Diet and Exercise: A Healthy Lifestyle for Wellness #AtoZChallenge

Posted on by Astrid

Welcome to my letter D post in the #AtoZChallenge. Usually when looking for inspiration this year, I have looked to The More or Less Definitive Guide to Self-Care by Anna Borges. Today though, no “D” topic inspired me. Besides, I had basically already made up my mind that I was going to write about diet. Then I decided to add exercise to today’s discussion, as I already have an “E” topic in mind.

Having a healthy lifestyle can be hard for most people and it’s especially hard for those of us struggling with mental health issues. When I suffer with major depression, for example, all I feel like is sleeping and eating and I certainly don’t feel like moving. I’m not telling you that you should force yourself to have a healthy lifestyle all the time. That’s not possible for most people and, when you suffer with serious mental health issues, it’s often not a priority. If it takes all your effort to get out of bed, I’m not telling you to exercise.

But generally, it can really be helpful for your wellbeing to mind your diet and physical activity level. I, for one, need to lose weight to get to a healthy BMI. However, that number on a BMI chart or even on the scale isn’t the main reason I try to eat a relatively healthy diet. It makes me feel better mentally if I get enough healthy food in me and don’t overeat. Getting enough veggies is a struggle with the poor quality of food we get here at the care facility, but I do try to eat enough fruit.

Besides nutrition, hydration is important too. I try to make sure I drink at least two liters of fluids a day. This has been harder now that my days are less structured due to the day center being closed, but I really need to get my hydration habit back up. I use an app called Water Reminder, which is free (with a one-time in-app purchase to remove ads and add some additional features).

It also certainly helps me to get moving. Now I must say that I’ve not been majorly depressed in a long time, so moving comes relatively easily to me. I particularly love walking, as regular readers of this blog will know. I also try to go on the elliptical a few times a week.

Do you try to develop or maintain a healthy lifestyle? Does it help with your mental health?

Cognitive Distortions: Change Your Thought Patterns to Feel Better #AtoZChallenge

Posted on by Astrid

I have been debating whether to continue the self-care theme for A to Z or not. I mean, I want to, but right now I’m not really motivated. I have a post in my drafts folder talking about coffee instead. Then I realized that, since I am struggling quite a bit today, I could really benefit from some self-care. For my letter C post, I am focusing on cognitive distortions. These are those dysfunctional thought patterns that often stand in the way of us feeling better.

While cognitive distortions are dysfunctional and often incorrect, they do make sense to our minds. Everyone employs cognitive distortions at times. Some thought patterns that aren’t reality-based, may even be helpful. For example, most drivers think they are less likely to end up in a car crash than other drivers, even though statistically only 50% of drivers can be less likely than others to end up in a car crash. This is called unrealistic optimism.

Many cognitive distortions though can be unhelpful. Examples of such cognitive distortions include:

  • Filtering: seeing the world through blue-tinted glasses. In other words, seeing the negative aspects of a situation only and overlooking the positive.
  • Polarized or black-and-white thinking.
  • Over-generalizing: drawing general conclusions based on limited experience.
  • Jumping to conclusions: thinking that you can read other people’s minds or predict the future.
  • Catastrophizing: always expecting the worst possible outcome.
  • Personalization: taking things that are not even remotely related to you personally. This can mean you apply random occurrences as being specifically about you, often in a negative way.
  • Fallacy of control: thinking either that everything is in your control or that nothing is. In reality, life is a complex combination of choice and circumstance.
  • Fallacy of fairness: mistakenly believing that everything should be based on what’s fair. Well, life isn’t fair.
  • Blaming: holding other people responsible for your feelings rather than taking ownership of them yourself.
  • Emotional reasoning: seeing your feelings as facts.
  • Fallacy of change: believing someone else or a situation will change if you’re patient enough. Basing your happiness on someone else’s or a situation’s changing rather than taking actions to change your own thoughts or behavior.

