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  1. Earlier
  2. Many of my clients, all of whom are coming to see me for help with anxiety, complain that they have a difficult time making decisions. Anxiety sufferers often have perfectionistic tendencies, and this plays into their decision-making process as well. When faced with multiple alternatives, they want to feel certain that they are choosing the right path. It is normal and often healthy to analyze different options when making a decision, but we each have our own “threshold” for when we have analyzed enough to pull the trigger on making a decision, even if we can’t be certain what the outcome will be. For people with high anxiety, this threshold for certainty is too high; they don’t want to finalize the decision until they can be 100% certain that it is the right decision. Of course, if the decision is not an inherently obvious one, reaching 100% certainty that you are making the right decision is not a realistic goal. So the decision-making process becomes endless. We call it “paralysis by analysis.” The process at play here is the same as it is for any type of anxiety: short-term avoidance of anxiety is feeding more anxiety in the long term. Anything you do to try to relieve anxiety in the moment you are feeling it actually creates more anxiety the next time you’re in a similar situation. Short-term resistance to anxiety unintentionally teaches your brain that you need the anxiety to stay safe. Let’s say a person with anxiety is unhappy in their job and is thinking about quitting. There might be a lot of factors to weigh here, such as how much money the job pays, how much they enjoy the people at work, the prospects the person might have for other jobs, etc. The trigger for anxiety around this decision is uncertainty: the decision is not an obvious one, and it is uncertain what is the right decision. When your brain senses uncertainty and perceives it as dangerous, it warns you about it by using anxiety as an alarm. Your brain tells you to try and get away from the supposedly dangerous uncertainty with a simple instruction: try to get certain about it! There are various ways we try to do this: mentally analyze it over and over (that’s what worry is), get other people’s opinions about it, or research the topic online. Doing these things often leads to reassuring answers about what the right decision might be, which leads to a temporary decrease in anxiety. But because anything that decreases anxiety in the short-term feeds more anxiety in the long-term, the anxiety gets worse the next time the person has a thought related to the uncertainty about the decision. Often, this happens about 5 seconds after we get a potentially reassuring answer when our brains say, “Well yeah but how do you KNOW?” In other words: “You aren’t 100% certain about this yet, so keep analyzing it until you are!” So the process keeps repeating itself. So what’s the solution? The answer is the principle of Exposure Therapy, a form of Cognitive-Behavioral Therapy (CBT) that has a strong evidence base for its effectiveness in treating anxiety. Exposure therapy means doing the opposite of short-term avoidance: purposely doing and confronting the things that make you anxious in the short-term, which retrains your brain that these triggers are not actually dangerous and decreases the anxiety in the long-term. Here’s how this applies to decision-making: the best therapy for anxiety about decision-making is to simply make faster decisions! When you have a decision to make, try to keep the analysis about it as brief as you possibly can — so brief that it even feels risky. Then make the decision and take action on it even though you are not sure it is the right decision. When you do this and no harm comes to you, your brain will learn that uncertainty around decisions is not actually dangerous and will give you less anxiety about it the next time you have another decision to make. As you do this repeatedly in many different situations, it will get easier and easier with less and less anxiety. My clients are often understandably anxious to do this because what if they end up making the wrong decision? When they are reluctant, I often have them add up an estimate of how many hours they have spent analyzing this decision already. The answer is usually dozens and sometimes hundreds of hours. My question to them then is: if you’ve already spent 100 hours analyzing this, do you really think the 101st hour is the one where you will become certain about it? Also, are you really going to make a different decision after 100 hours than you would have after one hour? Or even 10 minutes? I doubt it. When my clients follow through on this and make quicker decisions even though it feels risky, they often express a feeling of profound freedom, like they are off the hook from this hugely burdensome task that wasn’t doing them any good anyway. Even though it’s scary at first, it’s really a relief to spend less time in decision-making mode. Try it for yourself and see the power of making rapid, uncertain decisions! View the full article
  3. Rebecca Jo Manzella, 31, of Mount Clemens, was diagnosed with bipolar depression her junior year of high school. Lithium, the medication doctors prescribed for her, was the game changer. Its therapeutic benefits allowed her to return to her studies and continue to maintain healthy relationships with family and friends. View the full article
  4. Phobiasupportforum

    Stress may cause vocal disorders

    Do you feel anxious about talking in front of the crowd and feel as if there’s a frog in your throat? New reseach says that stress may be the culprit for such vocal issues. View the full article
  5. A study has found that anorexia nervosa may have a metabolic component that makes some patients lose weight more easily and be harder to treat. View the full article
  6. Phobiasupportforum

