One part of my treatment for schizoaffective disorder is an antianxiety medication I take as needed. I’ve been taking it for decades, but now my psychiatric nurse practitioner (NP) wants to ween me off of it. I have mixed feelings about this change in my schizoaffective treatment.

I Needed This Treatment for Schizoaffective Disorder Most When I Heard Voices

One of the most important things I’ve used this particular schizoaffective treatment for was when I used to hear voices, I would take it to calm down the voices, and it worked. Now that I no longer hear voices or have any delusions, it might be a good time to go off the medication. Although I am in no way at all antipsychiatry, I would like to be on less medication.

But this treatment helps my schizoaffective anxiety. I have very high anxiety. Yesterday, I got extremely anxious when my shopping cart grazed a display of Cheez-It bags at the grocery store. Normally, I never go grocery shopping alone. I always go with my husband, Tom. And usually, when I go with him, I stay in the car. There are so many things I could knock over and so many people who make me feel that I’m in the way. When we got home from this trip to the grocery store, though, I had to take my as-needed anxiety medication.

Using Therapy Skills as Schizoaffective Treatment

I am happy, though, that I no longer need as much of this treatment for schizoaffective disorder as I used to because my NP and I are decreasing it. And I’ve been using skills I’ve learned in therapy to fill in the gaps. Medication is important, but therapy skills are another crucial schizoaffective treatment for me.

Right now, the therapy skill that helps me the most, especially as my as-needed anxiety medication is being decreased, is telling myself if I’m worrying about something (which is all the time) to put it aside and worry about it later. Another is labeling worries as what-if thinking.

For more about cutting back on my medication for schizoaffective disorder, watch this.

Writing this has made me realize that I can handle slowly going off of this schizoaffective treatment. So, thank you, my readers, because you are why I write these articles. I mean, I quit smoking, I quit drinking, and I’m lowering my sugar intake. (I was getting most of my sugar from juice, so now I’m going back to drinking lots of water.) My whole point is: having done all that, how hard can this be?

It's hard to deal with anxiety when you're going through change. Change can feel scary and unpredictable, and even more so when you are already feeling stress and pressure in other areas of life. This is something I have experienced recently. Over the years, this anxiety trigger has been something I have worked hard on learning how to cope with. Years ago, I would find that any time any major life changes occurred, I would feel extremely anxious.

Why Change Is Difficult for Someone with Anxiety

One of the reasons I've noticed I feel anxiety around change is related to the unpredictability of the situation. When I experience new transitions, life isn't as predictable as it normally would be. Usually, I know what to expect from day-to-day, but if there are changes taking place and things are new, then I don't know what to expect.

That unpredictability taps into the overwhelming worry that often happens with anxiety. The rumination and the persistent thoughts and worries can become overpowering. Instead of feeling confident that I can cope with what may happen, I feel overwhelmed because I feel as though I don't know what is going to happen.

This also often results in withdrawing from others and wanting to isolate. I know, though, from experience, that this is actually not helpful for me and can ultimately have the opposite effect of making my anxiety worse when I'm going through change.

Essentially, I've been pushed out of my comfort zone, my daily habits and routine, and along with that comes feelings of disarray. The worry that I often feel that something bad is going to happen -- which is characteristic of anxiety -- becomes something that I feel very noticeably.

Dealing with Anxiety that Comes with Change

The problem with this is that it makes it hard for me to function on a daily basis. That becomes challenging when you need to be able to function effectively every day while, at the same time, you are having difficulty focusing because your thoughts are mired in worries about the future.

Things that I know are helpful and that I am continuing to try to work on when dealing with change and anxiety include practicing mindfulness, deep breathing, and meditation.

And while calming my nervous system helps, I think the most helpful strategy that I need to focus on is reframing my negative thought process. I need to recognize the patterns of thinking that lead me to feel overwhelmed, without control, and just worse overall. Sometimes, writing these thoughts down helps me to organize them in my mind and make sense of them to where I can regain a sense of control.

Are there strategies you use to help you cope with anxiety when going through change? If so, share them in the comments below.