Now that I think of it, I can identify at least a couple of these cognitive distortions as reasons behind my recent struggling. For example, yesterday I had symptoms that signaled a UTI, but I catastrophized that I had some serious illness. This was based on the thought that I’ve had for years that, once I’d find a place to live in where I feel safe, I’d die. This is jumping to conclusions. Then I thought that, by thinking I had a serious illness, I was making it real through some kind of twisted law of attraction that I don’t even generally believe in. This is an example of the fallacy of control. In the end, I felt miserable and all because of some cognitive distortions.

Do you often find yourself employing cognitive distortions?

Dear Diary: 2021

Posted on by Astrid

A ton of ideas are floating through my mind for topics I want to write about. However, I’m tempted to just do another #WDIIA post. I also realize I signed up for the #AtoZChallenge and haven’t even started drafting my posts for it yet. Ugh, that’s me being a blogger. Instead of drafting a post in advance though, I’m participating in Mindlovemisery’s Menagerie’s Sunday Writing Prompt for yesterday, for which the theme is Dear Diary. And no, this isn’t going to be a boring description of today. I hope it will be a diary entry I can write someday in 2021, when like I predicted last year, everything will be okay. Here goes.

Dear diary,

I just took a look at some old blog posts from last year. Today is September 30, 2021. My sister and brother-in-law have their fifth wedding anniversary today. Hubby and I just had our tenth on the 19th. It was wonderful! We celebrated by going out at my not-so-newly favorite restaurant, where both of us ordered unlimited piri-piri chicken. It was delicious! My husband had the following week off, so I decided to stay with him for the week. Since traveling still was discouraged last year, but isn’t this year, we took some time to vacation at a nice resort. I spent most of the time in the swimming pool. Boy, have I missed swimming!

I’ve also missed going out to dinner. Oh and ordering pizza. Though during most of the COVID-19 crisis, Domino’s still delivered pizzas, there was no-one to eat them with, since my husband couldn’t visit.

Oh, I’m so happy my husband didn’t leave me over that whole COVID-19 thing. I mean, it took several months before the no-visitors rule was lifted at my care facility. I was worried all of this time that hubby would want to have a real wife who could be with him. Apparently not. He wants me.

I’m so glad the worry is a lot less than it was last year. I’ve been working on my self-worth in therapy and getting EMDR for my childhood trauma. Thankfully, mental health resumed regular face-to-face sessions in June last year. By now, I feel better than I’ve ever before.

In 2019, I wrote on my blog that, by 2021, everything would be okay. I could not have predicted a pandemic making life much harder first. Thankfully, my husband and I survived and it’s made us and our relationship stronger.

Gratitude List (March 20, 2020) #TToT

Posted on by Astrid

It’s Friday and that means the Ten Things of Thankful (#TToT) linkup is open again. I haven’t participated in a while, but in these weird times, we need gratitude more than ever. Here are the things I’ve been thankful for lately.

1. Relatively tasty dinners. Here at the care facility, we get our dinners from a meal delivery company. Last week or the week before, I complained that we got boiled potatoes like four times a week and that I’d like rice, pasta or the like more often. Thankfully they customize the meals for each resident, so it’s not like if I want pasta, everyone gets pasta. I think my assigned staff told the company. In any case, I’ve had pretty varied meals lately. On Saturday, we got tuna macaroni and I loved it!

2. The sensory room. The real one at the day center and the makeshift one at the home. The day center was still open on Monday and Tuesday, so I was able to use the snoezelen® room then. On Thursday, some of the staff created a makeshift sensory room in the currently empty bedroom at our home.

3. Walking. Yay, we’re not in complete lockdown (yet)! I’ve been grateful for walks often before, but in these weird times, I get to appreciate it even more. I managed to get over 9000 steps everyday this week so far except for today (and I’m not going to make it today either).