    Podcast: Religion and Mental Illness

    From leisure activities to politics to relationships, people tend to be influenced by their religious beliefs. In this episode, Gabe and Michelle discuss the pros and cons of religious influence when it comes to treating mental illness and explore whether it is helpful when trying to reach recovery. SUBSCRIBE & REVIEW “They are dead (by suicide) and we are still stigmatizing their behavior.” – Gabe Highlights from ‘Religion and Mental Illness’ Episode [2:00] The intersection of religion and mental illness. [4:30] How the Jewish faith views mental illness. [10:00] How Christianity views mental illness. [16:00] Do all religions accept people with mental illness? [20:00] Is spirituality a valid treatment option? Computer Generated Transcript for ‘Religion and Mental Illness’ Show Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you. Announcer: Announcer: For reasons that utterly escape everyone involved, you’re listening to A Bipolar, a Schizophrenic, and a Podcast. Here are your hosts, Gabe Howard and Michelle Hammer. Gabe: Welcome to a very serious episode of A Bipolar, a Schizophrenic, and a Podcast. My name is Gabe Howard. I live with bipolar disorder Michelle: Hi, I’m Michelle and I’m schizophrenic. Gabe: I was gonna tell everybody you were dead. That was my whole plan. It was gonna be like, “Sadly, Michelle is no longer with us.” Michelle: That’s not funny, Gabe. Gabe: I mean it’s a little funny. Why do you assume that you’re dead like in the no longer exists? Since maybe you’re just dead to me? Michelle: No. Gabe: People who have listened to this show are fully expecting one of us to kill the other. So I think that at some point you’ve got to give the people what they want. Michelle: I don’t think that’s what the people want. Gabe: I brought up death because you know death quickly leads into religion and religion is one of those things that is sort of a double edged sword for people because a lot of people struggling with mental health issues living with mental illness whether depression, bipolar, schizophrenia, anxiety. They talk about how their faith has led them to wellness. So we want to acknowledge that right away before we trash religion for the next 20 minutes. Because there is this other side where religion has caused a lot of damage. This is a buffet. Take what you want and leave the rest. Michelle: Is it a Chinese buffet? Because I like a Chinese buffet with a Mongolian wok. Gabe: Ok. But do you eat every single thing on the Chinese buffet? Michelle: No. Well no because I’m allergic to shellfish. Gabe: Ok. So there are things on the Chinese buffet that you don’t like? Michelle: That’s right. Gabe: Do you stand in front of that thing and start screaming that you hate it or do you just focus your attention on the items that you like? Michelle: Oh you know like the chicken lo mein? I’m all about that. Gabe: Right. So isn’t it funny that on the internet nobody goes for the proverbial chicken lo mein? They all stand in front of the shellfish screaming and that brings me around to my point that if religion is working for you, if spirituality is working for you if you are living better in spite of a mental health challenge, and utilizing religion spirituality etc then hey this show is not for you. But there are many people who are hindered by religion in their recovery. Michelle: Let’s do it, Gabe. I think we should chat about it. Gabe: Let’s establish some ground rules. First I was raised Catholic. I am now an atheist. You, Michelle, were raised Jewish. And I have no idea what you are now. Michelle: I’m a. Gabe: New Yorker I guess? Michelle: I’m a cultural Jew. Gabe: A cultural Jew? What’s a cultural Jew? Michelle: A cultural Jew is where you really don’t celebrate the holidays but you identify as a Jew and you celebrate holidays meaning you have food on the holidays. Gabe: I can get behind that. Michelle: Yeah. You just don’t go to temple anymore. Gabe: I am a cultural Catholic because there is not a holiday out there that I will not eat food. In fact I’m going to become a Catholic Jew so that I can have two holidays and I can get double food. Michelle: You know what? I can agree with that. Gabe: Excellent. Do you want to become a Jewish Catholic so that you too can have double food? Michelle: Well I kind of want to celebrate this capitalist Christmas. Gabe: I love capitalist Christmas. As you know I dress like Santa so I am really into it because Santa is the spokesperson for capitalist Christmas. Michelle: And you get to yell at people. Gabe: I mean nothing says love like a guy breaking into your house and leaving you shit. Michelle: And just yelling, “Ho, ho, ho,” everywhere. Just calling people hos. Gabe: Ho, ho, ho! Michelle: Just calling everyone a ho. Gabe: Ho, ho, ho! Michelle: You’re really good at calling people hos there, Gabe. Gabe: Hey you’ve heard the hyper sexuality episode. It’s a thing. Michelle: Ho ho ho ho. I think I can go around doing that to people ho ho ho. Gabe: I mean yeah, if you trim up your beard and mustache a little. It’s getting a little long. Michelle: Fuck you. Gabe: From your experience as a person living with schizophrenia and what you have seen in your community, how open is the Jewish faith to the concept of mental illness? What are the teachings? What do they say? Michelle: Well it’s interesting. With mental illness and Jewishness it’s kind of a weird kind of a thing because it’s kind of like the media plays up the Jews as very anxious and neurotic. And it’s a hugely Jewish stereotype and you see it in a lot of films like the neurotic Jew. And it’s really just a stereotype. And when I was looking up a lot of things about Jews and mental illness and I found like studies and it said that this study found that Jews suffer from certain mental illnesses at higher rates including major depression, dysthymia, schizophrenia, phobia but had lower rates of others including alcoholism. And they also saw mental illnesses in Jews and other people can be higher if they’ve suffered traumatic events in the past. Think about like oh the trauma of like maybe the Holocaust? Things like that which could have turned Jews into this more neurotic kind of way. What do you think about that? Gabe: I think that you googled and it’s always fascinating when Michelle googles because if you google long enough you’re going to find out that all Jews have cancer. Because all medical conditions lead to cancer on the Internet. But I like what you said there about that neurotic Jew because think of like Woody Allen and when it comes to famous Jewish people you know Woody Allen is a really big example because I think he plays into the stereotype intentionally. You know he’s always doing these as you said, stereotypical neurotic Jewish things. And that probably helped his career a lot in the 70s and 80s because after all if you are the stereotype then nobody has to be afraid of you everybody knows you. And it sort of led to this kind of cutesy caricature. But you’re right. In actuality Woody Allen has a really serious anxiety disorder. Like how does he leave his house? He’s afraid of everything. But we all saw that as comedy. But in actuality that’s pretty serious, right? Michelle: It is serious but really it’s just a stereotype. He built up a stereotype everybody just built that stereotype of these neurotic Jews and they’re all nervous all the time and I think things are gonna go wrong. And even if you watch Curb Your Enthusiasm Larry David is all very like you know. Oh things are going to go wrong what am I going to say and he finds himself in these like ridiculous situations where you said things he wasn’t supposed to say. Things always go wrong because of Larry David saying the wrong thing in his messed up kind of a mind of who knows what he’s going to do and he says it. You know what I’m saying about Larry David’s show? Come on? Gabe: Yeah. Oh no I completely agree. And if we just look at our relationship so I’m not Jewish. You are Jewish and you don’t care about anything. Like right before we go on, you’re backstage you’re like sitting in the back with your feet up half asleep and I’m like circling the building at a thousand miles an hour just waiting for it to catch on fire. So it really should be the opposite I should be like calm and laid back and chill because that’s my stereotype I’m a white male I have it all put together and you should be neurotic for a number of stereotypical reasons. You know female being at the top you know Jewish being second. Schizophrenia is a strong third. But you’re relatively laid back and relaxed I don’t. I never really see you panic. Michelle: That’s a very good point. I think my panic is more internal. It’s more in my head of oh am I going to mess this up? Is this going to go right? I hope it goes well. But what if it doesn’t go well? Oh well but I think I think I know what I’m going to say so I hope it does the right thing. If I mess up, I mess up, you know. It happens. It is what it is I accept everything for what it is. So that’s why I’m kind of OK with it. Gabe: And that is very very healthy. But now let’s move to more scary topics. If somebody dies by suicide how does the Jewish faith handle that. Michelle: That’s a very good question. I don’t think that the Jewish faith really likes that too much but there are not. Gabe: Well I don’t I don’t think anybody likes suicide. I don’t think there’s a group out there that’s pro suicide but I mean are you allowed to be buried in a Jewish cemetery or are you allowed to have your funeral in a Jewish temple? Do they tell your whole family that you’re burning in hell? What’s that kind of. Because we’re gonna get to Christianity in a minute and there’s all kinds of fucked up messages over on that side. Michelle: No. No you can be buried in a Jewish cemetery if you kill yourself and that whole thing about tattoos and Jewish cemeteries. That’s really just a lie. Have you heard that stereotype, Gabe? Gabe: No. Michelle: There’s this like big lie that if you’re if you have a tattoo you can’t be buried in a Jewish cemetery. And that is one of the biggest myths and is a huge myth and people believe it for some reason it’s a complete lie because the people who have always said, “Oh no, if ever you have a tattoo you can’t be buried in a Jewish cemetery.” And I’ve always thought. Think about it the body goes to the cemetery. Do you think they really check the body for tattoos and say oh no this body cannot be buried here? Like that’s just the dumbest belief ever. And people have really said that to me. People really believe that. And it’s a complete lie. Gabe: What if it’s a stupid tattoo though? Michelle: Doesn’t matter. And if because the whole thing is you borrow your body I don’t really get it either but you borrow your body therefore you’re not supposed to make any permanent things on your body yet. Earrings are allowed. Gabe: But earrings aren’t permanent, you can take them out. Michelle: But they leave a hole. Gabe: That is very true. You know Michelle I don’t need to explain to you that Christianity is the biggest religion in America. Michelle: Yes. Gabe: More people associate with Christianity than any other religion including people who absolutely have never set foot in a church will claim Christianity as their religion the teachings surrounding mental illness and suicide are scary. And again to be fair not every single Christian religion, because there are many of them share this. But there are some that that teach things like if your loved one died by suicide, they will burn in hell for all eternity and they cannot have their funeral in this church and they cannot be buried in your church’s cemetery. Which is like, I mean the person is dead. So you’re not really doing anything to them what you’re doing is making their families suffer needlessly. And it’s just so incredibly cruel. Michelle: Yes. That’s horrible. Good things Jews don’t believe in hell. Woo! Gabe: Well but where do you go when you die? Are you able to go to the same place? Does the Jewish faith care how you die? Are there different restrictions based on your death to what happens to you in the heavenly plane or the afterlife? Or does it just not matter? Dead is dead? Michelle: Well from what I understand there is a purgatory for one year. And yet once you complete your one year of purgatory you then go up to heaven. Everybody goes up to heaven unless you are a horrible person like Stalin or Hitler, where you go to purgatory and then your soul dissipates and you never make it anywhere else. Gabe: What if you’re a horrible person like Michelle hammer? Michelle: No. Gabe: Like just one year in purgatory and you’re good? Michelle: No, I’m not a horrible person. I would go straight to heaven. You go to heaven and then you, and then you can live again in a new life. Gabe: So like reincarnation? Like could someone come back as a dog? Michelle: I don’t know about a dog but you can live again as like a human I believe. Gabe: So that means there is a possibility that your grandmother Blanche is out there? Michelle: Well they’ve been pretty soon but yeah I mean maybe Blanche might be living again. Who knows? Gabe: All joking aside the bottom line is if you die by suicide the Jewish faith community will support the family. Your funeral stays exactly the same. You’re buried in exactly the same place. And the afterlife works exactly the same way. There’s no extra teaching surrounding dying by suicide or dying by mental illness in the Jewish faith. Michelle: That is what I believe. If I am wrong I apologize but that is what I am pretty sure of. And I did look up a lot of stuff about just you know a mental illness in the Torah and it was very interesting. They were saying things like mental illness can lead to sin or sinning can lead to mental illness. Hold up one sec. We’ve got to hear from our sponsor. Announcer: This episode is sponsored by BetterHelp.com. Secure, convenient, and affordable online counselling. All counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist, whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face to face session. Go to BetterHelp.com/PsychCentral and experience seven days of free therapy to see if online counselling is right for you. BetterHelp.com/PsychCentral. Michelle: And in an effort to get a whole bunch of angry letters we’re back talking about religion. Gabe: As you know, Michelle, the Jewish faith is a minority in America. The largest faith in America is Christianity and Christianity comes in all different sects for example. I’m Catholic which is a Christian religion, my father is Presbyterian which is a Christian religion and Catholics and Presbyterians believe very different things and they believe a lot of the same things. So it’s really difficult to have a conversation about how Christianity feels about suicide. But there are large portions, not the majority I really don’t think. But but large enough to cause real damage that believe that people who die by suicide who die from their mental illness cannot get into heaven. They cannot be buried in Christian cemeteries. They cannot have Christian funerals and they tell their family members they’re going to burn in hell for all eternity. Michelle: That’s not OK. That’s not ok at all. That’s really not OK. I don’t I don’t like that. I don’t like anything about that and I don’t like that happens. Where can you be buried then? Like in a non faith cemetery? What if you have family members that are buried in that cemetery? You can’t be buried next to them? That’s not OK. Gabe: It’s just an example of where the stigma against people with mental illness continues into their death. That person is now dead. Let let’s be clear. They’re dead. It’s over. They’re dead and we’re still stigmatizing their behavior. We’re still telling their family members that this person is bad. And here’s the concept that I have trouble wrapping my mind around in Christianity we have this belief that you cannot sin accidentally sinning has to be willful. You have to want to do it. The second thing that we have is that anything can be forgiven literally anything can be forgiven. Remember Michelle: Right. Gabe: Christians Michelle: Right. Gabe: Aren’t perfect. They’re just forgiven. Michelle: Right. Gabe: Yet for some reason. Michelle: God always forgives. Gabe: Reason when it comes to mental illness you did it on purpose and you can’t be forgiven the end. Michelle: God always forgives. God always forgives. That’s what I learned. God always forgives. Gabe: Listen if you talk to the majority of Christian faith leaders that believe this kind of thing that believe that people who die by suicide cannot have church funerals cannot be buried in their church cemetery. They firmly believe that a murderer can be redeemed that a murderer on death row has a better shot at redemption than a person who dies by suicide because of mental illness. And that’s just that’s just so incredibly sad because let’s back that up a couple of steps. If that’s their belief after you die imagine what their belief is while you were alive. Let’s talk about some of the horror stories that we’ve heard there. We know a woman who suffers from schizophrenia childhood schizophrenia. She started showing symptoms at age 14 and when she was 17 years old she was given a three day exorcism to Michelle: Right. Gabe: Treat schizophrenia. Michelle: Right. Right. Gabe: Can you imagine the trauma? Michelle: I can’t and I can’t believe that she went through that and then. No I can’t I can’t imagine the trauma because it’s so absurd. I can’t imagine what she went through. Gabe: And now she’s you know 35 years old and she’s OK. I mean you know she still lives with schizophrenia. But could you imagine if she would have thought that it worked and would have wandered around saying, “I’m cured now?” Michelle: Right. Gabe: So she’d be a person living with schizophrenia. Untreated. Except, she now believes wholeheartedly that she’s cured so she wouldn’t be seeking help because, after all, God cured her. Thankfully that did not happen. She realized it didn’t work. God did not help and now, because of things like you know medication and therapy and medical intervention and coping skills and experience she’s living a good life. But what if she would have believed the church? Michelle: Yes. Gabe: If she would have she would have believed that the exorcism worked? Oh my God Michelle: Yeah. Gabe: Could you imagine? Michelle: Yeah. Something I was reading online was when this Orthodox family was speaking to a psychiatrist and the father this orthodox man was yelling at his daughter who was schizophrenic and she was he was saying to her you know, “Obey the Fifth Commandment. Honor thy father and thy mother. Honor thy father and mother. You are not obeying the fifth commandment.” And she’s schizophrenic and she’s just laying there just sitting there just being a schizophrenic not understanding and he’s just yelling honor thy father and mother, you are not obeying the Fifth Commandment and she can’t. She’s schizophrenic. So what is she supposed to do? He is not understanding. She is not understanding. What’s supposed to happen? You know you can’t just bring God into it when it’s mental illness. Gabe: And what is it scary to consider is that the father in that scenario one is not being malicious not being bad. He really does believe that this is the solution and he believes it because it’s ordained by God. Michelle: Right. Gabe: He believes that he is following the almighty and just yelling at his sick daughter. This isn’t an example of somebody being mean or malicious but it’s an absolute example of somebody being ignorant and not understanding how medicine works. And can you imagine if you removed schizophrenia and changed it with cancer? Stop having cancer obey your fifth commandment stop having cancer you’re not obeying your mother and father be cured of your cancer. Does that sound ridiculous? Michelle: Yes it absolutely does sound ridiculous. Gabe: But when you replace cancer with schizophrenia people are like, “Well, if she’d listened, she’d have a better life.” Michelle: This is an example of where we need medical intervention and not just religious intervention. So honoring thy father and mother and by not doing that does not mean you’re not following religion. It means you need medical help. Gabe: And this is the problem when religion permeates a culture because so many people when I teach classes I’m like OK. If somebody is having a mental health crisis where can they go. And we get examples that are that are really good you can call 911, you can go to a psychiatrist, you can go to a psychologist. But somebody always says you know priest rabbi spiritual leader minister. And it’s so hard to give pushback because they think that I’m being disrespectful to religion and I’m not a priest a rabbi a minister they’re all excellent for your spiritual needs but they’re not doctors. Religion has a lane that it needs to stay in. And again I know that God is always in our hearts and we carry him with us. And it really does permeate our culture. But nobody would think it was OK to refuse treatment to an 8 year old with leukemia because everybody is praying; they would think that that was horrible. But yet for some reason in our society we have religious leaders right now that are trying to pray the symptoms of mental illness out of people. And it’s incredibly dangerous and we know a woman who lives with severe bipolar disorder that was on her medication that was stable and she was going to church to improve her life. And when the minister found out told her to stop taking all of her meds because God had cured her and she believed him. And within a few months she went right to crisis where she could have died and it took her another couple of years to be stabilized. Think of the damage that that caused her. And she’s now fine. Everything is OK. All of my examples. Everybody is living well but can you imagine if she had died by suicide in those couple of years nobody would have blamed religion. Nobody would have blamed the minister. They all would have blamed her. They would have said that she was a bad person that couldn’t be buried in their cemetery. And her family would be left to suffer without the supports of their religious community. And these are the things that we need to change. Michelle: Dude, even more so than that even bringing up cancer. I had a cousin living in Israel, older than me in her 60s. She did not believe in modern medicine and she got cancer. So she believes in praying away the cancer. She’s dead. Gabe: And I don’t think that anybody hearing that story expected it to end any other way. Michelle: Yes. Gabe: But if you remove cancer and replace it with bipolar disorder everybody’s like, “Well how did it turn out?” How the fuck did you think it turned out? The message that I just want to leave everybody with and I’m so sincere about this. Nobody is saying there’s anything wrong with religion but religion is not a cure or even a treatment for mental illness. It is possible that it could be one of the tools that you use to cope with your life because it is Michelle: True Gabe: A coping mechanism. Michelle: It is I do have my western wall story where I do believe God spoke to me. People can think whatever they want but I do believe I had a divine moment at the Western Wall in Israel. I do believe. Gabe: And I am not going to disavow you of that notion unless you said that God told you that he cured your schizophrenia and to stop taking your medication? Michelle: Did not happen. That was not what was said. Gabe: But you live with schizophrenia and you have psychosis and sometimes you hear voices. How do you know which ones are delusions and auditory hallucinations? And which ones are God advising you? Michelle: I touched that wall, closed my eyes thought about some stuff, and then all the sudden I felt a power go shooting through my head, shooting through my arms and into the wall. Nothing like that has ever happened to me before and I never had a more moment of complete clarity in my life. Gabe: Thank you for sharing that. And that makes sense to me. I mean as much as it can. You know I wasn’t there I did not experience this. I’m not pro or con. What you’re saying. I believe you and I respect what you went through. But you know to play devil’s advocate and to kind of be a dick for a minute what if you told me that God told you that you’re supposed to vape? Or that God told you that you’re supposed to drink? Or that God told you to stop taking your meds? Michelle: Well, no. It was positive it was positive it was positive. I was thinking what’s the most important thing I need to do? I’m at the Western Wall. Gabe: Ok. Forget about the Western Wall. Michelle: What’s the most important thing? Gabe: Forget about the Western Wall. Forget the Western Wall. You have had dozens of years of auditory hallucinations and delusions. You are a schizophrenic. You live with schizophrenia. You have all of the hallucinations and delusions that come with that diagnosis. How do you know that all of them are not God? Michelle: Because I know they’re not. Gabe: How? Michelle: They’re not God, they’re not because I can. I know I just know. Gabe: So we have friends who live with schizophrenia. What would you, Michelle Hammer, say if one of those friends said, “Hey this morning God spoke to me and God told me to stop taking my medication?” Michelle: I would say you should still take your medication anyway. Gabe: But God told her not to. Michelle: That’s different Gabe: Why? Michelle: Because. Gabe: Would God lie to her? Michelle: They weren’t at the. They were not at the Western Wall. Gabe: Stop saying that! Michelle: And that’s detrimental. Gabe: Well how do people separate the difference between auditory hallucinations and the voice of God in their head? That’s the question. Leave the western wall out of it. Michelle: Because how is it going to benefit your life? I think if God is going to benefit your life in some way I think God would only speak to you to benefit your life. Gabe: But the Lord works in mysterious ways you don’t know how it’s gonna benefit until you obey the word of God in your head and stop taking your pills like he so commanded in his gentle and loving way. Michelle: Well, did he come to you in a burning was it was it a burning bush? Did the burning bush tell you to stop? Gabe: That’s an STD. That’s a completely different thing. Michelle: Moses. Moses, I shall part the Red Sea. Moses. Gabe: Listen we can we can absolutely go on forever with this line. But it is a problem, it is a a real problem. Imagine that you’re a 25 year old woman who was raised very religious. Or a twenty five year old man who is raised very religious and you have had you know visions and hallucinations and delusions your entire life. What if one of them you mistake for God? It’s not like he signs his e-mails. How do you know? This is a real problem for people sincerely in the research for this show and in talking to people people told me they’re like I thought my delusions were God. I thought God was telling me to quit my job because it was in my best interest. But all that happened is I lost my job. God told me to leave my wife. These are all real stories that I’m looking at of people who thought they were doing God’s will but in actuality they were responding to a hallucination and a delusion. How were they to know that? Michelle: I think God would only tell you to do things that are positive in your life. I don’t think God would try to do something detrimental in your life. I think that’s the difference. I think a negative voice would not be God. I only think something positive would come from a god voice in my opinion. That’s my opinion. Gabe: And further to go back to your western wall story it wasn’t it wasn’t just a voice that you heard. It was an all encompassing feeling all over Michelle: Yes. Gabe: Your body. From the tip of your toes to the top of your head you knew there was no doubt in your mind. It wasn’t. You were pretty sure it was the only thing that felt that way and the only thing that ever felt that way. Michelle: Yes. Gabe: I know that a lot of people described it with their hallucinations and their delusions and all of the stuff they were going through a schizophrenia that they were picking and choosing that you know this one is a delusion. This one is an auditory hallucination, this one is a visual hallucination. Oh look this one’s from God but in reality all of them were exactly the same. They just decided for whatever reason that this one was from God. And that was an excellent indicator for them that it wasn’t. It was just part of their illness process and they worked with their doctors and they found faith leaders who understood mental illness and didn’t overstep their bounds. And that’s really what we’re getting at, right? We just want faith to stay in its lane. We want religion to stay in its lane. We don’t let doctors preach the Word of God. Why are we letting religious people give us medical advice? There’s nothing wrong with either side and until they cross over and that’s what we want people to do to be well because some of these are scary. And I only use the ones where everybody turned out completely OK. Everybody is completely OK thank you all they’ve all gone on to lead great lives and they all say the same thing. Religion has its place but not in the treatment or cure of mental illness. Michelle: Agreed. I agree with that. Religion has its place. Take everything in a positive light. Don’t bring yourself down if you think you’re not obeying the laws of the Ten Commandments. You’re OK. Just because you have a mental illness does not make you some sort of hell demon in God’s eyes, you’re all good. You’re not a bad person if you’ve a mental illness, you are not afflicted by the sins of God or anything like that. You’re good. OK? You’re good. Gabe: Thank you everybody for tuning into this week’s episode of A Bipolar, a Schizophrenic, and a Podcast. My name is Gabe Howard, I live with bipolar disorder and Michelle Hammer who is a kick ass artist lives with schizophrenia. I’d say look behind her and see all of her great art, but this podcast is an auditory hallucination. We will see everybody next week. Announcer: You’ve been listening to A Bipolar, a Schizophrenic, and a Podcast. If you love this episode, don’t keep it to yourself head over to iTunes or your preferred podcast app to subscribe, rate, and review. To work with Gabe, go to GabeHoward.com. To work with Michelle, go to Schizophrenic.NYC. For free mental health resources and online support groups, head over to PsychCentral.com. This show’s official web site is PsychCentral.com/BSP. You can e-mail us at show@PsychCentral.com. Thank you for listening, and share widely. Meet Your Bipolar and Schizophrenic Hosts GABE HOWARD was formally diagnosed with bipolar and anxiety disorders after being committed to a psychiatric hospital in 2003. Now in recovery, Gabe is a prominent mental health activist and host of the award-winning Psych Central Show podcast. He is also an award-winning writer and speaker, traveling nationally to share the humorous, yet educational, story of his bipolar life. To work with Gabe, visit gabehoward.com. MICHELLE HAMMER was officially diagnosed with schizophrenia at age 22, but incorrectly diagnosed with bipolar disorder at 18. Michelle is an award-winning mental health advocate who has been featured in press all over the world. In May 2015, Michelle founded the company Schizophrenic.NYC, a mental health clothing line, with the mission of reducing stigma by starting conversations about mental health. She is a firm believer that confidence can get you anywhere. To work with Michelle, visit Schizophrenic.NYC. View the full article
  7.  One of the most dangerous misconceptions about suicide is that asking a loved one if they are suicidal will increase the odds that they will attempt suicide. Today Dr. Nate Ivers of Wake Forest University discusses the importance of making “the covert overt” by asking blunt, straightforward questions of those you suspect may be thinking about suicide. What words should you use, and if the answer is yes, what should you do next? And why are we so uncomfortable about asking these potentially lifesaving questions? Find out on this episode. SUBSCRIBE & REVIEW Guest information for ‘Discussing Suicide’ Podcast Episode Dr. Nathaniel Ivers is the department chairman and an associate professor in the Department of Counseling at Wake Forest University. His research interests include bilingual counseling; culture; terror management theory; existentialism; counseling with Spanish-speaking immigrants; and wellness. Computer Generated Transcript for ‘Discussing Suicide’ Episode Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you. Announcer: Welcome to the Psych Central Podcast, where each episode features guest experts discussing psychology and mental health in every day plain language. Here’s your host, Gabe Howard. Dr. Nate Ivers: Hello everyone and welcome to this week’s episode of the Psych Central Podcast. We are here today talking with Dr. Nate Ivers, who is the department chair and associate professor at Wake Forest University. Specifically, we are going to be discussing how to openly talk about suicide in our communities. Nate, welcome to the show. Dr. Nate Ivers: Thank you so much for having me. I appreciate you inviting me to be here and for allowing me to talk about something so very important. Gabe Howard: Well we appreciate you being here as well. Suicide is one of those things that absolutely everybody has heard of. We all know about it and believe it or not we’re all talking about it just generally incorrectly. You’re a doctor who studies and research is this. Why do people get it so wrong? Because it’s not a concept that people are unfamiliar with. Dr. Nate Ivers: Right. I think everybody unfortunately has been affected or touched by suicide. But yes there are lots of misconceptions. I think one of the major misconceptions is the thought that those who commit suicide really wanted to die. I think there are some instances where people do indeed want to die but most often the reason why people decide that they are going to go forward with committing suicide is because they feel so much pain and they feel so much hopelessness and helplessness related to their situation and they just want that pain to go away. Gabe Howard: I can really relate to that as someone who has had bouts of depression and been suicidal myself. I’ve said that since I reached recovery it’s not my life that I wanted to end it was the pain that I wanted to end and I saw no path forward. Dr. Nate Ivers: Right. Yeah. Yeah. Gabe Howard: And that’s one of the reasons I’m so interested in how to discuss suicide and wanting to die with the public because there’s many many many misconceptions floating around and one of the biggest ones that persists is that asking someone if they are suicidal will put the idea in their head and make them want to do it. How do you respond to that? Dr. Nate Ivers: It is a great question and I think that’s one of the fears that sometimes we have about trying to help someone who’s going through this sort of pain but all indicators suggest that talking to someone about suicide is not planted in their brain. In fact it’s the opposite when people are experiencing such pain to the point where they’re considering suicide. They very often are reaching out for help. Sometimes they’re doing it very directly by saying I am considering harming myself and so they broach the topic, they name the taboo. But many times it is sort of metaphorical they’ll say I just I just can’t keep doing this. I feel like I keep digging a hole and I can’t get out or I just want to walk into the ocean I just want to keep walking instead of turning around and then if we’re able at that moment to name that taboo or say it sounds like you’re really hurting right now and I’m concerned about you and sounds like you might be having thoughts as well of killing yourself is that correct. That sounds hard to say but in the moment that’s oftentimes what we do need and that is what we do need to do because it helps bring the cover to the overt and when we do that we can actually do something to work on it with that person and sometimes I think it brings relief to the person as well that finally this thing that’s so taboo that even they have ambivalence about has come out into the open. Gabe Howard: It’s fascinating to me that this is one of the myths that persist because we have all sorts of safety precautions in our society. You know, for example, nobody says that smoke alarms give people the idea to burn their house down. Dr. Nate Ivers: Right. Gabe Howard: Or that wearing seat belts gives people the idea to drive recklessly. Yet for some reason people feel that thoughts of suicide are so outside of the norm that they must not be able to come up with this on their own and that just even raising the name, it’s like Beetlejuice if you say the word suicide it will appear. Dr. Nate Ivers: Mm-hmm, right. Gabe Howard: Otherwise nobody’s thinking about it. And we’ve learned through research and understanding that as you said that’s just not true. People have come up with this on their own and by nobody talking about it it gives it space to grow. Dr. Nate Ivers: Yeah I think that’s a really good point. Going back to suicide is a taboo subject. We’re unwilling to even consider that someone would go that far as to think of suicide and it’s easier to just ignore it in ignoring it. I think it does fester. I think it grows and I think it affects people much more than it might otherwise. The heart of it is and it’s actually really hard for a counselor sometimes to what we call name the taboo and one of the things we do in our training programs is really work with our students to get comfortable with asking that question because they even bring in with them. These misconceptions that if I bring this up I might be priming my client to consider suicide when they may not have otherwise. Gabe Howard: And we’re back talking to Dr. Nate Ivers about discussing suicide in our community. Aside from all the misinformation or