blue and pink mountains illuminated by sunrise over snowy plains

Why Self-Care Can Be Hard For Me

Taking care of yourself comes in many forms, some easier than others and some more pleasant than others. Throughout my years of depression, self-care has meant several things to me. In times of severe symptoms, self-care focused on basic skills; eating, bathing, and taking my medications. When I’m doing better, self-care looked more like the conventional meaning of the term; taking time to relax, allowing myself tasty treats, watching a favorite show, etc. But no matter the state of my mood disorder, self-care has always included a mental component that can be particularly difficult: being nice to myself.

I know, that sounds so obvious it’s ridiculous, but you can absolutely do the actions of self-care without believing you deserve it. I run into this issue a lot; I spend an evening in sweatpants and a cozy sweater, absorbed in an episode of [insert ever-changing favorite show here]. Great self-care, right? Except I finish up the whole endeavor with terrible self-criticism for having let myself waste time and be lazy when I could have been getting work done. Somehow, it seems like that negates all the good that the action of self-care does for me.

Don’t get me wrong; I’m sure there are plenty of benefits of self-care even when you’re not feeling it. If you’re doing something essential to your survival, like eating food, of course that outweighs whether or not you think you should do it. Plus, there’s likely some neurological benefits of taking care of yourself- dopamine, less cortisol, heck, there’s probably benefit to just practicing those neural pathways and making them feel more natural. But it also seems logical that the benefit of self-care itself would be even better if you let yourself have it guilt-free.

Sometimes, the hardest part of self-care is believing that you deserve it. And that’s usually when I need it most urgently. It’s a work in progress, but I’m trying to be less critical of myself. Deliberately being nice to myself sometimes feels like a big lie, like I’m only humoring the part of me that thinks all my negative self-talk is pretty crappy. Living with depression makes it complicated because I know that I need to do things like exercise, take time to relax, and let myself say “no” to things. But the part of me that fights tooth and nail to appear “normal” resents the fact that if I’m not gentle with myself, I might end up debilitated by depression again. I don’t want to need anything, and certainly not anything pampering. I’m fine how I am.

“I’m fine,” she says stubbornly.

Sometimes you’re not fine, and that’s ok. And it doesn’t matter how long you’ve been not fine- you still deserve to take care of yourself. Sometimes I feel like having been depressed for a long time means that I’ve been indulgent in my sluggishness and I need to be hard on myself to get out of it. I would never tell someone else that. Be as kind to yourself as you would be to a friend in the same situation.

Stress and anxiety abound right now, so take care, stay busy, and get some fresh air when you can.

-G

 

extended-hand-holding-soap-bubbles-with-beige-background

COVID-19 and Anxiety: Caution vs Compulsion

Yesterday, my city declared a local disaster emergency. A growing number of presumptive cases of COVID-19 in my county have led officials to close all city facilities.

I was diagnosed with obsessive-compulsive disorder when I was about 12, and I dealt with many different obsessions over the years. Perhaps the longest-lasting obsession I had revolved around contamination and germs. For the last several years, I’ve been blessedly free of OCD, and when an old obsession pokes its head out, I’m fairly quick to oppose it by doing an exposure. Since the start of the media coverage of COVID-19 in Wuhan, I actively tried not to let it worry me too much. I could feel the pull of anxiety, coaxing me into watching the news coverage and letting it take over my life. Of course, I stayed informed but did my best to not obsess.

Now, my own city is seeing dramatic effects of the virus, both in increasing cases and in the social results of widespread, repetitive media coverage. Many of our city facilities were closed several days ago, and our city council has decided today to close them all. This afternoon, I finally made the trip to my pharmacy, located in a grocery store, to pick up my medications. The sight of so many empty shelves was unnerving. The only fresh vegetable remaining was lettuce. The bread aisle was sparsely populated with hamburger buns and a few loaves of whole wheat. A man asked the pharmacist where the thermometers were and was told there were none left. I bought my items and went home, then washed my hands several times between unloading groceries, putting them away, and cleaning the counter they sat on. I’ve been cleaning my phone case, our door handles, and even my sunglasses after touching them while out. Am I simply being cautious, or have I crossed the line into compulsions?