4. Getting day activities at the home. I was a little scared that, once the day center closed, we’d get no activities at all. Thankfully, that’s not true. I brought some games from the day center to the home with me and we have enough staff to do activities with us.

5. Going on the elliptical. I went on Tuesday, thinking I wouldn’t be able to use it for three weeks after that. However, two staff members transferred the elliptical to the empty room in our home, so that it’s now a combined sensory and gym room. I went on it for like 20 minutes yesterday.

6. Modern technology. I’m so glad this pandemic is happening now that we have the Internet and smartphones and the like. Otherwise I wouldn’t be able to connect to my husband, my family or the wider community at all. I’m so happy this thing does connect us all in a weird kind of way.

7. Meditation. I use an app called Insight Timer on my phone for meditating, but I hadn’t used it in a while. Then I checked it out and saw they have a whole section devoted to overcoming fear in these weird times. I loved listening to some guided meditations.

8. A phone appt with my CPN from mental health. We had a pretty good session. We actually did get started on some cognitive behavior therapy like we were planning on. She’s also going to get me signed up for the eHealth module with the agency.

9. My husband. Yesterday I was suddenly overcome with fear that I’d never see my husband again or that he’d want to divorce me due to our inability to be together in this crisis. My husband reassured me that I won’t lose him. He’s so lovely!

10. My health. I almost forgot that this thing is about a viral disease that takes actual lives. I so far haven’t had symptoms of COVID-19, but I’m confident that when (yes, it’s most likely a “when”) I do get the disease, I’ll survive.

What have you been grateful for lately?

Writer’s Workshop: If I Could Change One Thing About Myself

Posted on by Astrid

Mama Kat in one of her prompts for this week asks us what one thing we would change about ourselves if we could. She also asks us to think on why it can’t be changed.

This is pretty much a no-brainer to me. If there’s one thing I could pick to change about myself, it would be to widen my window of tolerance. The window of tolerance is the window at which point someone is stimulated enough that they aren’t bored too much, but not so much that they are overloaded. Each individual’s window of tolerance is different. Some people thrive on challenging activities and exciting stimuli. Others can barely handle any sensory or cognitive demands. I belong to the latter category.

If I’m correct, the window of tolerance also refers to the ability to tolerate distress or frustration. My distress tolerance is and has always been extremely poor.

So why can’t it be changed? Well, I tried. Ever since I was a little child, psychologists have recommended I work on distress tolerance. Now I must say I really wasn’t aware of the problem at all until I was about eleven, but even when I was, I had no idea how to heighten my distress tolerance.

My tolerance for sensory and cognitive demands was manageable up until I suffered autistic burnout at age 21. I mean, I was in classrooms with 30+ students in them, doing my schoolwork at a high level high school. Ever since my burnout though, I’ve hardly been able to function in group settings without getting overloaded. I also can’t seem to handle any sort of pressure.

In 2017, when I was being kicked out of the psychiatric hospital, it was recommended that I do dialectical behavior therapy (DBT). One of the modules of DBT is distress tolerance. The community psychiatric nurse (CPN) who started DBT with me, even wrote increasing my frustration tolerance as a treatment goal without my having asked her to. I didn’t see how I could work on this. After all, seeing this goal written on my treatment plan already created such immense pressure that I felt overloaded without even trying to work on the goal.

I know I have a bit of an external locus of control. This seems to be tied in with poor distress tolerance. I mean, it isn’t that I genuinely think the world owes me a sensory-friendly, low-demand environment. However, I can’t see how I can work on changing my ability to handle sensory stimuli, demands and distress.

Mama’s Losin’ It

Guilt Won’t Help Suicidal People

Posted on by Astrid

Yesterday Ashley shared a piece about a blogger friend of hers who had died by suicide and the guilt trips she received on Twitter. The person had scheduled her post for after the fact, so she most likely didn’t see the guilt-tripping. However, this got both Ashley and me thinking about guilt tripping not being a suicide prvention strategy.