Co-fronting with alternate personalities (alters) in dissociative identity disorder (DID) is something I only recently learned about. Sharing my mind with multiple identities, each with thoughts, feelings, and perspectives, lends itself to interesting conversations. These internal complexities can lead to co-fronting (when two or more alters are in control of the body at the same time) while significantly influencing how conversations unfold internally and externally, depending on the factors present at the time. 

Co-Fronting and Conversations with Alters in DID

Until a few months ago, I had never heard of co-fronting. I learned about it in therapy. Co-fronting is:

"a specific type of co-consciousness in which two or more alters are in control of the body at the same time to varying degrees."¹

For me, co-fronting with alters in DID makes every conversation become a delicate dance of managing identities and external interactions, working to ensure everyone feels heard and respected. However, even seemingly mundane discussions can trigger co-fronting between alters, disrupting the flow of dialog externally. It's like juggling multiple conversations at once, maintaining coherence while staying present in the moment and accommodating the diverse voices within. All of which can be disorienting. 

While my consciousness switching between alters ("switching") has decreased significantly over the past few years, co-fronting still impacts my relationships and everyday conversations. We've found the impact comes when triggered alters begin co-fronting, but they may not have the same skills or emotional regulation as I do. These conversations can look like a mini rollercoaster with twists and turns.

Learning to Co-Front with Alters in DID

To learn more about the impact of co-fronting with alters in DID, watch this video:

Co-fronting has taught me each alter may have different preferences, opinions, likes, dislikes, and communication styles. Co-fronting with alters in DID makes collaboration essential for navigating daily interactions smoothly. Picture a roundtable discussion where every voice has a seat and decisions are made collectively. However, the ins and outs of the day provide little to no time for roundtable discussions, which is why my system exists more as a mini rollercoaster, with two or more drivers at the wheel as we continue working to navigate co-fronting. 

Moreover, conversations can serve as triggers for switches or co-fronting, especially when the topic touches upon past trauma or deeply held beliefs within my collection of alters (system). What may seem like a harmless remark to one alter, could evoke intense emotions or memories for another, prompting a sudden shift in demeanor or communication style. 

Learning from Co-Fronting with Alters in DID

Despite these challenges, everyday conversations also provide opportunities for growth and understanding. Through dialog, I've gained more insight into the experiences and perspectives of my alters. Over time, this has fostered a deeper sense of empathy and cooperation within the system. Not every alter may be comfortable co-fronting in external conversations. Other alters may have much to say or be easily triggered, making for a bumpier co-fronting ride. Nevertheless, continuing to learn from my experiences has allowed me to understand what co-fronting with alters in DID means for our internal system and how this relates to our everyday conversations. 

My experience continues to show me that, while complex, everyday conversations while living with DID are a dance of managing internal and external dialogs. It's a journey of self-discovery, communication, and collaboration among alters, with each conversation offering opportunities for growth, insight, and understanding. 

Source

1. Dissociative Identity Disorder Terminology. (n.d.). Multiplied by One Org | Trauma and Dissociative Disorders. https://multipliedbyone.org/dissociative-identity-disorder-terminology/

Everyone has habits -- both healthy and unhealthy habits. Healthy habits might be drinking enough water throughout the day. Unhealthy might be drinking excessively every night. Lately, I am finding that some of my past behaviors and thought patterns have contributed to some of my unhealthy habits today. To learn more about my discoveries and experiences with habits, continue reading this blog post.

Unhealthy Habits Around Comfort Food and Gambling

As a child, I loved fast food and chocolate. At first, it was not an issue because I was slim and fairly active. But as the years passed, I couldn't get my hands on enough cookies and candy.

In middle school, I started to gain quite a bit of weight. It got a little worse in high school. But I thought that since I was young, I could change my eating habits at any time.

Eventually, it worked. I gave up fast food and started packing healthy lunches for school. I worked out for an hour every night. Toward the end of my senior year, I felt really good about my body. So, throughout the rest of high school and college, I kept going to the gym and restricting my calories. But these habits did not last.