worry of putting the ideas in people’s heads et cetera I think that another common reason that people don’t ask people if they’re suicidal is because we don’t know the warning signs. Maybe we are comfortable enough to ask our loved ones if this is going on. We just assumed our loved ones are fine. Dr. Nate Ivers: Yes. Gabe Howard: What are some of the warning signs? What should people be on the lookout for for their friends, family, co-workers, so that they can provide that care that people may need? Dr. Nate Ivers: Yeah I think that’s a really really good question. I think it also is tied to one of the other misconceptions about suicide is it to be suicidal one must be crazy one must be seriously mentally ill to be suicidal and so I know my friend, I know my co-worker, I know my son and my daughter, I know this person can’t be at a level of serious mental health issues and so I’m not even going to go there with them, and we know that that’s not true. Very few people who have serious mental health issues such as psychosis or schizophrenia are actually suicidal. It’s much more common for the common person to have a crisis and to struggle with some situations and then have these thoughts of suicide and so I think disassociating it from the idea of it being a psychosis may help us recognize that no it’s much more common than we might think but some of the some of the warning signs of suicide I mean one of the obvious ones is that someone is stating that they want to die even when someone says that I think we can we can sometimes discredit it. Maybe by saying, “That’s not true. You really don’t feel that way. I know you’re going through a hard time but that’s just a saying, you’re not really meaning that.” But that’s one of the more obvious ones. Another really really obvious one that we may not consider as obvious is just the enduring sense of hopelessness and despair. So I would say if you’re thinking if you’re worried about your friend or you’re worried about your co-worker or family member if they are experiencing this hopelessness that doesn’t seem to go away. That’s why I might start wondering maybe I should ask him or her this question maybe I should say, “Hey how are you? I have noticed that you’ve been really down lately.” That might start the conversation. When someone expresses that he or she is feeling like they’re a burden that sometimes is a good indicator that you might want to ask more doesn’t necessarily mean in any of these instances whether they’re feeling hopeless or whether they’re feeling like they’re a burden that they necessarily are suicidal. But it is a potential sign that they are changes in behavior can be a sign of this as well. So an individual for example who is punctual at work more recently has been coming in and doesn’t seem like he has his or her stuff together quite as much as someone who’s always well groomed and well dressed and seems put together and then comes in a little bit tattered in his or her appearance. Dr. Nate Ivers: That might be something it might not but that might be an indication as well. Other changes of course are drinking more or sleeping more or sleeping less being more irritable and usually you seem to be fairly easy going. Lots of different things like that just kind of really focus really recognizing some of the behavioral shifts that someone has. On the flip side of this, which seems a little bit contraindicated, is individuals who have generally seemed fairly depressed or anxious or irritable who all of a sudden seem like they’re much more content or happy or that might that might be a sign that they are considering suicide and they’ve kind of made up their mind about that and now they’re feeling this sense of pain is going is going to go away. They have a sense of peace. And so that’s another thing that one might want to keep his or her eye on whereas we might think oh finally so-and-so is feeling better but it might be that they’re actually closer to wanting to move forward with the suicidal plan. Gabe Howard: Now of course all of these that you just mentioned, they are signs. They’re not guarantees, they’re just signs. Dr. Nate Ivers: Right. Gabe Howard: We’re going to take a break for this message from our sponsor. Announcer: This episode is sponsored by BetterHelp.com. Secure, convenient, and affordable online counseling. Our counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face to face session. Go to BetterHelp.com/PsychCentral and experience seven days of free therapy to see if online counseling is right for you. BetterHelp.com/PsychCentral. Gabe Howard: And we’re back with Dr. Nate Ivers talking about how to discuss suicide in our communities. So, we move into the next step which is you sort of want to broach the topic with the person who you’re concerned about this, how do you broach the subject of suicide with somebody who you see these warning signs in? Dr. Nate Ivers: There is not a perfect way to do it obviously and some of it depends on your relationship with the person. But I think the first thing that you do is you help them recognize that you notice their pain. You help them recognize that you notice that they’re going through something, that there’s something different in their life. There are few things you can say that you know I just wanted to check in with you for a moment. I notice that you have been coming in late to work lately and you know there’s no judgment here but it just seems like there’s something on your mind or that there is something not quite right with you right now. I wondered if you wanted to talk about it? That is sort of a soft in, but in doing that you’re opening up a door and you’re also doing us what we said earlier is I care about you enough to stop and ask you how things are going in your life. So in its own way it’s kind of an intervention if the person then responds and says Yeah yeah things have been really really difficult lately and let’s say get to the point where they say it feels very hopeless. I just I just can’t keep doing it. I can’t keep living like this. Something’s got to happen. And at that point that’s where you might get a little bit scared because it looks like it’s getting a little bit closer to that taboo. And that’s where you want to maybe express that feeling. It sounds like you’re really sad right now. Things feel really hopeless at this moment. And again, you might you might be thinking, “Oh, no. This might do it. Did I just make them feel hopeless?” No. What you’re doing is you’re creating a connection you’re expressing that you’re hearing and someone actually understands to at least a degree what they’re going through. And as it gets deeper or closer to it than you say I just want to check. Are you having thoughts of killing yourself? Gabe Howard: And you should just be that blunt? You should you just look the person in the eyes and say it? Dr. Nate Ivers: Absolutely. Yeah. Yeah. Gabe Howard: Why does that work? I mean it seems very scary just to ask somebody. I mean I can see why people are going to take a deep breath and think oh I could never ask somebody that it seems so insulting. Dr. Nate Ivers: Yes. Well I think that’s one of the reasons why it’s so hard is because it’s not something you usually ask in polite conversation even things that are a little bit less taboo than that. Are you having a hard time with your drinking? How is your sex life? You know stuff like that you don’t you don’t really broach those topics very often it seems like it’s very private. Gabe Howard: Yeah, we’re trained to avoid them. Dr. Nate Ivers: Yeah you have to transcend your conditioning just a little bit in these instances to really provide the care that you want to provide. And in the instances where I have asked that question most of the time when I’ve asked the question is when in a counseling relationship and so it’s a little bit easier because there’s more of an expectation but other times where I have had to ask that question of a friend if they weren’t suicidal they very quickly told me Oh no no no no no I’m glad you asked that, but no. Yes I’m feeling very terrible right now. Life is hard. But here are all the reasons why wouldn’t do that. And then we move on. I believe them. In other instances where they are feeling a lot of pain. There’s usually some silence maybe a second or two. It might come with tears after that and then all of a sudden here it is. They lay it out. Gabe Howard: Let’s say that you ask the question you say to somebody are you thinking about killing yourself. And the answer yes. Yes I am. And then you try to help them but they refuse all help. What do you do then? Dr. Nate Ivers: That’s when it gets really really difficult. I would say if they if it seems imminent, and what I mean by that is they say that yes I’m having thoughts of killing myself and I’m scared that I really could do it at any point in time. And they have sort of a plan in place for it. And the means to carry it out. I would say what you do is you don’t leave them alone. At that point as much as you can avoid whatever else you need to do I would say stay with that person. And I would also recommend calling a crisis line. I would say look can we call the National Suicide Prevention Lifeline together and they’re going to ask you some questions and I’ll be here to assist you through that. And then we can get a better sense of what the resources are in the community and what your options are at this time to maybe help reduce this pain because I think what you want to do is help them know that I’m not just trying to keep you from committing suicide I’m trying to help you get to the point where this pain can go away. A lot of what you’re trying to do without minimizing what they’re going through is help them realize that there can be some hope there can be even a glimmer a small light at the end of the tunnel. And so that’s what I would probably start with is the National Suicide Prevention Lifeline. It may affect your friendship for a while especially if they’re not happy that you did that. I would say stay with them and say you know what we’re going to make this call together because I’m really worried about you. I can’t help you if you die. And if they leave and they say, “You know, I don’t want to talk with you anymore. I’m out of here.” Then I would call 911 and just let them know in what direction the person was in and the information that they shared with you and why you’re worried about them. I think one of the fears that a friend would have is am I doing this too preemptively? Am I calling in too much help too soon? And could that cause harm? And I would say no. I mean when in doubt, do it you need to do to help them but it may be helpful to get additional assistance. And I would say that’s what the hotline would be for. Gabe Howard: One of the best statements that I ever heard in suicide training that I attended once is that you can apologize for overreacting as long as a person gets the help that they need. You can’t apologize for under reacting if the worst case scenario occurs. It’s sad to think about it that way. It’s scary and traumatizing to think about it that way but yeah as long as that person is alive, I can repair our relationship. Dr. Nate Ivers: Right. That’s right. Gabe Howard: Let’s switch gears for a moment because we know that no matter how hard we try no matter how much education there is no matter how much training unfortunately somebody will die via suicide. How might the grieving process differ for those whose loved ones have died by suicide than if they pass away for any other reason? Dr. Nate Ivers: I appreciate your asking that question. It’s there are similarities of course. Someone has lost someone whom they love but there are differences as well. I think the differences are sort of all coalesce into one thing. It’s the taboo that we talked about earlier individuals whose loved one has died by suicide. Oftentimes experience some ambivalence associated with it. That’s not to say that people who lost a loved one from other causes also aren’t ambivalent. I would say that the swings are probably greater in terms of that going from extreme anger and frustration at the person who died to just really guilt ridden and sad about the experience as well. It’s also hard I think for the for the individual sometimes to really talk about the grieving process. Whenever someone experiences something traumatic it can be therapeutic for them to tell and retell their story. When the death is by suicide oftentimes the loved one sometimes to protect the memory of the one who died or other times just to reduce the amount of judgment that they feel from the community doesn’t feel like they have an outlet to fully discuss these situations. And so it’s difficult for the person trying to provide support for the individual whose loved one died by suicide but it’s really difficult for that loved one as well because there’s all of that ambivalence. And then there’s the fear of how it how it looks potentially to one’s community. Gabe Howard: And what recommendations do you have for the survivors? The person who lost a loved one to suicide? Dr. Nate Ivers: Well they have to be aware of some of the signs. Some of the behaviors that they may be engaging in that could be exacerbated in a situation one is isolating themselves too much. So although that may be their knee jerk reaction is I really can’t I really can’t do this with people right now. I really can’t speak with others about this. Staying engaged with others I think is really important and I think it’s really important if you know a family or you know a loved one who’s dealing with the death of his or her loved ones is just really keep tabs on that person. If it’s from a religious or spiritual perspective I continue to minister to them after the funeral after the memorial service after everybody else has gone home. Check in with them because you’re right it’s not it’s not a linear process and there’s certainly not a timetable on it. People will be experiencing things for years to come. I would say especially checking in during important dates like anniversaries or birthdays or holidays. I’d say recognizing that there’s no one size fits all model for grief and so knowing that the way that someone died maybe in that shocking or traumatic sort of way and then that it happened at their own hands by suicide recognizing that it’s going it can take a really long time and giving yourself the freedom to grieve allowing yourself to be sad for longer than is expected in American culture. Allowing yourself to be angry and allowing yourself to feel guilty and allowing yourself to have those emotions I think is very important. Preparing yourself for reminders. We think about this a lot when people have post-traumatic stress disorder that they’re going to have triggers but grief has a similar element to that. But being aware that there will be things that come up that will trigger their intense emotions. I would say having sort of a plan in place to handle those situations when a certain public or when it’s at work. And lastly which I think is the really important one is there are support groups for individuals and families affected by suicide. And so there are lots of grief and loss groups but I would say finding one that is specific to the type of loss that you’ve experienced which is your loved one died by suicide because you will be amongst individuals who will be speaking a very similar language who will be able to empathize with your situation in a way that’s different from those who have lost loved ones in other ways. Gabe Howard: Dr. Ivers, I can’t thank you enough for being on the show and I can’t thank you enough for the work that you do to help demystify the warning signs the symptoms and everything that surrounds suicide. As we said at the top of the show it’s one of those things where everybody’s heard of it but nobody seems to understand it or know how to prevent it or know what to do about it. And I really think that the work that you’re doing will absolutely save not only the lives of the people who are contemplating suicide but the relationships of the people around them. The amount of misinformation that gets tacked on to this already misunderstood thing is just incredibly massive and it makes a scary thing all the worse. Dr. Nate Ivers: Thank you so much for having me, and for giving us a platform to share a few pieces of information to hopefully help people who are trying to figure out maybe for themselves what they need to do or for their loved ones or for a friend of a friend. I appreciate your willingness to bring up the topic is so important and for some so difficult to broach as well. Gabe Howard: Again thank you, Dr. Ivers, for being here and thank you everybody for listening. And if you are listening interested in learning more about a master’s in counseling degree from Wake Forest University, I highly recommend that you head over to counseling.online.WFU.edu and see everything that they have to offer. And remember you can get one week of free, convenient, affordable, private online counselling anytime, anywhere simply by visiting BetterHelp.com/PsychCentral. We’ll see everybody next week. Announcer: You’ve been listening to the Psych Central Podcast. Previous episodes can be found at PsychCentral.com/Show or on your favorite podcast player. To learn more about our host, Gabe Howard, please visit his website at GabeHoward.com. PsychCentral.com is the internet’s oldest and largest independent mental health website run by mental health professionals. Overseen by Dr. John Grohol, PsychCentral.com offers trusted resources and quizzes to help answer your questions about mental health, personality, psychotherapy, and more. Please visit us today at PsychCentral.com. If you have feedback about the show, please email show@PsychCentral.com. Thank you for listening and please share widely. About The Psych Central Podcast Host Gabe Howard is an award-winning writer and speaker who lives with bipolar and anxiety disorders. He is also one of the co-hosts of the popular show, A Bipolar, a Schizophrenic, and a Podcast. As a speaker, he travels nationally and is available to make your event stand out. To work with Gabe, please visit his website, gabehoward.com. View the full article
  8. Do your nerves overwhelm you sometimes? Do you frequently find yourself burdened with anxiety or stress? Anxiety attacks and symptoms of stress can be overwhelming and terrible. You don’t like how you feel, but you don’t understand it, and you don’t feel like there’s any was you can possibly find out how to deal with anxiety when it strikes you. Anxiety symptoms can be severe and stress management is hard when your own body doesn’t know how to deal with stress or how to control anxiety when you’re just reacting to signs of stress and don’t see a way out. But with a little bit of stress management, you can actually learn to control this reaction and begin to trust your body again to deal with anxiety on its own. How to Practice Daily Self-Care (Even When It Seems Like Life Is Way Too Hectic) Think about it: If you could really trust your body, wouldn’t you live your life a little differently? If you knew that you had more influence to help yourself through difficult times, wouldn’t you feel more confident? You probably have a dream, a little or large wish for your life that you’ve wanted for a long time. These dreams often get pushed to the back of our lives, replaced by “realities” that feel safe and practical but tight and uncomfortable. Over time, the cycle of fear gets stronger. You push your dreams away because you don’t trust yourself in the world. The body feels this lack of trust and insecurity increases. Is your best life right in front of you, but you’re afraid to reach out and try it? You can start today to re-establish the trust you and your body need. You might be surprised to know that you can also take care of your nervous system. Never fear, it just takes a little practice. When you feel insecure, anxious, or depressed, breathe and ask yourself: “What is my deepest longing at this moment?” A quick answer might be a longing for change, happiness or for the pain to stop. As you look more deeply, though, the source of change and happiness is often surprising. What would life actually look like if you were happier and didn’t deal with anxiety symptoms all the time? Would you: Feel loved and supported? Make music (or other art)? Feel safe and secure in your relationship, (world, home, or finances)? Be seen, heard and accepted? Run your business; be your own boss? Know you’re a good parent? Play and dance more? Travel, see the world, and have adventures? Have more time to yourself and figure everything out? Honestly, stress is an essential part of life. But how you deal with the resulting anxiety doesn’t have to be bad. Problems, discomforts, and pressures — whether large or small — arise all the time. Questions and frustration are a natural part of growth and creativity. Think of the adversity the bud on the tree has faced before it blooms. However, unnecessary worry makes it even more difficult to move through a struggle with enough consistent confidence to realize your dreams. Bursts of confidence followed by hopelessness and a sense of failure derail your plans, your health, your relationships, and mood. When you feel a lot of worry, it’s easy to believe that you’re broken or faulty in some way. Truth is, your nervous system is wise and capable. There is nothing wrong with a nervous system that responds when it senses danger. The difficulty arises when you don’t understand what you’re feeling, cannot communicate with your body, and therefore, have no way to intervene to help yourself. Here are 5 ways you can use mindfulness-based stress reduction techniques to erase anxiety symptoms and the effects of stress from your daily life: 1. Acknowledge What You’re Feeling The body is made to respond to cues of danger. This is normal and healthy. Without the ability to feel your sympathetic nervous system — which triggers you to fight, flee, or freeze — you would never be alive today. The sympathetic nervous system is not intended to harm you. It is intended to save your life. However, your mind can become confused, reacting to lots of cues in the environment and signaling danger even when there is no danger there. When you feel chronically worried, you’re essentially living in the sympathetic nervous system. It’s natural (and inevitable) for life to appear more difficult and frightening from the sympathetic nervous system state. By recognizing, embracing and then calming this natural body process, you can stop this “danger” cycle. When you’re calm, learn more about your unique cues of danger. Notice when you feel anxious. Write down what you felt, thought, saw, smelled or heard that you think caused this feeling. 2. Pay Attention to What Caused Feelings of Panic or Stress Begin compiling your personal list. For example: I had a sense that I made a mistake. I smelled smoke, reminding me of our house fire. An ambulance passed by. The person beside me gave me a scowl. I thought my dog ran away. Get to know what happens in your body when a cue of danger is detected. Your body is not trying to harm you. Why not be curious about what it feels like when your sympathetic nervous system gets charged and ready to react? Breathe and familiarize yourself with your body from the inside out. Write down what’s going on in there when you feel upset or anxious. It may look something like this: Heart races, thoughts spin, tight chest, pulsing hands and feet, heavy pressure on my shoulders, etc. This is simply the nervous system causing a feeling. Remind yourself of this fact: It’s just a feeling. It is not trying to harm me. 3. Learn to Control Your Response to Initial Panic You can actually tone your nervous system so that when stress presents, your most advanced internal resources are strong and available to help you. Your ventral vagus nerve is key to a sense of calm and confidence in the world. This nerve extends from your diaphragm and heart up to your lower brain. This is your nerve of connection to others in a safe, social way. Each day, find and feel the sensation of ventral vagal energy in your body. You can bring this up by simply imagining something you love, a place where you feel happy or at least okay (if happy is not accessible), your favorite time, activity, or friend (human or animal). Allow the sensation to be pure pleasure as much as possible even for a few seconds. Hold as long as you are able. Practice moving between a sympathetic nervous system feeling and a ventral vagal feeling. Start with your calm, pleasant state from above and then allow yourself to sense a little more nervous energy with a worrying thought or image. Breathe and move back into the sense of wellness in your ventral vagal system as you imagine your calm state. Feel the difference in your body. Use your senses to strengthen your ventral vagal nerves. When you listen deeply, laugh, and breathe, you’re also working your vagus nerve. Use your senses each day with the awareness that you are innervating and strengthening this nerve. How far can you hear? Can you take long deep belly breaths? What range of sound can you make in your throat that feels good to you? 4. Check In With Yourself Every Day Remember that you have access to your nervous system. It doesn’t have to function like a runaway train. Use your breath to connect you to your nervous system. Breathe in slowly several times a day and just check in. Are you feeling anxious, alert, pleased, safe, worried? Be open to all that is happening with your nerves with as little negative judgment as possible. Imagine yourself as a competent and kind guide to your nerves. Celebrate the sensations in your body while providing calm and reason. Considering that these body sensations could, when needed, provide the energy to save your life, take some time each day to thank your body for this amazing ability. Easy Ways You Can Practice Self-Care Today 5. Remind Yourself That You’re Capable of Getting Through It Create your own personal system or tools to use when stressed. Now that you actually feel the nerves within your sympathetic nervous system for what they are, you can harness this information to use when you begin to worry. Here are just a few ideas: Write in a journal, post-its, note cards and/or lists to remind you of the sensation of safe and calm for when you need it later. Capture these feelings of wellness in as much detail as you can and keep them easily accessible. Do the same with any cues of danger so that you can remember these feelings are simply the body checking out your environment. Use your Imagination to feel or picture your ventral vagal sensation of social, calm, belonging, and OK in the world. Memorize “body bookmarks” of this good feeling and hold these feelings in your body. Let all your senses get involved! Use movement, dance, touching, or tapping the body, music or other sounds, laughter, and deep breathing. Remind your nervous system that it can trust you to be there, and that you will get through your stress and panic. This guest article originally appeared on YourTango.com: 5 Things You Need To Form Good Habits (So You Can Finally Improve Your Life). View the full article
  9. We might find ourselves going through a transitional process when we are traveling, moving homes, in-between careers, in-between relationships or simply searching for greater meaning or purpose in our lives and if this transitional process is acknowledged and navigated correctly it can result in significant growth and the transformation of our whole Self. There is a period in which something has come to end, yet the “new” has not yet begun. During this space we may experience discomfort, a sense of chaos, disharmony and intense emotions such as fear and anxiety. This is because the structures in our environment and our usual routines which stabilized us and helped us to feel grounded have dissolved away. This have left a void and an expansive space of the unknown. Within this void we fear not knowing where we are and what is going to happen next. We want to quickly ground ourselves and find a sense of security or comfort. We may rush into the next career, the next relationship or try and “fix” what we feel is in turmoil before us. Yet, it is important not to rush into the next stage of our transition or to try and “fix” this stage we’re in. We also shouldn’t turn away from the fear or anxiety that comes with this period of time as there is a huge amount of learning that can take place when we sit with the discomfort we are facing. We experience change every day. Nothing in life is static and nothing ever stays the same. However, a significant life transition is a process that goes beyond these usual day to day changes. A transition is an internal psychological and spiritual process which may be caused by shifts in our external environment, but it may also be triggered by an indescribable and intuitive need to transform our entire way of being. As Psychosynthesis Coach Barbara Veale Smith states in “Seeing through Separation & Embracing Unity”: a dawning awareness of the need for change arises, either suddenly or over time, which becomes known…through an impulse or desire, a thought, feeling, intuitive understanding, sensation or image If you are going through period of transition where you feel fearful and anxious, here are some techniques and mindful exercises you can try to stabilize and feel more grounded during this time. First, make sure to take care of your needs during this time. You might need to spend more time alone to process and reflect on the transition and changes that are going on. If this is the case, make space for this and don’t force yourself to be “OK”. You probably need to be more gentle with yourself than usual. Do things which you consider to be acts of self-care — such as going for walks in nature, attending yoga classes, exercising, having massages or simply take part in the hobbies and activities that you know fulfill you. Find ways to form structures around yourself that ground you. If you are seeking connection rather than being alone then reach out to friends or make connection with people which will help you to feel a sense of belonging. Form a routine and find activities or events to go to which will also nourish you. Stay with the sense of fear you are experiencing and don’t try and force it away. Make time each day to meditate so you can sit with your emotions. A mindful exercise I find really helpful is locating the fear in your body. What is the physical sensation of this fear? Communicate with it and ask it why it is present. Be compassionate towards it and welcome it into your body. Every emotion you experience is trying to support you in some way, and this is also the case with the fear and anxiety you might be experiencing now. You can also meditate and work to ground yourself using a guided visualization. For the visualization you connect with the energy of the earth to help ground and support you during this transitional time. You imagine roots going into the earth from the base of your spine or the area of your body that is in direct contact with the ground. Notice how these roots create a strong energetic connection with the earth and also become aware of how you are being fully supported and held by the physical ground below you. With this practice you are able to maintain a centered and firm presence despite external events that might be challenging. When you’re going through a transition it might feel like so many things in your life have come to an end, and there is even a tendency to question your very sense of self. Remember that although there have been many shifts, there are still many constants running throughout your life — friends, family and your core Self that are supporting you through this time. Look for the deeper meaning behind your experience. Even if you can’t make sense of it right now remember that every period of transition is a catalyst for growth and healing. Perhaps your transition is giving you the space to sit, to rest and heal. It might feel like you need to rush forward, but if you have been given an opportunity to take “time out” then make the most of this time and know it is OK to rest. If you feel the opposite and that everything is actually in a state of chaos, then perhaps you’re still in the earlier stages of your transition and things have not calmed down yet. Know that things will begin to settle and this time of turbulence is allowing things to come to the surface and break open, so that deeper healing and transformation can take place. Try the mindful exercises mentioned here and make sure to establish a routine for yourself. Remember that every day is different and this is especially the case during times of transition — so connect with what you need on each day and be guided by the intuition of your body. Stay present with each moment, and you will soon reach a new stage on your journey. View the full article
  10. It would be better if I wasn’t alive. This is the text message T-Kea Blackman sent her friend after her suicide attempt. And it’s the words that begin her powerful memoir Saved & Depressed: A Suicide Survivor’s Journey of Mental Health, Healing & Faith. Blackman had struggled with suicidal thoughts since age 12, regularly triggered by witnessing drug addiction and domestic violence. At the time of her attempt, she was 24 years old. She felt “powerless and hopeless.” For years, Blackman also struggled with depression and anxiety. “They both were beyond exhausting to the point I became numb,” she said. The depression was paralyzing, making her feel like bricks were laying on top of her. Her anxiety led her to feel like she “was in the middle of an ocean in a constant state of panic, flapping my arms and kicking my legs to stay afloat but I never drowned.” As Blackman writes in Saved & Depressed, before she was formally diagnosed, she “thought it was normal to walk around on edge all of the time. I had no clue that being ‘worked up’ and worried 24/7 was a problem. In fact, I thought everyone struggled with uncontrollable and racing thoughts to the point where they could not focus, sleep, or get daily activities completed…” An hour after Blackman sent that text to her friend, two policemen showed up at her apartment. She was taken to the hospital, and then transported to the psychiatric unit. Days later, she’d attend a partial hospitalization program for 6 weeks. This included individual and group therapy, and involved spending 6 hours at the hospital and going home at night. Initially, Blackman had zero desire to get better. “Depression felt like home—a warm blanket and it was comfortable,” she said. However, after being in the hospital and attending the outpatient program, she started to feel a glimmer of hope. With more treatment and support, that glimmer widened and brightened. Advocacy Work Today, Blackman is a mental health advocate, speaker, writer, and host of the weekly podcast Fireflies Unite With Kea. In particular, she focuses her advocacy work on the African American community, shattering the stigma of mental illness and help-seeking, and sharing stories of people who live and thrive with different diagnoses. “As an African American woman, I was taught to be strong and keep going because that’s what my ancestors did. But being strong was to my detriment because I felt weak for needing medication and therapy. And there are other women in my community who deal with those same thoughts and feelings.” Many African Americans also are hesitant to seek treatment because they “were taught ‘what happens in this house stays in this house’ and going to therapy to talk about things happening in your home [means] that you are airing your business and dirty laundry,” Blackman said. Some are taught that therapy is exclusively for white people, or that prayer is the only thing they need, she said. “My goal for my advocacy is to inspire my community to own their truth and more importantly heal.” Blackman further noted, “you can pray and see a therapist at the same time. Attending therapy does not mean that you lack faith in God or are weak; it means that you are a human working through challenges.” She also pointed out that therapy isn’t about “airing your dirty laundry”; rather, it’s about discussing “things that make it hard for you to sleep and function at your best. Therapy will provide you a safe space to be the best version of yourself.” Staying in Recovery Today, what helps Blackman remain in recovery is her “awesome therapist” and the support of her family and friends. She also connected with groups at the National Alliance on Mental Illness (NAMI). “I found people who could identify with me and support me.” Most importantly, she said, her recovery resides in “living a self-directed life.” “I have learned to define success and recovery for myself. As a peer support specialist and advocate, I have people who look up to me and I want to be the support I needed in my darkest days.” Blackman also credits her strong faith in God and her hard work. “I believe God spared my life to do this work and help save others from suicide. Working on myself has been harder than both of my degrees combined but to see my growth brings tears to my eyes and helps me stay in recovery. I am amazed at how I went from wanting to die and attempting to end my life to being so full of life and excited about my future.” If You’re Struggling, Too If you’re struggling with depression or anxiety and feel hopeless and incredibly overwhelmed, Blackman wants you to know that even though right now everything seems dark and you’re convinced you won’t get better, you absolutely will “with the support of a therapist and if needed, medication.” Blackman stressed the importance of identifying qualities or specialties in a therapist that are non-negotiable for you—and not to stop until you’ve found them. “When I was looking for a therapist, I wanted a black woman because that’s who I felt comfortable with. It took me a while but with the right therapist, I was able to make so much progress.” “Also, do not feel ashamed if you need to go to the hospital; it could be the very thing that saves your life.” In the moment, when you’re sick and feel awful, you can’t imagine a time when you’ll actually feel well. It’s similar to having the flu: You have a high fever. You are bed ridden. You feel weak. Even getting up to put a bowl of soup in the microwave feels impossible. But then, as the treatment kicks in, your body starts to heal, your energy returns, your mind becomes clearer, and the days pass, you do start to feel better. And maybe you even get to a point where you don’t remember as much about those sick days, or they’re not as vivid and visceral. Because they felt permanent, but were not. And even if you get the flu again, you’re better prepared. You have a good idea of what to do. You know what helps you. And you know it won’t last forever. If you’re struggling, please know that with treatment you can thrive and live a satisfying, fulfilling life. Blackman’s story is proof of that. And it’s just one of millions of such stories. If you’re thinking about suicide, please call the National Suicide Prevention Lifeline (1-800-273-TALK), text HOME to 741741, or chat online. View the full article
