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Outpatient Treatment: An Experience

For the past month, I’ve been receiving treatment for my depression via an outpatient program run by a nearby hospital. For three days a week, four hours a day, I am immersed in a world of people who know I have severe depression before they know anything else about me. Together, we all sit in a room and deal with our messed up lives. It’s an interesting experience.

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The first day of outpatient is usually the worst. You walk into this place thinking, “This probably won’t work…” “What am I even doing here?” or “God, could things get any worse?” It’s like being in a zoo, only you’re the animals and spectators…you feel like everyone is looking at you, wondering why you’re here, but at the same time you are looking at everyone else and wondering why they are here, too. It’s a room full of strangers who know you have a mental illness before members of your family or your closest friends do. You are instantly humbled, and incredibly defense. “What will these people want from me?” you might wonder. Yet in outpatient, questions never last long…

The day begins in community group, where everyone in the program (roughly 30 people) congregate in a big room and listen to the group leader read off a little thing called “The Daily Promise”. “The Daily Promise” is a book that has a passage for each day that asks you to think about your life, your choices, and your attitude. For instance, one day might ask you to contemplate whether you dwell on the past, present, or future. The group leader will then go around and ask everyone this, and then offer some bit of advice about their situation. It’s not really met to be therapeutic so much as it is meant to start your day off with some positivity, and get you to hold yourself accountable for your feelings and choices. It’s also a little bit of social time, where you ask about people’s weekends and if they caught the game last night. Some people tend to utilize this more than others. You have a strange set of cliques: the middle-aged ladies who discuss cooking recipes, the middle-aged men who are gruff and bitch about traffic, the really old people who make occasional small talk to the people next to them, the young women who are gossipy and thrive on scandal, the young guys who talk about the same stuff you heard from guys in middle and high school, and finally the quiet people, who sit there and do anything except talk to other people. The cliques are present, but fade when it’s time to open up.

There’s a strange sense of community at outpatient. People say hi to another or smile even when they’ve never spoken to each other. While people may ask why you’re there, there’s never judgement in their voices or criticism in their advice.  Everyone understands the hoops you must jump through when dealing with  health insurance, and everyone takes some kind of medication. We are each other’s community, and we understand each other in a way that most people in our lives don’t. While my parents or friends don’t understand how or why I can say in bed for days, people in outpatient nod their heads and murmur “I know what you mean” in agreement. When I mention not having the energy to see or talk to people, other patients offer suggestions while everyone else asks, “Why?” Even though the people in outpatient don’t necessarily know your story or know who you are, most of them know how you feel, which is a really big deal.

In the real world, no one talks about their problems or struggles with them due to abnormal brain functioning. In outpatient, everyone has problems, everyone has an illness. You look at people and see that they have a history, a whole story that leads them to where they sit in front of you, and you see the possibilities in life. I see old men grieving for a spouse they had for forty years. I see middle-aged men fighting their addictions for their families. I see women who have been beaten up and betrayed by those who claimed to have loved them, and I see children who yearn for parents that love them as they are. We all have problems, we all could be worse off, yet we are here, we are surviving. Everyone in the room is trying and fighting for their life, for their happiness. And it gives you a sense of hope in the world…all from a bunch of strangers.

The day continues with group therapy. You’re assigned to a room with about ten people total, and throughout the day two or three therapists come in to give lessons or facilitate conversation. This is where you learn the famous coping skills, the relaxation techniques, and the tips for effective communication. It’s also where you are put on the spot and asked about your life. You hear a lot of stories in group…from spontaneous marriages and trouble with the law, to dead-end jobs and ungrateful families. Some people open up right away and others need prying. But we all get our turn to say what matters, and why. It’s been in these group meetings where I’ve discovered something I had long forgotten: that I have a voice.

