Navigating the Health Care System: How to Find a Therapist

Navigating the Health Care System: How to Find a Therapist

Whether via the private or public health care system, the task of finding a therapist can be daunting. You have to approach it from two different angles: 1. Finding your way through your health care (or lack thereof), and 2. Seeking out a professional whom you can afford, has space for you, and can give you the kind of help you need. As I’ve always contended– forcing a person who is struggling to make it day to day to advocate for their own care in a broken system is cruel. But it’s our reality currently so I hope that this can help make the process a little easier, and I will step off my soap-box for now. *Please note that no advice given here should be taken as an absolute as all plans and providers and marketplaces have their own rules and can vary significantly. Additionally, because there are so many moving parts to mental health care, this article is loaded with links to try and help pare down the excessive amount of information it takes to understand how to effectively navigate the system.

On health care: Insurance can be so confusing! Picture it as a tree– at the top you have your two options: private vs. public health insurance. Underneath each branch you have your various plans with their caveats, both financial and coverage-related, we’ll compare those later. The private insurance branch which is sold by companies like Aetna or Blue Cross, generally to large companies and organizations, then purchased by individuals as part of a group plan, or individually through your specific state’s health insurance marketplace (the latter’s monthly premiums may be subsidized based on your income). The other branch is public health insurance which is funded by the government and is generally for low-income families, individuals, the disabled, and seniors. So if you have a full time job, a part time job that offers coverage, belong to an organization (like a university or union) that offers coverage, or are self employed you would more than likely fall under the private insurance branch through your group plan or via your state’s marketplace. If you fall under a yearly income threshold based on your state’s limits, are unemployed, disabled, a student, or a senior, you would likely fall under the public health insurance branch. Here’s a good tool to help determine where you land with your income.

How private insurance *generally works: Here is a relatively accessible overview of how private insurance works. Under this branch we have two more branches: group plan providers which are acquired through employers or organizations, and your state’s health care marketplace if you are self employed or a small business. Whichever branch you fall under, here’s the short of the long: you must enroll during the open enrollment period (unless you have a qualifying life event) usually during the Fall, you will pay a monthly, quarterly or semi-annual insurance premium (which may be either partially or fully subsidized by either your employer or the state), you will likely have an out-of-pocket plan deductible before your plan will begin covering services for you (which does not include your premium payments), you will also likely have a co-pay each time you see a provider (many plans now cover preventative care visits at no cost, however).

Coverage: This is where it gets super convoluted and difficult to understand. I will only make a basic attempt at explaining this because I don’t want to overstep my base of knowledge as every private provider works differently. What I recommend here is utilizing your resources, by that I mean is grab a pen and paper and call the insurance provider/broker/marketplace, etc. and have them lay it out for you in as plain of English as you need them to, that’s what they get paid for. Another good resource often offered with employer group plans is an Employee Assistance Program (EAP), and they can help point you in the right direction when searching for mental health options and providers. Make sure you understand the basic terms that will be used and the following generalizations, such as the higher your premium the lower your deductible and vice versa, and that if you intend to see the doctor often you are likely better off with a lower deductible plan whether through a group plan or the marketplace. Here’s a good article on high vs. low deductible plans.

State Marketplace/Exchange: When it comes to state care, AKA the ACA, AKA Obamacare, here is the best place to start. If you find the marketplace/exchange confusing, I still recommend picking up the phone and calling for explanation. Some cool things about it are that the plans are required to provide the 10 essential health benefits (mental health coverage being one of them!!), and they have simplified the offerings to some extent with a tiered plan system: platinum, gold, silver and bronze. Starting from the top to the bottom, platinum covers more of your expenses but has a higher monthly premium, bronze has a lower premium but your services will cost more. When I was working full time self-employed and seeing a psychologist and/or psychiatrist anywhere from 1-4 times a month, I went for the silver plan and a portion of my monthly premium was subsidized by the state based on my income.

HMO vs. PPO: Under each branch, group or marketplace, you finally have two more branches of coverage option: Health Maintenance Organization vs. Preferred Provider Organization. Here’s the difference between the two and what they generally offer. Each plan has what’s called a network. The HMO network is self-contained meaning all your eligible providers already exist within the network and anyone you see outside of the network will not be covered. They generally want you to go see your primary care physician to get a referral to any kind of specialist, but they keep the coverage simpler with lower out of pocket costs, deductibles and premiums. A PPO network will allow you more providers in-network and will potentially partially cover some out of network providers (like if you have a doctor you really love but have to switch to a plan they don’t accept), but in exchange you’re going to pay higher costs.

How public insurance *generally works: Here is a good overview of how public insurance works. To me, public insurance can be simpler in ways but can take longer to navigate, and the behind the scenes administrative part of it can at times be frustrating (for example the time my Medi-Cal was cancelled due to an employee accidentally inactivating both my health and dental insurance instead of just my dental insurance and I had to spend a few hours calling around to get to the bottom of it, escalate it to management, then it took a week to have it reinstated). One tip, public care resources can feel like less of a one stop shop than private which is why I always recommend starting out with your local county public health care office when you need help. You will have a case worker, they will determine your eligibility and help walk you through finding a provider and explaining your options. There are 2 branches under which you can fall in the public system: Medicare which is for seniors and the disabled, and Medicaid (called Medi-Cal here in California) for low income children, families and individuals. Being a student and working part-time, I qualify for Medi-Cal and what was really great about it is I got to stay with Kaiser, which is a pretty decent HMO group offered in CA and a few other states. Options are more limited than private health insurance but care is available and when I can’t find a resource on my own, I find calling my county office or case worker a valuable resource to finding what I need.