  11. It would be better if I wasn’t alive. This is the text message T-Kea Blackman sent her friend after her suicide attempt. And it’s the words that begin her powerful memoir Saved & Depressed: A Suicide Survivor’s Journey of Mental Health, Healing & Faith. Blackman had struggled with suicidal thoughts since age 12, regularly triggered by witnessing drug addiction and domestic violence. At the time of her attempt, she was 24 years old. She felt “powerless and hopeless.” For years, Blackman also struggled with depression and anxiety. “They both were beyond exhausting to the point I became numb,” she said. The depression was paralyzing, making her feel like bricks were laying on top of her. Her anxiety led her to feel like she “was in the middle of an ocean in a constant state of panic, flapping my arms and kicking my legs to stay afloat but I never drowned.” As Blackman writes in Saved & Depressed, before she was formally diagnosed, she “thought it was normal to walk around on edge all of the time. I had no clue that being ‘worked up’ and worried 24/7 was a problem. In fact, I thought everyone struggled with uncontrollable and racing thoughts to the point where they could not focus, sleep, or get daily activities completed…” An hour after Blackman sent that text to her friend, two policemen showed up at her apartment. She was taken to the hospital, and then transported to the psychiatric unit. Days later, she’d attend a partial hospitalization program for 6 weeks. This included individual and group therapy, and involved spending 6 hours at the hospital and going home at night. Initially, Blackman had zero desire to get better. “Depression felt like home—a warm blanket and it was comfortable,” she said. However, after being in the hospital and attending the outpatient program, she started to feel a glimmer of hope. With more treatment and support, that glimmer widened and brightened. Advocacy Work Today, Blackman is a mental health advocate, speaker, writer, and host of the weekly podcast Fireflies Unite With Kea. In particular, she focuses her advocacy work on the African American community, shattering the stigma of mental illness and help-seeking, and sharing stories of people who live and thrive with different diagnoses. “As an African American woman, I was taught to be strong and keep going because that’s what my ancestors did. But being strong was to my detriment because I felt weak for needing medication and therapy. And there are other women in my community who deal with those same thoughts and feelings.” Many African Americans also are hesitant to seek treatment because they “were taught ‘what happens in this house stays in this house’ and going to therapy to talk about things happening in your home [means] that you are airing your business and dirty laundry,” Blackman said. Some are taught that therapy is exclusively for white people, or that prayer is the only thing they need, she said. “My goal for my advocacy is to inspire my community to own their truth and more importantly heal.” Blackman further noted, “you can pray and see a therapist at the same time. Attending therapy does not mean that you lack faith in God or are weak; it means that you are a human working through challenges.” She also pointed out that therapy isn’t about “airing your dirty laundry”; rather, it’s about discussing “things that make it hard for you to sleep and function at your best. Therapy will provide you a safe space to be the best version of yourself.” Staying in Recovery Today, what helps Blackman remain in recovery is her “awesome therapist” and the support of her family and friends. She also connected with groups at the National Alliance on Mental Illness (NAMI). “I found people who could identify with me and support me.” Most importantly, she said, her recovery resides in “living a self-directed life.” “I have learned to define success and recovery for myself. As a peer support specialist and advocate, I have people who look up to me and I want to be the support I needed in my darkest days.” Blackman also credits her strong faith in God and her hard work. “I believe God spared my life to do this work and help save others from suicide. Working on myself has been harder than both of my degrees combined but to see my growth brings tears to my eyes and helps me stay in recovery. I am amazed at how I went from wanting to die and attempting to end my life to being so full of life and excited about my future.” If You’re Struggling, Too If you’re struggling with depression or anxiety and feel hopeless and incredibly overwhelmed, Blackman wants you to know that even though right now everything seems dark and you’re convinced you won’t get better, you absolutely will “with the support of a therapist and if needed, medication.” Blackman stressed the importance of identifying qualities or specialties in a therapist that are non-negotiable for you—and not to stop until you’ve found them. “When I was looking for a therapist, I wanted a black woman because that’s who I felt comfortable with. It took me a while but with the right therapist, I was able to make so much progress.” “Also, do not feel ashamed if you need to go to the hospital; it could be the very thing that saves your life.” In the moment, when you’re sick and feel awful, you can’t imagine a time when you’ll actually feel well. It’s similar to having the flu: You have a high fever. You are bed ridden. You feel weak. Even getting up to put a bowl of soup in the microwave feels impossible. But then, as the treatment kicks in, your body starts to heal, your energy returns, your mind becomes clearer, and the days pass, you do start to feel better. And maybe you even get to a point where you don’t remember as much about those sick days, or they’re not as vivid and visceral. Because they felt permanent, but were not. And even if you get the flu again, you’re better prepared. You have a good idea of what to do. You know what helps you. And you know it won’t last forever. If you’re struggling, please know that with treatment you can thrive and live a satisfying, fulfilling life. Blackman’s story is proof of that. And it’s just one of millions of such stories. If you’re thinking about suicide, please call the National Suicide Prevention Lifeline (1-800-273-TALK), text HOME to 741741, or chat online. View the full article
  12.  Does anxiety keep you from living the best life possible? Do you feel that you are nervous all the time? Are you not sure the difference between anxiety, worry, and paranoia? Want some suggestions on how to cope? Listen in as our hosts discuss all this – and more – on this week’s episode of A Bipolar, a Schizophrenic, and a Podcast. SUBSCRIBE & REVIEW “I am constantly paranoid that my whole life will fall apart because I’m not good enough.” – Gabe Howard Highlights From ‘Anxiety & Paranoia’ Episode [1:00] What’s the difference between anxious, nervous and paranoid? [3:00] Michelle explains her delusions — which stem from anxiety. [5:00] Night time is when anxiety is worst for Gabe. [10:00] What is paranoia? Is it anxiety induced? [14:30] Does Michelle get anxious selling her clothing line Schizophrenic.NYC on the streets of NYC? [20:00] Gabe can’t help but see the worst in his speech evaluations. [23:00] Nerves can be good sometimes. Computer Generated Transcript for ‘Anxiety and Paranoia – How to Deal’ Show Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you. Announcer: For reasons that utterly escape everyone involved, you’re listening to A Bipolar, a Schizophrenic, and a Podcast. Here are your hosts, Gabe Howard and Michelle Hammer. Gabe: Hello everyone and welcome to this week’s episode of A Bipolar, a Schizophrenic, and a Podcast. My name is Gabe Howard and I have bipolar disorder. Michelle: Hi I’m Michelle Hammer and I’m schizophrenic. And this week we are going to talk about anxiety. Michelle: I’m so nervous talking about this. Gabe: I think that it’s interesting that you said I’m so nervous talking about it because there is a world of difference between nerves and anxiety just like there’s a world of difference between anxiety and paranoia but they’re all kind of on the same spectrum. Michelle: Does it go nervous, anxious, paranoid? Gabe: I mean yeah. And arguably it could start off with like worry like I’m worried now I’m nervous now I’m anxious now I’m paranoid. Then you get into like delusions or paranoid delusions or just straight up losing touch with reality. People that are fans of the show that have heard Michelle talk before you were paranoid about your mother because you thought that she was trying to hurt you. Michelle: Oh, yeah. Gabe: You weren’t worried about it. You weren’t anxious about it. You were straight up delusional. Michelle: Oh straight up delusional, absolutely delusional. Yes absolutely. I still go delusional all the time before I go to bed I start thinking about all kinds of things that happened throughout my life and I completely go delusional. Every day I’m delusional. Gabe: We don’t want to talk a lot about delusions because we really want to focus on anxiety but I think that’s kind of an important thing that you said you said two things that I think are very important one you said that you have delusions almost every day and to you’re aware of them. Having delusions every day is something that you probably want to talk to a doctor about. Michelle: Yes. Gabe: That’s not ideal. Right? Right, Michelle? Michelle: I would agree with that one yes. It’s not ideal. Don’t want them but it happens. Gabe: So you are working on that with your medical team? I have to ask. Michelle: Yes. Yes. Yes. Gabe: But you are aware of them and that’s you know delusions they take away your ability to be rational. That’s why it’s a delusion. If we all understood when we were being delusional we wouldn’t be delusional. So you’re kind of like in a gray area where you acknowledge that they’re delusions but you’re also kind of like hey I’m aware that they’re delusions. What’s that like? Michelle: You know it’s pretty awful actually. It’s always really before I go to bed. I’m just trying to fall asleep and start thinking about the past and I’m thinking and this happened. This must have happened this person said this to me and that said this to me and I said this. And we said this and then this happened. And then I was horribly embarrassed and this horrible thing went down oh no. Oh no no. But then something else will come in. Oh remember when this happened? And then this happened and this happened oh no I was horribly embarrassed and then maybe a new story will pop up and then this happened in this happened in this have I don’t know I was horribly embarrassed pretty much how it goes Gabe: But are all those stories false? Michelle: I have no idea if they’re false. Which is really interesting. I don’t know if maybe parts of them could be true parts or true parts are false. I don’t really know. Sometimes I call people and ask them or sometimes I don’t want to ask anybody if these delusions are true because I’m too afraid that they might actually be true because they’re so horrible. Gabe: It really sounds like you have like a little combo deal going because of their completely made up and fabricated in your head. They’re absolutely unequivocally delusions. But if they actually did happen and you’re just worried about your role in them, that’s anxiety. And of course if it is a delusion that you had a long time ago but you’re worried about how you’re remembered you’re anxious about a previous delusion and you’re probably nervous as to where this conversation is going. Michelle: I mean I don’t know. The thing is all of these things are so of the past that are totally irrelevant to my life now that I really don’t care anymore about them. So I don’t understand why they just why I’m dwelling on this nonsense late at night just stop already. Just stop already. Get over it. Why can’t I just get over it and stop thinking about it. I’m done. It’s done. Who cares. It’s done. Make it stop, Gabe! Gabe, make it stop. Gabe: I’m trying to make you stop. This is exactly how anxiety works though and for many people myself included Nighttime is when anxiety is absolutely the worst. It’s quiet. There’s nothing to distract my brain. There’s nothing to focus on. It’s just me in a dark room lying in bed with nothing but my thoughts and as I start bringing up those thoughts I start ruminating. I start ruminating on ideas for example the last one that happened involving you a couple of days ago I had texted you about something and you answered you know like I texted you and I said Hey do you have headphones and you go back. I have headphones and wrote I back. Great. I’m glad you have your headphones and you’re like why wouldn’t I. And I was like Oh that’s funny. And I put my phone away and then now at night I’m like wait. She said Why wouldn’t I have headphones? Ohhhh, she thinks I’m accusing her of losing her headphones. Oh no. Michelle thinks that I don’t trust her. Oh Michelle is going to quit the show. So here I am 3 in the morning and basically trying to decide if it’s reasonable to call you and ask you if you’re mad at me because I asked you about headphones. That’s what anxiety does to a person. Now I’m not delusional because we did have a conversation about headphones. I’m not paranoid because I don’t think you’re coming to kill me. I don’t think there’s anything bigger it’s just the story. It’s just I’m anxious about a conversation that we had in the past and that maybe I misunderstood your reaction to it. Now by the time I sleep get a good night’s sleep everything’s fine I wake up and I think you’re a fucking idiot games doesn’t give a goddamn about headphones. But but that at night that night was rough man. Michelle: It is. Gabe: It was rough. Michelle: It’s rough at night. Why is it so rough at night? Gabe: Well I’m gonna say because we don’t practice good sleep hygiene. Michelle: Huh. Gabe: But it’s quiet and it really is true. A lot of us don’t respect the process of falling asleep and therefore we do things that sabotage it and that sabotage has consequences. That’s why we did a whole episode on sleep hygiene. Michelle: Yeah but you ever have those moments where you have a whole conversation with a person and then you leave and then you wish you said something completely differently the entire time. Gabe: Oh my God. Yes. Yes. You are the number one person. I do that with the number one person. Whenever we have a discussion and we don’t agree on something and we like hang up on each other and since we always video chat I like the key that I have to press to end the video chat is broken on my computer like I have to buy laptops in order to replace that key because I always hang up on you like, click. It’s like for real. Kendall always knows when we’re done because I slam that key so hard. And then I replay the entire conversation in my head for like the next four hours thinking of all the things I wish I would have said to you. I win every argument. After we’re done talking. Michelle: And after we’re done talking I go. I’m not thinking about Gabe for another day. Gabe: I know that’s not true. This is how I know you’re thinking about it because like a couple of hours later you’ll text me and you’ll be like Hey how are you. What’s going on today. Michelle: Because I worry about you because you’re always flipping out you’re like you’re like Gabe: See. Michelle: We got in a fight and now I’m sleeping under a chair. Gabe: That was a really bad fight. Michelle: So now gotta check up on you. Gabe: I’d like to point out that in that fight you told me that I ruined your life and you quit the show and that I was a horrible horrible person. I literally threw my phone across the room. It’s just by the grace of I don’t know who is in charge of the universe that it hit a nice comfy fluffy chair and because I was having this conversation with you in the dark I had to try to find my phone in the dark. And then I fell asleep under the chair. This is what mental illness looks like. This is what anxiety looks like. It causes these things in people even people who are friends. And that’s why Michelle and I bring this up when we’re not bringing this up because we want you to think that you know we’re insane. That part should be evidence. Michelle: That part should be quite evident. As of now any listeners of this show that has listened to at least two episodes should know. Gabe: You think they need to. I think if you’ve listened to five minutes of any episode you’re like wow these people are co-dependent and in a bad relationship. Michelle: Let’s take a break and hear from our sponsor. Announcer: Announcer: This episode is sponsored by BetterHelp.com. Secure, convenient, and affordable online counselling. All counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist, whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face to face session. Go to BetterHelp.com/PsychCentral and experience seven days of free therapy to see if online counselling is right for you. BetterHelp.com/PsychCentral. Michelle: And we’re back. I was worried we weren’t gonna make it. Do you ever get paranoid? Gabe: I get paranoid all the time all the time and it starts off with anxiety. Is that how yours kind of flows. You and I both talk about paranoia but you have paranoid schizophrenia. Your paranoia makes my paranoia look like a walk on the beach. What is it about paranoid schizophrenia that’s so much different or so much worse for you. Because my paranoia has never driven me to psychosis. Yours has Michelle: Well it does. Gabe: And could again. Michelle: Well OK first of all I take I take enough medication now that I don’t get super paranoid anymore so it’s been it’s been a while but I used to like to see newspaper headlines and I thought they were speaking to me like telling me like just just on purposely telling me things just for some reason. That was one thing. But like in high school being paranoid in class anytime I heard a whisper I thought it was about me there whispering about me. Everybody’s talking about me. Everybody everybody all the time if they’re looking at me they’re whispering always which is really actually vain if you think about it and you think everyone’s talking about you. It’s vain. Gabe: But hang on let let me let me let me stop you right there. Is it being worried that people are talking about you. Isn’t that just on the worried and anxiety spectrum. Are you just anxious that people are talking about you or like you said Michelle: Because. Gabe: You know Is it narcissism is it vanity like how is that paranoia. That seems like anxiety to me. Michelle: It’s because it just overpowers you because then you’re sitting in class instead of learning. You’re thinking What is everyone saying about me. Are they talking about my clothing or are they talking about what I said. Are they talking about anything about me do they know if I’m smart They think I’m stupid. What am I doing. And then I have no idea what’s going on in class anymore because I’m too worried about what everyone’s saying about me. Anything like that I can’t I can’t do anything without being worried or paranoid that people are saying things about me just anything. Gabe: So it does start off that way it starts off as if you’re worried about it then you’re anxious about it and then it becomes a full blown paranoia. Michelle: Yeah because then you start to believe it. Gabe: So this is an excellent example of how unchecked anxiety can really lead to big things. I mean like worse things like so many people believe that anxiety is like is like something that they should be able to control on their own like oh you’re anxious we’ll get over it. Buck up you know be stronger it’s not about you toughen up Michelle: Yeah. Gabe: Why are you anxious Don’t be a chicken shit. I mean there’s a lot Michelle: Yeah Gabe: Of that but it’s. Michelle: Because like you could have a whole group of friends you’re friends with but then I really believe that all of them actually really do hate you and they just hang out with you. To be nice. Gabe: I think it’s funny that you said that you’re worried that everybody was talking about your clothes because now that you are the founder of schizophrenic NYC the fourth clothing line started by a schizophrenic. You’re now paranoid that people aren’t talking about your clothes. Michelle: Yes this is true. Haha. Gabe: Don’t be paranoid Michelle. Michelle: Don’t be paranoid. You look great. Gabe: You look great. You need one for anxiety. You need one for anxiety like, “Don’t be anxious your ass is fine.” Michelle: Yeah that’s a great one. Don’t be anxious, your ass is fine. Gabe: You could put it on leggings. Michelle: I’m not doing that, Gabe. That’s not funny. Gabe: Why can’t I ever get my ideas onto your clothing. Michelle: Make your own clothing. Then why don’t you make your own leggings like that. Gabe: I don’t want to make leggings but I do have my own bipolar clothing line which as you know is being discontinued overrun gave Howard AECOM right now. So as soon as it’s gone it’s gone. And you made me a coupon code for like twenty five percent off and I don’t even remember what it is. Michelle: I think it’s just 25 off. Gabe: Like 2 5 0 F F. Michelle: Yeah capital O F F. Gabe: So there you go. You can save 25 percent on a bipolar shirt by going over to GabeHoward.com right now. Michelle: Great, Gabe. Gabe: I just. Yeah yeah. See how I work that in there. Now I’m anxious that nobody is gonna buy a shirt and that everybody’s gonna think that the shirt sucks and that’s why nobody’s buying it. That’s not even a joke like I really do think when people come over to like a booth that I have in public Michelle and I in go public and we have booths and like Michelle sells her clothing. I’ll sell my books. And when people come over and look at our stuff and then they walk away I think Oh my God. This means they hated me. This means that Michelle piss them off. This means that I don’t know that we did something wrong. Isn’t just commerce. Michelle: Well, selling is very very different. It’s hard. You can never. There’s no algorithms you never know how you’re gonna do. You never know you can be somewhere you could sell a lot. You can go somewhere else not sell it. It’s never you. It’s the market. If the street is where you are. You can’t be I think that way. Gabe: I’ve got a couple of quotes because Michelle you you sell your clothing on one of the most aggressive streets in the world in one of the most aggressive cities in the world. And you’re like 5′ 2″ 100 pounds. You’re a tiny woman and you’re standing on the streets of New York City in front of tourists and other vendors. And that’s where you sell your goods. That’s got to be anxiety provoking. I mean it’s anxious working in retail causes anxiety. And this is a whole nother level. This is like street fighting retail. Michelle: No. Gabe: How is not for you? How do you manage it? Michelle: I just do You just do. You get to know people you start talking to people you learn your customers are you know I’ve been doing it for so long that I know what I’m saying. Everything I’m saying I’ve said a million times before. Most questions I get asked. I’ve been asked a million times before. You know I’m. I’m selling my own products and they’re selling other people’s products. So I know I have answers for everything. And sometimes some people want to talk and sometimes people already know who I am which is kind of interesting. Gabe: Michelle, what you said there though if you peel away all the fluff is that you’re prepared. Michelle: Yeah. Gabe: You have stock answers you by gaining experience and preparation. You know what people are going to ask. Nine times out of 10 and you have a set answer for those things that allow things to go smoother. This is really analogous to like learning coping mechanisms. Like so if if somebody asks you does this shirt come in an 8XL you know to say oh I only carry up to a size 2XL. The design doesn’t look good if you make it too big. And if the design is too small it doesn’t look good. I know you don’t say that but that’s an example. Michelle: Yes, that would be so dumb to say that, Gabe. Gabe: Listen I don’t. I don’t sell shirt but you know what to say to make the customer happy and then you immediately which I think is something that you actually do well. The minute you don’t have something that somebody once you answer the question of what they don’t want. And you immediately try to get them to focus on something that you have. It’s like Do you have the shirt in a 3XL? I don’t have the Define Normal in a 3XL, but I do have the Don’t Be Paranoid, You Look Great in 3XL. Like it is just so seamless that helps your experience. Now maybe when you first started you would’ve just been like no. Michelle: Yeah. When I first started I had no idea what I was doing. I didn’t even have a sign. Gabe: Right. So think about people who are managing anxiety you know nerves anxiety worry at this high level. This is where coping skills can really really help because you’re probably a lot less anxious and nervous and worried as a street vendor in New York City. Now that you have all this experience and you’ve essentially learned coping skills coping mechanisms you learn things that worked to help you become better at what you do to manage your business. But it also allows you to manage your own anxiety. Michelle: I kind of get what you’re saying as a coping skill in everything. Yes. Being prepared does help. Yes. Because like I said I. I say a lot of the same things and people ask me a lot of the same questions. So I really do always have an answer unless I’m really the only answers I don’t have is like these girls that come up to me and they said that their mother was schizophrenic and they want to know what schizophrenia is like because of their mom. Their mom was and I was just so taken aback I was like What am I supposed to say to these girls. That was a hard one. Gabe: But being hard it doesn’t mean that you can’t get through it. Michelle: True. Gabe: And because you didn’t have all of these little anxiety provoking things when the big one did happen you were probably in a good space right. Michelle: Right. Yeah. Gabe: Because just like in retail anxiety you can’t control everything. I think that everybody in America knows that first days are anxiety producing. You don’t have to have mental illness or an anxiety disorder to think that like the first day at a new job or at a new school or a new anything. Michelle: I’ve had quite a few first days. Gabe: Yeah well that’s right because you get fired a lot. Michelle: Asshole. Gabe: Yeah I know but I had this routine that I would do whenever I started someplace new whether it be you know a new job a new school or whatever where the night before I would drive the route I would drive around in the parking lot and figure out where I was going to park. I would learn where like the cafeteria was if they had one and if they didn’t have a cafeteria I’d learn where the nearest you know McDonald’s or something was for lunch. I would plan out as much of my day as possible. I would know when to wake up I would pick out my clothing the night before that way that day I’d already made all of the decisions that I could reasonably think of. So when the things happened that I couldn’t prepare for I had the energy to use for that I didn’t have to worry about using energy on whether or not my clothes looked good because I got over that anxiety the day before and I think this really has helped me in my life. I do the same thing when I speak. You’ve seen this I always go and walk up on the stage and I look at where my mark is and I look at the podium and I shake it to see whether or not it rattles or not I. I see if it’s a lapel mike. I have this whole routine. That way when I’m onstage I don’t have to worry about any of this stuff. I made all those decisions yesterday. I really think this is just good advice to be prepared. But I think that if you’re out there managing an anxiety disorder or you’re just a naturally anxious person. Preparation is valuable. It’s really valuable. Michelle: Even if all that preparation for your speech you still believe you did a great job afterwards? Gabe: No I’m always anxious that I did an awful job. And this is where we start to get into you know more paranoia or more delusions. But it starts off with the anxiety. I gave a speech the other day in front of 30 people. It was actually a class; it was an eight hour class. I was in the class for eight hours. I was the instructor. I got the evaluations. There was 28 evaluations, so two people didn’t fill them out. And out of those 28 evaluations, 25 people gave me a “5.” The highest you can get. Two people gave me a “4.” No big deal. One person gave me a “1.” Michelle: What a dick. Gabe: Yeah, that’s exactly right. And that’s all I can think about. Michelle: No, you can’t please everyone. Gabe: I don’t care. I should have been there for that person. I didn’t meet that person’s needs. That person didn’t have a good day. I should have I should have worked harder to meet that person’s expectations. But here’s the thing that I do tell myself if I would have met that one person’s expectation then it’s not unreasonable to assume that the other 25 people would have then given me a “1” because that person gave me a “5.” And these are all anonymous. I have no idea why that person gave me a one. Maybe that person doesn’t believe in mental illness. Maybe that person was forced to come to this class by their wife spouse or their child. Who knows who knows why they gave me a one maybe and this is what my wife said because she’s super awesome. Maybe the person read the instructions wrong and was saying, “Gabe is number one.” Michelle: That’s true. Maybe there are the instructions wrong. Gabe: But notice that that’s what we’re talking about. Notice that I never said Hey, Michelle, I’m a really good presenter. I got twenty five fives out of 28 emails. You know how amazing that is. That’s a really excellent. That’s valedictorian level evaluation scores. But that’s not what I can focus on. All I can focus on is that one person hated me. That means I suck. That means I’m never gonna get hired again. I’m never going to teach that class again. I’m not going to be able to pay for anything. That’s just how I feel. I’m constantly paranoid that my whole life is going to fall apart because I’m not good enough. And that starts with anxiety. It starts with anxiety. The day that I take the class or the speech or the contract I just think oh what happens when they realize they made a mistake and that anxiety slowly grows and I work very very very very hard to manage it. But even I fall apart sometimes I do I end up under the proverbial chair. Michelle: The proverbial treasure. I’m sorry that happens to you, Gabe. Gabe: Really? Michelle: Well I never had any comment cards or evaluations or anything but after every speech I’ve given I’ve always thought like was that good. Did I do OK. Did I suck. I don’t know. Maybe I don’t know. Could’ve done better. Maybe. Gabe: And I really do believe that some of that is healthy. I think that if you are 100 percent positive that you are 100 percent great 100 percent of the time you’re an asshole. Michelle: Understood. Understood. Gabe: You know anxiety and nerves. They have a place. People asked me for advice on being a speaker all the time and they’re like, “Well I’m just so nervous.” And I always say this: Good! Nerves are good. You should be nervous. You are responsible for your words for the audience for everything that is about to happen on that stage. You you’re responsible for all of that all by yourself. If you’re not a little bit nervous you’re not taking it seriously. I’m always a little bit nervous before I walk out on stage and I got to tell you I love that feeling. It’s exhilarating. It’s a little bit scary. It’s a little bit hopeful. It’s exciting and I walk out and then I see that audience and that’s what my preparation kicks in. That’s when my training kicks in. That’s when you know I know that the podium rocks back and forth or not. And I have my first few lines memorized so I already know what I’m gonna say even if I don’t know anything that’s going on. The first three lines of my speeches are always exactly the same because they’re just that practiced and then it subsides. Michelle: I mean I go out there thinking I don’t know what I’m doing. And sometimes it just works. It just works. I don’t know. I don’t know why I just get up and have a delivery of this is what I’m saying. This is how it is and I get a good response from the audience that way. Get a read the audience. Gabe: But what happens if you don’t. Michelle: Well you know what if the audience isn’t really getting my drift. Maybe there are a bunch of old crotchety people? Gabe: Wow. So your mechanism to handle anxiety is to blame the audience? Michelle: I’ll blame the audience because I Gabe: Wow. Michelle: Think I have quite a delivery of just like, “Oh hey guys. How you guys doing today?” And if their response is rude, they suck. Gabe: Attention event planners and conference people. I want you to know that if you’re choosing to hire a mental health speaker and your choice is Michelle Hammer a.k.a. I hate the audience and they suck or Gabe Howard I’ll do whatever it takes to make sure that your attendings have a great experience. I think you know what to do. Michelle: No. The thing is all audiences will love me. They will love me. All audiences. Gabe: Wow. Now you are delusional. Michelle: Now I’m delusional? You know it. That’s right. Gabe: Straight up delusional. Michelle: All right guys. Anxiety is totally manageable. It sucks to have but it’s completely manageable. I’ve dealt with it. Gabe has dealt with it. It totally sucks but you can power through you can power through your worries compare through the anxiety the nervousness you can get through paranoia. It takes a while but you can get through it. It might not ever go away but you can get through it. And Gabe: And in fact, they probably won’t go away. Michelle: Yeah Gabe: I mean you and I still bit our anxiety is so much better than when we started. Michelle: Absolutely. Yeah. Took me a long time. Still deal with it though not as paranoid as I used to be. Gabe deals with his life somehow sleeps under chairs. You know what I’m saying? So it all works out. You got this bro. Gabe: What about the ladies? Michelle: And the ladies. Gabe: Michelle, it is always awesome hanging out with you. Do you have any last words for our listeners? Michelle: Take some big deep breaths. Gabe: Do you find that helpful, seriously? Michelle: No, not really at all. Gabe: Then why are you telling people to do it? Michelle: I don’t know. That’s what annoying people tell nervous people to do. Gabe: That is true. But listen. Just because something is annoying advice doesn’t mean that it’s not good advice. Take a deep breath slow down sit down. Count to 10. Michelle can’t do any of those things because she’d have to stop talking in order to do them. Thank you everybody for listening to this week’s episode of A Bipolar, a Schizophrenic, and a Podcast where ever you download this podcast. Write us a review. Use your words. Leave us as many stars as humanly possible. Share this on social media. Send it to a friend. Tell all of your support groups about us. Really. We still don’t have the money to take out advertising so we’re counting on literally you. We’ll see you next week on A Bipolar, a Schizophrenic, and a Podcast. Announcer: You’ve been listening to A Bipolar, a Schizophrenic, and a Podcast. If you love this episode, don’t keep it to yourself head over to iTunes or your preferred podcast app to subscribe, rate, and review. To work with Gabe, go to GabeHoward.com. To work with Michelle, go to Schizophrenic.NYC. For free mental health resources and online support groups, head over to PsychCentral.com. This show’s official web site is PsychCentral.com/BSP. You can e-mail us at show@PsychCentral.com. Thank you for listening, and share widely. Meet Your Bipolar and Schizophrenic Hosts GABE HOWARD was formally diagnosed with bipolar and anxiety disorders after being committed to a psychiatric hospital in 2003. Now in recovery, Gabe is a prominent mental health activist and host of the award-winning Psych Central Show podcast. He is also an award-winning writer and speaker, traveling nationally to share the humorous, yet educational, story of his bipolar life. To work with Gabe, visit gabehoward.com. MICHELLE HAMMER was officially diagnosed with schizophrenia at age 22, but incorrectly diagnosed with bipolar disorder at 18. Michelle is an award-winning mental health advocate who has been featured in press all over the world. In May 2015, Michelle founded the company Schizophrenic.NYC, a mental health clothing line, with the mission of reducing stigma by starting conversations about mental health. She is a firm believer that confidence can get you anywhere. To work with Michelle, visit Schizophrenic.NYC. View the full article
  13. Phobiasupportforum