Outpatient has given me a strange sort of confidence boost and slap in the face all at once. After many weeks, and many contemplative conversations (not to mention getting on meds), I’ve sort of woken up from my depression fog. The colors and happiness in the world are coming into focus, and actually seem within reach. By getting out of bed, driving to the hospital, and spending a significant amount of time with the sole intent of bettering myself, I feel productive and proud of myself for the first time in ages. I’m accomplishing something that is difficult but necessary, and I’m doing it because I am worth it.  After months of a downward spiral, I’ve finally gained the motivation to start fixing my life, one baby step at a time. This isn’t to say that I haven’t gone over the mistakes that I’ve made. I look at the things I am learning, the skills I am building, and see all the times I should have used them. Throughout my depression I’ve broken a lot of trust, hurt many feelings, and pushed away a lot of wonderful people. Some of it I can fix, but others I’ll just have to learn from. Acceptance is a major part of healing, especially when there’s a mental illness involved, so accepting my mistakes and letting go of my self-hatred have been essential during my time in outpatient

I know no matter how much I describe it, there will always be people who don’t understand outpatient, or why I needed it. Depression is an invisible illness, and a lot of people have trouble accepting that, especially when treatment is expensive and/or intense. But, for the people who are reading this and learning about my experience in outpatient, I hope what you take away from this blog post is that you never know how deeply treatment can effect and help someone, so please do not judge it. Anytime anyone admits to having a problem and commits to fixing it, they are taking a fundamental step toward recovery. So remember that recovery takes time, and looks different for each person. I don’t know how long my recovery will take, and I don’t know how long I will be on meds, or struggle with depression, but I do know this: I am a strong person, I deserve to be happy, and I’m glad I chose to go to outpatient.

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The Process of Seeking Help

It’s been a week since I moved back in with my parents and I still can’t catch my breath. Everyday I’ve been busy, whether it’s avoiding my responsibilities, catching up with old friends, trying to fit all of my stuff in my old room, or searching for a new car. I’ve been feeling better, but it’s the kind of better that has fine print attached—“Feelings of happiness have a high probability of fading within 2-3 weeks. As your schedule clears, side effects may follow that include time to process that your life is still messed up, and that you still have no idea how to fix it. Proceed with caution.”

In the short time I’ve been back home the distractions have been endless. Somehow I’ve managed to round up a couple of dates, some nights out drinking with my old friend Val, and seeing a few movies with Fred. My parents have hardly mentioned getting me into treatment, although my mom is convinced I need to be back on medication ASAP. Rightfully so, might I add. But there’s no doctors appointments booked, or any attempt to find a new part time job on my end. The temptation to avoid the problem is winning out over my fear of not getting better, and other stressors that are less important take up space in my mind. I know I need to confront the source of my depression—not only the chemical imbalance, but all of the insecurities, the social anxiety, and the fear of trusting both myself and others. The time has come for me to grow up and face the demons of my depression.

Getting help is a process, and it’s not as simple as most people make it out to be. Like last time I did outpatient, there was an act of desperation that brought my depression to the attention of others. After that, there were the precautionary steps where I moved back in with my parents and the idea of treatment was tossed around. Now it’s come to the step where I need to put the plan in motion, to go get help.

Treatment can be a scary thing for people who have lived with an untreated disorder for a long time. Even though I’ve been going to 757f4e338ff3a58315a7e6b0a91a8f04therapy for a few months, the idea of walking through those double doors marked “Behavioral Health” for everyone to see is daunting. Depression can be a really secretive disorder, and letting strangers know you struggle with it by the mere act of being in a treatment center leaves a person exposed and vulnerable. Our society is one that praises people for “toughening up” and “pulling yourself up by the bootstraps”; sometimes getting help can feel like failure for someone who’s tried so hard to keep their disorder in the dark. It’s important in these moments not only to be supportive of the person seeking treatment, but to also let them confront these feelings on their own. You can’t force another person to reveal what is going on, as many people in my life have tried with me. You must let them peal off the layers of security slowly, and allow them to dismantle the walls they’ve built on their own. It’s a significant moment when someone with a mental illness accepts help, and it’s one that must be acknowledged, respected, and given patience.

