Mental Health Monday #6

Hey there, friends!

I am so sorry I didn’t write last week! Life snuck up on me and I ended up being busier than anticipated and dealing with some ugly brain issues, but I’m back again! Hopefully there will be no more interruption in my schedule.

This week’s post is a continuation of the post I made two weeks ago, so if you haven’t seen that yet, I encourage you to check it out!

We’re supposed to fill out thought records whenever we’re in a stressful/upsetting situation. These vary slightly depending on your therapy, but they’re all relatively the same.

The first part of a thought record is the easiest. Just add the time and date at the top/side, depending on whether you’re filling your record out horizontally or vertically.

I personally prefer to write my thought records top to bottom, whereas a lot of clinical thought record sheets come side-to-side. There is no right or wrong way to do it, though, just find whatever works best for you personally! 

After you put the time and date to your thought record, you need to identify the situation you’re in.

Then, you need to identify what you’re thinking about during the distressing situation. These are called automatic thoughts. These are usually a direct response to a trigger and are often out of our control.

Sometimes these thoughts occur so rapidly that you won’t even notice them, but they can still affect your mood. 

Because automatic thoughts are oftentimes negative and harmful, it’s important to replace them with new, rational thoughts. (Remember when I talked about wise mind, reasonable mind, and emotional mind?)

After you’ve identified our thoughts, you need to identify the emotions tied to them, and rate their intensity from 0-100%. The numbers don’t have to add up together. It’s a rating of how much you feel that particular emotion. The other emotions get their own rating.

If this doesn’t make sense right now, don’t worry! I’ll share an example of a completed thought record in a minute.

Also, side note, it’s completely normal for thought records to feel foreign or silly at first, and your first few probably won’t be very detailed, and that’s okay! It’s all about practice. You’ll get there if you just keep working at it!

The next part sounds a bit complicated, but it’s not that bad when you start understanding the necessary steps. 

First, you have to identify the thinking styles you engaged in, which is why my last post was so important. Feel free to refer back to them when filling out your thought records!) during this upsetting/distressing/stressful time. Then you have to evaluate how much you believed the automatic thoughts you had/have during the event from 0-100%. Again, these numbers don’t have to add up together.

From there you need to re-evaluate those automatic thoughts you had before. Is there any evidence that those things are true? Evidence is only what is verifiable and solid. You’re not allowed to use things like, “because I feel this way, it must be true.”

Write down your evidence “for” your thoughts.

Now write your evidence “against” your thoughts.

Again, you need hard evidence. Things that can be proven or otherwise verified. If you’re not sure if these things are true or verifiable, think about describing the evidence to a friend or someone else trustworthy. You don’t have to ACTUALLY describe it someone else unless you want to, but ask yourself, if you told someone the evidence, would they agree that it’s actually true?

Is there an alternative to your automatic thought? Write that down as an option, even if you don’t believe it. But you must write down a realistic alternative.

What is the best thing that could happen in this situation? Again, even if you don’t believe that it will, you should write it down! 

Also write down the most realistic outcome, if you can think of it.

It’s okay if you can’t answer all of these questions, just do the best you can!

Finally, ask yourself, if a close friend were in the same situation as you are, what would you tell them? The way we speak to the people we care about is often so different from the way we speak to or think about ourselves. Write down your advice to your “friend”. 

Now how do you feel? Are your emotions the same? Have they gone down? Elevated? 

Write down any emotions you may be feeling, as well as the emotions you put down before. Rate (or rerate) any of the intensity of these emotions.

Thought records don’t always make a huge difference right away, but they are important to be able to look back on, especially if it’s a reoccurring situation we find ourselves in.

A fabricated example of a “complicated” completed thought record (just so you get the idea) might look like this, though you can make your own as detailed or simple as you’d like! 

August 3rd 2020

The situation: I got in a huge fight over the dirty dishes with my significant other today! 

My automatic thoughts: Everything is my fault. I am the worst. I hate myself and my significant other hates me too! If only I had done the dishes like I was supposed to, we never would have fought. I’m a bad significant other.

My emotions: sad (80%), unworthy (50%), unlikable/unlovable (100%). regret (60%)

The thinking styles I experienced: Personalization, Should statements, magnification.