    What Is ERP for Obsessive-Compulsive Disorder?

    Noah didn’t care for ERP (Exposure and Response Prevention) therapy despite his struggles with harm OCD. Stories that he had heard from acquaintances and friends were not positive. In fact, one of his friends felt traumatized by ERP. He also indicated that he was asked by his previous mental health counselor to sit in front of a bunch of knives so he could habituate or get used to the feelings and sensations the knives created. He said he had already been around sharp knives for three weeks while working at a knife shop temporarily while he looked for another job. His excruciating anxiety was off the charts. “I basically white-knuckled each day until I found a better job. I was exposed to knives all this time, and I’m still the same. ERP simply doesn’t work,” he claimed. What do you value in life? When Noah’s next therapist asked him, “What and who matters most in your life?” Noah indicated that all he cared about was to eliminate the intrusive thoughts and anxiety. It made sense to him as he believed that once he could control his thoughts and feelings, he could move on with life. Noah had put his life on halt believing that he could master his internal experiences (i.e., thoughts, memories, feelings, sensations, and urges) before he could strengthen his friendships, go back to school, date again, get married, and have a family. During treatment Noah learned that behaving towards internal events as if they were external ones was not effective. For example, he could easily discard appliances when they weren’t working, but he could not remove thoughts or feelings when they were unpleasant. Viewing and treating internal events as if they were external experiences led him to get trapped in the OCD cycle. Why is ERP effective? Your mind’s inherent job is to protect you, and when you struggle with OCD, your mind works overtime. Thoughts that appear useful may lead you to avoidance and compulsions. When you avoid situations and become stuck, you are not able to disrupt the beliefs and expectations related to your anxiety and despair. On the other hand, when you become proactive in facing your fears, you can truly learn and discover what happens. Instead of falling for your mind’s advice, you can be willing to interact with the experiences that bring fear but may also disconfirm your mind’s assumptions. You will discover that you have the inner wisdom to handle any situation even when it’s terrifying. However, if you don’t give yourself a chance, you’ll never know. What may ERP look like for you? Your treatment plan is personally designed. But learning occurs before, during and after exposures. You can focus on the things that are important and meaningful rather than trying to eliminate what’s occurring naturally. Your treatment provider will guide you through ERP. The exposures are done randomly and not in a hierarchy because life does not take place according to your fear hierarchy. Life happens and you can learn to be willing to face whatever shows up, so you can cultivate the life you wish to live. During Exposures: As you increase awareness of your internal events, you will be able to acknowledge them as such — thoughts, memories, feelings, sensations, and urges. You can learn to welcome them, and you don’t have to like them. You’ll learn to make room for them because you know it is futile to resist them. Your focus will be on your values — what you want your life to be about (i.e., relationships, employment, education, spirituality, etc.). What you’ve been missing out on because of OCD. The question you’ll ask yourself is, “If I act on my mind’s advice, will that lead me to living the life I want?” You will also learn to accept the uncertainty that OCD brings. Though this is difficult, the more exposures you do, the more willingness you will develop in accepting uncertainty, which after all is part of life for every human being. After Exposures: You will recognize that life does not need to be about getting through the anxiety and fear. With repeated exposures, you will learn that allowing the emotions and sensations, instead of fighting them will give you more freedom to live purposefully. You will feel empowered as you practice the skills to develop more flexibility in your thinking. After each exposure answer these questions: What did I learn from this experience? What can I do next time to be more flexible when I encounter a trigger? Where can I find more opportunities to practice the skills that will help me face my fears and focus on improving the quality of my life? Noah learned skills to view his internal events with a different mindset. He acknowledged and allowed them to naturally come and go without having to wrestle with them. He was able to live the life he had yearned for. He recognized that he had a choice of whether to act or be acted upon by his OCD mind. ERP is not about facing your fears and white-knuckling the situation. You already do that every day. Your therapist will provide skills to prepare you to do ERP. This practice can give you long-lasting results and enable you to live a richer and fuller life, even when the OCD mind spits out unhelpful thoughts. Give it a try! References Craske, M. G., Liao, B, Brown, L. & Vervliet B. (2012). Role of Inhibition in Exposure Therapy. Journal of Experimental Psychopathology, 3 (3), 322-345). Retrieved from https://www.academia.edu/2924188/Role_of_Inhibition_in_Exposure_Therapy Twohig, M. P., Abramowitz, J. S., Bluett, E. J., Fabricant, L. E., Jacoby, R. J., Morrison, K. L., Smith, B. M. (2015). Exposure therapy for OCD from an acceptance and commitment therapy (ACT) framework. Journal of Obsessive-compulsive and Related Disorders, 6, 167–173. Retrieved from http://dx.doi.org/10.1016/j.jocrd.2014.12.007. View the full article
  14. The Woodland Trust says the Japanese practice of “forest bathing” should be prescribed by doctors to tackle stress and other mental health problems. View the full article
  15. Pregnancy and childbirth are often an exciting, happy time in a family’s life, but it is also an incredibly stressful time to the whole family. This becomes even more difficult when mom works. Caring for a newborn (especially the first born or a child with special needs) is a significant time commitment. This becomes more challenging as moms and other caregivers lack proper sleep. There are also additional financial pressures in caring for a new family member and taking time (sometimes unpaid) away from work. Post-birth, the medical focus is primarily on the new baby. Though newborns are checked multiple times in the first month of life, mom may not be seen by her obstetrician until six weeks post-labor. Add all this together and having a child can become quickly overwhelming. Ten to twenty percent of new moms struggle with postpartum depression. Even moms who have the best support systems and no previous history of mental health concerns can struggle. Why Should Employers Care? For progressive employers, the health and well-being of ALL employees is extremely important. This increases productivity and drives business results. Employers also want mom to get back to work as quickly as possible, and that’s difficult to do when she’s struggling with mental health concerns in the postpartum period (defined as 12 months post-delivery). Once mom returns to work, mom can be more fully engaged when all her physical and emotional health concerns are addressed. Many employers face a tight labor market, and the war for talent (particularly in the tech industry) is real. Helping to care for new families demonstrates that an employer is family-friendly and cares about the whole person (not just the worker). What Can Employers Do the Support Mom Who Are Struggling? There are many tactics employers can take to support new families: Provide robust behavioral health resources through medical benefits programs and an Employee Assistance Plan. Help to raise awareness and reduce the stigma of ALL mental health concerns, not forgetting this vulnerable time surrounding birth. Encourage insurers/health plans to monitor whether obstetricians are screening for potential mental health issues during pregnancy/postpartum and facilitate access to in-network reproductive mental health providers. Also encourage health plans to reimburse postpartum depression screenings by both pediatricians and obstetricians (since baby is often seen by a doctor far earlier than mom in the postpartum period). Both the American Academy of Pediatrics and the American College of Obstetrics and Gynecology recommend this, but reimbursement is not always made by health plans/insurers. Implement extended parental leave programs to support recovery and bonding. Offer flexible work arrangements to support work/life integration (vs. work-life balance). Employers have a terrific opportunity to support new families and drive long-term employee engagement and loyalty by supporting new moms with all their physical and emotional health needs. This post courtesy of Mental Health America. View the full article
  16. Bethanyspawls

    Emetophobia sufferer

    Would love to chat sometime!! I have very similar problems. So proud of you for being a Mum!
  17. Bethanyspawls

    I'm looking for people who suffer from emetophobia!

    Hi all, I am so glad I have found this place, I have suffered all my life, I’m now 28. Feel relieved to know that I am not the only one that feels this way. Really hope some one wants to chat. Bethany
  18. Phobiasupportforum

    12 Depression Busters for New Moms

    It’s supposed to be the most exciting time of your life … and everyone is telling you how lucky you are to have a beautiful baby, but all you can do is cry. You’re pretty sure none of your new-mom friends are feeling this way. But they might be. Because 15 to 20 percent of new moms, about 1 million women in the US each year, experience some form of postpartum depression. Truth be told, my baby days were the most difficult and painful hours of my life. I was a hormonal and stress train wreck. Looking back now–my youngest is five–I see that a few alterations in my lifestyle might have helped matters. I’ll share them with you, so that you don’t have to feel so bad … or, you know, all alone. 1. Say it … “Yikes.” Take a moment to consider all that has changed in your life. Your social life is … poof … gone, not to mention your sex life and any romance that was left in your marriage. You don’t remember becoming a Navy Seal but, like them, you operate on about three consecutive hours of sleep at night. Plus there is this seven-pound creature that you are responsible for – and let’s just say it’s more demanding than the fern in your kitchen that will forgive you if you forget to water it for a day or so. Oh yeah, that adorable, Gerber baby is louder than the Winnie the Pew keychain one of your frenemies bought you. But the very act of registering all the modifications can be surprisingly comforting … like proof that you’re not imagining it: you’ve entered another world, and you definitely don’t speak the language. 2. Identify the symptoms. At some point, you’re going to need to distinguish symptoms of the new-mom culture shock and its accompanying baby blues from a bona fide mood disorder. You can find a list of the standard symptoms for postpartum depression by clicking here, but better than that, I think, is the description actress Brooke Shields gives in her memoir, “Down Came the Rain”: At first I thought what I was feeling was just exhaustion, but with it came an overriding sense of panic that I had never felt before. Rowan kept crying, and I began to dread the moment when Chris would bring her back to me. I started to experience a sick sensation in my stomach; it was as if a vise were tightening around my chest. Instead of the nervous anxiety that often accompanies panic, a feeling of devastation overcame me. I hardly moved. Sitting on my bed, I let out a deep, slow, guttural wail. I wasn’t simply emotional or weepy, like I had been told I might be. This was something quite different. This was a sadness of a shockingly different magnitude. It felt as if it would never go away. 3. Start talking. Journalist Tracy Thompson begins her insightful book, “The Ghost in the House” with two brilliant lines: “Motherhood and depression are two countries with a long common border. The terrain is chilly and inhospitable, and when mothers speak of it at all, it is usually in guarded terms, or in euphemisms.” Which is why you need to start talking …. often, for long periods of time, and loudly. But with safe people. 4. Find safe people. How do you find these so-called “safe people” who won’t report you to the pope or child services for saying things like you want your body back, you want your old life back, and at times you wonder if you made the right decision by having sex with your husband without a birth control method in place? That’s tough, and like so much else in life, you just need to feel your way through. I personally look for a sense of humor. Any mom who can laugh at the squash stains on her new Ann Taylor sweater is a candidate. The mom who left the playgroup 15 minutes early to get in the half-hour pre-nap ritual is definitely not. 5. Get support. Once you identify five or six suitable moms who aren’t too annoying, it’s time to start a support group, known in some parts of the country as a “playgroup.” It can be fewer than five or six, but you should be able to corral lots of takers if you hang out long enough at your library’s children’s hour, Tumble Tots or some other gymnastics class, or attend any workshops or social events organized by national mom groups like “Professional Moms at Home.” Me? I walked around my neighborhood and put a flyer into the mailboxes of homes in which I could see a stroller. I also posted signs at a local office supply store, coffee shop, and diner. Once ten moms confirmed interest, I hosted a playgroup every Wednesday morning at my house. For a year. The group eventually disbanded when I asked folks to take turns hosting because my house was getting too trashed. It didn’t matter, though, because it had served its purpose: which was NOT to help our children socialize–that’s only what we claimed–but to provide an outlet for us to spill our guts because many of us were absolutely going crazy. 6. Beg for help. In her informative book, “A Deeper Shade of Blue,” Ruta Nonacs, M.D., Ph.D., writes: “One of the most challenging aspects of caring for young children is the social isolation. In traditional cultures, a woman’s family fathers around the mother after the birth of a child. They help her learn how to care for her child … Nowadays most women with young children spend most of their time at home, alone.” I advise you to get on your knees, to skip all those manners and laws of social grace that keep you from pleading with your in-laws for some help. Barter with them, negotiate, promise to name the next kid after them if they babysit for a night, ANYTHING you possibly can to get some free help because you are going to need it, and the less of it you have, the more risk for developing a serious mood disorder. If your relatives are unable to assist, buy the help. Cash out the retirement funds for this one. Trust me. You’ll be glad you did. 7. Sleep. No really … sleep. Part of the reason I’m so adamant that you get help is because the longer you stay sleep-deprived the better chance you have of winding up like me … in a pysch ward. Brain experts have always made the connection between insanity and insomnia, but new research suggests that chronic sleep disturbances actually cause certain mood disorders. You stay up one too many nights with that crying baby, and you are bait for a mental illness. Not to scare you. But, again, BEG FOR HELP so that you can at least get a few hours of uninterrupted sleep … consistently. Don’t follow in my tracks and get your first night of slumber in a hospital. 8. Hang unto you. The second biggest mistake I made as a new mom was throwing my old self into a locked closet until, well, I graduated from the outpatient hospital program, where I learned that motherhood doesn’t require chucking my prior existence: my interests, my friends, my career, and so forth. In fact, the nurses there convinced me that if I could recover a little of my old self, I might even be a better mom. So I hired a babysitter for a few hours a week, which allowed me to pursue some writing projects, go on an occasional bike ride, and have coffee with a non-mom friend and talk about something other than poop. 9. Watch your language. I’m not talking about the profanities that you’re no longer allowed to utter in front of the miniature tape recorder disguised as your infant. I’m referring to your self-talk. Erika Krull, a mental-health counselor who blogs for Psych Central, wrote this in a recent blog on motherhood and depression: “It’s the combination of ‘must, can’t, won’t, should, could’ kinds of thoughts with the high level of emotion that can send moms down into the pit of depression or anxiety. Black and white thinking is a setup for disappointment, despair, lack of satisfaction and meaning, and low self worth.” 10. Eat brain food. I hate to be a killjoy here, because I know that you’ve already had to say bye-bye to lots of pleasures in your life. But here’s the thing: the more stressed and sleep-deprived you are, the more inclined you are to grab for the chips and the cookies. Research has actually confirmed that: sleep deprivation and stress both contribute to obesity. It’s a vicious cycle, because the more chips and cookies you consume, the more out of control your world spins, and so forth. Ideally, you want to shoot for lots of omega-3 fatty acids, vitamin B-12, and folate. Unfortunately, they’re not hiding in a Hershey’s dark chocolate bar. If I were God, I would change that. You can find omega-3 fatty acids in boring but tasty things like salmon, tuna, sardines, walnuts, canola oil, and flaxseed. Vitamin B-12 is found in fish, seafood, meat, poultry, eggs, and dairy products. Folate is found in fortified cereals, spinach, broccoli, peanuts, and orange juice. Your brain will thank you. 11. Get online. You’re lucky, in that cyberspace is pretty much ruled by new moms. A few years ago I attended a BlogHer conference, where approximately 80 percent of the blogs represented were mommy blogs. In fact, the BlogHer site is a good place to start if you want to know what other moms are experiencing and writing about. Other winners: The Motherhood, CafeMom, Maternally Challenged, Postpartum Progress, and Dooce. 12. Don’t lose your sense of humor. If one thing saved me during those years my kids were babies it was a sense of humor. “If we couldn’t laugh, we would all go in sane,” sings Jimmy Buffet. So, if you have already gone in sane, it’s best to snicker at the madness in front of you. Ah, the relief I felt some of those afternoons, once all the tension held in my shoulders and in my cheeks released into a wild laughter … after I had spent an afternoon chasing two kids at the mall, one with diarrhea and the other hiding underneath the bras in J.C. Penny’s lingerie section. Flexing that humor muscle … it’s as important as the tight abdominal muscles that you’ll never get back. View the full article
  19. im new to this forum so sorry if this was posted in the wrong place but i have a phobia and have been struggling recently but i dont know what it is. basically, its hot air balloons/large spaces in the sky/changes in the sky. im still not 100% sure what triggers it but from what i can tell its things in the sky that aren't supposed to be there, or a change. it started with hot air balloons about 2 years ago and when i see a hot air balloon in the sky i freeze, struggle to breath and cry all out of my control. however its not the fear of transport in the sky as im fine with planes and its not balloons as im fine with all other types of balloon. recently a neighbour cut down a large tree and it exposed a large area of the sky. when i saw this i had the same reaction and have kept curtains closed since. before it started with hot air balloons i had similar experiences but only in dreams. where the sky had strange patterns on or stars were glitching and i felt something similar whilst in the dream and after waking up. i cant explain how it makes me feel but its like an uneasiness and almost like im in a dream. ive looked through many forums but never found a name for it or even anyone eles with this. is there a phobia of irregularity's in the sky? of hot air balloons? plz help
  20. Nature is an important aspect of our daily lives that is too often taken for granted. Now, in our technologically-driven society, we are often shut away from nature, and the times that we are out in nature, we are unable to appreciate it in its entire splendor. It is hard to truly separate yourself from the rest of the world, considering we are always “on”, but the effects of doing so prove beneficial to your general well-being and emotional clarity. “[We] are all a part of nature. We are born in nature; our bodies are formed of nature; we live by the rules of nature,” writes Wesley P. Schultz, PhD, professor of psychology at California State University San Marcos. Why then, are we so avoidant of nature? Schultz explains that historically, it was necessary for us to be in nature — we hunted, lived, socialized and traveled in nature. As we progressed and became more technologically advanced we became more shut in — living, socializing, and traveling predominantly in man-made environments (Schultz, 2002). Now, when we interact with the environment it is with the idea of “what can I get from this environment?” It can be argued that some people still hunt, but this is more to derive a sense of pleasure or sport, rather than for survival. Hunting as a requirement for sustenance is no longer there. This overwhelming idea that nature is something outside of us is rooted in and motivated by our consumerism. We have become heavily reliant upon our things and what those things can offer us — a sense of identity, a sense of community and acceptance. We no longer consider where these things come from. The phrase “Keeping up with the Jones’s” is more relevant than ever in the 21st century. Every few months there are new trends we need to buy into to be considered relevant and be accepted by our peers. And of course this is the only way we are able to derive any sort of happiness. This, of course, is not the way to find happiness, and in fact if we were to rely more on the environment and lead a more simplistic life, we would be more likely to find a truer, long-lasting kind of happiness. This is not only due to the aesthetic appeal nature offers us, but because we, like plants, require the environment for survival. The sun is of particular importance in maintaining a healthy mind. Depression is a significant mood disorder whereby those diagnosed with it experience a depressed or irritable mood, fatigue or loss of energy, feelings of guilt or worthlessness, suicidal ideation and a decreased interest or pleasure in most activities (APA, 2013). Exposure to the sun can help moderate mood by activating the release of the neurotransmitter serotonin. It can also help with vitamin-D levels, which is important for proper bone health (Nall, 2015). Physical health is directly correlated to mental health. The brain and body should not be treated as separate from each other, because they are inter-related; “in terms of the way it functions, the brain is always linked to the body and, through the senses, to the world outside” (Doidge, 2015). The sun is not the only aspect of nature that has beneficial effects for treating depression and relieving every day stress. Simply put, the aesthetic provided by nature elicits an overwhelming feeling of awe and admiration, particularly due to its beauty. The romantic poets acknowledged the power nature has over us. Consider these lines from Coleridge’s Frost at Midnight: “For I was reared In the great city, pent ‘mid cloisters dim, And saw nought lovely but the sky and stars. But thou, my babe! shalt wander like a breeze By lakes and sandy shores, beneath the crags Of ancient mountain, and beneath the clouds, Which image in their bulk both lakes and shores And mountain crags” Here Coleridge acknowledges the better life he hopes his child will have because of his constant exposure to and interaction with nature, as opposed to his life cloistered away from nature. This is not to say that Coleridge understood the positive psychological and physiological effects nature has on us, rather, his, along with other romantic poets, can offer some insight into nature and its effects. Surely if he, along with other poets of his time, felt the power and pull of nature without understanding the underlying reason, there are significant and positive effects. Fresh air, provided by surrounding yourself with more green space offers positive effects on the brain, due to the increased amount of clean oxygen which is essential for proper blood-flow. Taking a walk in a forest not only provides exercise and a beautiful atmosphere, it also provides one with a way to connect with nature — in a spiritual and very necessary physical way. Trees and greenery provide us with clean air and oxygen needed to keep the brain healthy. These important physiological effects have a significant effect on our mental state as well. It offers us a more calm and relaxed mood, and further offers us a feeling of connectivity to nature. The importance of this connectivity should not be underestimated, nor should the healing properties that nature provides us. Consider Sister Jean Ward, in WWII, who brought premature babies with jaundice into a sunlit courtyard in the hospital in Essex, England. Their condition improved due to the wavelengths of visible blue light in the sun radiating through the exposed skin. Light also decreases pain and improves sleep, which of course is closely related to feelings of depression (Doidge, 2015). A lack of sleep may make it difficult to focus or enjoy proper cognitive functioning, and depress the body. Feeling tired makes the mind tired, and since the body is not getting enough rest it has no way to regenerate itself for the next day. This may have negative effects on both the mind and body, contributing, not only to sleep problems and the perpetuation of depressive symptoms, but may also contribute to the development of pain (Mann, 2010). Therefore, getting the proper amount of sunlight is essential to proper functioning, and improving mental health. How do we get the proper amount of sunlight and fresh air? By going back to nature. It is the most simplistic, yet essential mode of treatment for feelings of depression. Perhaps, by experiencing the regenerative properties nature has to offer us, we too, may feel compelled to write about nature’s beauty like Coleridge and the many romantic poets of his time. References: American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed). Coleridge, T. S. (1997). Frost at Midnight. In Keach, W. (Eds.), The Complete Works. (231-232). England: Penguin Books. Doidge, N. (2015). The Brain’s Way of Healing. New York: Viking. Nall, R. (2015). What are the benefits of sunlight? Retrieved from: http://www.healthline.com/health/depression/benefits-sunlight#Overview1 Mann, D. (2010). Pain: The Sleep Thief. Retrieved from: http://www.webmd.com/sleep-disorders/excessive-sleepiness-10/pain-sleep?page=2 Schultz, P. W. (2002). Inclusion with Nature: The Psychology Of Human-Nature Relations. In Schmuck, P., & Schultz, P. W. (Eds). Psychology of Sustainable Development (61-78). New York: Springer US. View the full article
  21. Phobiasupportforum