After I completed outpatient the first time I felt better than I had in 08c38db83b874a6759dea67bb14a321da long, long time. I was seventeen, and for the first time in five years  I believed in myself. I believed I could fight for myself, protect myself, and find happiness. I knew I had something worth living for—I knew I owed it to myself to live a full, happy life. Now I’m back at square one, utterly confused and hopeless, but there’s a difference. I remember that feeling…I remember that once I survived, I pulled myself out of the hell I was living in and I fought back. And I have hope that I can do it again.

So I guess this is all to say that if any of you readers are going through treatment or even considering treatment, I’m proud of you. I believe in you. I know that you might feel like you’ve set yourself up for the impossible, but keep trying. No matter how many sessions in therapy, no matter how many pills you’re prescribed, no matter how many treatment centers or desperate phone calls to your loved ones…You can do it. You are worth rescuing. You deserve a happy life. Hope exists, and it’s waiting for you.

A Rant About Therapy

humanistic therapyTherapy is bullshit. As someone who is on their 6th round of therapy, I feel as though I have authorization to say this.

It’s not bullshit in the sense that it doesn’t work—if it wasn’t for therapy back in middle school and high school I probably wouldn’t be here—but it is bullshit in the sense that the process of going through it feels completely counterproductive at times.

Take this: today I go into my therapist’s office for my second appointment. I know exactly what I want to talk about. I get in there, and what happens first? She asks me how I felt about last time. “Okay, I guess.” She stares at me, so I look at my shoes. “Okay….well, was there anything that we talked about that stuck with you? Did you think about it in the days following it?” “Uh…I guess…I thought…uh, that maybe I was kind of stand-offish.” “In the days after the appointment?” “No, um, during the appointment.” “Oh,” she said, and waited for me to say something else. But really, there was nothing to say. “I don’t really think that’s significant though…like, you asked what if I thought anything about it in the days afterword, and that was what I thought. That’s it.” “Well, I’m not a mind reader. I just wanted to know how you felt, and if there was anything that stuck out to you…” and then she just prattled on and repeated herself. Dude, I know you’re not a mind reader. But I swear, I don’t really have any opinion about our last appointment. Now can we talk about the things I came here to talk about?

Finally I get to start my spiel about my feelings. And what does she say? Nothing. She just asked questions that prompted more information, and then said something obvious, like “It sounds like you’re doing a lot of comparing in two different [situations]”. There was no helpful insight, no hints at what would be good for me. Just her, repeating basically everything I said.

And then we talked about friendship. Well, she talked. I got this lecture about how I’m never going to make friends or have friends if I don’t take initiative. I tried explaining to her that I was having a hard time reaching out to people because it stresses me out, and all she said was, “Sometimes you have to be a bit uncomfortable in order to get to that place of comfortableness.” See what I’m talking about? Utter bullshit. It was like I was listening to my mom’s tough love advice when really what I needed (and came there for) was pointed guidance and techniques. “Sometimes it’s easier to just rip off the band-aid,” was not the wisdom I was looking for.

I sat there feeling like I was going to cry if I tried to explain myself any further, and I really didn’t want to cry in front of her. By the time I left, I felt even more shitty and isolated from the “normal” population of people around me. I wished I could talk to my old therapist from the outpatient program I went to when I was 17. But I was stuck here in college town, and if I switched therapists now, it’d be another 2 month process of even getting an appointment.

I just wish I could talk about my feelings without a) feeling like I’m being judged, b) feeling guilty for talking about myself, or c) getting a lecture. I wish I lived closer to my friends from high school so I could feel free to share without all of those things. Everyone here in college town either feels too distant to talk to, or probably secretly hates me. The one person I talk to here is moving away on Friday.

Guess I’m stuck in this therapy bullshit for now.

The Perks of Being Scared Sh*tless

I haven’t written or checked the ol’ blog in a while, so here I am. And what do I have to say this time? A lot. About what? A lot. A lot of bullshit, probably, but ultimately things that matter such as:

-College. Have I mentioned that I leave next Tuesday?

-My last post. Someone actually read it.

-Long-distance relationships. Will we make it?