On finding a therapist: This part can be equally as tough but for different reasons. Whether via private or public insurance it’s hard to know whom to go to for what and how to get to who you need. If you’re looking for medication only, your general practitioner is usually a good start. If they don’t feel comfortable prescribing you what you’re looking for they can refer you to a psychiatrist. If you’re only looking for therapy, you can also ask your GP for a referral but there’s a few different types when it comes to mental health professionals, ex: psychologist, LMFT, peer support, counselor, nurse, etc. If you are looking for the dual approach of medication and therapy, you will likely have to see a psychiatrist and psychologist independently as they no longer co-exist within one professional as they used to.

Once you know who you want to see now you begin the search of finding the right professional. I am lucky living in San Francisco, I have an accessible concentration of professionals in my city, however I realize that those living in more rural areas run into issues of both accessibility and lack of professionals. Finding the time during your work day to go to the doctor can be tough, as can finding a professional who is accepting new patients or one who accepts your insurance. This is where I’d recommend keeping a spreadsheet of some sort, outlining  the following: Name of doctor, location, hours, are they accepting new patients, do they have after hours appointments, can they do video or phone appointments (there’s now also apps out there to get remote therapy on demand– Talkspace, and Larkr are two), are they within an accessible radius of your home or work (maybe there’s a shuttle?), etc. The best approach to narrowing down who might fit the bill is again to call your insurance provider and make them work for you. If you have private insurance call their main customer service line and ask for help finding professionals in your area based on your criteria. If you have public insurance you can call your local county office, ask for the same thing and they can help by giving you a list of providers to call, or point you in the direction of a resource who can. Also one thing to keep in mind given that the demand for mental health care is blowing up right now (yay, keep seeking help!), many insurance providers are having to farm their mental health care out to a secondary provider in order to meet our demands. This can add a level of complexity to it but don’t sweat it, you can work their resources the same way you’d work the ones provided by your direct carrier. For example I see a therapist at Kaiser 1-2x a month, her case load is too large for me to see her any more frequently so she has given me a referral to a company called Beacon who is finding me another provider whom I can see more frequently.

Where rough meets tough: Let’s say you’ve found someone, they’re taking new patients, you can get to their office, they take your insurance, and you can afford the copay, but the only time they can see you is during the workday. You can take the time off of work to see them but don’t want to tell you boss for fear of the repercussions. That’s OK! Treat it like any other doctor’s appointment, let them know you have an appointment, it may turn into a regular thing and you will need the time off. By law they cannot ask you who you are seeing or why, frankly your self care is none of their business. You may have to forgo a few paid hours at work if you don’t have leave time you can take but I’ve always said the reality mental health is that it’s always at a cost. Whether it’s time, money or energy, mental health care equates to a resources expenditure. But it’s beyond worth it so please DO NOT FEEL GUILT OR SHAME over making the time to take care of yourself. In the end you may very well be happier and more productive at work because you took the time to get care! (Also please consider the remote therapy apps if missing work and/or logistics prove to be care-prohibitive).

Let’s say you’ve found a therapist but you’re not jiving with them. It can be really tough to open up and spill your innermost darkness and troubles to a total stranger. In order to heal we need to try and find a safe space within which to carry out the healing process. So if you find a therapist and you feel they aren’t hearing you, are not offering you workable solutions, are too old, too young, male when you’d feel more comfortable with a female or vice versa, etc. my advice is to NEVER GIVE UP, HELP IS OUT THERE, YOU ARE WORTH IT. Good doctors can be hard to find, they are not one size fits all. Don’t be afraid to ask for what you need whether that be from your therapist or your insurance company. Be firm but kind, be direct, and don’t take no for an answer. A pragmatic approach to care is the best; you have problems to solve, you likely have limitations on how you’re able to solve them, and you need a clear path to solving them.

When you go into the vast space of mental health, I recommend having some semblance of a plan, know what you want. My very first visit to my first therapist in my early twenties, I walked in knowing nothing other than I wanted to feel better and I needed help getting there. The first thing she did was give me a post it and ask me to sit there and think about and nail down the biggest thing I wanted out of treatment and to write it down. I still have that note and it’s a goal I’m still working to attain 13 years later. It’s a process; being mindful of that, as well as being kind and gentle to yourself, and remembering that you’re not alone will really help elevate your care and healing during what can be a confusing, difficult, and frustrating time. Logistically it can also help to work backward, knowing your transportation options to get to the doctor, what days and times you can go, how far you can travel, what you can afford, who you want to see, and what your ultimate goal is can help you to narrow things down from a different angle.

If you’ve made it this far, thanks for sticking around to read through. It’s a lengthy topic and I hope that I’ve been able to help provide some education and direction when it comes to setting afoot on this journey. The least but utmost important piece of advice I can give you is DON’T GET DISCOURAGED. This can be a really tough process, you won’t see immediate results, especially when it comes to medication, but you’re taking a crucial first step, don’t give up! It will feel discouraging at times, and you might want to quit but if it’s not working for you and you are able to change it, then change it. Use your resources, and be as relentless as you can in your quest for self-betterment because you and your wellness are 100% worth it.