This person had written that her intent was to be hit by a train. This led people to blame her for traumatizing the train driver. While it is true that train drivers are often traumatized by people running in front of their trains, it is equally true that guilt won’t help suicidal people.

I was in a suicidal crisis in 2007. I also intended to be hit by a train. I disclosed this to my support worker in a voicemail message, which people overheard, as I was on a bus. They called the police, who called someone called a community physician. This doctor was supposed to liaise with the mental health crisis service. For some stupid reason, the police in that city can’t directly call the crisis service. Anyway, this doctor told me I was making people feel responsible for me.

Well, let me tell you, in a depressive state or any state that can lead to suicidality – mine was diagnosed as adjustment disorder -, this won’t help. This will, if anything, just tell the sufferer that their suffering isn’t as important as someone else’s suffering. It will also most likely reinforce the prevalent idea among depressed people that they aren’t worth much, which may further reinforce their suicidal ideation.

I also want to say there is no way of dying by suicide that won’t affect others. Then again, there is no way of dying that won’t affect those lefte behind.

Some people think that running in front of a train is extra selfish. Well, once I was in the hospital, I spoke to my mother. She told me that I was selfish, because if I died by suicide, my parents would have to pay for my funeral. Let me tell you, this only made my depressive mood worse.

Sometimes, it can help suicidal people if you gently ask who they will leave behind, so that they might realize they still have loved ones. It didn’t help me. I didn’t have friends at the time and my family were, like I said, very unsupportive. In any case, don’t appeal to someone’s sense of responsibility or selflessness. That’s only going to make them feel worse and it won’t actually help those who would be affected by someone’s suicide. People who are suicidal benefit from support, not judgment or guilt tripping.

#FOWC: Euphoric

Posted on by Astrid

I haven’t felt really happy for longer than a few minutes at a time in a long while. I mean, yes, sometimes I laugh out loud and feel pretty good for a few moments. Overall though, I feel irritable.

I have never experienced an euphoric mood as far as I know. Then again, in mental health, euphoria isn’t seen as something positive. It is one of the manifestations of the (hypo)manic phase of bipolar disorder. The other, dysphoria, is not as commonly recognized as a bipolar or mood disorder phase.

I’m not bipolar. I never experienced mania or even hypomania. I do however experience dysphoric symptoms. In fact, I’m almost always irritable.

Back in the day when the DSM-5 was being drafted, the term for what is now called disruptive mood dysregulation disorder, was temper dysregulation disorder with dysphoria. Neither term feels right to me, as someone who may’ve been diagnosed with DMDD as a child had it existed in the mid-1990s. I feel mood dysregulation disorder with dysphoria would be a better name. I mean, yes, of course these kids are disruptive, but the focus should be on their unstable mood. DMDD is characterized by the occurrence of frequent mood outbursts combined with a generally irritable mood even when the child isn’t experiencing dysregulation.

Thankfully, irritability was added to depression’s mood criterion in DSM-5 too. Before then, it was only a criterion in children and adolescents. I, however, have always experienced dysphoric depression. In fact, I’m pretty sure I’m diagnosable with persistent depressive disorder.

This is one reason I might want to experience a bit of an euphoric mood at times. Maybe I do get it, but usually it happens at an inconvenient time. I mean, I occasionally experience an extreme flow of ideas combined with an urge to act on them. Usually this happens during a night I cannot sleep though, so I cannot act out my impulses immediately. Then often the next day I’m back to my usual, irritable and slightly depressed self. Even though I know that it’s not an entirely positive thing, I wish I experienced euphoria for a longer while at times.

2019: The Year in Review

Posted on by Astrid

Wow, can you believe 2019 is almost over yet? It was truly an eventful year. I want to do a review of the year. I originally intended on waiting till the 31st to do it, but I’m not sure I’ll have time for it then, as I’m celebrating New Year’s at my in-laws.

