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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The Disappearing Girl

She’s all here,

And then she’s all gone,

And we’re left to wonder if she was ever here at all.

How The Ontario Mental Health System Let Me Down — Again

Alternatively titled: I busted out of the mental hospital yesterday “AMA” and now I want to tell you about it. 

It’s been a while since I posted here, but today I’m frustrated with the mental health system in Ontario, Canada and I thought it’d be a good time to update you on what’s going on in my life.

Let me back up for a second to 2013, it was the first time my parents took me to the hospital for suicidal thoughts. The nurses then didn’t take me seriously at the time; they blamed the entire incident on my family, and because I was only fifteen at the time, the best ‘solution’ they could offer me was to send me to foster care, if I wanted that, and I didn’t. I chose to stay home, knowing full well that my family was not to blame for my breakdown. We went back to the hospital a few days later and they still refused to help me. They gave me Ativan to stop the nightmares and they sent me home, again.

My mom did 24 hour watch with me for days; I slept on Mom and Dad’s bedroom floor and tried to pray and will myself through the darkness. It’s truly only by the grace of God that my parents and I made it through that incident with only a few mental scratches.

Fast forward to the present.

I had a pretty bad episode this past Saturday and my mom convinced me to go to the hospital. [Shoutout to both of my parents for being the bomb dot com, by the way!]

Despite me telling the intake nurses and the emergency psychiatrist that, YES, I wanted to die, and YES, I had a plan, they really did not want to take me. They hmm-ed and haa-ed and tried to convince me to just wait until Monday and see a psychiatrist, but I wasn’t sure I was going to be able to make it until Monday, so I fought with the nurses and another psychiatrist until they put me on a form 1. That’s 72 hours of inpatient “care”.

But it wasn’t.

When I signed myself in, I was told there would be counselling and they’d help me deal with my dermatillomania (skin picking) AND we’d try medication as well, so hopefully I’d get my stuff sorted out, or at least be on the way to getting it sorted out, by the time I got out of the hospital.

Well, here’s what actually happened:

I slept, a lot. I barely ate for five days (to be fair, they offered me ‘food’ but it was extremely questionable, and most of the time I’d just rather NOT eat!) and I only saw my doctor twice when he was supposed to come every day.

Oh, and after the 72 hours were up and my form expired, I was considered a voluntary patient, but I wasn’t allowed to go home! But I’ll write more on that in a minute.

There was no counselling, no help with my dermatillomania — I actually honestly think I picked MORE in the hospital than I do on a regular basis because I was so stressed out and BORED! — and while I did try medication, it didn’t go well.

I’m sorta allergic to everything, so I wasn’t surprised when I was allergic to the Cipralex they gave me on the second day I was there. It made me break out in hives and I was basically like, “Nope, not doing that again!” So the next day (if you’re keeping track with me, this is day three of my stay in the hospitHELL now) they tried me on Zoloft, and I had an even worse reaction; bigger hives, way more itchy. It was so bad my arms and shoulders looked like I had a sunburn and yet, it took them two hours of me scratching myself like a flea riddled dog to requisition a Benadryl. The fourth day, the doctor didn’t come see me at all but he prescribed Wellbutrin and at that point I was fed up and said, “Screw it, I don’t want to take another medication because my reactions have been getting worse. I just want to go home.” Maybe you think that’s stupid and I should’ve kept playing medication roulette until I found something that worked or killed me, but for me, it wasn’t worth it. So I asked my nurse for other options and she said she’d get me a list of outpatient care programs.

Do you think I got that list? No.

As for going home, this is where things get interesting. I already mentioned that after 72 hours — which they said was noon on Wednesday (though I don’t understand WHY because I checked in somewhere around nine pm on Saturday night, but anyway!) — I was considered a ‘voluntary patient’ but my employer said I would need a note from my doctor to return to work, so in order to go home I would have to see my doctor. As I said before, he didn’t come see me at all on Wednesday even though he had been at the hospital and I had inquired with a nurse about when he was coming to see multiple times that morning. So he didn’t give me a note, or the referrals I would need for outpatient care on Wednesday, and the nurses told me later that the doctor “didn’t know I wanted to go home” so he didn’t make it a priority to come see me, but I could be assured he’d come see me early Thursday morning, so I should “sit tight and suffer a little longer” so my visit wouldn’t be a total waste.

The typical morning routine in the hospital is a nurse knocks and announces the arrival of “food” at 7:45am, and if you go down to “breakfast” they leave you alone until you get back, but otherwise you’re bombarded for the next fifteen minutes with people coming in to check your vitals and then the doctor typically visits, if he’s going to, then you can go back to sleep or do whatever you want to.

My nurse on Wednesday night told me she was going to leave a sticky note on the board for them to wake me up at 7am instead of the usual time, so I would definitely be awake and ready for the doctor when he came in.

Thursday morning came and surprise, surprise, they didn’t wake me up until 7:45am when “food” arrived. That was fine, I could get over that. I chose not to go for breakfast because 1) the food is beyond gross and 2) I thought I’d be getting out soon and I could grab something at a coffee shop on my way out. Wrong! 

I’ll spare you from the long story of how I spent the NINE HOURS waiting for that doctor yesterday before they finally told me he wasn’t coming in and that I’d have to wait ANOTHER day for the doctor. I said NO WAY! So I signed myself out “against medical advice” because the doctor couldn’t be bothered to see me and the nurses kept yanking me around, telling me he was coming in and then he never showed up.

It’s interesting to me that it was considered “against medical advice” when I had barely seen a doctor at all, not to mention I was “voluntary” at that point, but I guess because I hadn’t been formally discharged they considered it “AMA”. Though it’s hard to get discharged when the doctor never comes in!

Thankfully they DID let my dad pick up the doctor’s note today (even though my nurse on Wednesday night told me they COULDN’T DO THAT) after work, but still I got no referrals, no counselling, no help with my skin picking, no help at all. Just a five day “vacation from life” that felt more like a jail sentence.

I fought to get in to the hospital and fought to get out, and had no help in between.

That’s pretty screwed up, if you ask me. Something in our system needs to change, and soon.

I Miss My Friends

My head’s a mess,

I miss my friends,

But trying to reply is the biggest mountain I have to face sometimes.

I’m frustrated and I’m tired.

I want to talk, but I don’t have the energy that’s required.

It takes a lot from me to make conversation,

Honestly, I lack the motivation.

Please be patient with me, and know that I love you, even if it takes me two weeks to respond.

Welcome To Wonderland (A Dark Poem) — Mental Health Post #16

I realize that this probably takes away from the “writing” portion of this post, but I had to make a disclaimer: this poem is quite old and I was in an extremely dark place when I wrote it, and it doesn’t apply to me anymore.

It almost feels wrong to post this for mental health month, honestly, but I think it’s important to see the darkness as well as the light. This was not meant to be a glorification of mental illness, it’s just how I personally felt in the middle of the darkness. Please, please do not read any further if dark themes upset you. Stay safe, Friends.