Peace, love, and wellness.

 

 

 

 

 

Death by Depression, Not Suicide

Death by Depression, Not Suicide

It can be difficult to explain mental illness to those who might have little or no experience with it. Part of my goal as an advocate is to help society to understand the gravity of mental illness and abate the stigma, especially when it comes to depression and suicide. There’s still so much stigma and mystery around both topics that when the following email landed in my inbox after last week’s tragedies of Kate Spade and Anthony Bourdain, I felt I should pass it along. It’s by two members of bringchange2mind.org and it not only hit home with its title “Death by Depression, Not Suicide”, but it does a great job of helping to unravel the difference between the two in accessible terms. Suicide is an unthinkable act to most, and this email helps explain death via depression, with compassion, rather than propagate the stigma by labeling it as suicide…

“Recent shocking news has reported on the deaths of celebrities Kate Spade and Anthony Bourdain. Many have speculated about how such successful, beloved people can “kill themselves.” While the news is horrible, the story line misses critical points. First and tragically, Spade and Bourdain join a growing number of more than 100, mostly less famous, Americans having similar deaths “by suicide,” each and every day.  More importantly, the notion that Spade, Bourdain, and the others, decided to end their own lives is, in a deep sense, not true. These individuals are the victims of the pernicious illness of the brain, Depression.

Depression is a horrific illness that affects as many as 10% of Americans at any one time. Depression is a brain disease that can cause confusion and distortions in thinking, as well as interference with basic physiologic functions, including:  sleep, energy, appetite, motor function and more. It is neither self-inflicted nor a moral failure. Depression interferes with cognition (or thinking), making it impossible for the individual to perceive and accurately interpret the environment with a consequent inability to experience pleasure and anticipate the future. The brain’s failure to undertake accurate self-assessment of risks is intrinsic to Depression, with a disruption in sense of self and loss of the basic evolutionary drive for survival; this leads to dangerous behaviors and even death. Death during Depression is not a “self-inflicted” death (suicide) because the sense of self is gone; it is Death by Depression.

In the face of overwhelming evidence that Depression and other psychiatric disorders are serious illnesses that can disrupt brain function, including the will to survive, why do we still use the term “suicide?” “Suicide” is associated with the stigmatizing concept that those with psychiatric illness are intrinsically flawed or weak and want to die. Stigma and antiquated understandings about Depression and brain disease foster ignorance about the fact that Depression is just as life threatening an illness as are cancer and heart disease.

It important to accurately understand Depression and Death by Depression. Depression is a treatable brain disease and, Death by Depression is preventable. Depression is a medical emergency! It requires the immediate attention of medical professionals, friends, and family. The victim of Depression should not be left unattended any more than should someone bleeding profusely or having a heart attack – even if they insist that they are “OK.” Along with the immediate protection of the person with Depression, it is essential to rapidly apply evidence-based treatments. This will not only prevent death and debility but it will also help those with Depression save their lives so they can have much wanted, productive futures to share with friends and family.

Protection and prevention of complications (including injury and death) are the important first steps in treating Depression. But, this can’t be done if Depression is not identified early. Look for depression! When you find it, act promptly. If you are the victim of Depression, immediately tell someone (friend, family member, and / or professional) and let them help you get treatment. If you know someone with Depression, ask how you can help and make sure that they receive urgently needed professional care.

No one wants to die from Depression, or any other illness. To suggest otherwise is diminishing the value of life and the individual affected by Depression. Unfortunately, the concept of “suicide” interferes with our shared responsibility and opportunity to effectively prevent Death by Depression.”

Bennett L. Leventhal, MD
BC2M Scientific Advisory Council + BC2M HS Research Co-Lead
Professor of Psychiatry, University of California San Francisco

Neal D. Ryan, MD
Professor of Psychiatry, University of Pittsburgh

++++++++++IF YOU OR A LOVED ONE NEEDS HELP, PLEASE REACH OUT+++++++++++

❤️National Suicide Prevention Lifeline: 1.800.273.8255

❤️National Alliance on Mental Illness: 1.800.950.6264

❤️Text: HOME to 741741

❤️Text: ANSWER to 839863

Peace, love, and wellness.

Update: I Missed Mental Health Awareness Month…Oops

Update: I Missed Mental Health Awareness Month…Oops

Hi there, how have you been?

It would only make sense that I would do at least one post last month given that it was Mental Health Awareness Month. I had every intention of doing so, I was just a bit too consumed by life and my own mental health awareness, so I thought I’d catch up with an update. The big news, I was accepted last month to the bachelors of social work program at SFSU, I’m over the moon!! But I was also rejected at first. Ok, I was wait-listed. I was devastated, so I let myself feel sorry for myself for a day or two and then I moved immediately into figuring out a backup plan. While I was in the midst of my self-pity an old poem from my childhood popped into my head called Harlem, by Langston Hughes. It graphically challenges your answer the question, “What happens to a dream deferred?”, and then suggests that maybe the dream just explodes. Well, my answer to that was a resounding– hell no my dream does not explode, it absolutely lives, albeit deferred. And so I began planning what I would do should I not make it off the wait list this year and have to wait another year to reapply.