    Common Signs of Someone Who May Be Suicidal

    About 70 percent of people who commit suicide give some sort of verbal or nonverbal clue about their intention to end their life. That means you could be in a position to guide someone to get help before they commit the one action that can never be taken back. While 30,000 Americans die each year due to suicide, more than 800,000 Americans attempt suicide. Although women attempt suicide three times as often as men, men are four times more likely to be successful in their attempt. Warning signs of suicide are not difficult to spot, but professionals differentiate between someone who simply has a passing thought of suicide or ending his or her own life, and someone who has persistent thoughts and has a definite plan. However you don’t have to know how serious a person is in order to help them. Possible Suicide Warning Signs Have you ever heard someone say two or more of the following? Life isn’t worth living. My family (or friends or girlfriend/boyfriend) would be better off without me. Next time I’ll take enough pills to do the job right. Take my prized collection or valuables — I don’t need this stuff anymore. Don’t worry, I won’t be around to deal with that. You’ll be sorry when I’m gone. I won’t be in your way much longer. I just can’t deal with everything — life’s too hard. Soon I won’t be a burden anymore. Nobody understands me — nobody feels the way I do. There’s nothing I can do to make it better. I’d be better off dead. I feel like there is no way out. You’d be better off without me. Have you noticed them doing one or more of the following activities? Getting their affairs in order (paying off debts, changing a will) Giving away their personal possessions Signs of planning a suicide, such as obtaining a weapon or writing a suicide note Friends and family who are close to an individual are in the best position to spot warning signs. Often times people feel helpless in dealing with someone who is depressed or suicidal. Usually it is helpful to encourage the person to seek professional help from a therapist, psychiatrist, school counselor, or even telling their family doctor about their feelings. The National Suicide Prevention Lifeline (1-800-273-8255) offers free and confidential support for people in distress as well as prevention and crisis resources for you and your loved ones. Remember, depression is a treatable mental disorder, it’s not something you can “catch” or a sign of personal weakness. Your friend or loved one needs to know you’re there for them, that you care and you will support them no matter what. Suicide is one of the most serious symptoms of someone who is suffering from severe depression. Common signs of depression include: Depressed or sad mood (e.g., feeling “blue” or “down in the dumps”) A change in the person’s sleeping patterns (e.g., sleeping too much or too little, or having difficulty sleeping the night through) A significant change in the person’s weight or appetite Speaking and/or moving with unusual speed or slowness Loss of interest or pleasure in usual activities (e.g., hobbies, outdoor activities, hanging around with friends) Withdrawal from family and friends Fatigue or loss of energy Diminished ability to think or concentrate, slowed thinking or indecisiveness Feelings of worthlessness, self-reproach, or guilt Thoughts of death, suicide, or wishes to be dead Sometimes someone who is trying to cope with depression on their own might turn to substances like alcohol or drugs to help ward away the depressive feelings. Others might eat more, watch television for hours on end, and not want to leave their home or even their bed. Sometimes a person who is depressed may stop caring about their physical appearance on a regular basis, or whether they shower or brush their teeth. It’s important to realize that people who suffer from serious, clinical depression feel depressed for weeks or months on end. Someone who’s just having a particularly rough or stressful week (because of school or work demands, relationship problems, money issues, etc.) may not be suffering from clinical depression. View the full article
  22.  Most people suffer from certain social anxieties. Just the idea of speaking in front of a crowd can make otherwise confident people break into a nervous sweat. Fear of rejection is also very common in society… just ask any teenager who’s too afraid to ask out their crush. In this episode, we talk about these common feelings from the perspective of having additional mental illness thrown in, creating a blend that is no one’s favorite. SUBSCRIBE & REVIEW “You’re afraid of being humiliated. You’re afraid of what you just said.” – Michelle Hammer Highlights From ‘Social Anxiety’ Episode [2:00] Where are you from? [4:30] Social anxiety and the big city. [8:00] Talking to important people is scary. [10:30] Overthinking your whole day when you go to sleep at night. [12:30] Delusions about the past. [16:00] How can you be content with the past? [18:00] Putting rejection in your own control. [23:30] Google says people of our ages shouldn’t have social anxiety, anymore. [24:00] How we get rid of anxiety and public speak! Computer Generated Transcript for ‘ Social Anxiety, Delusions, Rejection, and Mental Illness!’ Show Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you. Announcer: For reasons that utterly escape everyone involved, you’re listening to A Bipolar, a Schizophrenic, and a Podcast. Here are your hosts, Gabe Howard and Michelle Hammer. Gabe: Hi, everyone, you’re listening to A Bipolar, a Schizophrenic, and a Podcast. My name is Gabe Howard and I live with bipolar disorder. Michelle: Hi. I am Michelle Hammer and I’m schizophrenic. Gabe: Straight up schizo. Straight out of Compton. Michelle: That’s right. Yeah, totally out of Compton. Straight out of New York. That’s right. Gabe: Right out of New York. Well you were. You were born and raised in New York City, right? Michelle: Not technically. Sure. Well I mean, close enough. Gabe: Most people, when they’re not something, they don’t claim it. But there’s a few things that if you’re close enough, you’re like, “Oh yeah, I’m from New York City.” So you’re not from New York City but you tell everybody that you are. Michelle: Well, I currently live in New York City. And if I explained, “Well, I’m actually from the first county right above the city, not far from the Bronx. So if I drive about 20 minutes I enter the Bronx which, so if you really want to get technical, I’m very close but not technically New York City. Some people would call it upstate. Some people would say it’s not upstate if you’re from where I’m from. It’s an argument that we have a lot. Gabe: Because people from New York City think that you’re a poser. Michelle: No. They would say I’m from upstate. Gabe: But not from New York City? Michelle: Right. Gabe: So Schizophrenic NYC should actually be Schizophrenic upstate New York? Michelle: Not now, because it exists in the city. Because I live in Astoria, Queens now and exists and sells all the merchandise in New York City. Gabe: This is extraordinarily complicated. Michelle: I don’t really think it’s that complicated, Gabe. And I don’t know why you are so confused about where I live because I live in Queens, which is one of the five boroughs of New York City. Gabe: So it’s schizophrenic dot Queens? Michelle: Queens is part of New York City which is NYC. Do you get it now? Gabe: Are you the King of Queens? Michelle: No I’m not the King of Queens. Gabe: Michelle, today we are talking about social anxiety and the reason that we went through this godawful exercise is because every time we meet people, one of the kind of the social questions that people always ask is you know “where are you from?” I mean they start with your name and then where are you from? Michelle: Yes. Gabe: You have it much worse than I do. No matter where you go in the country, people feel that they understand New York City because of television and movies etc. Michelle: Yeah. Oh yeah. And then they tell me. “Oh I visited New York City. I was in that area. Oh, it was by this. Do you know that I rode the subway one time? It was very dirty.” And I’m like, “Oh, yes. Yes, yes, subways are dirty, yes. Yes, oh.” “Oh I was there 20 years ago.” Well you know I wasn’t there 20 years ago so I really can’t tell you about it what it was like 20 years ago. I’m sorry. I don’t know much at all. Gabe: I’m like “I’m from Columbus” and they’re like, “we don’t give a shit.” Michelle: Yeah. I was watching you on a Facebook Live and you’re like, “Yeah I’m from like a really big city,” and stuff and I’m like you’re telling it’s big? You’re from Columbus. Stop saying that, Gabe. Gabe: It’s the 14th largest city in the country. Michelle: 14th? 14th? It’s not even top ten. So stop saying that. 14th. Don’t be proud of that, Gabe. Gabe: But it just, it’s a big city. Michelle: You walk out of your house, how long does it take you to get to a store? To get to a store walking? Gabe: Walking? Well, I don’t know because I’m never going to walk. Michelle: Exactly. Because it’s that far. Because it’s that far. I know how long it takes me to get to any kind of establishment. Moments. I walk out my door, less than 30 seconds. Gabe: But in my old apartment, that I called my pod, in 30 seconds I’d be within a whole bunch of places. I lived there on purpose because I wanted to be able to walk to the pizza place the gas station etc. I know you called gas stations bodegas, I apologize. Michelle: No, and gas stations are not bodegas. You will never understand the concept of what a bodega is, Gabe. Gabe: It is true. I never will. But interestingly enough, you feel like you suffer from social anxiety and I feel like I suffer from social anxiety which makes a lot of people confused because they can’t figure out how to people as lively and. Michelle: And boisterous? Gabe: And boisterous and loud as Gabe and Michelle can be anxious in social situations. And that goes an extra step for you because people are like my god you live in the biggest city in the country and like you said you walk outside and you’re at an establishment. So you can’t get away from people. Michelle: You know having like social anxiety is kind of like thinking it’s almost a little bit like paranoia? That you’re nervous to be around new people cause you don’t know what people are really going to say. But when you live in New York City, you can say something to somebody and if it’s stupid you’ll probably never see that person ever again. So it doesn’t really matter. Gabe: And you feel that this is why it helps? Like it’s that anonymity that makes you feel good? Whereas in when we’re at a conference or when we’re giving a speech somewhere everybody knows your name. Michelle: Exactly. Gabe: They’re like. Michelle: And that is so much more nerve wracking. Gabe: Because if you make a mistake. Michelle: Everybody knows who I am. Gabe: Everybody knows that Michelle Hammer is the one that accidentally said fuck off on stage when she was at the Catholic college. Michelle: Yes. But I never actually did that, he just made that up. Gabe: That was a lie. That one’s a lie. Michelle: Yeah that’s the lie. Gabe: Later in the episode I will tell the truth and you will know it’s a truth because Michelle will not say a word. But that actually did happen to a colleague. He said fuck on stage and like everybody went nuts and he was just like Why? Why is this a problem? And he wasn’t embarrassed by it because I just don’t think he has the ability to get embarrassed. But he obviously didn’t think that it would offend anybody and it did. So now he’s kind of back on his heels apologizing for a comment that was just a throwaway comment to him and that’s kind of how you and I feel. To us, we’re just like up on stage saying something. But if the audience hears it wrong or feels about it wrong or we just slip up and say something that maybe you know just I really like the fuck example because we can say fuck in New York City and nobody is gonna care. Michelle: But oh you don’t you don’t even know the things I’ve overheard people say in your city right it’s hilarious. There was once a website called Overheard in New York and it was just all of these conversations was that were ridiculous that people overheard in New York. Gabe: But if you get hired in let’s say like a very conservative state you know like a Mormon college in Utah you’re not going to swear right? You’re gonna put on? Michelle: Oh oh no no no. Well, I mean, that would be hilarious if I got hired at a Mormon college. If any Mormon colleges would like to hire me, letting you know I’m available. Gabe: And she promises not to swear. Michelle: And I will not swear a word. Or drink soda or coffee or you know all that Mormon stuff. That’s like all I know about it. I’ve known one Mormon my entire life. She was a very nice girl. She was sweet, loved her. But that would be really funny. So Mormons, hit me up. I will not swear. Gabe: So that that’s what I mean though. You know that you can swear in New York City no problem right. Michelle: Pretty much, as long as the you know it’s not children around. But I mean I mean many many times I’ve cursed in front of children that I’m like oh there’s a child. Gabe: And the child probably corrects your swear. Michelle: And tells you the new well they look at you with a dirty look like Mommy, that lady just said a bad word. Gabe: I can see that’s like mommy that bitch just swore. Wait, what? But so that’s what I mean though. New York City you can swear Utah don’t swear. It’s the middle ground, it’s the middle ground that messes us up. Where we’re not sure so we don’t get how to behave and that’s where the nervous comes in, right? Michelle: Exactly. Sometimes you just don’t know what the right social norm is so you don’t know how to act or who to talk to or who’s maybe you’re like is that person really important? Wait what’d did I say to them. Maybe I said something stupid to them and then you’re all anxious because of that and then you’re like you want to go talk to somebody else and somebody you know interrupts you and you want they want to really talk to you but you don’t want to talk to them at all. But then you realize that you really messed up and should have spoken to that person in the first place. Gabe: Exactly. And it’s not because you’re sucking up to big names or you know brown nosing or kissing ass. It’s because maybe that’s the person who hired you. Because we don’t know what a lot of these people look like. You know, we can get hired over e-mail and phone we’re like Oh Julie thank you we’ll send over the contract. They know what we look like because they’ve seen our headshots they’ve seen us on social media. We never know what they look like. Michelle: Never. Yeah never. People have come to my pop up shop. Hi it’s so nice to finally meet you. Hi. You too. Who are you? Exactly. Gabe: But then they get and then sometimes they’re like Oh I understand you meet a lot of people this is your job. You travel around and but other times they’re offended. They’re like we hired you. We’ve talked on the phone a lot. This is what causes my social anxiety. I’m not worried about purposely hurting somebody’s feelings because I’m a really nice guy. I’m worried about the accident. The misunderstandings. Michelle: The accidents? Gabe: Yeah. Michelle: You know I kind of looked up the definition of social anxiety and it just said symptoms may include excess fear of situations and one in which one may be judged. Worry about embarrassment or humiliation or concern about offending someone. So it really is to me it seems like paranoia to me doesn’t it? Gabe: I guess it’s not paranoia though because it isn’t like paranoia or worse like yours I guess. Michelle: Yeah yeah yeah. Gabe: Like your mom is trying to kill you. Then your roommate is trying to kill you. Then Gabe is trying to kill you. Michelle: I guess but it’s sort of like a social kind of a paranoia and in a sense like that. You know you’re afraid of being humiliated. You know you’re afraid of what you just said. You’re afraid of how you’re acting or did you act well. It’s just kind of dwelling on things after they happened because you don’t know if you did the right thing. Let’s take a quick break and hear from our sponsor. Announcer: This episode is sponsored by BetterHelp.com. Secure, convenient, and affordable online counselling. All counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist, whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face to face session. Go to BetterHelp.com/PsychCentral and experience seven days of free therapy to see if online counselling is right for you. BetterHelp.com/PsychCentral. Michelle: And we’re back talking social anxiety. Gabe: I really like what you brought up there, Michelle. The dwelling. Do you ever like after the event is over after the conference day is over after the speech is over whatever. Do you lay awake at night and replay the entire day in your head looking for mistakes? Michelle: Oh yeah yeah yeah yeah but the thing is I go delusional. I think about the day and then I start making lies up about the day. Then I start believing the lies about the day and then I just go crazy. Gabe: Wow that’s what’s your like coping mechanism for that? I do part of that. You know before I was treated before I got you know lots of therapy and lots of medication and lots of help. I did that exact same thing. One of the things that really helped me was you know therapy and medication it really helped tamper down those delusions to the point where I don’t have them anymore. So when I spiral out of control it’s all I was talking to Jane and I told Jane that she looked very nice today and then I think Jane looked to the left and I know that looking to the left means that gee I offended Jane. Oh my God I shouldn’t have said that she thinks I was hitting on her. Oh I didn’t mean to hit on her. Oh my God she thinks I’m a creepy pervert what’s going on. And I start to feel really really bad like I owe Jane an apology. In the old days I would have sent Jane this rambling e-mail that made absolutely no sense and just really caused a lot of problems. New Gabe just sits on it and does nothing because I don’t want to sound like a crazy person. But you believe that it’s true. So now you wake up and you no longer are curious as to whether or not you sexually harass Jane. You believe that you did it sometimes. Michelle: Sometimes I do believe. Sometimes I’m not sure and I’m confused but then I try to verify things with people. I ask friends, ask people who are there. I try to set up a timeline. Does the things that really did happen that way or if they didn’t happen that way because sometimes the conversation that I have with somebody I changed the entire conversation to something else completely. So I tried to figure out what is real. What makes sense, what was actually happening. But what’s worse about is that it had a sometimes that delusions they’ll happen for things that happened years ago that I can’t verify if they’re real or not. So what am I supposed to do then? Gabe: Like maybe the reason that you lost touch with your friend Bob isn’t just because time marches on and Bob got a job and had a couple of kids. Maybe you offended Bob? Michelle: You never know. Who knows? I never I never know things. Things just make up their own stories and things don’t make any sense anymore. And I don’t know what’s real. I don’t know what’s happening, but I don’t know. Gabe: When we talk about social anxiety and I don’t know how we got on this but this is social anxiety because this is one of the reasons that you’re so nervous to talk to people because you’re nervous that you’re afraid that you’re gonna make a mistake but then you’re nervous that you’re gonna think you made a mistake and then dwell on it and it’s going to ruin the next day. This is the spiral that happens to me and a lot of people with social anxiety even if we don’t mess up during the event that we were worried about we’ve convinced ourselves later on that we always made mistakes. Michelle: Yeah we’ve made tons of mistakes. Gabe: I really like what you said about checking in with the people around you as you know that’s something that we do to each other a lot. I’ll ask you when we get off stage. Hey did you think that went OK? You’ll ask me Hey did I do a good job? And we kind of have a little you know like decompress or you know we just kind of go over everything together. Now we trust each other. Michelle: You’re right. Gabe: Michelle trusts Gabe. Gabe trusts Michelle. But what if you don’t have a person that you trust because you know people could exploit this a lot. You know it’s a cut through a world out there. You can’t just ask a random panelist Hey did I do ok? Because maybe that panelist wants your job so they’ll be like, I don’t know Michelle. You offended a bunch of people. You really sucked. Michelle: Wow. Yeah you’re right about that one. Gabe: But maybe they’re telling the truth. Maybe you did suck. How do you know when to trust people and when they’re not? Like isn’t that another whole layer? Michelle: I mean sometimes I just have confidence. And if somebody tells me I did a bad job I’m just that bad mostly let me just make me angry and I’d be like I did better than you. Gabe: And on one hand that kind of confidence is good but you can’t just ignore people who give constructive criticism or you’ll never improve. Michelle: But is that constructive criticism? If I ask somebody next to me and they’re like no, I think you did really bad. Gabe: Well it’s not constructive but it could still be true. Michelle: I don’t know. I’ve been on panels before and I mean based on questions coming to me. Questions from the audience stuff like that. You can base it on that. I mean if you’re getting more questions from the audience and the rest of the people don’t you think you’ve done better? Gabe: Well maybe except that as you know some of the most viral videos in the world are of people failing. That doesn’t mean you did a good job just because a ton of people are watching you get hit in the nuts or falling off a bike. Michelle: Well I understand that. But the questions aren’t negative. The questions are because they’re interested and they want to learn more. But Gabe: But you. You said earlier that you have a problem running it through accurately. You’re like I was asked four questions that were very positive that were very interesting for me. I would say that part was good but my answer sucked that. Michelle: That can happen, that can happen. I think like I should have said this instead I should have said that. T is what I should have done there. This is what I should have done there. But use it in a more constructive way for next time trying to turn all the delusions into more a positive way. It’s when I can’t turn the delusion off it inches anything positive out of that way. It just makes me go argh, when you can’t change the past that you really want to change. Gabe: And of course we still have to go on to the next gig. Michelle: Yes. Gabe: So it doesn’t matter how badly we feel about the last one and or whether it’s true or false you’re only as good as your next gig. That’s the life of everything our podcast is only as good as our previous episode. Our writing is only as good as our previous writing. Your clothing line is only as good as your last piece of art. Wouldn’t it be great if we could just make one podcast or just be famous forever or give one speech and just live off the residuals for life? Even Friends had to make what over 200 episodes over a decade? If that show would have started to suck in the middle, it would’ve just gotten canceled. It would’ve been the Drew Carey Show. It started off hot fizzled right out. But it didn’t. It stayed good. How do we stay good? Michelle: How do we stay good? Confidence. Gabe: How do we stay confident. Michelle: For every negative thing we think we have to say three positive things about ourselves. Gabe: Excellent. I know for a fact that you are thinking something negative about me right now. So now you, Michelle Hammer, have to say three positive things about me. Michelle: I would say in self reflection. In self reflection all. Gabe: So you can’t even think of three positive things to say? Michelle: No. I know you’d interpreted it in the wrong way in yourself. If you think something negative by yourself then you have to say three positive things about yourself. Not me about you but you about you. Gabe: Let’s say that I can’t think of three positive things and I say to my friend Michelle, man I can’t think of three positive things about myself. Will you help me? What would you say? Gabe: You are not bald. You are very tall and you have a lovely wife and dog. Gabe: The three positives about Gabe. I am not bald. I am very tall and I have a lovely wife and dog. Michelle: What are you looking for? Gabe: Honestly Michelle that might have been perfect. A conference that I was at recently you know it didn’t go so well. I know that it was not the best it could be. So just establish that as a baseline fact and this is one of those conferences that you have to apply for. And now because of that I can’t apply next year because if I apply next year and I don’t get in I will go back another whole year and decide the reason that I didn’t get in is because of what happened and I can’t live with that. Like that’s just too much anxiety that’s too much pressure that’s too much stress. So to save myself all of that I’m just not going to apply. And now the reason that I didn’t get in is because. Michelle: Yeah it’s under your control. Gabe: Right. Sometimes it’s worth it to risk the rejection. You know what I asked you if you wanted to host this podcast with me and you said no that was worth it. And then when I circled back a month later and gave you more data to why I thought this would be a good idea. That was worth the risk. And even if you would have said No I would’ve felt good about it. But sometimes I just can’t risk the rejection and this is one of those examples of where it’s just not worth it for me if I get in. I’ll be like Oh yay. They still love me but if I don’t I’ll spend the rest of my life thinking Man I fucked it up so bad and I can never recover from it and that will seep into other areas. Michelle: No, I completely understand. I feel the same way, too. So many times I’ve gotten emails like Oh we’re looking for a speaker. Please send us your rate and everything. I send them my rate, and then crickets. I never hear back. Gabe: One of the things that helps me with that is I learned that the average person gets three quotes for a speaker which means that they may have rejected me but they also rejected somebody else statistically. Also I always write this lovely letter back. Thank you so very much. I completely understand. Please keep me in mind for next year. I’m very easy to work with. I understand that you went a different way. And then I kind of put him in my calendar to follow up with next year because I believe from a sales cycle standpoint that there is no such thing as no. Michelle: Isn’t that really how you found out who I was? Somebody asked you about like two different schizophrenic advocates? And you had to choose between the two and I was the one that didn’t get it. Gabe: Yes you didn’t get it. Michelle: But, I got you. I got you. I didn’t get this speech but I got you. Gabe: I think it worked out. Michelle: Yeah, it worked out. And that girl that got the speech, she wasn’t even schizophrenic. Gabe: What the hell? They hired a non schizophrenic for a speech? Michelle: She just had a schizophrenic mom. Oh it’s so terrible having a schizophrenic mom. Living with a schizophrenic is so terrible let’s hear about that let’s not hear about it from a schizophrenic person. Gabe: I mean in fairness when you stay at my house for four days it’s pretty awful. I don’t think that has anything to do with your schizophrenia. It might have to do with your sloppiness and your crazy. Michelle: But seeing your dog is crazier than me. Gabe: That’s true my dog still carries around your sock. Michelle: Yes seriously I don’t carry my socks in my mouth. Gabe: Wouldn’t it be funny. I do realize this isn’t true but since you brought up the dog. After you leave, my dog always finds one of your socks. I don’t know how this happens I don’t know if it gets slipped under the bed or whatever. But he carries around the damn sock and we just let him because we don’t care. But I have this idea in my head that all the way back in New York City, Michelle is carrying around some dog toy of Peppy’s and the two of you are just like cosmically connected. Are you carrying around Peppy’s tennis ball? Michelle: Not that I’m aware of but now that I know about this I’m going to take something of his. I have a lock of his hair, actually. Gabe: You do not. Michelle: I do, I have a lock of his hair in my locket. Gabe: In your locket? You don’t even have a locket. Michelle: How do you know? Lockets are still in style. Gabe: No they’re not. Even Blanche would say Oh honey. Michelle: Blanche bought me a locket when I was little. It was real gold then I bit it. Gabe: It’s been so long since we’ve referenced Blanche. You realize that new listeners have no idea who we’re talking about. Michelle: Blanche was my grandmother. Gabe: And she was the best grandma. Michelle: She was a good grandma. She told me save a penny here, save a penny there. Then next thing you know you got a dollar. Gabe: Blanche loved me. She said that of all of Michelle’s friends, I was her favorite. Michelle: You never met Blanche. Gabe: But she would have said that. Michelle: Well, she would’ve only liked you if you were in a union. Gabe: My father was in a union. Michelle: OK. We can stop talking about this because it’s uninteresting. Gabe: It very much is yes. All right we need a closing. Michelle: What I see about social anxiety on line is that it starts during the teenage years and it gets better as people get older. So apparently we still have social anxiety when Google says we shouldn’t. Gabe: Well Michelle: So Google. Gabe: Doctor Google knows best. Michelle: Apparently Google knows best and we’re not supposed to have that same social anxiety because we’re too old for it. Can it be cured? There is no cure says Google. Gabe: There’s now cure for schizophrenia bipolar depression etc. But, Michelle, sincerely we both suffer from social anxiety yet we do this job. We get out there in public. What is the message that you want to give somebody who’s listening to this and their social anxiety is so bad at the moment that they are unwilling to leave the house or they’re unwilling to even like you know go to McDonald’s or Starbucks and get a Diet Coke or a cup of coffee. Because a lot of our listeners they think that we don’t suffer from this stuff because they see us out there. They don’t know that we’ve just managed to push through. What is your number one tip for somebody to push through that social anxiety and get to the other side? Because let’s face it, we do adore being on that stage. We do love meeting people. It can be hard for us but it is worth it because we love it a lot. Even you and you hate everything. Michelle: You know it is hard and a lot of people ask me like how do you get on stage and talk. It seems so nerve wracking. People say they’d be so nervous. It makes me nervous. Sometimes you just take a deep breath and go for it and that’s how I get on stage and do the thing and almost if you pretend that you really know what you’re talking about people will believe you really know what you’re talking about. You just have confidence if you believe in yourself and you believe what you’re saying and everything that you’re doing is the right thing. It can be OK if you don’t leave your room, if you’re only in your house, there’s always the internet. You can speak to people online. Baby steps. Gabe: It is fake it until you make it, right? Michelle: Fake it till you make it. Gabe: And I really like the buddy system. I understand that if you’re kind of a shy person and you have anxiety you have social anxiety that you wouldn’t want to go out alone because being in a roomful of people where you know nobody that’s scary. So you know bring along somebody. Before I met Michelle I brought my friend Lisa and she was always very helpful. In fact some of my first speeches I just gave them to Lisa. There was a whole bunch of other people in the room but I just made eye contact with Lisa and Lisa would give me you know nice feedback and she would help me. So you know maybe on a lower level just grab your friend, go out for coffee and maybe go to a busy restaurant. Michelle: That’s interesting what I find when I give speeches is I look at the back of the room. I don’t look at any of the people I lean towards the back of the room. Gabe: That’s what I do. Well depending on where I’m at, I either look at the back of the room or I look at the middle of the room. I’ve decided that I can gather more data on how I’m doing as a speaker by looking at the middle because see the back they’re sitting in the back because they don’t care. They didn’t care the minute they sat down. The people on the front are way too enthusiastic. They’re so excited. They sat up front so they’re going to love you no matter what you do. You can holler at your boy come out like a boxer and fall over and they’re going to love you. But the middle of the room, they’ve decided I don’t know how I feel about this guy. So the middle of the room is usually where I keep my gaze. Michelle: I actually meant the back wall. Gabe: Literally the back wall? Does the wall give you positive feedback, Michelle? Michelle: I just try not to look at the people. They make me anxious. Gabe: Michelle, I love working with you because in spite of your outward projection of confidence it does take work and you are nervous when you do it and you do push through it every day and you know sometimes it doesn’t work out but most of the times it does. And I really like that you don’t beat yourself up when things go poorly even though maybe you should. Michelle: I should? Gabe: Listen only one of us has been thrown off a plane. Thank you everybody for tuning into this episode of A Bipolar, a Schizophrenic, and a Podcast. If you liked this show, please share it on social media. Head over to iTunes, Google Play, Stitcher or wherever you found this and leave us a review. Actually type words. For some reason the internet likes the words. And finally you can go to PsychCentral.com/BSP. Look for a little logo that says ask us questions, click on it, and ask us questions and we might use it for future episodes. We will see you next time. Announcer: You’ve been listening to A Bipolar, a Schizophrenic, and a Podcast. If you love this episode, don’t keep it to yourself head over to iTunes or your preferred podcast app to subscribe, rate, and review. To work with Gabe, go to GabeHoward.com. To work with Michelle, go to Schizophrenic.NYC. For free mental health resources and online support groups, head over to PsychCentral.com. This show’s official web site is PsychCentral.com/BSP. You can e-mail us at show@PsychCentral.com. Thank you for listening, and share widely. Meet Your Bipolar and Schizophrenic Hosts GABE HOWARD was formally diagnosed with bipolar and anxiety disorders after being committed to a psychiatric hospital in 2003. Now in recovery, Gabe is a prominent mental health activist and host of the award-winning Psych Central Show podcast. He is also an award-winning writer and speaker, traveling nationally to share the humorous, yet educational, story of his bipolar life. To work with Gabe, visit gabehoward.com. MICHELLE HAMMER was officially diagnosed with schizophrenia at age 22, but incorrectly diagnosed with bipolar disorder at 18. Michelle is an award-winning mental health advocate who has been featured in press all over the world. In May 2015, Michelle founded the company Schizophrenic.NYC, a mental health clothing line, with the mission of reducing stigma by starting conversations about mental health. She is a firm believer that confidence can get you anywhere. To work with Michelle, visit Schizophrenic.NYC. View the full article