How much I believed the automatic thoughts: 

– Everything is my fault (50%)

– I am the worst (70%)

– I hate myself and my significant other hates me too (60%)

– If only I had done the dishes like I was supposed to, we never would have fought (70%) 

– I’m a bad significant other (90%)

Evidence FOR my automatic thoughts: 

– I didn’t do the dishes even though it was my job and my significant other was angry about it.

Evidence AGAINST my automatic thoughts:

– My significant other said they still love me, even after we fought.

– I did other household chores today, such as vacuuming and washing the windows.

Alternative ways to think about the situation:

– Today happened and I made a mistake, or a lapse in judgement, perhaps, but this doesn’t make me “the worst”. 

– I can still do the dishes, if my significant other hasn’t already done them.

– Sometimes couples fight. I apologized, and they said they forgive me.

What’s the best outcome in this situation?

– My significant other forgives me, and I can do better tomorrow.

What is the most realistic outcome in this situation?

– My significant other forgives me, and I can do better tomorrow.

If a close friend was in this same situation, what would I say to them?

– It’s okay, everybody has bad days.

– Your significant other loves you, and you not doing the dishes tonight isn’t going to change that.

Final emotions: 

Relief (70%), loved (60%), sad (20%), unworthy (0%), unlikable/unlovable (10%), regret (30%)

Something to note: it’s totally normal to not be able to identify your thinking styles right away! Don’t beat yourself up about it. It takes practice. Just do your best, and be aware of the thinking styles so maybe you can identify them in future situations! 

Alrighty, friends, that’s it for me for this post. I hope this was helpful and not too confusing! If you have any questions, feel free to let me know. I’m not a doctor or professional of any kind, but I’ve learned a little throughout my time in therapy and I like to share.

Stay safe everybody!

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Mental Health Monday #5 — Cognitive Distortion / Unhelpful Thinking Styles

Hi friends!

First, I just wanted to say thank you for the positive reactions to my newest post from Friday, it really meant a lot to me!

Second, sorry this post is coming to you so late. I wish I could figure out the WordPress scheduling system but every time I try it comes out wonky.

Anyway,

I’ve been wanting to talk about CBT (cognitive behaviour therapy) for a while now, and today seems like a good time to do it.

CBT isn’t something I’ve talked about a lot on this blog yet, but over this week and next, I’d like to talk about thought records.

I wanted to do the whole thing today and originally wrote this post with both parts, but it ended up being way too much for one post, so I apologize for that.

Before we get to the “thought record” part of CBT, which is the part I’m most excited about (I promise, that’s next Monday’s post!), it’s important to learn to identify negative thinking patterns known as “cognitive distortions” or “unhelpful thinking styles” first. These patterns will also show up again in DBT, so I won’t be explaining them again but if I talk about “cognitive distortions” or “unhelpful thinking styles” again in the future (which I’m sure I will!), you can always refer back to this post!

All Or Nothing Thinking

Otherwise known as “black and white thinking”. 

This is a pretty straightforward concept.

This is when we get in our heads and say things like, “XYZ is all good” or “XYZ is all bad”, and we’re unable to think of an in between.

In 90% of all situations, things cannot be accurately and logically be seen in terms of all or nothing*.

There is often a middle ground to be found, even if the person experiencing the cognitive distortion cannot see it at the time.

*I made this statistic up. It is not a factual number, but it is an incredibly high percentage of situations. 

For example: Sarah drops her phone on the floor, superficially cracking the screen.

Instead of picking it up and carrying on with her day, she says it’s ruined and stomps on it, or goes shopping online for a new phone.

Mental Filters

A mental filter is where someone takes a small event or a thought and focuses on it excessively, “filtering out” other factors.

This is often to an inappropriate level and can affect a person’s mental well-being (often temporary, but still potentially harmful), as well as social events, someone’s workplace performance, and more.

For example: Jacob goes to a party with his friends and someone calls him a mean name. Jacob then fixates on the name, and can’t enjoy the rest of the party, even if it’s technically really great and he would otherwise be having fun.

Overgeneralization

Overgeneralization is just a fancy way of saying that someone experiencing this cognitive distortion uses words like “always” and “never” after a single event, or a series of events.

This can be a very dark way of thinking, or can cause other people that are informed of a situation to think badly of a situation that may not really be that bad.