Given that I want to go into mental health in the LGBT community, I began looking at a minor curriculum in LGBT studies, I was actually pretty excited about the idea of it. While I was busy making these alternative plans, and being a total pain in the ass squeaky wheel to the entire social work department, I was notified that I’d been moved from the wait list into the program. There’s 25 seats, about 50 people applied, I’m happy as a clam on my new path! But it was hard earned. This whole process of totally uprooting my life in my mid-thirties, working only part time and going back to school has launched a serious platform for forced growth, and it seems in my years of experience that when it comes to growth and healing, it gets worse before it gets better.

I’m immensely grateful to be able to say that after a lifetime of depression symptoms and about 12 years of actively battling clinical depression, I feel I’m finally free of its daily grips (that’s not to say I don’t still get down from time to time, and I can’t say at this point in time that I or anyone can fully be cured of depression from a clinical standpoint. I am hopeful though). But what has come along in full effect in its place, and is the topic of many of my posts this year, anxiety. More specifically morning anxiety.

It’s a horrible way to wake up (often after a night of minimal sleep) and start off the day with that wad of tension in my chest, my mind racing, extremities tingling. Feeling out of control and scared my heart starts racing, my breath gets hyper, the noise in my head gets louder and louder and before I’ve reached 30 minutes into my day I’m broken down mentally, physically and emotionally, and in tears. There’s so much nervous energy in my body combined with the cacophony in my head, it creates so much resistance toward the whole day, and I’ve lost control before I even had the chance to try and hold onto it. It disrupts my sleep, it steals my cognitive ability, it makes me sad. And I can’t say it’s because I’m forever stuck in the future, I just wake up this way first thing with a full mind/body effect. I’ve done loads of research on morning anxiety and the only real biological factor that plays into it is that the stress hormone cortisol is highest in the morning. Otherwise everything else steadfast suggested a good morning routine.

The good thing about anxiety is that with all this nervous energy, it’s become a great motivator. I took the advice of a morning routine despite wanting to hide under my blankets in bed from the world where it used to feel so safe during depression. Now with anxiety, I genuinely fear that if I stop moving I’m going to self destruct. So the first thing I do is wake up early. It works out because usually now once I wake up I can’t go back to sleep anyway, and it allows me the time to 1. engage in my morning routine, and 2. not feel rushed to get ready and out the door for the day. Both have proven to be quite helpful in maintaining my morning chill vibe. What’s also helped is not just the morning routine, but self-care throughout the day. If I’m feeling tense or worked up by nervous energy or stuck in my head, I do something about it instead of resisting it and allowing it to fester.

Here’s what I’ve been doing and the general frequency, in any combination throughout the morning, afternoon, or evening:

  • Morning pages, most days. I do 1-2 pages
  • Meditation 1-2 x a day or as needed, no less than 10 minutes
  • Yoga 1-2 x a day, 10-20 mins
  • Stretching throughout the day
  • Walking 4-8 x a week, whether its 10 mins around the block or meandering 3 miles through the city
  • Jogging 3-5 x a week for at least 15 mins. I was never a jogger but for whatever reason the higher impact seems to help clear the nervous energy better
  • Smaller interval exercises like crunches, pushups, squats, wall sits 1-2 x a day
  • Breath work as needed throughout the day
  • No alcohol during the week
  • No caffeine (I get my jollies from a cup of decaf a few days a week)
  • Cleaner diet– I’m mostly vegetarian but I default to carbs. I’ve tried replacing  more of those with fruits and veggies, seriously limiting sugar, and avoiding anything that will make me feel heavy
  • Ashwaganda and CBD oil to help calm my nervous system
  • Acupuncture 1 x a week
  • Reaching out to my community and loved ones for support as needed

One other thing I’ve learned to do that’s been really helpful is to not resist the anxiety. I know that sounds totally counter-intuitive– like um, ok I’ll just let the anxiety have me until it grinds me down into a panic attack and they my whole day is shot? Yes and no.  This took a bit for me to understand, too. I realize it’s fully instinctual for us to resist that which causes us harm, but maybe anxiety isn’t there to try and harm us. Maybe its trying to tell us something, like a child crying out for help but who has no words to express himself. Maybe whatever it is that’s in us that crying out for help just needs to be loved and cared for instead of turning a cold shoulder to it, so that it may ultimately heal and release on it’s own. It’s almost like Murphy’s Law in that the more you resist something, the more you’re feeding it your power through the resistance, giving it reason to stick around, and therefore it’s going to be further destructive. If it can go wrong, it will go wrong.

So when I feel it start to rise up, or when I’m fully in the throes of it, I try and remind myself to not be upset over the way I’m feeling because it’s more than likely a part of me that needs healing, and it’s going to be a process. If tears need to flow I let them, if I need to let off nervous energy then I move, if I need to quiet my mind and calm my body I meditate and breathe and allow myself to be present with my feelings, no intellectualization needed. Not only that but it all helps to keep things in perspective and it helps me keep the faith in myself that I can and will make it to the other side of the daily struggle with anxiety, just as I have with depression.

I’m sorry I missed you last month. Things in life are falling into place, and anxiety has been actively trying to displace all these things I’m working so hard to maintain. But with love and compassion for myself and my challenges, I will keep a place for everything and everything in its place.

Peace, love, and wellness.