In my mid-20s, I started to get chronic back pain. I became severely depressed and lost my interest in exercising. Since then, I have found my weight slowly increasing. Last year, in addition to eating fast food and chocolate, I started playing slots when I was stressed out. I thought that it would help me feel better when I needed a win. But after losing my money, that was not the case.

My Unhealthy Habits Are Triggered by Shame

When it comes to impulsive, unhealthy habits, there is a thought pattern I recognize. Here it is.

• I made some money today. I'm going to reward myself with a Big Mac meal.
• Now I should probably exercise. But the bar is right around the corner. It is time to play slots.
• I just lost 20 dollars. Maybe if I just spend 10 more dollars, I will win it all back and then some.
• I just lost all my money. I'm more disappointed than I was before. Maybe a sundae will help me feel better.

But before I knew it, my unhealthy habits had a tight grip on my mind, body, and self-esteem. Every time I looked at myself in the mirror or checked my bank account balance, I hated myself. To feel better, I turned to my unhealthy habits all over again.

Before I started writing this blog post, I had lost a lot of my hard-earned money on slots. Tonight, it hit me: Every time I give in to an unhealthy habit, I lose something that I could have been gaining by creating a healthier one. I am wasting the time, money, and energy that I need to thrive in the long run. So, now that I have written all this down, this is the first step to change.

If you are struggling with an unhealthy habit or an addiction, please know that you are not alone. You are human, and you are allowed to make mistakes. Everyone is a work in progress. It can be easy to fall sometimes. But if you can fall, you can also rise and become stronger than before. The most important thing is to keep looking forward and be intentional about making healthy changes.

In the pursuit of nurturing self-esteem, my journey spans nearly two decades of mindfulness meditation practice and affirmations. The profound influence of mindfulness meditation practice has allowed me to comprehend the potency residing within my own mind, transforming it from a tumultuous sea of thoughts into a serene sanctuary that nurtures my self-esteem. Affirmations have a power all their own.

The Transformative Power of Mindfulness to Nurture Self-Esteem

Mindfulness, a discipline requiring persistent effort, has taught me the art of quieting the mind and reclaiming a peaceful state, free from the intrusion of unwanted thoughts. This commitment to being present in the moment, coupled with non-judgmental observation, serves as a powerful tool in countering the persistent waves of negativity often associated with low self-esteem and mental health conditions. 

The journey to quieting the mind is no magical remedy; instead, it is a skill cultivated through consistent practice. Through the lens of mindfulness meditation, I have harnessed the ability to steer my thoughts away from negativity, redirecting my focus toward tranquility. The rewards of this effort extend far beyond the meditation cushion, permeating various facets of my life and nurturing the foundation of self-esteem. 

Positive Affirmations: A Guiding Light to Nurture Self-Esteem

Another facet of nurturing self-esteem involves the deliberate practice of positive affirmations. These simple yet potent statements act as beacons of positivity, dispelling the shadows of self-doubt and fostering the growth of self-worth within. 

Understanding the malleability of our thoughts, positive affirmations play a crucial role in reshaping the narrative of our inner dialogue. Customized to individual needs, these affirmations serve as a continual reminder of our strengths, resilience, and intrinsic value. They act as a shield against the arrows of negativity, fortifying the armor of self-esteem. 

In the age of technology, accessing positive affirmations has become effortlessly convenient. Social media platforms offer an abundance of affirmations that can be seamlessly integrated into daily routines. Whether through written messages or audio affirmations, these tools provide a constant source of encouragement, reinforcing the belief in one's own self-worth. 

By regularly engaging with positive affirmations, we consciously nurture our self-esteem, infusing our subjectivities with thoughts that uplift, inspire, and affirm our inherent value. This proactive approach to self-esteem is an ongoing journey, yet the rewards are immeasurable: a resilient mind, a compassionate heart, and a bolstered sense of self-esteem. 

I encourage my audience to consider how they can incorporate mindfulness and positive affirmations into their daily routine to nurture self-esteem. I assure you it is worth it. 