  23.  Most people suffer from certain social anxieties. Just the idea of speaking in front of a crowd can make otherwise confident people break into a nervous sweat. Fear of rejection is also very common in society… just ask any teenager who’s too afraid to ask out their crush. In this episode, we talk about these common feelings from the perspective of having additional mental illness thrown in, creating a blend that is no one’s favorite. SUBSCRIBE & REVIEW “You’re afraid of being humiliated. You’re afraid of what you just said.” – Michelle Hammer Highlights From ‘Social Anxiety’ Episode [2:00] Where are you from? [4:30] Social anxiety and the big city. [8:00] Talking to important people is scary. [10:30] Overthinking your whole day when you go to sleep at night. [12:30] Delusions about the past. [16:00] How can you be content with the past? [18:00] Putting rejection in your own control. [23:30] Google says people of our ages shouldn’t have social anxiety, anymore. [24:00] How we get rid of anxiety and public speak! Computer Generated Transcript for ‘ Social Anxiety, Delusions, Rejection, and Mental Illness!’ Show Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you. Announcer: For reasons that utterly escape everyone involved, you’re listening to A Bipolar, a Schizophrenic, and a Podcast. Here are your hosts, Gabe Howard and Michelle Hammer. Gabe: Hi, everyone, you’re listening to A Bipolar, a Schizophrenic, and a Podcast. My name is Gabe Howard and I live with bipolar disorder. Michelle: Hi. I am Michelle Hammer and I’m schizophrenic. Gabe: Straight up schizo. Straight out of Compton. Michelle: That’s right. Yeah, totally out of Compton. Straight out of New York. That’s right. Gabe: Right out of New York. Well you were. You were born and raised in New York City, right? Michelle: Not technically. Sure. Well I mean, close enough. Gabe: Most people, when they’re not something, they don’t claim it. But there’s a few things that if you’re close enough, you’re like, “Oh yeah, I’m from New York City.” So you’re not from New York City but you tell everybody that you are. Michelle: Well, I currently live in New York City. And if I explained, “Well, I’m actually from the first county right above the city, not far from the Bronx. So if I drive about 20 minutes I enter the Bronx which, so if you really want to get technical, I’m very close but not technically New York City. Some people would call it upstate. Some people would say it’s not upstate if you’re from where I’m from. It’s an argument that we have a lot. Gabe: Because people from New York City think that you’re a poser. Michelle: No. They would say I’m from upstate. Gabe: But not from New York City? Michelle: Right. Gabe: So Schizophrenic NYC should actually be Schizophrenic upstate New York? Michelle: Not now, because it exists in the city. Because I live in Astoria, Queens now and exists and sells all the merchandise in New York City. Gabe: This is extraordinarily complicated. Michelle: I don’t really think it’s that complicated, Gabe. And I don’t know why you are so confused about where I live because I live in Queens, which is one of the five boroughs of New York City. Gabe: So it’s schizophrenic dot Queens? Michelle: Queens is part of New York City which is NYC. Do you get it now? Gabe: Are you the King of Queens? Michelle: No I’m not the King of Queens. Gabe: Michelle, today we are talking about social anxiety and the reason that we went through this godawful exercise is because every time we meet people, one of the kind of the social questions that people always ask is you know “where are you from?” I mean they start with your name and then where are you from? Michelle: Yes. Gabe: You have it much worse than I do. No matter where you go in the country, people feel that they understand New York City because of television and movies etc. Michelle: Yeah. Oh yeah. And then they tell me. “Oh I visited New York City. I was in that area. Oh, it was by this. Do you know that I rode the subway one time? It was very dirty.” And I’m like, “Oh, yes. Yes, yes, subways are dirty, yes. Yes, oh.” “Oh I was there 20 years ago.” Well you know I wasn’t there 20 years ago so I really can’t tell you about it what it was like 20 years ago. I’m sorry. I don’t know much at all. Gabe: I’m like “I’m from Columbus” and they’re like, “we don’t give a shit.” Michelle: Yeah. I was watching you on a Facebook Live and you’re like, “Yeah I’m from like a really big city,” and stuff and I’m like you’re telling it’s big? You’re from Columbus. Stop saying that, Gabe. Gabe: It’s the 14th largest city in the country. Michelle: 14th? 14th? It’s not even top ten. So stop saying that. 14th. Don’t be proud of that, Gabe. Gabe: But it just, it’s a big city. Michelle: You walk out of your house, how long does it take you to get to a store? To get to a store walking? Gabe: Walking? Well, I don’t know because I’m never going to walk. Michelle: Exactly. Because it’s that far. Because it’s that far. I know how long it takes me to get to any kind of establishment. Moments. I walk out my door, less than 30 seconds. Gabe: But in my old apartment, that I called my pod, in 30 seconds I’d be within a whole bunch of places. I lived there on purpose because I wanted to be able to walk to the pizza place the gas station etc. I know you called gas stations bodegas, I apologize. Michelle: No, and gas stations are not bodegas. You will never understand the concept of what a bodega is, Gabe. Gabe: It is true. I never will. But interestingly enough, you feel like you suffer from social anxiety and I feel like I suffer from social anxiety which makes a lot of people confused because they can’t figure out how to people as lively and. Michelle: And boisterous? Gabe: And boisterous and loud as Gabe and Michelle can be anxious in social situations. And that goes an extra step for you because people are like my god you live in the biggest city in the country and like you said you walk outside and you’re at an establishment. So you can’t get away from people. Michelle: You know having like social anxiety is kind of like thinking it’s almost a little bit like paranoia? That you’re nervous to be around new people cause you don’t know what people are really going to say. But when you live in New York City, you can say something to somebody and if it’s stupid you’ll probably never see that person ever again. So it doesn’t really matter. Gabe: And you feel that this is why it helps? Like it’s that anonymity that makes you feel good? Whereas in when we’re at a conference or when we’re giving a speech somewhere everybody knows your name. Michelle: Exactly. Gabe: They’re like. Michelle: And that is so much more nerve wracking. Gabe: Because if you make a mistake. Michelle: Everybody knows who I am. Gabe: Everybody knows that Michelle Hammer is the one that accidentally said fuck off on stage when she was at the Catholic college. Michelle: Yes. But I never actually did that, he just made that up. Gabe: That was a lie. That one’s a lie. Michelle: Yeah that’s the lie. Gabe: Later in the episode I will tell the truth and you will know it’s a truth because Michelle will not say a word. But that actually did happen to a colleague. He said fuck on stage and like everybody went nuts and he was just like Why? Why is this a problem? And he wasn’t embarrassed by it because I just don’t think he has the ability to get embarrassed. But he obviously didn’t think that it would offend anybody and it did. So now he’s kind of back on his heels apologizing for a comment that was just a throwaway comment to him and that’s kind of how you and I feel. To us, we’re just like up on stage saying something. But if the audience hears it wrong or feels about it wrong or we just slip up and say something that maybe you know just I really like the fuck example because we can say fuck in New York City and nobody is gonna care. Michelle: But oh you don’t you don’t even know the things I’ve overheard people say in your city right it’s hilarious. There was once a website called Overheard in New York and it was just all of these conversations was that were ridiculous that people overheard in New York. Gabe: But if you get hired in let’s say like a very conservative state you know like a Mormon college in Utah you’re not going to swear right? You’re gonna put on? Michelle: Oh oh no no no. Well, I mean, that would be hilarious if I got hired at a Mormon college. If any Mormon colleges would like to hire me, letting you know I’m available. Gabe: And she promises not to swear. Michelle: And I will not swear a word. Or drink soda or coffee or you know all that Mormon stuff. That’s like all I know about it. I’ve known one Mormon my entire life. She was a very nice girl. She was sweet, loved her. But that would be really funny. So Mormons, hit me up. I will not swear. Gabe: So that that’s what I mean though. You know that you can swear in New York City no problem right. Michelle: Pretty much, as long as the you know it’s not children around. But I mean I mean many many times I’ve cursed in front of children that I’m like oh there’s a child. Gabe: And the child probably corrects your swear. Michelle: And tells you the new well they look at you with a dirty look like Mommy, that lady just said a bad word. Gabe: I can see that’s like mommy that bitch just swore. Wait, what? But so that’s what I mean though. New York City you can swear Utah don’t swear. It’s the middle ground, it’s the middle ground that messes us up. Where we’re not sure so we don’t get how to behave and that’s where the nervous comes in, right? Michelle: Exactly. Sometimes you just don’t know what the right social norm is so you don’t know how to act or who to talk to or who’s maybe you’re like is that person really important? Wait what’d did I say to them. Maybe I said something stupid to them and then you’re all anxious because of that and then you’re like you want to go talk to somebody else and somebody you know interrupts you and you want they want to really talk to you but you don’t want to talk to them at all. But then you realize that you really messed up and should have spoken to that person in the first place. Gabe: Exactly. And it’s not because you’re sucking up to big names or you know brown nosing or kissing ass. It’s because maybe that’s the person who hired you. Because we don’t know what a lot of these people look like. You know, we can get hired over e-mail and phone we’re like Oh Julie thank you we’ll send over the contract. They know what we look like because they’ve seen our headshots they’ve seen us on social media. We never know what they look like. Michelle: Never. Yeah never. People have come to my pop up shop. Hi it’s so nice to finally meet you. Hi. You too. Who are you? Exactly. Gabe: But then they get and then sometimes they’re like Oh I understand you meet a lot of people this is your job. You travel around and but other times they’re offended. They’re like we hired you. We’ve talked on the phone a lot. This is what causes my social anxiety. I’m not worried about purposely hurting somebody’s feelings because I’m a really nice guy. I’m worried about the accident. The misunderstandings. Michelle: The accidents? Gabe: Yeah. Michelle: You know I kind of looked up the definition of social anxiety and it just said symptoms may include excess fear of situations and one in which one may be judged. Worry about embarrassment or humiliation or concern about offending someone. So it really is to me it seems like paranoia to me doesn’t it? Gabe: I guess it’s not paranoia though because it isn’t like paranoia or worse like yours I guess. Michelle: Yeah yeah yeah. Gabe: Like your mom is trying to kill you. Then your roommate is trying to kill you. Then Gabe is trying to kill you. Michelle: I guess but it’s sort of like a social kind of a paranoia and in a sense like that. You know you’re afraid of being humiliated. You know you’re afraid of what you just said. You’re afraid of how you’re acting or did you act well. It’s just kind of dwelling on things after they happened because you don’t know if you did the right thing. Let’s take a quick break and hear from our sponsor. Announcer: This episode is sponsored by BetterHelp.com. Secure, convenient, and affordable online counselling. All counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist, whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face to face session. Go to BetterHelp.com/PsychCentral and experience seven days of free therapy to see if online counselling is right for you. BetterHelp.com/PsychCentral. Michelle: And we’re back talking social anxiety. Gabe: I really like what you brought up there, Michelle. The dwelling. Do you ever like after the event is over after the conference day is over after the speech is over whatever. Do you lay awake at night and replay the entire day in your head looking for mistakes? Michelle: Oh yeah yeah yeah yeah but the thing is I go delusional. I think about the day and then I start making lies up about the day. Then I start believing the lies about the day and then I just go crazy. Gabe: Wow that’s what’s your like coping mechanism for that? I do part of that. You know before I was treated before I got you know lots of therapy and lots of medication and lots of help. I did that exact same thing. One of the things that really helped me was you know therapy and medication it really helped tamper down those delusions to the point where I don’t have them anymore. So when I spiral out of control it’s all I was talking to Jane and I told Jane that she looked very nice today and then I think Jane looked to the left and I know that looking to the left means that gee I offended Jane. Oh my God I shouldn’t have said that she thinks I was hitting on her. Oh I didn’t mean to hit on her. Oh my God she thinks I’m a creepy pervert what’s going on. And I start to feel really really bad like I owe Jane an apology. In the old days I would have sent Jane this rambling e-mail that made absolutely no sense and just really caused a lot of problems. New Gabe just sits on it and does nothing because I don’t want to sound like a crazy person. But you believe that it’s true. So now you wake up and you no longer are curious as to whether or not you sexually harass Jane. You believe that you did it sometimes. Michelle: Sometimes I do believe. Sometimes I’m not sure and I’m confused but then I try to verify things with people. I ask friends, ask people who are there. I try to set up a timeline. Does the things that really did happen that way or if they didn’t happen that way because sometimes the conversation that I have with somebody I changed the entire conversation to something else completely. So I tried to figure out what is real. What makes sense, what was actually happening. But what’s worse about is that it had a sometimes that delusions they’ll happen for things that happened years ago that I can’t verify if they’re real or not. So what am I supposed to do then? Gabe: Like maybe the reason that you lost touch with your friend Bob isn’t just because time marches on and Bob got a job and had a couple of kids. Maybe you offended Bob? Michelle: You never know. Who knows? I never I never know things. Things just make up their own stories and things don’t make any sense anymore. And I don’t know what’s real. I don’t know what’s happening, but I don’t know. Gabe: When we talk about social anxiety and I don’t know how we got on this but this is social anxiety because this is one of the reasons that you’re so nervous to talk to people because you’re nervous that you’re afraid that you’re gonna make a mistake but then you’re nervous that you’re gonna think you made a mistake and then dwell on it and it’s going to ruin the next day. This is the spiral that happens to me and a lot of people with social anxiety even if we don’t mess up during the event that we were worried about we’ve convinced ourselves later on that we always made mistakes. Michelle: Yeah we’ve made tons of mistakes. Gabe: I really like what you said about checking in with the people around you as you know that’s something that we do to each other a lot. I’ll ask you when we get off stage. Hey did you think that went OK? You’ll ask me Hey did I do a good job? And we kind of have a little you know like decompress or you know we just kind of go over everything together. Now we trust each other. Michelle: You’re right. Gabe: Michelle trusts Gabe. Gabe trusts Michelle. But what if you don’t have a person that you trust because you know people could exploit this a lot. You know it’s a cut through a world out there. You can’t just ask a random panelist Hey did I do ok? Because maybe that panelist wants your job so they’ll be like, I don’t know Michelle. You offended a bunch of people. You really sucked. Michelle: Wow. Yeah you’re right about that one. Gabe: But maybe they’re telling the truth. Maybe you did suck. How do you know when to trust people and when they’re not? Like isn’t that another whole layer? Michelle: I mean sometimes I just have confidence. And if somebody tells me I did a bad job I’m just that bad mostly let me just make me angry and I’d be like I did better than you. Gabe: And on one hand that kind of confidence is good but you can’t just ignore people who give constructive criticism or you’ll never improve. Michelle: But is that constructive criticism? If I ask somebody next to me and they’re like no, I think you did really bad. Gabe: Well it’s not constructive but it could still be true. Michelle: I don’t know. I’ve been on panels before and I mean based on questions coming to me. Questions from the audience stuff like that. You can base it on that. I mean if you’re getting more questions from the audience and the rest of the people don’t you think you’ve done better? Gabe: Well maybe except that as you know some of the most viral videos in the world are of people failing. That doesn’t mean you did a good job just because a ton of people are watching you get hit in the nuts or falling off a bike. Michelle: Well I understand that. But the questions aren’t negative. The questions are because they’re interested and they want to learn more. But Gabe: But you. You said earlier that you have a problem running it through accurately. You’re like I was asked four questions that were very positive that were very interesting for me. I would say that part was good but my answer sucked that. Michelle: That can happen, that can happen. I think like I should have said this instead I should have said that. T is what I should have done there. This is what I should have done there. But use it in a more constructive way for next time trying to turn all the delusions into more a positive way. It’s when I can’t turn the delusion off it inches anything positive out of that way. It just makes me go argh, when you can’t change the past that you really want to change. Gabe: And of course we still have to go on to the next gig. Michelle: Yes. Gabe: So it doesn’t matter how badly we feel about the last one and or whether it’s true or false you’re only as good as your next gig. That’s the life of everything our podcast is only as good as our previous episode. Our writing is only as good as our previous writing. Your clothing line is only as good as your last piece of art. Wouldn’t it be great if we could just make one podcast or just be famous forever or give one speech and just live off the residuals for life? Even Friends had to make what over 200 episodes over a decade? If that show would have started to suck in the middle, it would’ve just gotten canceled. It would’ve been the Drew Carey Show. It started off hot fizzled right out. But it didn’t. It stayed good. How do we stay good? Michelle: How do we stay good? Confidence. Gabe: How do we stay confident. Michelle: For every negative thing we think we have to say three positive things about ourselves. Gabe: Excellent. I know for a fact that you are thinking something negative about me right now. So now you, Michelle Hammer, have to say three positive things about me. Michelle: I would say in self reflection. In self reflection all. Gabe: So you can’t even think of three positive things to say? Michelle: No. I know you’d interpreted it in the wrong way in yourself. If you think something negative by yourself then you have to say three positive things about yourself. Not me about you but you about you. Gabe: Let’s say that I can’t think of three positive things and I say to my friend Michelle, man I can’t think of three positive things about myself. Will you help me? What would you say? Gabe: You are not bald. You are very tall and you have a lovely wife and dog. Gabe: The three positives about Gabe. I am not bald. I am very tall and I have a lovely wife and dog. Michelle: What are you looking for? Gabe: Honestly Michelle that might have been perfect. A conference that I was at recently you know it didn’t go so well. I know that it was not the best it could be. So just establish that as a baseline fact and this is one of those conferences that you have to apply for. And now because of that I can’t apply next year because if I apply next year and I don’t get in I will go back another whole year and decide the reason that I didn’t get in is because of what happened and I can’t live with that. Like that’s just too much anxiety that’s too much pressure that’s too much stress. So to save myself all of that I’m just not going to apply. And now the reason that I didn’t get in is because. Michelle: Yeah it’s under your control. Gabe: Right. Sometimes it’s worth it to risk the rejection. You know what I asked you if you wanted to host this podcast with me and you said no that was worth it. And then when I circled back a month later and gave you more data to why I thought this would be a good idea. That was worth the risk. And even if you would have said No I would’ve felt good about it. But sometimes I just can’t risk the rejection and this is one of those examples of where it’s just not worth it for me if I get in. I’ll be like Oh yay. They still love me but if I don’t I’ll spend the rest of my life thinking Man I fucked it up so bad and I can never recover from it and that will seep into other areas. Michelle: No, I completely understand. I feel the same way, too. So many times I’ve gotten emails like Oh we’re looking for a speaker. Please send us your rate and everything. I send them my rate, and then crickets. I never hear back. Gabe: One of the things that helps me with that is I learned that the average person gets three quotes for a speaker which means that they may have rejected me but they also rejected somebody else statistically. Also I always write this lovely letter back. Thank you so very much. I completely understand. Please keep me in mind for next year. I’m very easy to work with. I understand that you went a different way. And then I kind of put him in my calendar to follow up with next year because I believe from a sales cycle standpoint that there is no such thing as no. Michelle: Isn’t that really how you found out who I was? Somebody asked you about like two different schizophrenic advocates? And you had to choose between the two and I was the one that didn’t get it. Gabe: Yes you didn’t get it. Michelle: But, I got you. I got you. I didn’t get this speech but I got you. Gabe: I think it worked out. Michelle: Yeah, it worked out. And that girl that got the speech, she wasn’t even schizophrenic. Gabe: What the hell? They hired a non schizophrenic for a speech? Michelle: She just had a schizophrenic mom. Oh it’s so terrible having a schizophrenic mom. Living with a schizophrenic is so terrible let’s hear about that let’s not hear about it from a schizophrenic person. Gabe: I mean in fairness when you stay at my house for four days it’s pretty awful. I don’t think that has anything to do with your schizophrenia. It might have to do with your sloppiness and your crazy. Michelle: But seeing your dog is crazier than me. Gabe: That’s true my dog still carries around your sock. Michelle: Yes seriously I don’t carry my socks in my mouth. Gabe: Wouldn’t it be funny. I do realize this isn’t true but since you brought up the dog. After you leave, my dog always finds one of your socks. I don’t know how this happens I don’t know if it gets slipped under the bed or whatever. But he carries around the damn sock and we just let him because we don’t care. But I have this idea in my head that all the way back in New York City, Michelle is carrying around some dog toy of Peppy’s and the two of you are just like cosmically connected. Are you carrying around Peppy’s tennis ball? Michelle: Not that I’m aware of but now that I know about this I’m going to take something of his. I have a lock of his hair, actually. Gabe: You do not. Michelle: I do, I have a lock of his hair in my locket. Gabe: In your locket? You don’t even have a locket. Michelle: How do you know? Lockets are still in style. Gabe: No they’re not. Even Blanche would say Oh honey. Michelle: Blanche bought me a locket when I was little. It was real gold then I bit it. Gabe: It’s been so long since we’ve referenced Blanche. You realize that new listeners have no idea who we’re talking about. Michelle: Blanche was my grandmother. Gabe: And she was the best grandma. Michelle: She was a good grandma. She told me save a penny here, save a penny there. Then next thing you know you got a dollar. Gabe: Blanche loved me. She said that of all of Michelle’s friends, I was her favorite. Michelle: You never met Blanche. Gabe: But she would have said that. Michelle: Well, she would’ve only liked you if you were in a union. Gabe: My father was in a union. Michelle: OK. We can stop talking about this because it’s uninteresting. Gabe: It very much is yes. All right we need a closing. Michelle: What I see about social anxiety on line is that it starts during the teenage years and it gets better as people get older. So apparently we still have social anxiety when Google says we shouldn’t. Gabe: Well Michelle: So Google. Gabe: Doctor Google knows best. Michelle: Apparently Google knows best and we’re not supposed to have that same social anxiety because we’re too old for it. Can it be cured? There is no cure says Google. Gabe: There’s now cure for schizophrenia bipolar depression etc. But, Michelle, sincerely we both suffer from social anxiety yet we do this job. We get out there in public. What is the message that you want to give somebody who’s listening to this and their social anxiety is so bad at the moment that they are unwilling to leave the house or they’re unwilling to even like you know go to McDonald’s or Starbucks and get a Diet Coke or a cup of coffee. Because a lot of our listeners they think that we don’t suffer from this stuff because they see us out there. They don’t know that we’ve just managed to push through. What is your number one tip for somebody to push through that social anxiety and get to the other side? Because let’s face it, we do adore being on that stage. We do love meeting people. It can be hard for us but it is worth it because we love it a lot. Even you and you hate everything. Michelle: You know it is hard and a lot of people ask me like how do you get on stage and talk. It seems so nerve wracking. People say they’d be so nervous. It makes me nervous. Sometimes you just take a deep breath and go for it and that’s how I get on stage and do the thing and almost if you pretend that you really know what you’re talking about people will believe you really know what you’re talking about. You just have confidence if you believe in yourself and you believe what you’re saying and everything that you’re doing is the right thing. It can be OK if you don’t leave your room, if you’re only in your house, there’s always the internet. You can speak to people online. Baby steps. Gabe: It is fake it until you make it, right? Michelle: Fake it till you make it. Gabe: And I really like the buddy system. I understand that if you’re kind of a shy person and you have anxiety you have social anxiety that you wouldn’t want to go out alone because being in a roomful of people where you know nobody that’s scary. So you know bring along somebody. Before I met Michelle I brought my friend Lisa and she was always very helpful. In fact some of my first speeches I just gave them to Lisa. There was a whole bunch of other people in the room but I just made eye contact with Lisa and Lisa would give me you know nice feedback and she would help me. So you know maybe on a lower level just grab your friend, go out for coffee and maybe go to a busy restaurant. Michelle: That’s interesting what I find when I give speeches is I look at the back of the room. I don’t look at any of the people I lean towards the back of the room. Gabe: That’s what I do. Well depending on where I’m at, I either look at the back of the room or I look at the middle of the room. I’ve decided that I can gather more data on how I’m doing as a speaker by looking at the middle because see the back they’re sitting in the back because they don’t care. They didn’t care the minute they sat down. The people on the front are way too enthusiastic. They’re so excited. They sat up front so they’re going to love you no matter what you do. You can holler at your boy come out like a boxer and fall over and they’re going to love you. But the middle of the room, they’ve decided I don’t know how I feel about this guy. So the middle of the room is usually where I keep my gaze. Michelle: I actually meant the back wall. Gabe: Literally the back wall? Does the wall give you positive feedback, Michelle? Michelle: I just try not to look at the people. They make me anxious. Gabe: Michelle, I love working with you because in spite of your outward projection of confidence it does take work and you are nervous when you do it and you do push through it every day and you know sometimes it doesn’t work out but most of the times it does. And I really like that you don’t beat yourself up when things go poorly even though maybe you should. Michelle: I should? Gabe: Listen only one of us has been thrown off a plane. Thank you everybody for tuning into this episode of A Bipolar, a Schizophrenic, and a Podcast. If you liked this show, please share it on social media. Head over to iTunes, Google Play, Stitcher or wherever you found this and leave us a review. Actually type words. For some reason the internet likes the words. And finally you can go to PsychCentral.com/BSP. Look for a little logo that says ask us questions, click on it, and ask us questions and we might use it for future episodes. We will see you next time. Announcer: You’ve been listening to A Bipolar, a Schizophrenic, and a Podcast. If you love this episode, don’t keep it to yourself head over to iTunes or your preferred podcast app to subscribe, rate, and review. To work with Gabe, go to GabeHoward.com. To work with Michelle, go to Schizophrenic.NYC. For free mental health resources and online support groups, head over to PsychCentral.com. This show’s official web site is PsychCentral.com/BSP. You can e-mail us at show@PsychCentral.com. Thank you for listening, and share widely. Meet Your Bipolar and Schizophrenic Hosts GABE HOWARD was formally diagnosed with bipolar and anxiety disorders after being committed to a psychiatric hospital in 2003. Now in recovery, Gabe is a prominent mental health activist and host of the award-winning Psych Central Show podcast. He is also an award-winning writer and speaker, traveling nationally to share the humorous, yet educational, story of his bipolar life. To work with Gabe, visit gabehoward.com. MICHELLE HAMMER was officially diagnosed with schizophrenia at age 22, but incorrectly diagnosed with bipolar disorder at 18. Michelle is an award-winning mental health advocate who has been featured in press all over the world. In May 2015, Michelle founded the company Schizophrenic.NYC, a mental health clothing line, with the mission of reducing stigma by starting conversations about mental health. She is a firm believer that confidence can get you anywhere. To work with Michelle, visit Schizophrenic.NYC. View the full article
  24. It’s very common for Kristin Bianchi’s clients to tell her that they’re feeling anxious, but they’re not sure why. They say they recently haven’t experienced anything particularly stressful or anxiety provoking, so it doesn’t make much sense. Consequently, “they frequently become worried about the meaning behind these seemingly random feelings of anxiety,” said Bianchi, a licensed clinical psychologist who specializes in treating OCD, anxiety disorders, PTSD, and depression at the Center for Anxiety & Behavioral Change in Rockville, M.d. In other words, she noted, “they become worried about worrying, or frightened of fear.” When many of Regine Galanti’s clients initially start working with her, they, too, describe their anxiety as just happening. Galanti is a licensed psychologist and director of Long Island Behavioral Psychology, where she specializes in using evidence-based treatments for anxiety and related disorders in children, teens, and adults. Many of us believe our anxiety comes out of the blue. It just feels so random and sudden—startling us like the siren of a smoke alarm, or a squirrel jumping out of the bushes. But this is rarely the case. Rather, we simply don’t notice our triggers. What we do notice is our anxiety, because it tends to be blaringly, glaringly loud. “When we feel something strongly, we often zero in on it and discount all the information leading up to and surrounding it,” Galanti said. And the information that leads up to your blaringly, glaringly loud anxiety might be a thought, feeling, or behavior. Galanti noted that anxiety, and really all emotions, consist of those three parts. For instance, you might feel horribly anxious the morning after going to sleep past midnight, she said. You might become anxious as you notice your heart beating faster, she said. Bianchi noted that it’s very common not to recognize that our thoughts are a significant trigger. “Thinking happens so quickly and automatically that we often don’t realize that we’re having stressful dialogues or creating catastrophic narratives in our own heads.” For instance, she said, you might not even realize that you’re revisiting a recent conversation that caused you some stress. Maybe you’re replaying how your coworker was gossiping about your boss, which made you very uncomfortable. Maybe earlier this morning you and your spouse fought over your monthly budget (or lack thereof). Maybe your mind drifted to the sarcastic remarks your date was making (and how annoying they were). The catastrophic narratives your head is spinning might include: “wondering whether or not you turned off certain household appliances, then imagining your house burning down if you forgot to do so; worrying that something bad will happen to a loved one, then imagining your reaction if that type of personal tragedy were to occur; creating ‘worst-case scenarios’ involving academic, career, or financial ruin when thinking about a recent disappointment or setback in any of those domains,” according to Bianchi. Panic attacks also are a prime example. They seem sudden, but there are usually specific triggers, Galanti said. It might be a thought, “I can’t easily escape this situation,” or a physical sensation, such as your heart rate speeding up, she said. And then there’s our digital culture. “We reflexively hop from tab to tab, app to app, and website to website, generally giving very little thought to the process,” Bianchi said. But while we might not notice that we’re doing all this hopping and scrolling, we’re still responding emotionally to what we’re consuming, she said. That means that we are responding emotionally to sensationalist news headlines, flawless Instagram images, and emails from colleagues and clients, all of which can trigger anxiety. However, we’re too hyper-focused on these stimuli to notice what’s brewing inside our bodies. “Even low-level anxiety reflects that we’re experiencing a fight-or-fight response,” Bianchi said. “When we finally notice it, it can come as a surprise to us, as we hadn’t been paying attention to it up until that point.” So what can you do? What are your options when your anxiety seems to arise out of the blue? Below, you’ll find a few tips on identifying your triggers—even the subtle ones—and reducing anxiety when it starts. It’s especially helpful to practice the relaxation strategies when you’re not anxious. This way you’re familiar with them, and maybe even created a habit. Act like a scientist. Galanti tells clients that the goal is to help them treat their anxiety like a scientist: to “take an outsider perspective on their insides.” To do this, she suggested readers use a journal or the notes section on your phone to record your anxiety. That is, whenever you feel anxiety coming on, she said, ask yourself, “What just happened?” “literally, what happened immediately before and then try and pinpoint [your] thoughts, physical feelings, and what [you] do.” Maybe you downed a huge cup of coffee. Maybe you thought about your to-do list. Maybe your thoughts shifted to your child’s first big presentation. Maybe you read an email from your boss. Maybe you said yes to an invitation (that you really, really didn’t want to accept). Maybe you started sweating because it’s so hot. Tracking what triggers your anxiety helps you to spot patterns, and “those patterns can help people come up with solutions,” Galanti added. Slow down your breathing. Bianchi suggested “breathing in slowly through your nose to a count of 4 to 6 seconds, holding your in-breath for 1 to 2 seconds, then slowly breathing out through your mouth to a count of 4 to 6 seconds.” When you’re breathing out, it helps to “imagine that you’re blowing fuzz off a dandelion or blowing a stream of bubbles,” she said. Practice this grounding technique. According to Bianchi, find five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste. “This shifts our focus away from the anxiety and helps us to reconnect to the present moment using our five senses.” Practice progressive muscle relaxation. This involves scanning your body for muscle tension, and then “unclenching” tight muscles to release that tension, Bianchi said. “When doing this, it’s important to remember to relax your jaw, open your mouth slightly, and make sure that your tongue is positioned at the bottom of your mouth (versus flexed against the roof of your mouth).” You also can use an app that offers a guided practice, such as Headspace; Stop, Breathe, and Think; and Pacifica, Bianchi said. Face your fears. Avoidance only amplifies and strengthens our anxiety. Facing your fears, a skill known as “exposure” in cognitive behavioral therapy (CBT), is incredibly effective in reducing anxiety. Galanti suggested devising a list of small steps to help you face your triggers. For instance, she said, if caffeine triggers your anxiety, you might “start drinking a little bit of coffee a day, and see what happens. Even if you do feel anxious, maybe you can handle it better than you think you can.” Another option is to work with a therapist who specializes in treating anxiety with CBT or other successful treatments. Bianchi suggested starting your search at a professional organization, such as https://adaa.org, and http://www.abct.org. Anxiety can sometimes feel like it has zero rhyme or reason, which can be exceptionally frustrating. It can feel like you’re going about your business, and BAM! an object falls from the sky and smacks you on your head. But when you delve deeper, you realize that there’s a thought, feeling, or behavior that sparked that bam! And that’s valuable information. Because now you can focus on the root of the issue and try to resolve it, whether that’s a conflict with a loved one, difficulty saying no, the fear of fear, not enough sleep, or something else altogether. View the full article
  25. Some days you feel well, and other days, darkness envelopes you. You feel achingly sad, or you feel absolutely nothing. You’re exhausted, and every task feels too big to start. You feel weighed down, as though there are sandbags attached to your shoulders. Managing the symptoms of depression can be hard. But even the smallest steps taken every day (or on most days) can make a significant difference. Below, you’ll learn how five different women live with depression on a daily basis, and the small, yet pivotal actions they take. Having a daily routine. “Having a daily routine helps me push through the days when I’m not feeling my best,” said Denita Stevens, a writer and author of the recently released poetry collection Invisible Veils, which delves into her experiences with depression, anxiety, and post-traumatic stress disorder (PTSD). Stevens’s routine starts at night with two morning alarms: one alarm is optional, the second one, which rings around 7 a.m., is not. “I take a moment to gauge how I’m feeling before deciding which one I wake up to.  Sometimes I don’t always have a good night’s sleep and an extra hour of rest helps.” When she’s up, she drinks coffee and reads. Then she focuses on work. The evenings are dedicated to personal time. This “gives me motivation to accomplish what I need to do during the workday in a timely manner and allows me to end the day investing my time in myself,” Stevens said. This me-time might mean socializing, exercising, relaxing, or working on a writing project—right now she’s working on a memoir about what it was like to live with undiagnosed PTSD and how she recovered. On weekends, Stevens doesn’t have a schedule. “A balance between scheduled and unscheduled time every week seems to work best for me,” she said. Setting boundaries. “Setting boundaries is extremely important to my mental and emotional well-being,” said T-Kea Blackman, a mental health advocate who hosts a weekly podcast called Fireflies Unite With Kea. For instance, Blackman has set her phone to go into “Do Not Disturb” mode every night at 9 p.m., because she wakes up at 4:45 a.m. to exercise. “Working out has been beneficial as it helps to improve my mood and I sleep much better.” Going to bed around the same time and waking up around the same time helps her get consistent rest. “When I am not well rested, I am unable to function throughout the day.” Exercising. “I make myself exercise even if I don’t feel like it,” said Mary Cregan, author of the memoir The Scar: A Personal History of Depression and Recovery. “If my mind is troubling me, I’ll try using my body instead.” If Cregan’s energy is really low, she goes for a walk. And these walks have a powerful benefit: She gets to see other people—“little kids in playgrounds, old people walking with their shopping bags, teenage girls all dressed alike. People can be interesting or amusing, and help me get out of my own head.” Cregan, who lives in New York City, also likes to walk along the Hudson or around the reservoir in Central Park, and admire the water. She likes to look at the plants and trees, too. “If the sun is out, I’ll sit on a bench with the sun on my face.” Tidying up. Cregan also regularly makes her bed and cleans up the kitchen. This way, she said, “things don’t feel messy or ugly, because that would be depressing in itself.” Sometimes, she buys flowers for her home, since looking at them cheers her up. Having downtime. Blackman prioritizes downtime to help her unplug and recharge. Sometimes, this looks like listening to water sounds—waves crashing onto the shore, water hitting the rocks—and putting on her essential oil diffuser as she listens to a podcast or reads a book. Other times, it looks like lying in bed and letting her mind wander, as she listens to the water sounds and breathes in the essential oils. Wearing comfortable clothes. Fiona Thomas, author of the book Depression in a Digital Age: The Highs and Lows of Perfectionism, regularly tunes into her inner dialogue. When she notices the chatter is negative—“you’re so lazy”—she decides to actively challenge the voice and be kind to herself instead. “One small way that I’m kind to myself every day is by wearing clothes that I feel comfortable in as opposed to what I think people expect me to wear. If I want to wear leggings and a baggy jumper to the supermarket, then I do it.” Creating small moments of self-care. Another way that Thomas is kind to herself is by going out for coffee, or taking several minutes to stand by a canal and watch the ducks go by. Practicing self-compassion. In addition to depression, Leah Beth Carrier, a mental health advocate working on her master’s in public health, also has obsessive-compulsive disorder and PTSD. When her brain tells her that she isn’t worthy, doesn’t deserve to take up space, and won’t ever amount to anything, she gives herself grace. “This grace I give myself allows me to be able to hear these old tapes, acknowledge that they are fear based and my fear has a purpose, and then continue to go about my day.” Taking a shower. “I try my hardest to take a shower every day even though I find this really difficult with depression,” Thomas said. “Even if [showering is the] last thing [I do] at night, I know it helps me feel healthier in the long run.” Looking in the mirror. “I have also found that the simple act of looking at myself in the mirror, eye to eye, each morning and making a point to say hello to myself—as silly as it sounds—keeps me grounded,” Carrier said. “It is also a little reminder that my existence here on earth is allowed and OK, maybe even something to be celebrated.” Of course, the specific small actions you take will depend on the severity of your depression, and how you’re feeling that day. The above actions are examples that speak to the power of small. Of course, it’s also vital to get treatment, which might include working with a therapist and/or taking medication. Ultimately, it’s important to remember that the pain isn’t permanent, even though it absolutely feels permanent in the moment. You won’t feel this way forever. “Having lived with depression since I was a teenager, I’ve discovered that even at my lowest points, I can still survive and it will get better,” Stevens said. “It always gets better. May not seem like it at the moment, but those feelings are only temporary.” “I never believed it when people told me it would get better when I was in my darkest days and attempted suicide, but I remained committed to my recovery…,” Blackman said. She’s made various changes, and has seen a huge improvement in her mental health. Don’t discount the power of small daily acts and steps. After all, before you know it, those small steps have helped you walk several miles—a lot more than had you been standing still. And if you do stand still on some days, remember that this is OK, too. Try to treat yourself gently on those days, to sit down, and extend yourself some compassion. View the full article
  26. Phobiasupportforum