For people with anxiety disorders, the COVID-19 pandemic puts them in a confusing position. People are being encouraged to be extra careful about handwashing and touching potentially dirty items. Events have been canceled and gatherings are recommended to be limited, making it easy to justify complete isolation due to anxiety. So when the behaviors that normally indicate a disorder are socially sanctioned, what do you do?

I can tell that going to the pharmacy triggered something, and where before I was simply careful, I’m now afraid of things in my own house because they came from outside and I haven’t cleaned them. This alarms me because it’s exactly how I used to feel in the grips of OCD. It’s overwhelming to suddenly feel like nothing around you is safe to touch. This coronavirus could live on surfaces for two to three days, so maybe constant cleaning and disinfecting are completely warranted. I imagine many people are feeling this despite never having experienced feelings like it before. Nobody really knows how much is too much, and this is exactly why OCD is so tricky. In non-pandemic times, contamination-focused OCD is fed by a seed of doubt (indeed, every kind of OCD is fed by doubt). It can feel shameful because you know that your compulsions are irrational. Now, it’s unclear what rises to the level of irrationality. Maybe the compulsions I usually try to avoid are precisely what I should be doing.

There is no blueprint for handling this pandemic. I think it’s reasonable to increase your awareness of surfaces you might normally touch and to wash your hands more frequently. However, I know that for me, allowing myself to engage in my old compulsions is a slippery slope. It might be acceptable to do right now, but it will be harder to stop the longer I let it go on. It’s a balancing act, and I have to decide how much my anxiety is serving a purpose now versus how detrimental it is and could be in the future.

I’m certainly not going to tell anyone how to keep themselves safe. I am, however, going to tell myself to be cautious about being too cautious. As long as I can leave the compulsions behind again when life approaches normal, I’ll be okay.

Stay safe,

Genevieve

How Perfectionism Can Block Creativity

Over the years, I’ve made deliberate efforts to reduce my perfectionism surrounding my artwork. I think I’ve made some good progress. When I’m in the groove of regular artwork production, I can sit down with a blank page and some materials and just… start. With minimal agonizing, I can just start to put lines or colors on the page and see where it goes. But, when I stop making art for a while, the barrier of perfectionism returns. It always leaves me overthinking and judging myself harshly for my attempts to get started again. I haven’t been making anything in the last couple of months, and it took me some serious intention to pull out my watercolors and paint this.

IMG_5516

Rationally, I know that it doesn’t matter if I make something and rip it up, or if I make something and let people see it even if I’m not proud of it. But the perfectionist in me thinks I need to have a piece planned out and executed perfectly. I do think that there is some value in this trait. It can give you the patience to get something “just right,” or to sketch your concept with different angles or color schemes and figure out what you like the best. But then again, art never turns out exactly how you imagine it, and there’s rarely a point where you know for sure that it’s done. While perfectionism can help you get closer to your mental vision, it can also keep you from getting started at all– and that’s paralyzing.

In my experience, perfectionism and creative block go hand in hand. You can’t figure out what to make because none of your ideas are good enough; your attempts don’t look like you imagined them, so you scrap the whole thing; the longer you go without making something you like, the higher your expectations and the harder it is to get started. My approach to getting through this is to pick something that I like looking at and just start drawing/painting it. I don’t try to come up with a completely original idea yet- just pick a reference and get started. Sometimes this is enough to jumpstart my inspiration, and at the very least, it usually gets me excited about creating more things– whether from imagination or reference.

That painting I showed earlier– I don’t like it much. It’s based on a photo of Stella that I absolutely love, and my painting doesn’t come close to giving me that feeling. So, I don’t like it much, but I like that I made it. I like the feeling of seeing something coming together, even if it doesn’t match my expectations. I’ve been trying for weeks to get over the funk of creative block, and I think this painting may have helped.

Fighting perfectionism takes practice, and for me, it seems to take deliberate consistency. Letting my practice collect dust makes it harder to pick back up later. But no matter how long it’s been, I know that the more willing I am to make mistakes and to take risks, the more satisfied I am with the results.

As a bonus, here’s my attempt at depicting the fish wedding from one of my ketamine infusions (part 8). It looked pretty much like this:

fish wedding

Yup. Pretty weird.