I had a theory when I was a teen that said life ran in cycles, by which every three years I’d find myself struggling significantly, then the next year would be one of hope, and the third year would be one of disillusionment, by the end of which I’d spiral into despair again. 2001, 2004 and 2007 were all years of despair, whereas 2002, 2005 and 2008 where years of hope. I didn’t continue to be superstitious about this past that point and honestly looking back each year was really a mixed bag. By this logic though, 2019 would have to be a year of despair. It was to begin with, but it ended on a really positive note, whereas by my teenage logic, the fall of the year of despair would be the hardest.

Well, let me say this year was extremely eventful indeed. At the end of 2018, we had just mailed out the application for long-term care funding. I started the year really hopeful by looking at a living facility and having my long-term care assessment in January. Then in February, I grew cynical. I decided everything wouldn’t be okay till 2021, as that would be the year people with lifelong psychiatric conditions would be allowed access to long-term care. I was right. My funding application got denied.

March, April and May were all largely months of waiting, as we sent out the appeal letter and my appeal was looked at. In late May, my support coordinator told me I would most likely not be granted long-term care funding this time either, but the lawyer in charge of my appeal was going to see if she could find a way to approve me anyway. She did somehow. I feel the long-term care regulations put people with multiple disabilities at a significant disadvantage. I remember writing blog posts explaining the legalities of long-term care back in like 2009 on my very first WordPress blog and I already felt the rigid care packages based on primary disability, were stupid. I don’t know how they managed to grant my appeal and even if I knew, I wouldn’t share it here.

By the time my long-term care funding was approved, my support coordinator had been informed that the care facility in Raalte with her agency had several available rooms. I started the intake process. By late August, just as I was losing hope again, I was told I would be accepted. I moved on September 23.

The past three months have been good. I feel a sense of calm, even though I still experience meltdowns. I had one tonight. Like a fellow patient on the locked unit said once, I can move around all I want, but I still need to look to myself for improving my own mental health.

When I looked at my review of 2018, I saw that my husband had been warming me up to us buying a house in his work city. I thought then that this may not happen if I go into long-term care, and indeed the house we bought isn’t in his work city. However, it’s still a house he likes. It is legally my house too, of course, which is good, in that I can move there if I ever get kicked out of long-term care. I also try to stay involved with renovation plans, but I struggle with this.

I took a look at my hopes for 2019 as I was preparing to write this review. I can be pretty satisfied with how I did on them. The only goal I didn’t meet, was to have a healthier lifestyle and lose weight. I’m doing okay on the healthier eating part, as I haven’t had binges much since coming to the care facility and make sure I don’t indulge into my every food whim. However, I don’t exercise nearly as often as I want to, though I get about as many active minutes as I did when living with my husband.

I did buy a new computer. Two, in fact, as I wasn’t happy with the Mac I bought and sold it to my mother-in-law. I am very happy with my current Windows PC though. Having a working computer again enables me to do so much more with my blog than I could when only using my phone. This helps me keep a regular blogging schedule too. Finally having found a feed reader that works in my browser, also helps. That was my only initial frustration with my current PC, as my Mac had a good feed reader and I struggled to find one for PC.

My last hope for 2019 was to stay mentally stable. I’m pretty sure I have reached this goal, as I’ve not been in serious crises at all. I’m also more than happy with how my staff handle my meltdowns or short crises as they do happen.

Friday Evening Ramblings

Posted on by Astrid

Hi all,

A lot has happened over the past few days. Last Tuesday or Wednesday, we were checking out the website for our current care agency and we found out they have stories from clients, family and staff on the website. One of the stories was about a woman who lives with minimal brain dysfunction. This is the old term for invisible effects of brain injury. She had this from birth. I loved reading her story. It was so relatable. Then again, some of us were feeling off. Like, this woman lives in housing for people with brain injury and some wondered whether we can do this too.