-Sex and pregnancy. It seems as if everyone is getting pregnant and it’s freaking me out.

-My last group therapy. *Sniffle sniff*

So, let’s begin. I move into my dorm next Wednesday, at about 8 or so in the morning. Not only will I probably be sleep deprived from insomnia and anxiety, but I will also be engaging in physically demanding work while a) trying not to have a complete freak out, and b) loving my parents while also hating my parents for being so old and clueless. And then, after my half of the matchbox-sized dorm room is filled with crap, my parents will leave me. Suddenly, that first day of preschool will become totally understandable again, as I try not to cry when my parents abandon me in a strange, foreign place. And then what? I unpack? I go out and try to make a friend? I hide under the covers?

At least I know I’m not alone. My high school friends are freaking out, too. Lately we’ve all been spending time together, soaking up our low-maintence fun before having to begin the high-maintence task of making new friends. One of them actually approached me about how I was handling everything going on…see, she read my last post and was a tad concerned. Immediately I felt bad because I thought none of my friends ever bothered reading this anymore, and wrote about it in the post she read. I also felt bad because I realized she cares about me a lot, and I’ve always neglected to come to her when I’m feeling upset. And then there was also just maybe fifteen minutes ago when I logged onto my blog and saw that a few WordPress readers liked it. That made me feel a bit bad too. But, alas, everyone gets in a bitchy mood sometime, and at least when it is written down it is optional to listen to.

Speaking of listening, everyone who has given me advice about my upcoming long-distance relationship is saying the same thing: make it or break it. It’s all about the work you put into it, and how much you both want it to work. Well great. Great. I’m left with the realization that if my relationship fails, it will be because one of us will either cheat or be too lazy to keep trying. That information is like a sack of potatoes, awkward and pressure-filled, balancing on the top of my head while I hula hoop with a ring of fire.

One thing about working at McDonald’s in this day and age is that the majority of my coworkers a) have kids b) are pregnant and c) are around my age. Everyone is squeezing them out. And all of those after-school specials I watched as a goofy middle-schooler are catching up with me; if you are having sex, does that pretty much make you doomed to have an unplanned pregnancy? That’s the LAST THING I need before leaving for college. Maybe I’m just worried because I don’t want to end up like Candace off of The Perks of Being A Wallflower, aborting some unwanted baby. The only thing I want to abort is Taco Bell from my stomach after one too many tacos. And even then, I’m aware of the down-sides.

There is just so many endings going on right now. Tonight I said my goodbyes to my grandparents, Tuesday night I said my goodbyes to group… Ugh, it was so sad. I’m happy that everyone in the group is in a good place now, but I know whenever I’m all screwed up again I’ll need them and want to hear about their lives. A few of them have become part of my family in a way, and I want them to be in my life still. For over a year we’ve been spilling out our souls to each other…that bonds people, you know?

But I know I’m doing the right thing by going away to college. It’s a new beginning, with new possibilities to change my life, blah blah blah, inspirational garbage. All I know is that the things that scare you are the ones worth while, so I’m right where I should be.

Being-Optimistic

Understanding the “There”

As much as the ability to understand people and their situations is a blessing, there are some things I wish I didn’t understand.

Yesterday my dad asked me about group therapy, and how it works. He was trying to understand why I “need this”, while earlier at group I was in group thinking about Susannah and trying understand her decision to down thirty pills. Turns out, when I eliminated her from the situation, and thought of myself back in June it wasn’t so hard to understand her decision at all.

And that’s what group is for. No one else in our lives is able to look into our eyes and understand what it is like to be on the brink of ending your own life. And thank goodness for that, because they can make us want to be better for them. But they can also give you more reasons that you are on the brink in the first place. “All I’m doing is worrying Mom….” “I’ve pulled away from all my friends and hurt their feelings…” “How would Grandpa and Grandma feel if they knew I was like this?”

Guilt eats us away, even if we have therapists at our side. “They’re only listening to get my money.” “They don’t want to hear about this shit.” “They’re just watching for me to look away so they can sneak a peek at their watch.” But group, those other people around our age who voluntarily come here, they’ve been on your side of things. They aren’t there to judge you, or be worried about you. They are there to look you in the eyes and honestly say, “I’ve been there.”