 

tile-wall-with-pastel-pinks-greens-and-orange-shapes

Noise: The Ketamine Chronicles (Part 14)

Yesterday, I had another ketamine infusion for my treatment-resistant depression. It had been almost five weeks since my previous infusion, and while three weeks was our best guess for my interval, it seems like now I can actually go something like four weeks before really noticing it wearing off. I’m hoping that if I keep doing the behavioral things that help my depression (running, volunteering, therapy, etc.), I can at least maintain this amount of time between infusions.

Most of my ketamine infusions have been visually focused, and usually what stands out to me are snapshots of images and colors. Yesterday’s infusion, however, was much more auditory-heavy. Throughout it, conversations in the hallway and the other room sounded loud and close, and I felt as if I were being crowded around in the room I was in. Strangely, conversations outside the room sounded loud but were completely unintelligible. The boundaries of words and sentences disappeared and I was washed in streams of unending verbal noise. Nothing made sense, but I still strained to understand. The sounds of english words were familiar, but I just couldn’t parse them enough to grasp their meaning.

This theme of linguistic confusion stretched throughout the infusion. I remember a filing cabinet, stuffed with folders that I couldn’t read. The letters were there; I could pick them out, but putting them together and reading them as words eluded me. Later, messy papers with gibberish words filled my internal vision. I felt confused, I was upsidedown, my arm with the IV ached. The room seemed loud, and I saw stampedes of paper animals, painted with pastel watercolors. They piled up and tumbled around me, threatening to knock me over and crush me. The fan in the room added noise that pushed it all to an intolerable volume, so I asked Erin to turn it off. I got ready to speak, opened my mouth, and seemed to just think the words out loud.

I notice this feeling often during infusions, and it’s interesting to note how little deliberate control over our mouths’ movements we need in order to make coherent sounds. All I do is form an intention to say something, and it just…happens. It feels a little like I’m inhabiting my body separately from its direct controls. I can still talk, but it feels like someone else is doing the talking. In any case, my request apparently worked, as she got up and switched the fan off. That lowered the ambient volume enough that I could focus again on my music.

I remember there being more visual scenes after that, but I don’t recall them very well. The only one I have memory of is a scene set in a grocery store with a broken jam jar, shards of glass glinting under the fluorescent lights and wine-red jam splattered on the linoleum.

The rest of the day is a blur; I slept off and on, interrupted by Stella periodically. It wasn’t until about 6 P.M. that I started to feel more like a person, but I was still glad to crawl into bed at night and sink into sleep. This morning, I’m tired. I’d like nothing more than to go back to bed for the rest of the day, but I know it’s important to get myself up and moving. I do best with routine, so in the interest of helping my brain repair itself, I’ve already had coffee and been to the dog park. So far, so good.

 

How Do I Love Thee? A Haiku About Meds

New bottle of pills

Contains capsules, not tablets

Let me count the ways

 

Three of my nighttime pills are tablets, and I like to take them all at once to minimize the horrible dissolving-pill taste as much as possible. One time, two went down but one got stuck to the back of my tongue and began to dissolve. It was like purifying the essence of every cruciferous vegetable and mixing them with charcoal, then pouring the horrific concoction down my throat. Immediately, my esophagus’s movement reversed direction and it took serious effort not to hurl right then and there. Instead, I had to force myself to chug water and think about anything but my poor tastebuds. To this day, the memory makes me shiver in horror.

And now, a change in the formulation of one of my meds means that I have received capsules instead of tablets. It’s the little things.

Thoughts on Perspective and Depression

coin-operated-binoculars-with-raindrops-on-surface-and-red-knob-reading-turn-to-clear-vision
Photo by Chase Murphy on Unsplash

When I’m moving out of severe depression and into something closer to happiness, I’m intensely aware of the fact that I will soon forget what it felt like to be depressed. Not intellectually, of course. Having the experience of depression makes me forever able to empathize with others and remember, in objective terms, what it felt like. But the internal feelings– the heaviness, the soul numbness, the twisting slowness of being utterly squashed by life’s requirements- all of those will trickle away until I can only comprehend them from afar. Just as I can’t quite grasp the truth of happiness when I’m depressed, I can’t quite understand depression when I’m well.

It’s a problem I contemplate fairly often. Holding two perspectives at once isn’t fully possible, so I find myself slipping between two conclusions with different contexts. When I’m depressed, I vaguely remember feeling better. That memory, however, always pales in comparison to current pain. I eventually end up concluding that dragging myself back to mediocre happiness would not be worth the effort.