For example: Jamie’s girlfriend once asked him politely to put the toilet seat down after peeing, and Jamie complains to his friends that his girlfriend “always” yells at him to put the seat down, and “never” appreciates it when he does.

This may not sound like a horrible thing in and of itself, but it may cause Jamie to think things such as, “my girlfriend is always mad at me!” When she’s not, or in the case of Jamie’s friends, they may start believing that his girlfriend is controlling and/or abusive, when in reality she only asked once, and not in a harmful or abusive way like he described to them.

Discounting The Positives

I personally see this as another form of overgeneralization, though none of my research online seems to agree. 

When we discount the positives, we discount, ignore, or invalidate the good things in our lives.

For example: Autumn got the employee of the month award at her job on Monday, but on Tuesday she made a small mistake at work that caused her manager to speak to her about it, and she thought to herself that nothing good ever happened to her, and she couldn’t ever do anything right.

This cognitive distortion is harmful because when we focus only on the negative things that happen in our lives, we can get depressed, and it’s easy to think that if nothing good ever happens to us, then nothing good ever can or will happen to us, which can lead to suicidal thoughts or just prolonged depressed or low moods.

Magnification (AKA Catastrophizing) 

Small, personal side note: I had never heard the term “magnification” until I started doing research for a coping skills PDF I was trying (and am still trying) to put together.

In CBT class they always called it catastrophizing, and I cannot for the life of me say that word for some reason, so from here on in, I’ll probably use the term magnification for personal reasons, but please just know that they are interchangeable terms and mean exactly the same thing.

Magnification basically just means over-exaggerating to a problematic level, or imagining the worst-case scenarios.

This is a personal example, but I know near the end of the days where I did drugs, I wasn’t even having fun when I got high anymore, but I managed to convince myself that my brain was such an unbearable place to be in without drugs that I needed them, and I’d tell myself it would be fun, even though it usually wasn’t. 

Another (probably better) example:

Annie was a great baker, well loved by people all around her city. One day she made a single bad batch of cookies that she didn’t intend on sharing with anyone other than her husband, and she thought to herself “I’m the worst baker alive. Everybody hates my baking and they think I’m a fraud.”

This was, of course, not true. Everybody still loved Annie and her baking, and the only person calling her a fraud was herself.

When we magnify situations to a problematic level, this can create unnecessary stress or depression.

Minimization

This is the opposite of magnification.

It’s basically saying, “it’s no big deal!” Or a lot of times it means avoiding taking responsibility for things that we do, good or bad.

For example: Elliot pays his rent late every month, and his landlord tells him that if his rent isn’t paid on time in the future, he will be evicted.

When his check comes in on the 30th, he should have just enough to pay his rent on the 1st and buy groceries for the month, but instead he buys a new laptop computer, thinking “Oh, I get paid again in two weeks, I’ll just buy groceries with what I have left over, and I’ll pay rent when I get paid again.”

This can go the other way as well, when we minimize the good things we’ve done, like, “Oh, I wrote a book but it’s no big deal! Lots of people write books.”

This cognitive distortion can be particularly dangerous and harmful, as it can lead to risky decisions or losses in relationships, among other things.

Jumping To Conclusions

There are a few different types of jumping to conclusions. Common ones include “mind reading” and “fortune telling”.

Mind reading is when we assume we know what someone else is thinking without them telling us.

To be clear: the only way we can know for certain what someone else is feeling or thinking is when they expressly tell us so.

Though it can be frustrating not knowing what someone else is thinking or feeling, it is downright dangerous and unhelpful to assume you know what someone else is thinking, and it can lead to a lot of unnecessary tension, guilt, shame, depression, or anger.

Fortune telling is a lot like mind reading, but it’s more about events. It’s when we assume that, often based on our past experiences (but not always), things will turn out a certain way.

For example: Adam has never been in a romantic relationship and assumes that, based on that fact, he will be alone forever.

This mindset can be harmful because no human being knows what the future holds, and if we tell ourselves things will turn out a certain way, we become closed off to the possibilities life has to hold, or because we believe something so strongly, it turns out just the way we think it will, which reaffirms our thinking and we’re likely to react in a way that’s unhelpful or harmful.

“Should” or “Must” Statements

I think this one is fairly self-explanatory. 

