in the power of healing self-talk, and I want you to harness that same power for yourself.   

For the past six weeks, my left knee has been causing me a lot of pain. The pain is flaring up as I sit to write this. It may have been caused by doing a stretch during an online ballet class--I honestly don’t know what caused it. What I do know is that it hurts a lot, and it’s wreaking havoc on my schizoaffective anxiety and schizoaffective depression.

How Knee Pain Affects My Schizoaffective Disorder

First of all, although I suffer from frequent migraines, I wouldn’t say I’ve been in this kind of constant physical pain before. Also, the migraines usually come at night before I go to sleep and are gone in the morning. This is different. I can barely walk at times. I haven’t been able to go for my daily walks outside. This has caused me to sink into a deep cavern of schizoaffective depression, with some anxiety thrown in for good measure.

A lot of the anxiety has been caused by driving to the doctor to get my knee checked out. You see, I have a phobia of driving, especially driving in the snow. (I know, I know, Chicago is probably the wrong city for me.) But I made myself drive to the doctor today--even with the threat of snow--because I’ve read or heard from multiple sources that the only way out of driving phobias is to move your way through them. I’m happy to report that I didn’t get into an accident. I didn’t even get honked at.

Schizoaffective Disorder and Worrying About My Knee

Driving to the doctor is not the only source of my anxiety surrounding my knee, though. I’m worried about my knee. I don’t know what’s wrong with it, though my general practitioner has suggested a torn meniscus, the cartilage that cushions the bones at the shin and thigh. The holidays are coming up, and I don’t want my knee to be messed up over the holidays. I get depressed just thinking about that.

I’ve seen two doctors about my knee, and I’ve had X-rays done. The X-rays show that I don’t have arthritis, so that’s a relief. Now I need to get a magnetic resonance imaging (MRI) scan done to look at the tissue inside the knee. I called a place to get the MRI done and it’s scheduled for next week.

Waiting for phone calls from doctors is also a big source of stress and anxiety for me, and a lot of that’s been going on as I try to figure out what’s wrong with my knee. I always thought having something wrong inside my head was worse than having something wrong with my body. But I’d never had something significantly wrong with my body like this before. Sure, it could be true that my mental illness is making this experience of having a knee problem worse. But I’ll never take my physical health for granted again.

Although victims of verbal abuse do not have bruises or other physical scars, the effects of verbal abuse are still genuine. While anxiety and depression can result from verbal abuse, they are not the only side effects.

Verbal Abuse's Physical Complications

In fact, many people, like myself, who suffer at the hands of an abuser will have physical problems that stem from continuous verbal abuse. Knowing how abuse can affect your physical wellbeing is just one of the ways to help you maintain a healthier life. 

Physical Symptoms of Verbal Abuse

You may wonder how verbal abuse can cause physical harm, but it is possible. Someone who regularly faces put-downs, insults, criticism, or degradation can develop physical ailments. These symptoms are the body's way of responding to circumstances that it cannot control.

Some physical problems, as noted in "Psychological Trauma and Physical Health: A Psychoneuroimmunology Approach to Etiology of Negative Health Effects and Possible Interventions" as Kathleen Kendall-Tackett explains, verbal abuse victims may have a higher increase of health problems, including:¹ 

• Heart disease 
• Cancer 
• Stroke  
• Diabetes 
• Chronic bronchitis 
• Emphysema 
• Chronic pain
• Obesity 
• Chronic inflammation 

Even though verbal abuse victims do not carry bruises or visible wounds, their bodies may hurt just as much as their psyche does. 

One study from the Center for Substance Abuse Treatment in the "Trauma-Informed Care in Behavioral Health Services" found victims of trauma experience:² 

• Disturbances in sleep patterns
• Respiratory issues 
• Gastrointestinal problems
• Urological issues
• Dermatological disorders 
• Cardiovascular issues

How to Counteract Physical Symptoms 

For many individuals, physical symptoms appear because they have no way to resolve the negative feelings they have from verbal abuse. Much like those who keep anger bottled inside, anxiety, depression, or other emotional triggers that do not have an outlet for resolution and healing can manifest in physical signs. 

If you or someone you know is experiencing verbal abuse and dealing with one or many physical side effects, there are ways you can help minimize them. 

• Talk to a professional for emotional support. Allowing yourself to work through your feelings from verbal abuse will allow your body to release the building anxiety. You may also find better tools and methods of dealing with your internal feelings, so your body does not have to.
• Try to participate in some physical activity each day. You do not have to go to the gym for an hour or run a marathon. I've found that even taking a walk after dinner for 15 minutes can do wonders for my mind and body. 
• Try to follow a healthy diet. Your body will function better at handling stress if you minimize junk foods or alcohol. I try to eat a well-balanced meal with snacks each day, and make sure I drink enough water. 

There Is Help 

Even if you have visited your family physician who cannot explain your physical ailments, there are ways you can get help. With the proper tools and methods, victims of verbal abuse can live a healthier life without dealing with physical or emotional side effects. Talk to a professional in your area or through a toll-free line from our resources page, and start taking care of your physical health by helping your emotional wellbeing.

Sources

1. Kendall-Tackett, K., "Psychological Trauma and Physical Health: A Psychoneuroimmunology Approach to Etiology of Negative Health Effects and Possible Interventions." Psychological Trauma: Theory, Research, Practice, and Policy, Vol 1, No 1, 35–48, 2009.
2. Rockville (MD), "Trauma-Informed Care in Behavioral Health Services", Treatment Improvement Protocol (TIP) Series, No. 57, Center for Substance Abuse Treatment (US), 2014