Inevitably, when the depression ends or at least improves, I understand how clouded my judgment was. Over time, I forget just how sharp and all-encompassing depression can be. I disregard its immediacy, letting healthy coping skills fall to the wayside. When I move beyond the basics– eating, bathing, stepping outside– to more advanced skills like socializing and nurturing my ambition, the basics are the first to go when stress hits. This is especially true when time has faded the memory of how quickly depression can return.

It scares me that depression so thoroughly warps my thinking, and recalling the cycle of depression and recovery makes me wonder if any number of episodes will teach me to ignore my depressed brain. It’s easier when each day is different; I can tell myself that this will pass– and I might believe it. But when I’m entrenched in depression, it stretches ahead of me until it’s all I can see. Then, the lies my brain tells me seem awfully convincing.

Right now, I’m going day by day. Things aren’t wonderful, but they’re not terrible, either. When I want to crawl back into bed in the middle of the day and not get up until tomorrow, I try to remember that I’ve been here before. I’ve been here before and I’ve done that before, and it never changes anything. Eventually, things will get better, and maybe I can get there faster if I make those hard but healthy choices. So, I’m back to the hardest self-care of all: doing what’s best for you even when it’s the last thing you want.

Sensory Ramblings About Building a Fire

One day it’s 70 degrees, and the next there’s freezing rain and heavy snow. February in Colorado is a strange creature. After a day of low light and cold fingers, I clomped down the stairs to the back door, Stella in tow. She stood on the stairs to the deck and watched me as I chose logs from the woodpile underneath her. That’s by far my least favorite part of building a fire; I always inspect each piece carefully for spiders before I put it in the crook of my elbow. It’s probably too cold for them to be at the top of the pile, but as seeing black widow spiders was not unheard of in the house where I grew up, it’s my preference to be a choosy wood-carrier.

Building a fire is a skill that I learned as a child. We heated our house with a wood stove, and my formative winters were spent helping my parents keep the fire burning and the cold at bay. Now, when the snow is falling and I have nowhere to be, my first inclination is to get a fire going and then park myself in front of it with a book and a blanket. On this day, I brought two armfuls of wood upstairs and then searched the recycling for some newspaper or junk mail to burn. Then I grabbed some matches and plopped down in front of the fireplace.

From an occupational standpoint, building a fire is a fairly complex task, and it offers a lot of sensory input. You have to be able to tell which logs are dry, which ones have dangerous spiders on them, and then carry them safely to the fireplace without tripping over the dog. I know what kinds of materials are good for getting the blaze going, and which kinds are good for maintaining it. Arranging all of those materials in a way that lets enough oxygen in is a skill that takes practice, and you need to be able to look at your materials and imagine the best arrangement. This is a praxis-heavy task. Fortunately for my coziness goals, I’ve had plenty of practice. Building a fire is also a task that requires a lot of sensory discrimination; you have to use your eyes and ears to determine when and where it’s safe to put your hands near the flames. Even lighting a match is tricky if you can’t tell how much pressure to use. I remember being horrified as a kid, watching my dad place new logs in the fireplace, convinced he would catch on fire as he stuck his hand over the flames. Now, I know that he simply had a good sense of the heat and sparks.

I love sitting in front of a fire in winter. It feels cozy and warm, and it gives me the sense that there’s nowhere else I need to be. There’s the sound, the flickering light, the heat, and all the other parts of being inside by the fire, like hot chocolate and pajamas. Sitting in front of a fire evokes a feeling of security in me, even if I’m already safely indoors. Many people believe that the discovery of fire and how to control it marked an acceleration in human evolution because it offered a new abundance of calories and nutrients from more easily digestible, cooked foods. It may also have served to bring communities together, strengthening bonds and changing the dynamics of an already social genus. Perhaps my brain recognizes this ancient connection and knows that family is nearby and predators will stay away. At the very least, there’s gentle crackling and a nice, orange glow that puts me at ease. Plus, my domesticated canine, who also evolved around fires, likes to rip up the paper and small kindling while I’m getting it started, and that’s always fun to watch. She’s such a good helper.