 

The Daily Struggle

The Daily Struggle

Given mental health challenges, my reality is that most days, at least to start, are a struggle for me. I wake up, I’d rather not get out of bed, I’m not overly excited to start my day, I’m not exactly looking forward to whatever greets me or what challenges may lie ahead. I either have to work myself up to, or relax myself into the idea of the day before I even get out of bed. I call this process waking up slowly– it involves a lot of meditative-style breath work, clearing of my mind and energy, sometimes an emotional purge in the form of tears, and a promise to myself to start my day on the best foot possible. If I wake up, immediately get out of bed and start my day without acknowledging whatever I’m feeling, it’s usually a bad start to the day.

That said, I personally for whatever reason tend to wake up feeling anxious. This is something I’m very much working on but have yet to find my answer. There isn’t much concept of “waking up fresh” daily for me. I’m moreso in a constant loop, I just get breaks of unconsciousness and rest in the loop. I have a lot of resistance in me toward life and it’s obstacles, and I fully acknowledge it. I know it’s via both nature and nurture, and it’s also something I’m actively working on. I genuinely want to rewire my point of view so that I no longer see daily life as being loaded with obstacles facilitating this built-in resistance. It’s easier said than done.

It’s not that I have no lust for life, or no excitement for anything or just a really shitty outlook. I definitely do have passion for certain aspects of life and I do at times get breaks from feeling this way. It’s that given mental health challenges, even when well managed, still make every single day challenging in one way or another and my fervor can easily get buried underneath it all.

It’s like every day I wake up wondering– how am I going to stand tall today, find my happiness, balance, productivity, and so on? How am I going to only let in what I need and keep out what I don’t? Every day is this simultaneously new but old navigation of how to make it from start to finish. How to deal with the daily build-up to break-down, then finally levelling out. Consistency is few and far in between for me, albeit I try my best to maintain in the ways I know how.

But it’s also like being in a constant state of distress in one way or another. I’m forever saving face, feeling disruption, or suspended in fight or flight. It’s an “invisible illness”, so most don’t have any idea I’m even in this state, but it does show itself sometimes in things like my posture, my tone of voice, choice of words and communication, or the look on my face. It can appear in my lack of patience with the people and stimuli around me, my responses and reactions. I see and feel it on the inside all the time, but the above is how it tends to manifest itself on the outside.

I know anyone can be subject to a bad day or waking up in an off mood but I often wonder if most people have any idea what it’s like to wake up many days only wanting to get to the other side of the day so they can stop going before they’ve even started. Hoping and praying to just make it through the day and feel ok because feeling “good” is a bit too ambitious and at times just unrealistic. Wishing to feel ok enough to be productive and with-it enough to actually accomplish what you’ve set out to do for the day. I’ll reference the spoon theory here; every day how many spoons am I going to be lucky enough to start off with? And if I don’t have what I need, how am I going to manage and then also make up for lost time/productivity? I feel like I’m generally running to catch up. It doesn’t exactly help the anxiety.

This isn’t every day for me, thankfully. But so many factors weigh into it when most everything hits you really hard all the time. I’m a very sensitive being, and I seem to keep getting moreso as time goes on. Most things are too much for me most of the time. I don’t sleep well, I have some emotional or personal challenge, I’ve not taken good enough care of myself, I’m overloaded by my schedule or stimuli, then I shut down and there goes my mood, energy and productivity. There’s always this delicate balance to be struck, this homeostasis to maintain. It takes on an absolute physical, mental, emotional, and spiritual effect. Some days I can hardly maintain and regulate something as simple as my body temperature, let alone my mood, energy, appetite, reactions, sleep, productivity level, etc.

On the worst days daily life can end up boiling down to just getting done what was absolutely necessary, even if that’s only showering and feeding myself. There have been days where it’s been reduced to simply continuing breathing and existing and all my effort goes to just maintaining a state of what I’d call existential purgatory; it’s not good, but it’s not hell in a hand basket either. I can’t function, but I’m still here and tomorrow is a new day. I failed today but I get to try again. For the day I’m forced to set the bar lower and it ends up becoming a total reorganization of daily priorities based on whatever I’m processing and my capacity for handling what’s in front of me.

That said, I’m always finding my process. I’ve got my usual tools in my kit but every day I’m learning what may or may not help me get out of these spots and into where I want and need to be, and how to stay there. Clearly tears are a big one for me. I let emotionally at least a few times a week when I’m struggling, if not once a day, just to get stuff out of me. I’ve had to work hard to be ok with that because of my own emotional cognitive dissonance; it’s not cool to be overly emotional, but, I honestly don’t have a choice. Sometimes it’s my only outlet, it’s going to come out of me no matter what, and frankly it’s a damn effective one for me. I meditate A LOT. It often leads to crying. Self care is HUGE, listening to my body, being kind to myself when it comes to my feelings and emotional needs as opposed to viewing myself as high maintenance and beating myself up over it. I find myself constantly checking in with myself in an attempt to stay grounded and continue getting to know myself and my process. I’m always trying to stay objective about it and step outside of myself to not get too caught up in what’s going on inside. It’s a weird duality to exist under, honestly. At the same time I often wonder if I am really dealing with myself in the right way, which brings me to my next topic of self-care, medication and substance.

It adds another level when you bring substance into the picture. As much as I personally prefer to naturally dig myself out of any hole I’m in, I don’t always get to do it my way and so at times the need to medicate can be hard to avoid. Example: I’m experiencing so much anxiety I’m having to Xanax myself to sleep then coffee my way out of it in the morning. If I don’t sleep I can’t function the next day, I can’t get anything done. But if I take something to sleep I wake up feeling like a zombie and I can’t fully function. But if I drink too much coffee I get edgy and anxious. It becomes this viscous cycle of maintenance that’s hard to get out of and I’m really sensitive to substance– benzos, caffeine, alcohol, cannabis, you name it I’m a lightweight. It helps and at the same time throws a real wrench into my program to be simultaneously tired and wired.