    Preventing Youth Suicide: Strategies That Work

    American children are taking their own lives at an alarming rate. Over 7 percent of high school students say they engaged in non-fatal suicidal behavior, while 17 percent say they seriously considered suicide within the previous year, according to a nationwide survey. For children under 15, the prevalence of death by suicide nearly doubled from 2016 to 2017. Considering these sobering statistics, it’s no surprise that suicide has become the second leading cause of death for youth between the ages of 12 and 18. Sadly, many parents don’t recognize the signs of depression in their children until a crisis occurs. It can be difficult to determine the difference between normal adolescent behavior and something far more serious. For National Children’s Mental Health Awareness Day I want to use this opportunity to share strategies that have been proven to decrease suicidality in children and teens. A few years ago a teenage girl named Alyssa* came to me for therapy, along with her family. She described feeling disconnected from her parents, who didn’t understand her interests. She spent a lot of time in her room watching anime, playing video games, and chatting with her friends online. Like many young girls, she had negative experiences with peers at school and felt acute academic pressure. Her parents saw no cause for alarm until they were contacted by a concerned school counselor, in whom their daughter had confided. When they learned Alyssa had thoughts about harming herself, they decided it would be safest to place her in a hospital while they made a plan to address her challenges, which included anxiety and depression. Prevention Is Key Fortunately, Alyssa turned to a trusted counselor for help. For individuals concerned about child suicide, a number of protective factors have been shown to help reduce the risk of suicidal behavior. These include community connectedness, abstinence from drugs and alcohol, close family relationships, strong peer support systems, and regular involvement in hobbies or activities. Joining activities that promote positive self-expression (music, art or drama) or self-efficacy (such as sports or skill-based activities), and continuing them through adolescence, can support building a positive and stable identity, the primary task and stress of teenage years. Other protective factors are more difficult to cultivate. People with a positive self-image, strong problem-solving skills, and the ability to regulate their emotions tend to be more able to cope in times of increased stress. If a child is struggling in these areas, especially while distancing themself from family or friends, it may be time to think about family therapy. Engaging teenagers in therapy isn’t easy, so building a trusting relationship with a mental health professional early for youth with heightened risk factors is instrumental in suicide prevention. Working with youth also comes with a unique set of challenges. They can be more impulsive, have trouble seeing a long-term perspective, and be heavily influenced by their friends and online relationships. These are just a few reasons why it’s important to find a therapist with extensive experience treating youth. The right professional can advise parents on what’s typical versus when to access other services, and how to keep channels of communication open. Trust Evidence-Based Therapies When a child is in therapy for suicidal thoughts or actions, it’s critical to use an evidence-based treatment approach. As a career therapist and Director of Youth Shelter Services at Grafton Integrated Health Network, my team and I rely on the CAMS model. Short for Collaborative Assessment and Management of Suicidality, CAMS was developed over 30 years ago to specifically assess and treat suicidal risk. This method uses a highly individualized approach that allows patients to be actively involved in the development of their own treatment plans. Rather than shaming youth for their suicidal behavior, our therapists take an empathetic and non-judgmental approach, which helps us identify and treat the root causes of the client’s suffering. In randomized controlled trials, the CAMS model has been shown to more accurately assess the need for acute hospitalization and reduce suicidal thoughts. We know this approach works. With the help of a psychiatrist, music therapist, and individual and family therapy using mindfulness and cognitive-behavioral interventions, Alyssa was able to feel more hopeful and connected, while reducing her thoughts of suicide. Her therapy included identifying and working towards positive future goals, improving problematic communication patterns, increasing connection in activities with supportive peers, and following a safety plan. There is no quick fix for youth suicide, but promoting good mental health and seeking professional help early is the best prevention we have. It’s also never too late for a child and family to seek the right supports to build resiliency and move towards recovery. * Patient name has been changed to protect privacy. If you are in crisis, call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), available 24 hours a day, 7 days a week. The service is available to anyone. All calls are confidential. View the full article
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