Stella fire

black-dog-with-pointy-ears-sitting-near-mountains

How Running Helps My Mental Health

I really wish that my dog, Stella, was a good running buddy, but she’s just not. First of all, she refuses to do the entire 3.5-mile loop that I run. She’ll reach a point where she turns around and sits on the path, facing back the way we came. I’m jogging in place, pulling on the leash and cajoling her into moving, to no avail. If I start to really put my weight into her harness, she’ll lie down so that her center of gravity is low and I can’t tip her towards me. She then begins her slow army crawl towards home, belly in the dirt. She looks so pitiful that I often give in.

Keep in mind that Stella is a healthy, almost 2-year old cattle dog mix who sprints in giant circles in the dog park and wrestles for an hour every day. She’s not out of shape. She’s not opposed to running in the park. She’s just not interested in running with me. Not to mention that she’s compelled to investigate every smell we run by, so I’m constantly tugging her along or getting my shoulder yanked so that she can traipse into the grass. It’s ok– if I were a dog, I’d rather explore with my nose, too. Jogging is boring compared to 300 million olfactory receptors.

Suffice it to say, Stella is not a good running buddy. Maybe when she’s a little more grown-up she’ll like it more, but I’m not holding my breath. It would be nice to have the motivation of having a dog to run with, but I’m actually pretty well into a running habit these days. On days when I’m not feeling it, I do the regular loop. Frequently, I add more distance with the other paths on the mesa, and sometimes I even do the loop twice!

Every time I take an extended break from running and then start it up again, I find that it’s easier to regain my endurance. I’m always worried that I won’t be able to get back to the part where it’s enjoyable, but I’ve found that part at the beginning where you’re lifting cement shoes off the trail and breathing through a straw to be much shorter than I remember. Once my body readjusts to the requirements of running, I’m always happy that I did it. I notice that running helps my mental health in more ways than just the release of those precious endorphins. It also gives me a routine to plan my day around and something to look forward to. When I get home from a run, I often feel grounded and capable, and noticing my tired muscles is an exercise in mindfulness. Plus, there’s the simple fact that I’m not looking at a screen while I’m outside, running.

I really enjoy the sense of accomplishment that it brings me, although I have to be careful not to connect this too tightly to distance. Otherwise, I find myself disappointed if I don’t run as far or farther than my current limit. (Curse you, perfectionism!) It’s much better to feel accomplished for the act of running itself; I got out of the house, breathed some fresh air, and got my heart rate up. That’s all that matters.

Tracking My Anxiety

The anxiety began when I was eating lunch and scrolling through youtube, trying to find something interesting to watch. I scrolled faster, considering each thumbnail more and more briefly as the tightness in my chest increased. “Hold up,” I thought. “I’m supposed to be tracking my anxiety for my appointment next week. Let me write this down.”

Here’s how to overthink your anxiety record: First, I spent several minutes considering the medium I should use to document my anxiety; paper and pen seemed reasonable, but what kind of format? List? Table? Stream of consciousness essay? I also considered the kind of paper I’d use, be it sticky notes, that half-used legal pad in my bookcase, small notebook–ugh. Too many choices. Let’s go digital. Thank goodness the Notes app is pretty minimal, or I’d still be waffling on what kind of font to use. (Speaking of “stream of consciousness”, I just realized that I could totally make a PowerPoint presentation, complete with awesome clip art and slide transitions. That would really prove my therapist right when she said I’d probably find a way to make it complicated because I’m an overachiever. Challenge accepted.)

So far, I have written down everyday things like realizing I wasn’t sure if someone introduced themselves as Janice or Janet and imagining the obviously catastrophic embarrassment when I inevitably pick the wrong one. I also have bigger things like my unknown life plans, noticing that Stella had put her sneaky paws on the counter and eaten chunks of chocolate cookies out of the pan (she’s fine), and also seemingly random anxiety with no discernable cause. Some of the “random” anxiety is probably due to sensory processing disorder and my tendency to steamroll over discomfort rather than make adjustments for my nervous system. It’s a work in progress.

I think I’ve spent a long time telling myself that anxiety isn’t an issue for me, which makes it a challenge to be mindful of it. After the OCD mostly disappeared, I guess I went “Well, that’s done. I don’t have anxiety anymore.” If only it worked like that. I keep having to reassess my understanding of what’s a normal amount of anxiety and in what contexts it’s normal. Seriously, I have no idea at this point. Do other people feel anxious when they have to walk by the check-out lanes on their way to somewhere else in the grocery store because they can feel people looking at them? No? What kind of lie have I been living?! I guess I knew that some of my anxiety was unreasonable, but convinced myself that it was minor enough that it didn’t need to be addressed. Now I’m just not sure what should be on my list of concerns. Time to go put “worrying about the amount I worry” on my list.