“There” is a scary place to be. I remember the evenings I would be driving to work and thinking of what I had ahead of me: exhaustion, tears, sweat, and stress. Then I would see the lane next to me, full of the blinding lights that came with incoming traffic. And all of a sudden I would feel very calm. Just a few seconds of a decision and my hand could jerk and be smashed into nothing. And it’s all my decision. No one could stop me, not my parents or friends or teachers. They would all just have to deal with the fact I’m dead and cold and finally numb. Because I was tired of dealing with all the pressure inside my head.

“There” also means that “everything will get better eventually” is bullshit. Things haven’t gotten better, they’ve gotten me here, and it’s just been getting worse and worse. “There” means you have come to the point where advice is meaningless words, and love is a constant source of disappointment. Basically, no one but yourself can help you, and you are so weak and tired…feeling utterly helpless.

So that’s why I enjoy group and continue to go to it, though I’m feeling stable right now. Because I wish someone had said they understood when it was me. Being alone “there” is one of the scariest things I understand.

Happiness, A Revolving Door

Since when is being happy a problem? Since never, right? Now I know, I know…She’s going to start down-grading happiness? What the hell do I see in this BS?? But hold on to your panties, I haven’t finished my thought.

See, lately, things have been going really well. And I don’t mean to jinx it or whatever, but my stress has from constant to fleeting, my parents and I are on good terms, I’ve picked up more hours at work, and I am currently involved in fantastic relationship. It’s been great! Hell, yesterday I spent a little time cleaning my room, even.

Depression-wise, I feel like I am kicking ass. But that’s been rough coming out of my mouth in group therapy, because how do you revel in your joy and help someone who might not recover at the same time?

My group therapy is the same people every night, once a week. You start to get to know these people, and trust them with your problems, and pow! You suddenly care for a person you don’t know the last name of, as much as people who knew you back when you were playing Barbie’s. Only you do know what they think about as they cry themselves to sleep or when they wake up each morning.

It’s this girl Susannah. She’s super quiet but the observant, practical type. You know she’s bad ass underneath her catholic school uniform. She’s the person you can exchange a smile with and immediately know you’re both thinking the same thought. I’ve been in this group with her six months now, and she has never missed a single meeting. Guess what? She missed a meeting.

Okay, okay, no big deal. Just catch her around next time, right? Sure, sure…except she hasn’t been doing so well for weeks. And as much as your heart begs and pleads to help her, she won’t let you pry her open, though she accepts your care. It’s damn frustrating and damn saddening. When you have smiled that fake smile as many times as I have, you know it when you see it. And I see it every time me and one of the other members stay behind and say, “If you ever need anything, or anyone to talk to…” and when she says, “I’ll be fine.”

“I’ll be fine”. I have said that before. “I’ll be fine” is a wistful statement, one that leaves the rest of the sentence unspoken: “I hope.” It’s something to say when you’ve been caught in the sadness and don’t want to go the whole emotional crying route. It’s the way you buy yourself time. Time before the rest of the whole realizes you will not be fine.

So in group I’ve held back a lot of what’s been happening in my life. Happy people can just really suck dick sometimes, if you’ll pardon my french. And in there, I let myself remember how far gone I truly have been, so I am able to help others more. Out in the world, I let myself be happy for me (whether that’s a grammatical statement or not), and can have nothing to hide.

It’s funny, whenever I’m sad I shut the world out and keep the group in. But I just never knew it worked both ways.

Life, Depression, And Other Things You Might Not Care About

Life. Some people think it’s complicated. Some think it’s easy, so long as you keep a positive outlook. Others think it’s easy, so long as they have their crystal meth. Generally, people recognize that it’s confusing. You life could consist of being some cancer patient, a hobo, a millionaire, a celebrity, a dictator, a prisoner, a martyr, a clown, a teenager writing some stupid crap on the internet about their insignificant life…

But anyway, you could always be better off. You could always be worse off. So either way you lose, because both those things mean you have to suck it up when life gets messed up. Easier said than done. What’s really the thing that gets me is the moments where you feel like you’ve screwed up your entire life. And you’ve had about ten of those. Whoever came up with the concept of the mid-life crisis obviously forgot what its like to be a teenager.

