Documenting my journey through the mental health system

Trying to sum up the last few days is difficult. My mind has been all over the place, my energy high, my libido even higher.

We closed out emotion regulation in IOP, the end of week six for me. Riley the therapist wanted to see me after. I’m at roughly the one-month mark and it was time for another assessment. She asked how I was feeling so far, what did I think about the material, what were my thoughts on my progress? She had me fill out another GAD assessment (Generalized Anxiety Disorder) as well as the PHQ (patient health questionnaire) and both my scores were exactly 11. I am in the mild range for both depression and anxiety which means my anxiety has improved somewhat. I may always be dysthymic, or feel a persistent low-grade depression, for the rest of my life. Even in manic and hypomanic moments, when I feel invincible and unstoppable, there is the underlying bedrock of my psyche – cynical, pessimistic, anxious, fearful, doubtful.

She asked how I was feeling. I admitted feeling overwhelmed at the material and doubted my ability to truly incorporate it. I often feel too damaged, to far beyond repair. She reminded me I’m not something that needs to be “fixed,” and that this three-month DBT course really just scratches the surface of the different skills. “You will have the rest of your life to practice these skills, and there’s nothing wrong with maintenance that lasts years. Or your whole life. It shows true strength to stay motivated to change and maintain that change over a long period of time.”

I’m doing a per diem at my agency job, and the facility is only a few blocks from the mental hospital in which I was recently incarcerated. I have to drive right by it. I didn’t think this would be so triggering for me. It’s not like they mistreated me, or anything like that. But I had no insight, no ability to regulate, and it was simply one of the worst times of my life. They kept me alive, but at great cost.

I told Ceila about it in a text. It’s embarrassing, but I have a small panic attack after driving by it, every time, on the way to work. I even leave earlier just so I can try to re-center myself in the parking lot when I arrive at the facility in which I’m filling in. I’ve learned a lot about emotion regulation the last few weeks in IOP. I’ve put forth monumental effort into using the coping skills – using the momentum of feeling good to reinforce positive mental states, building mastery by maintaining my environment and staying on top of tasks, attending to relationships by staying in touch with friends (avoiding isolation) and learning to identify my emotions in the first place. I always struggled with that in the past, leading to further dysregulation.

Next week we go into mindfulness. Staying centered and in the moment. I know a lot about it already. When I was in the VA psych ward this time last year, we practiced mindfulness every morning to start the day and ended with it in the evening. It is another thing I have difficulty in incorporating. I know the benefits, I know how much more peace one can attain with it, but it takes a lot of effort in the beginning. My mind is very noisy. There are voices who interrupt and talk to me. There are a lot of stresses, worries, anxieties. It is very hard to calm down in general sometimes.

My energy is high, my appetite poor, my concentration poor. I’ve tried to expend the excess energy in a productive way – picking up extra agency shifts. I’ve been taking my medication as I’m supposed to. I had a few days off work from the VA and put a lot of effort into sleeping better – using my meds and PRNs and trying to establish a bedtime routine conducive to sleep. I did sleep a little better, up to seven hours, only waking up a few times. My energy level actually gets more even when I get better sleep. In hypomanic states the lack of sleep feeds itself, raising the energy as the feelings of sleeplessness and insomnia continue.