They say what doesn’t kill you makes you stronger, so I hope that every day I’m garnering a little more strength and lesson learned out of my struggle. I hope I can pass that onto others and help by sharing my struggle. It’s the only silver lining to it really, because this kind of existence is a whole other level of being a “constant work in progress”. So many days of just maintaining and not truly enjoying life and being able to live it to the fullest.

Every day I’m always curious if all these other people existing around me have any idea what this experience is like. I can’t help but wonder how much more naturally simple and blithe and unadulterated others’ daily lives might be. Maybe they’re not, I don’t know. I only know my own daily struggle. Either way it doesn’t make me feel sorry for myself, it only makes me try harder and play the hand I was dealt to win.

Peace, love, and wellness.

Meditation Medication Mediation

Meditation Medication Mediation

It’s kind of funny how all 3 of those words are just one letter off from one another. On my journey over the last 5 years or so in search of alternative methods to dealing with mental health issues, aside from plant medicine, meditation was one of the first ones I landed on. It took me a while to sort out what it was or what it meant. I learned that a lot of people go through that, the notion of exactly what mediation is can be elusive. Like anything else I want to unravel and apply, I’d begun by simply researching it via articles and discovering all the different types. Then I began trying to understand what it meant to me and how I could apply it in the way that worked best for me. Know now that there is no one way to meditate.

What I really wanted when I’d originally set out on this path was a rehab of sorts; an escape from life, the real world, mental illness, and some way to begin to work out the remainder of the trauma knots and triggers I had left in me that medication and therapy couldn’t seem to touch. Mental health rehab centers are essentially financially out of the question for the lot of us and I’d already tried voluntarily committing myself to an inpatient ward. I was rejected because I wasn’t actively trying to physically harm myself or anyone else, despite how deeply I’d been mentally and emotionally hurting myself. I knew through and through that I was in need of somewhere to go physically, mentally, emotionally, and spiritually.

I started off with basically trying to see if I could just sit still and shut myself off from my biggest enemy at the time- my mind. To say it was challenging is an understatement. But I didn’t feel like I had a whole lot of other options and frankly I wanted to see if I even had the discipline to make a practice out of it. I also thought I’d better start somewhere and discover what was right for me. Then I found the method of closing my eyes and focusing on my breath. It still wasn’t enough, I didn’t feel like I was getting it. I needed guidance and was still looking for that sweet escape. I found it in Vipassana Meditation. 10 whole days of silent self-observation in a residential course, following a prescribed code of discipline, led by teachers appointed by the now deceased S. N. Goenka. It was either a cult or the immensely difficult beginning of an incredibly massive journey I was about to embark upon. I did my due diligence of lots and lots of research and, spoiler alert: it was the latter. I sent a group email to those closest to me letting them know I’d be incommunicado for a while working on myself, and off I went.

I stepped foot onto the beautiful Dhamma Manda grounds, 12 days before my 31st birthday. They were some of the most challenging days of my life but also the most rewarding. If I’m totally honest, it kind of felt like voluntary Buddhist internment camp, and I don’t know if I came out of it fully understanding what meditation meant to me but I knew I’d gotten a great start. Not only that, I was pretty damn proud of myself for not quitting. The attrition rate of that course, as you might imagine, is fairly high.

It was almost 4 years ago that I took what I was given from those 10 days, slowly but surely adapted meditation into what I needed, and begun to turn it into a regular practice, using multiple techniques based on whatever my needs are at the time. These days I’m honestly no good without it. I do it at least twice a day, whether it’s 30 seconds or 30 minutes. Sometimes I can sit for over an hour, easy. I get lost, I absolutely love it, I crave it, I consider it my mental defragmentation. Mental health issues, anxiety specifically, and a very acute sensitivity to daily life get me worked up pretty easily. I’ve learned over time and trial that if I don’t self-care through meditation I will work myself right into a panic attack and/or depression and life will become a real bitch very quickly. I’m on a slippery slope here, meditation has become like an insurance policy, and it’s become contagious. I’ve got my dad doing it now, my boyfriend, my best girl friend and her kids. Who’s next?!

My friend Danni said it best, “meditation is the best drug there is”. He would know, his story is pretty incredible, and he himself is powerfully inspiring. He started this group based on a meditation/journaling journey he did last year called 108 Days of Meditation. Oddly enough, akin to my Vipassana journey in 2015, it ends on my birthday. As soon as I heard he’d put it out there, there was no question for me. I do it every day anyway, and we also know I love to write to get things out of me, why the hell not? It felt very serendipitous actually, given those circumstances and the fact I’ve recently up-ended my life’s path.

All that being said, it’s not the ultimate answer to everything, but it has done wonders for me, my general sanity and well-being, and keeping my shit together on the daily. I’ve found that silence is loaded with answers, and that meditation is one of the safest places on this earth. I wake up in the morning with anxiety, I meditate and choose to start my day that way instead of clenching my jaw teetering on the verge of an episode. I come home from work or school wound up super tight and tired as hell, I put myself on a meditation time out and all of a sudden I can think straight again, have my calm back, and actually have more energy. I don’t always win at meditation, but I’m always better for having tried. It’s taken a lot of practice, hard work, focus, effort, and really honestly wanting it, and here I am using it as one of my most effective tools at managing my mental health. I hope that you can, too.