Using “should” or “must” statements isn’t always a bad thing, but it definitely can become a problem when we start making ourselves feel bad about the things we “should” be doing, or the things that “should” be happening. When regarding things that “should” be happening, these statements are often tied to a feeling of injustice.

For example: Harrison sometimes gets angry because he thinks he should be in med school, but he failed some of his classes, and therefore didn’t qualify. But he can’t stop thinking about how he “should” have passed those classes, or “should” be attending med school soon.

This causes Harrison a lot of guilt or anger, both at himself and the world, but being angry will not change his grades or get him into med school, only hard word and perseverance will.

Personalization

This is when we assign blame to ourselves, or take things personally, without logical reason to do so.

For example: Jenny’s husband came home from work in a foul mood, and she automatically assumed it was because of something she had done.

Be kind and compassionate to yourself. We are our often harshest critics, and needlessly so. The things you hate about yourself are quite often the things other people love most about us!

In conclusion, these are only some of the types of cognitive distortions that may come up, but they’re some really common ones, and it’s a good place to start.

Let me know what you think of this post, and feel free to add anything I’ve missed, or things you would change about my explanations. I’m always looking to learn and improve.

As always, stay safe, friends.

I’ll see you in my next post!

Paige

Mental Health Monday #4 — Personal Update

Hey there friends!

We are back with the forth instalment of this series, but today I don’t have any skills to share (well, I have lots to share over the coming weeks, but not today), instead I’ve decided to take the advice of my therapist and share something kinda vulnerable.

As I mentioned in previous posts, I’m on new medication, and today’s post is about that. So if you’re sensitive to medication posts or anything like that, feel free to click off, no hard feelings!

I think I’ve mentioned in old posts that I’ve changed medications a lot over the years. I tried Zoloft and Cipralex which both made me break out in massive hives, and then I was on Wellbutrin and Abilify, which didn’t do much for me either way.

Then my old doctor switched me to Cymbalta, which helped a lot for a while, but in the end it was making my manic episodes worse.

I was almost at the point of giving up on medication altogether, and then my new doctor put me on lithium for my new diagnosis of bipolar disorder, and I started to see some change. I had more motivation, and I actually wanted to do things for once. It was nice to feel “normal” for a change, but the side effects were a lot to handle. I was dizzy all the time and couldn’t sleep, I was nauseated and hallucinating, and my doctor said I should try something else.

So along came Seroquel XR which made me EXHAUSTED and dizzy, and I thought my depressed episodes were getting worse, but my doctor actually upped my dosage this past Friday, despite sounding counterproductive to me, and you know what? I think it might be working.

I am still super tired, and now I’ve got the added symptom of restlessness, but I’m actually way more motivated than I’ve been in a long time. “Happy” is still a stretch for me, but I’m doing okay.

So, I guess the point of this post is to tell you that it may be frustrating finding the right medication, or the right doctor, or the right therapy, but it’s worth hanging on for.

Again, I’m still not where I wish I was, but I’m getting there. Don’t give up. You deserve to get help, too.

If you’re on psychiatric medication, what are you on? Does it work for you? How many times did you have to switch before you found something? Let me know in the comments, I’d love to hear your stories!

As always, and especially in times like these, stay safe, friends.

Until next post,

Paige 🙂

Mental Health Monday #3 — A Few DBT Skills (TIPP & cold water)

Hiya friends! Welcome to third instalment of my mental health Monday series.

To be honest, I nearly forgot about this handy little acronym, though it’s one of the first skills I learned in DBT! The TIPP skill is great because it’s about basically tricking your body, which tricks your brain. Both TIPP and the Cold Water skill are great for when you’re experiencing extreme and potentially dangerous or harmful emotions that you need to change such as anxiety or anger.

T – Temperature

I – Intense exercise

P – Paced breathing

P – Paired Muscle Relaxation

Temperature. The idea here is to cool your body down. Take a super cold shower. Put an ice pack over your eyes and cheeks. Put your face in a bowl of ice water (another skill I’ll discuss at the end of this post!)

Intense exercise. Exactly as it sounds. When we experience strong emotions, our bodies create excess physical energy, that can lead us to being impulsive or doing something harmful. So, go for a run! Walk on the treadmill at a brisk pace. Lift weights. Do Zumba. Make sure you get your heart rate going and work up some sweat!