As I recovered from my mental illness, I still had an overwhelming, heavy feeling that I was behind in life. I spent so much time asking myself what I had done wrong when I really should have asked myself, "Why do I feel this way?" Comparing myself to others was a dangerous, harmful game, and at the end of the day, I was the only one keeping score in being behind in life.

Recovery and Reflecting on Being Behind in Life

My birthday is coming up soon; in fact, one week from today, and for some reason, that anniversary always puts me in a funk. The passing of time has always been a scary concept for me, and every birthday, I end up asking myself, "Why am I not further along?"

I like social media. I believe there are genuine, good things that come from it. But there are also undeniable negatives to its usage as well. As I scroll, I see people my age, or even younger, smiling in front of a "sold" sign, propping up a baby on their hip, accepting a work award, or cutting a wedding cake. Long after I put down my phone, I ask myself, "Where are your accomplishments? Why are you behind in life?"

Why Do I Feel So Behind in Life Compared to Everyone Else?

Sometimes, my big accomplishment of the day is getting out of bed or walking around the block. I've never run a marathon. I don't have my own family, and my professional title doesn't start with "senior." 

My life has had some bumps. When I was at the height of a long depressive episode and had undiagnosed attention-deficit/hyperactivity disorder, I would let things slip. A great example is with mail. I would get a bill, and it would sit in a pile of mail for months. Eventually, several of my school loans went months overdue. It was terrible for my credit, but I couldn't get myself to care enough to fix it. 

It's hard to plan for the future when you can't picture a future. When existing feels hopeless, it feels useless to open a bill, let alone create goals. I was surviving day-to-day, and at that point, it was the best I could do.

The Dangers of Thinking You're Behind in Life

Comparing myself to others never had a positive outcome -- it always made me feel behind in life. It made me feel weak, untalented, and undisciplined, and I am none of those things. But how am I supposed to feel when being fed the highlight reels of everyone else's lives?

I finished eight books this year, but it doesn't matter because my friend finished 12. I tried a new workout class. Cool, but my coworker ran a race. I found an apartment I like. That's great, but an old classmate just bought a house.

It felt like nothing I did was good enough. But good enough to who, to everyone else? I've recognized that I didn't even want some of the things my peers were doing. I've slowly wrapped my head around the fact that the only person I need to be "good enough" for is me.

Everyone struggles, but those with mental illness have it even harder. At some points in my life, working, keeping up relationships, going to the gym, and even getting up were hard. I did my best. And the most important part is that it was my best, and not anyone else's. At the end of the day, that's all that matters.

As someone who has struggled with gambling addiction for a long time, I understand firsthand the challenges of preventing the relapse of gambling addiction. One moment, you feel like you are finally gaining back control, and the next, there is this overwhelming urge to gamble. In this article, I'll be sharing my experience with preventing a gambling addiction relapse, as well as proactive strategies to sustain long-term recovery.

Understanding Gambling Addiction Relapses

Relapse is the return to addictive behavior (in this case, gambling) after a period of abstinence. In my experience, there are three stages of relapse: emotional, mental, and physical.

1. Emotional relapse -- This begins with subtle shifts in emotions and behaviors, such as increased stress, irritability, or isolation. 
2. Mental relapse -- This involves thoughts of returning to gambling, rationalizing past behavior, or romanticizing the "good times" associated with gambling. You start feeling like you are missing out and life in recovery is boring.
3. Physical relapse -- This marks the actual return to gambling behavior.

Causes and Signs of Gambling Relapse

Slipping back into gambling can be triggered by a multitude of factors. In my experience, the main ones are stress, financial difficulties, and relationship problems. For me, it was financial problems. I had pumped all my cash into a project, and unfortunately, it didn't work out. I felt like I was a failure, and to escape, I returned to gambling. I wanted something to distract me, and gambling worked just fine.

Identifying the various triggers and ways you can manage them is crucial in preventing gambling addiction relapse. You must also recognize warning signs that might include mood swings, being increasingly secretive about your finances, neglecting personal responsibilities, and lying to loved ones.