Peace, love, and wellness.

The Mean Reds — Anxiety

The Mean Reds — Anxiety

I’ve seen Breakfast at Tiffany’s about a million times. And there’s this one line Holly Golightly says to her future lover, Paul, that speaks to me every time still:

Holly Golightly: You know those days when you get the mean reds?

Paul Varjak: The mean reds, you mean like the blues?

Holly Golightly: No. The blues are because you’re getting fat and maybe it’s been raining too long, you’re just sad that’s all. The mean reds are horrible. Suddenly you’re afraid and you don’t know what you’re afraid of. Do you ever get that feeling?

I’ve said it about a million times, upheaval in life is a trigger for me. Some people, things just bounce right off them, they’re able to roll with the punches and weather the storms. Then there’s me, surely like a lot of you, who is an absolute sponge and feels everything to the nth degree. At first it all just kind of blurs together and I think I’m managing alright, but then it hits me, the weight of it all. I step outside of myself and am able to realize the extent of exactly what I’m dealing with and how it’s becomes the mean reds.

That was my week last week and it took me down hard. I haven’t experienced a breakdown like that in over a year. I was truly afraid and I didn’t know what exactly I was afraid of. I woke up last Monday morning hysterical, out of nowhere. Hyperventilating, inconsolable, out of control, hiding in my bed, screaming into my sheets, with no answer to my hysteria. I’d totally lost myself, and over what? I realize I’ve flipped my life on it’s head changing jobs, working only part-time because I’ve made the decision to go back to school for my degree in social work, the addition of the newness of certain relationships, the old toxicity of others, fresh hell greeting me on what seemed like a daily basis at that point in one way or another, stress, grief, struggle. But sometimes that’s just life.

I had to do something, anything. So I did one of the things I feel I do best to get me out of these pickles: I wrote. I couldn’t meditate my way out of this, I’d been stuck in it for two days already, I had attitude about medicating when a friend came to me with all the love, Thai food, and Klonopin he had to offer (although I ended up backing down and taking his advice and medication by the middle of the week, and was utterly grateful for it), and I had by that point ceased to be functional. I can’t remember what day it was last week (As I’ve mentioned I have that natural mental protective mechanism that blocks out painful events and it’s details), but I just verbally vomited in pencil all over 3 pages of my school notebook (instead of doing my homework), and I’d like to share it with you in hopes that maybe some of it will speak to you, or maybe help you not feel so alone when the anxiety monster strikes. It came out of me in bullet-point fashion so I’m going to translate it here as such, in order.

  • Anyone who doesn’t believe in anxiety has never truly experienced it.
  • It’s crippling/all-consuming- A hurricane-like internal unstoppable shit-storm living in your mind, body, and spirit.
  • Nothing matters.
  • The mean reds, you’re afraid and you don’t know what you’re afraid of.
  • Meditation is the best drug there is.
  • I’ve been to the ER twice for anxiety, with no insurance, absolutely worried for my safety, feeling my world crashing down on me.
  • I often wake up with anxiety for no reason, it can strike out of nowhere, and I often go to bed that way, too.
  • I have to work really hard to keep anxiety at bay. I meditate my way out of anxiousness at least 2x a day- I don’t always win but I can at least regain enough composure to carry on.
  • It’s often a buildup, then a breakdown that sometimes just shows up out of nowhere and sometimes it’s because I know something before I actually know it (intuiting things).
  • Do I accept it and give it love to quell it or do I fight it? Do I let it run its course, or medicate?
  • You lose your grounding entirely. It feels like falling off a cliff and being stuck in mid-air waiting for the ground to come at you at full speed.
  • You lose yourself, your self-control, and control of your mind. You think you’re dying and there’s no answer.
  • Feelings of wanting to hide in bed, crying, shaking, wanting to jump out of my skin, coming unglued.
  • I looked up the definition of panic: “sudden uncontrollable fear or anxiety, often causing wildly unthinking behavior”.
  • There’s a difference between a regular cry and an anxiety cry which involved uncontrollable hyperventilation, as well as the physical symptoms. There is no way to anticipate them.
  • Why is severe anxiety a thing and what even is it?
  • Do I learn anything from it? What?
  • It’s so real when you’re in it, your mind and body have no idea it’s not.
  • With depression you don’t just “get over it”, with anxiety you don’t just “calm down”. It’s impossible to get a grip.
  • Pain and fear are often at the root in my experience, as well as stress, both mental and physical. Feeling overwhelmed with pain, fear, and stress, being caught in a negative feedback loop or full of unresolved emotion.
  • Every day I get to start over, fresh.
  • I try to remember I may not always win the battle but be mindful of what really matters in spite of the struggle- love, loving myself, all that I am, and blessing myself.
  • What good can come from it? A reminder to slow down, to be kinder to myself, to love myself, to have gratitude for what is right in my life, to work through my issues, and not try to stifle them?
  • Can anxiety be a call to action? A call to go deeper? To look inward and connect with myself? To listen and respond to things I might not have known I needed? A chance to sort myself out?
  • A quote I reminded myself of- “If you’re depressed you’re living in the past, if you’re anxious you’re living in the future, if you’re at peace you’re living in the present”.
  • Keep trying everything I know: The Ho’oponopono Meditation, the Mental Health Check-in Check List, The Serenity Prayer, go outside and let nature cleanse the filth, pick up your favorite hobby, surround yourself with positive people, express yourself through words, art, exercise. Anything to get you out of your head and distract you, but still be able to come back and deal with the anxiety at some point.
  • The last thing I wrote down, because I’m forever a proponent of natural remedies is “Lithium Orotate“. It’s a naturally occurring element that can help relieve symptoms of anxiety without the side-effects of Benzodiazepines.