Paced breathing. Take big, deep breaths in through your nose, and exhale through your mouth for even longer periods. I learned a technique a few years ago called the 4-7-8 method for breathing. Inhale through your nose for 4 seconds (make sure to count your Mississippi’s!), hold your breath for 7 seconds, and exhale for 8 seconds through your mouth. Do this 3-5 times until you feel calmer. 

The paces breathing especially is honestly a God send for anxiety, but works well for anger and sadness as well. Probably other things too.

Takes some practice, but I would highly recommend it!

Paired muscle relaxation. Breathe in and tense the muscles in your body, notice how that makes you feel. Then, when you breathe out, relax all that tension, and notice how you feel when you aren’t all tensed up. I recommend starting with “easy” muscles like hands, legs, toes, shoulders, etc.

For the cold water skill, it doesn’t actually have to be ice water, but make sure it’s cold. Hold your face in a bowl or sink full of cold water for somewhere between 15-30 seconds.

Scientists say that this triggers a response in your brain called the “dive response”. 

It tricks our brains into thinking that we’re actually quite literally diving under water, so to compensate, our brains will send signals to our heart to slow down a bit. Blood flow to our extremities get slowed way down, and instead the blood gets redirected to more “vital” parts of us, such as the brain and heart. 

Alrighty, friends! That’s all I have for today.

Like I mentioned last week, I’m on new meds again and I’m so tired, so writing is a bit harder than usual but I’m trying to stick with it.

Feel free to ask any questions you may have, but keep in mind, I’m not a medical professional, and I’m still learning myself.

Keep your chin up.

As always, and especially in times like these, take care of yourselves and your loved ones, friends!

Paige

Mental Health Monday #2 – An Apology and a DBT skill (Wise Mind ACCEPTS)

Hi again, friends!

Sorry I didn’t make a post last week. I bet you thought I disappeared again, but I didn’t.

These last few weeks have been rough. I’ve changed medications twice since I wrote last, I think, and I’ve had a lot going on mentally and situationally.

Today is day two of Seroquel and it’s kinda kicking my ass, honestly. I’m exhausted and having a bit of a rough day mentally, but I decided that if all I get done today is this post, then that can be enough for me.

So with that said, I’m going to write about this skill in DBT called Wise Mind ACCEPTS.

If you recall my last post, I talked about the difference between wise mind, emotional mind, and reasonable mind.

Wise mind is the place where reason and emotion meet.

ACCEPTS is an acronym. It stands for:

A – Activities. 

C – Contributing.

C – Comparisons.

E – Emotions.

P – Pushing away.

T – Thoughts.

S – Sensations. 

These are all distraction techniques, but the acronym is a helpful way to remember them. In no way are you meant to do all of these things at once.

Activities can be things like exercising, cleaning your house or bedroom, watching your favourite movie, or starting that new show you’ve been meaning to watch, or reading a book. The point is to do something you enjoy.

Contributing can be things like volunteer work, or donating things you don’t want or need anymore, or messaging an old friend and giving them words of encouragement, or heck, even go hug someone you love.

Comparisons are when you think back on old situations and appreciating how far you’ve come. 

Emotions. Try to evoke an emotion in yourself other than the one you’re feeling right now. If you’re sad, watch a comedy that will make you laugh. If you’re angry, listen to your favourite happy or sad song. The point is to feel another strong emotion other than the one that caused you to use the skill in the first place.

Pushing away is about setting your current emotion aside for now. This doesn’t mean forgetting about it or avoiding it forever, but if you’re unable to deal with your present emotion, try to find a way to think about other things.

Thoughts are about distracting your current thoughts. Start counting, whether you just want to count to 10 or 100, or count the colours you see in a room, literally anything you want. Or if numbers aren’t your favourite, try to remember all of the words to a song you know, or focus on the words in a book. It’s all about focus.

Sensations are about creating new physical sensations in your body to distract from emotions. You can do this by holding an iced cube in your fist, taking a warm or cold shower, getting someone close to us emotionally to scratch your back or “pet” your hair. Squeeze a stress ball. Eat spicy food. Stuff like that.

These things help distract us from our current situations and emotions until the emotion is “cooler” or more calmed down, or the situation feels less overwhelming, and we can (hopefully) return to it in wise mind.