How to Prevent Gambling Addiction Relapse

Here are some things you can do to prevent gambling addiction relapses:

• Identify your triggers -- Know the possible things that can push you to gamble and avoid situations that might tempt you.
• Develop better coping mechanisms -- Learn healthy coping mechanisms to manage stress, anxiety, and gambling cravings. These can be meditation, yoga, journaling, etc. 
• Limit access to money -- If you find having cash at your disposal challenging, you can give a trusted family member control of your finances. 
• Remove access to gambling apps and websites -- Unlike some years ago, there are now so many gambling websites and apps, and you can bet at the click of a button. This makes it more challenging, especially since a phone is not something you can do without in today's age. I recommend self-exclusion. 
• Reach out for support -- Talk to trusted friends, family, and other recovering gambling addicts about your feelings and struggles.

Relapse is not a sign of failure but a part of the process. Understanding the triggers and signs of gambling relapses can help you take proactive steps that will keep you on track in your gambling addiction recovery journey. Check out this video below for more:

Believe it or not, a mundane trip to the grocery store helped me learn to enjoy food again. The year was 2019. I had recently moved across the United States from Florida to Arizona. And in my new zip code, there was a Trader Joe's on almost every corner. I am aware that makes me come across as a basic Millennial stereotype (which I own, for the record), but living near Trader Joe's has proven to be a crucial milestone in my eating disorder recovery. Here's how this grocery store helped me learn to enjoy food again—and to eat what I love without shame. 

How I Learned to Enjoy Food Again with Help from a Grocery Store

Before I dive into this topic, I want to acknowledge it is a socioeconomic privilege to have access to food within close proximity. The U.S. Department of Agriculture (USDA) estimates that around 44 million Americans experience food insecurity, either due to their location or income bracket.¹ This can exacerbate the prevalence of eating disorders in some communities and present systemic barriers to healing.² I would be remiss to overlook this disparity. As such, I have immense gratitude for the opportunity to rediscover enjoyment in food.

The first time I walked into my local Trader Joe's, I felt an immediate gravitational pull toward the snack aisle. As someone who dealt with anorexia for 15 years, I wasn't much of a snacker between meals—but I was intrigued by the sheer volume and eclectic variety of snacks along those shelves. From chili lime cashews and tempura seaweed to almond butter pretzels and Jerk-seasoned plantains, my mouth began to water in anticipation of those unique flavor combinations. As I stared at all the options available, a new thought occurred to me: 

"Is food more than just a source of utility and function? Could it be pleasurable, too? Can I nourish myself, while also savoring the experience?"

With this question in mind, I bought a few snacks. That small but intentional choice inside a grocery store built the foundation on which I would learn to enjoy food again. 

I Learned to Enjoy Food Again—and Combat Shame in the Process

It has been four years since this introduction to Trader Joe's, but my love for food only continues to grow. When I crave an afternoon or evening snack, I no longer repress that desire. I listen to it; then I respond—even when my eating disorder wants me to do the opposite.

Cultivating this mindset was an incremental process, and it still feels counterintuitive sometimes. But in the moments when guilt creeps back in, I remember that paradigm shift in the snack aisle of Trader Joe's. I recall the freedom of realizing I could enjoy food with no shame attached. Then, I make the deliberate choice to reach for a handful of chili lime cashews or almond butter pretzels. I tune out the eating disorder voice in my brain. I lean into the pleasurable flavors on my tongue. And I smile at the simple realization that a grocery store helped me learn to enjoy food again.

Sources

1. USDA ERS - Key Statistics & Graphics. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-u-s/key-statistics-graphics/#insecure
2. Hazzard, V., et al (2020). Food Insecurity and Eating Disorders: A Review of Emerging Evidence. Current Psychiatry Reports, 22(12). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7596309

For some people, an all-or-nothing mentality can be one of the possible results of verbal abuse. However, it isn't just verbally abusive actions that can cause this. Anxiety, depression, and low self-esteem are also commonly linked to an all-or-nothing mentality. 

I've experienced many negative emotions during my verbal abuse journey. Regular exposure to intense screaming, insults, and threats contributed to a contrasting view of relationships. The extreme emotional swings within the cycle of abuse reinforced a black-and-white dynamic that was a common occurrence. 