I have been able to slowly but surely see my way out of this episode and even have a revelation or two. Hopefully you can relate to some or any of this, and know that you’re not the only one who feels this way, and that there are solutions whether you deal with anxiety daily or occasionally.

Peace, love, and wellness.

Thankful for Remembering Depression

Thankful for Remembering Depression

The following is from yesterday, it’s not eloquent. As I’m sure most of you know, mental health challenges don’t exactly lend themselves to fully functional cognitive abilities. I’ve been riding this massive wave of transition lately in all aspects of my life and it came to a head this week. I’m learning that major upheavals on fundamental levels in my life be they good or bad, are big triggers for me. So instead of waking up yesterday feeling grateful for seeing my family, feeling the love, and having a killer dinner together, I woke up with a big fat cloud over me.

I was grateful for it anyway because as I’ve mentioned in previous posts, I have a built-in protective mechanism that blocks out a good majority of my past mental illness experiences and their accompanying symptoms. I quite literally can’t remember on a granular level most of the time what it truly feels like to be depressed.

It all comes back to me in tsunami-like form however when I’m in the thick of it, so I’m thankful for the reminder because my intent here and in my work is to be able to relate to those dealing with mental health issues so I can be of help. It’s hard to help when I can’t fully relate because I’ve subconsciously blocked most of it out, so the reminders really helpful. What else is helpful is documenting it, for myself, and for you. And so, I’m grateful for my episode yesterday, even more grateful for having been able to process it and enjoy the holiday, and grateful I put my feelings into words. Here they are:

“It starts with waking up to the feeling of my body being really heavy and letharged, not wanting to get out of bed physically or mentally. The world outside is cold and complex, it’s almost holding me down where I lie. It’s alright, It’s safer here. The world is all going to be sensory overload anyway. The lack of motivation and will are far too familiar. The dread of the day ahead, even when it’s an easy day ahead filled with family, food, and love. Body aches and a dull, unforgiving headache. A wash of slight sadness over my being but for reasons I can’t fathom. A cynicism toward whatever lies ahead of me, none of it feels worth any effort. My body is slow and defunct, so is my outlook. My brain is foggy and still, and at the same time busy in the background full of useless noise. All I feel like doing is achieving unconsciousness again, I feel like I could sleep for a hundred years. The thought of that gives me a little relief. I don’t wonder what’s going on out in the rest of the world around me because I don’t care. There must be a storm cloud above me because I can feel it weighing me down, it might even be sitting right on my chest because it feels heavy there and kind of hard to breathe. I pay attention to the expression on my face and notice a natural frown. I have no appetite and realize I’m parched but with no plans to do anything about it. I could really use a shower, it would probably help. No plans for that either, and no will or energy for any of it. What can I do? Staring at the ceiling, my old friend. Checking out. Why that does so much for me when I feel this way? I believe it’s because I’m fried and my brain really appreciates the blank white space rather than the cluttered dark noisy mess that otherwise exists. My vital energy has been robbed, my mental sharpness and clarity are gone, too. I can’t even access the more descriptive words I’d normally be using to describe this experience because I haven’t got them right now. Everything is so tired. And this is a mild day, a mild experience. One where if I really try, I can begrudgingly drag myself slowly out of bed and start my day one chore at a time. Everything is a chore when I feel this way, and I slog through my day just waiting for it to be over so I can either maybe start feeling better, or just let it be over and eek a little joy out of going back to bed. My shinyness is dulled, my vibrance buried under this heavy existence that I will endure for the day. The hardest part is having no rhyme or reason behind it. Maybe if I knew what was causing it I could do something about it. All I can really do is acknowledge it and try to press on taking as good of care of myself as I can. But even that’s too much work for me right now, I haven’t got the energy or motivation to take care of myself and so I fall deeper down into whatever’s got it’s hold on me today. I hope it will fade away and I will get myself back. My head hurts and I hope so much deep inside that this will last just one day that it makes me a little emotional. This is no place for me to be and I don’t deserve this, it’s not fair. It’s not who I am. I want it to go away. It’s like a vicious monster from the closet that I have to fight for my life and my only defense is to feebly throw feathers from my torn pillow at it as I watch it creep closer and closer toward me, threatening to eat me alive. I feel so weak. So I take a deep breath, wipe a tear from my face and make the decision to start somewhere, anywhere, by getting up and brushing my teeth. The simplest thing, but the absolute last thing I have the energy for or want to do. I remind myself that I love myself and I deserve to be here and to be happy, then I put my feet on the floor, I feel my lower back ache, and go from there. I look forward to the notion of this just being one day, hopefully, and not continuous. I remember exactly how easy it is to forget this feeling when I’m not feeling it every single day anymore and I wish myself luck.”

Peace, love, and wellness.