Alrighty, friends, that’s it for me for now because I feel like garbage. Hopefully you find some help in posts like these. Feel free to ask any questions you may have, but keep in mind, I’m not a medical professional, and I’m still learning myself.

Keep on keeping on.

As always, and especially in times like these, take care of yourselves and your loved ones, friends!

Paige

Mental Health Monday #1 – A Personal Update & A Coping Skill (DBT // STOP! Skill)

Hello friends!

Wasn’t actually planning on posting this post until next Monday because I had another post planned for tomorrow, but tomorrow’s post has been postponed or possibly cancelled, depending on whether I can ever get it to sound the way I want.

So, instead of just saying “forget it” and not posting a blog post at all this week, I’ve decided now is the perfect time to start this series I’ve been wanting to do for a while.

First of all, for the sake of those uninterested in my own personal updates, I will talk about a coping skill that I’ve found helpful, and then I’ll talk about what the heck has been up with me at the bottom so you can just skip the “boring” stuff.

So, I’ve been in and out of therapy since I was about 15 or 16, I think. I’ve tried talk-therapy, religious therapy, medication, no medication, cognitive behavioural therapy (CBT), and dialectical behavioural therapy (DBT), that I can remember. I am NOT a mental health professional in any way, and I would always advise seeing a professional if you need help, but I still want to share a few things I’ve learned.

My favourite form of therapy has to be DBT, but I have definitely gleaned a good amount of information from other forms of therapy.

The skill I want to talk to you about today is the STOP skill from DBT.

The STOP skill is especially helpful in crisis situations, but can be used in other situations as well.

It’s an acronym that stands for:

S – Stop! You’re probably experiencing a strong or “hot” emotion right now, but do not react to that emotion. This is hard, but it’s important. Reacting to strong emotions often leads to regrets, fights, or sometimes damage or harm to ourselves.

T – Take a step back. When possible, remove yourself from the situation entirely for a while. Take some deep breaths at the very least. It’s best if you can take some time to really cool down, but this isn’t always possible. We’ll be discussing distraction techniques in an upcoming post*, though, in the event that you do get the chance to take a break from the situation. The main goal here is still NOT reacting to your strong emotions until you’ve “cooled down” a bit and can return to it with a “wise mind”.

DBT teaches us that there are three mindsets to be in. 

These are emotional mind, reasonable or logical mind, and wise mind.

Emotional mind is often the easiest mindset to slip into. It’s where our emotions take control of our actions and thoughts, and can cause us to act impulsively.

Reasonable or “logical” mind is where we approach a situation completely with our intellect and fact. This may sound like a good way to approach things, but we can come across as cold or unfeeling this way. 

Wise mind is the mindset where we try to see both the emotional side and the reasonable or “logical” side, and find the course of action that fits both sides, if there is one.

O – Observe. Take a second to notice your surroundings, and how your body feels, and finally your emotions. The trick is to just notice these things and try to let them go. This isn’t always possible, but noticing is the first step. I’ll talk more about that in another post as well.

P – Proceed mindfully. Think about your desired outcome in the situation, and take the necessary steps with a new awareness. What can you do to make the situation better, and what actions should you avoid that will make the situation worse?

And that’s it! This skill is to hopefully help stop us from making bad decisions.

*As much as I’d love to discuss distraction tips and what they call “non-judgemental stance” in this post, I feel like I’m already rambling too much, and I want to keep these Monday posts as “bite sized” and easy to digest as possible.

And now quick update on my own personal mental health, because as mentioned, I’ve already rambled too much!

I was diagnosed three or so years ago with borderline personality disorder (BPD) and have tried a bunch of medications, and honestly, I just seemed to be getting worse. I was in and out of the hospital, increased intensity of my manic and depressed episodes, and more. So I recently changed doctors and wouldn’t you know it? I have bipolar disorder!

It was scary as all get out to get a new diagnosis after adjusting to my old diagnosis and learning to “cope” with BPD, but ultimately I think it’s probably a good thing because now I can try proper medication and get proper therapy. It’s been a long, hard road. But for the first time in forever I’m starting to feel like maybe I can get better.

It was so frustrating to be working so hard at getting better and not getting anywhere, but now I understand why.

It’s too soon to know if the new meds are working, but I am optimistic.

Thanks for reading.

As always, and especially in times like these, take care of yourselves and your loved ones, friends!

Paige