My latest crisis all started on Thursday afternoon. I had a shrink appointment that I was not looking forward to. The session before I had completely shut down on my therapist because she was reminding me of my mom and it pissed me off. Despite what a lot of people think, shrinks are people too, and all people have relationships with another, no matter how strange. So it’s sometimes hard to not treat them like everyone else and care what they think, make assumptions, and get somewhat attached to their company.  You get pissed off at them, frustrated, happy, all that jazz. So I wasn’t too sure how this next session would go, and actually considered dropping individual therapy, despite my cutting.

Well, my pissy mood didn’t last because there was this girl in the waiting room with me, drawing. And I’ve got this problem with sitting in a room with one other person in absolute silence for an extended amount of time. I kept looking over, because for some reason she really reminded me of me back when I was motivated and artsy. So I finally ask what she’s drawing and before I know it we’re chatting it up and she’s giving me hope in finding inspiration to draw again, which almost sounds like a metaphor for finding hope and inspiration to keep the whole “life” thing going…

So then my shrink comes out, who is also this girl’s shrink, and it’s time to bare my soul. I exchange my blog info with her, and just like that, I made a new friend. Not too bad for a depressed, awkward slacker. Well, that kind of gave me courage and all, so I sat down and told my therapist flat-out why I was pissed at her. And then I bared my soul and started crying and blabbering and all that embarrassment.

After that I decided to go see my best friend Val and see how her day had been going. And so what was supposed to be a twenty-minute hello turned into hours of hanging out. And then my man-friend called me. And before I knew it, I was begging my mom to spend the night at “Val”‘s and let me skip school for once in my life. A couple of hours later, I was at his house.

So I spent the night. And it was wonderful, every unexpected and expected moment of it. And just as I was leaving, my mom decided to blow up my phone. So I call her. And guess what? She called Val’s mom. BUST-STED.

Guess who’s grounded?

But you’re wrong if you think I regret it. I have this new philosophy to stop living my life based around what other people think makes a “good” person and start living it based around me, and what I actually want. So that means I skipped taking the SAT/ACT this morning as well.

My mom was PISSED. But I was happier.

Blah,blah,blah, I went to work, Mom calmed her shit down, and I began my night of being a loser/hermit, home alone. And I started feeling awful like I always do. After all, I’ve become super lazy, am failing calculus, dropped speech, am behind on my school work, have a job that barely pays for gas, have a habit of cutting myself, and loads of other shit-tastic things. I had hit my crisis moment.

I’m not going to lie to you people: I am not doing too good right now. I constantly sleep, eat junk food instead of real meals, lack motivation, barely participate in the things I used to love, and keep drawing away from those closest to me. Depression has officially taken over, and I’m on my last leg.

But I’m guessing that you readers have had some sort of exposure to depression and know how it feels to be on your way to rock bottom, where nothing makes you feel alive anymore. So I won’t elaborate any further. The thing I’m asking is, how do you really know when you are ruining your life? Or, even more so, is there any way to know if you are ruining your life? I could list off a bunch of people who might say that I am right now, but I want confirmation from myself. (Because honestly, who gives a damn what other people think about my life when they aren’t the ones living it?)

Side Note: Readers, readers…as much as I try to make this blog exposed to the world (hence the new Facebook ‘Like’ box), I know that not too many people read this crap. Which is okay with me, because the minute I saw that one person had read and liked my first post I was ecstatic. But I just want to let the few of you know how much I appreciate your input through comments, tweets, ‘likes’, all of it. In all honesty, you guys are the only people who really know what’s going on with me, and can relate to my trouble with depression. So, thank you. Every word you read makes me feel one step closer to the rest of the world, and one step farther from life’s complication.

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