In case my therapist reads this: don’t worry, I will not be showing up with a PowerPoint detailing my anxiety, although that would be hilarious and probably a new one for you.

 

hand-holding-whole-shrimp-in-front-of-ocean

Tower of Shrimp: The Ketamine Chronicles (Part 13)

This ketamine infusion features a crime scene, a tower of shrimp, and a painting of a carnivorous giraffe. Folks, I couldn’t make this stuff up if I tried.

I remember feeling it almost immediately, and I closed my eyes as I lost track of my limbs. The music I was listening to was a lively classical piece, and my mind created intersecting lines to the notes that formed long evolutionary trees. There were noises around me that distracted me at first; something that sounded like hammering from the floor above us, then quiet conversation in the room, and a door opening and closing. Soon, though, the ketamine pulled me away, and I wasn’t concerned with anything outside my mind.

Silhouettes of a human face and a bull in profile, carefully stretched-out tape measures arranged in rows, and thousands of old family photos being sent on a conveyor belt to be turned into decorative pebbles were just some of the odd things I saw this time.

The crime scene was set in an arid landscape; there were shrubby bushes and reddish-brown caked dirt as far as the eye could see. Two or three people stood around a small body of water- what seemed like the only one for miles and miles. I got the sense that they were pondering something, as a detective would do when a puzzling scene presents itself. As I tried to read more of the scenario, my perspective began to shift. I zoomed out smoothly but quickly, like I had scrolled down on Google Maps with intention. Perhaps I’ve been watching too many police procedurals and true crime shows lately.

The shrimp tower stretched higher and higher, eventually reaching the edge of the atmosphere. The singular shrimp at the very top swayed back and forth, pondering the shrimps holding it aloft and balancing in the wind. Each shrimp interlocked with the shrimp around it, like that barrel of monkeys in Toy Story. I don’t know if you know this, but the sensation of perching on top of a stack of shrimps that stretches all the way to the edge of the atmosphere produces some stomach-dropping vertigo. If you’ve ever read the Dr. Seuss Book, Yertle the Turtle, the shrimp tower may remind you of that. Instead of an incredibly arrogant shrimp forcing the others to form the tower so that it could sit at the top, this was the reverse. The top shrimp wasn’t entirely sure how it got there and was not very comfortable with it.

There are some interesting parts of my infusions that seem to blend my identity with strange scenarios and characters. For instance, how did I know that the shrimp at the top of the tower didn’t know how it got there? Was I the shrimp? Similarly, the funeral scene in my seventh ketamine infusion also evoked a sudden understanding. I was watching the scene, but when the coffin was set down, I felt like I was being pressed into the ground. Was I watching, or was I in the coffin?

The day before this ketamine infusion, my aunt and I did one of those paint-n-sip classes. The painting to emulate was a cute, cartoonish giraffe with multi-colored spots. We noticed that there were two kids in the back who had really taken their paintings to the next level. Their giraffes had blood-red eyes, thick, metal earrings, and gaping smiles filled with pointed teeth. One also had thick blue stripes rather than spots, but that’s neither here nor there. We got a big kick out of these kids’ creativity and confidence to go off-book. They seemed proud of their paintings, and we thought they were awesome.

Imagine that painting in the style of a ten year old’s artistic skills, and then imagine how taken aback I was when a dark silhouette in my ketamine dream revealed itself to have that giraffe face. It was both unsettling and hilarious at the same time.

After the carnivorous giraffe, my brain may have opened the door to where the creepy images are held because I remember seeing dark forms standing over me, laughing. Thankfully, something in the room beeped, and I reoriented myself to my surroundings. That was probably the most disturbing thing I’ve experienced during a ketamine infusion, and even that was not bad. I knew that it was creepy but didn’t feel especially scared.

Most of the time, I just see bizarre scenes like the tower of shrimp, marvel at how much my teeth feel like stale marshmallows, and wonder if I’m slowly tilting in one direction or another.