An All-or-Nothing Mentality In Verbally Abusive Relationships

As I navigated my feelings, my coping mechanisms evolved into extreme thinking. There was never a stable middle ground in my life for many years. If I wasn't doing things right in the eyes of my abuser, I was completely wrong. 

Each mistake I made was magnified and focused on, making me feel worse about myself. So, I lived each day trying to be perfect and avoid any confrontation. The verbal abuse reinforced several absolutes that aligned with this black-and-white mentality, such as: 

• I will never be enough.
• I am always screwing things up.
• I can't do anything right.
• I'm not smart enough to achieve (a goal).
• No one likes me.
• I'll never be happy.

Changing the All-Or-Nothing Perspective 

Through therapy, I've grown to understand that these negative thoughts are not entirely true. I am not perfect, and sometimes, these statements may apply to some degree. Occasionally, someone won't like me, or I make a bad decision, but that doesn't mean I can't learn from these situations. I can grow and change, moving away from this all-or-nothing mentality. I understand that although I'm not 100 percent perfect, I'm not 100 percent a failure either. 

When it comes to my relationships now, I recognize that when my partner is mad at me, it won't result in verbal abuse. Yes, we disagree, but there aren't the insults, name-calling, or threats that were once a part of my life. 

I have the trust I need now to know that even if I make the wrong decision, my partner and I can talk through it. I don't live each day thinking I'm not good enough anymore. And that grace I receive goes both ways. I am more open to communicating with others when I'm upset with their actions. Slowly, I'm building the relationships I need and deserve.

After years of analyzing my past and present relationships, I'm not sure if verbal abuse caused my all-or-nothing mentality. However, I know it's an unhealthy way to live my life. Every day is unique; sometimes, it's a struggle, and other days, I'm feeling great. I remember to take it one day at a time and try not to beat myself up when I'm not 100 percent perfect because I know that I'm not 100 percent a failure either. 

Forced gratitude happens thanks to the fact that gratitude is trendy -- it's been in for a couple of years now. And whenever something becomes popular, many of us jump on the bandwagon. Of course, it may be that practicing gratitude benefits your mental health. But what if your gratitude isn't genuine but forced? Can it then backfire and harm your mental health? Let's take a look. 

What Is Forced Gratitude? 

To know what forced gratitude is, we need to take a look at what gratitude is. According to PositivePsychology,

"Gratitude is an emotion similar to appreciation. Gratitude is both a state and a trait. Better explained, one can experience gratitude for someone or something at a certain moment in time, and someone can experience gratitude more long-term as a positive character trait."¹

When one expresses gratitude that is not genuine or sincere, I call it forced gratitude. 

Why Does Forced Gratitude Harm Your Mental Health?

I feel, as a practice, gratitude is good for your mental health only when it's genuine. For example, if you make a list of things to be grateful for at the end of a good day, you might feel grateful after the exercise. But if you force yourself to make a gratitude list on a day when nothing went right, you might end up feeling like a fraud. Because at the end of a bad day, it can be difficult to hold back tears, let alone find things to be grateful for.  

That is what happened to me.

A while back, I sincerely tried gratitude journaling on the recommendation of my therapist, and it backfired terribly. I felt forced gratitude was invalidating my problems by overlooking them and thinking that "others have it worse." The truth of the matter was that I had some serious issues going on in my life, and I was in a dark place mentally. Life was not in my favor back then, and forcing myself to be grateful for things like having a roof over my head only made me bitter and resentful. 

What Can Improve Your Mental Health Instead of Forced Gratitude?

If practicing gratitude every day doesn't improve your mental health, what does? Check out the video below, where I talk about more organic ways to boost your mental health.

How has an attitude of gratitude impacted your mental health? Let me know your thoughts in the comments section below. 

Source

1. Millacci, T. S., PhD. (2023, October 3). What is Gratitude and Why Is It So Important? PositivePsychology.com. https://positivepsychology.com/gratitude-appreciation/