Then we had an idea. We read about a training program called Hersenz. This translates roughly to “brain etc.” It is kind of like a continued course about the effects of brain injury and learning to handle those at home. For like when you can’t be in a rehabilitation center but can’t quite cope at home either. I don’t know whether it’s for people who live independently only, as we have no intention of leaving this facility.
I then inquired about whether there’s a brain injury cafe in my area, where people with brain injury come once a month to discuss their issues. There isn’t as far as we can tell, so oh well. Oh, you all know that we have some level of brain injury from a brain bleed we sustained shortly after birth right?
We also have been thinking of asking whether we can have our story on the agency website too. That would be fab!
Today we had a meeting with our psych nurse and nurse practitioner from the mental health team. I can’t quite remember all that we discussed but it was a good meeting.
Oh by the way, I’m Danique. I’m 21 like Clarissa and I guess I split off from her. Not really sure why. I don’t care though. There’s someone softly telling me that splitting isn’t possible in adulthood unless you experience recurring trauma, which we don’t right now. Well I don’t care. We also think we found a younger one who is 11 and is called Janita or Janique Or Janelle but she isn’t really sure about her name.
I feel pretty awesome right now! I guess there’s someone else feeling triggered or sad or whatever, as I sense those feelings too.

Danique

Friday Flashback: Diagnonsense, Oh Diagnonsense!

Posted on by Astrid

Today I’m joining in with Fandango’s Friday Flashback and sharing a post I wrote exactly three years ago on my old blog. I let my domain registration for the blog expire this week, but it’s still available on a WordPress subdomain. With this post, I have edited out typeos and am not going to keep all the internal links. I’ll provide a link to the original at the bottom of this post.

A few months ago, I wrote about my changing diagnosis. My autism diagnosis that’s been confirmed three times since 2007, was removed. That left me with just borderline personality disorder (BPD) as a diagnosis. If you thought I gracefully accepted this, you do not know me. I consulted with the patient liaison person at my institution, who recommended I seek a second opinion at another hospital. Now, three months on and we’re back at square one, and it’s not because an independent provider agreed with my psychologist.

On August 15, I talked to the patient liaison person, who on that same day E-mailed my psychologist asking her to make the necessary arrangements for me to get a second opinion. Instead, my psychologist told me she wanted to contact a psychiatrist at the brain injury unit first to inquire about the diagnosis of autism in people with brain injury. This doctor told her that indeed autism shouldn’t be diagnosed in people with brain injury, but the same is true of BPD. My psychologist would need to diagnose personality change due to a general medical condition instead. I stupidly agreed with her changing my diagnosis herself rather than sending me to an independent psychiatrist or clinical psychologist.

My psychiatrist, who is the head clinician responsible for my care, however, disagreed with my psychologist’s diagnosis. My named nurse said they were throwing around all sorts of diagnoses at my treatment plan meeting last month. Eventually, my psychologist informed me they’d settled on dependent personality disorder, borderline personality disorder traits and a developmental disorder NOS. I hate the DPD label, but can see how I might have some of its features. I needed to see my treatment plan to see what they’d meant with developmental disorder NOS, which isn’t a diagnostic code in DSM-IV unless prefixed by “pervasive”. That would essentially mean autism. As it turned out, they hadn’t settled on this diagnosis, as the developmental disorder was gone.

Instead, I now have DPD, BPD traits and depressive disorder NOS. I asked my psychologist whether this was a coding typeo, but it wasn’t. Her explanation was that I may formally meet the criteria for this, but the main reason for the diagnosis is for insurance purposes. You see, I can’t be in the mental hospital without a diagnosis on axis I (anything that isn’t a personality disorder). A nurse even twisted my psychologist’s actions like she’d done me a favor.

Last week, when I found out my final diagnosis, I lost it pretty much and was considering checking myself out of the institution. My psychologist was called, because the nurses thought I said I was definitely leaving, which I can’t remember having said. My psychologist encouraged me to leave right then, which I refused. My husband instead came to pick me up the next day for a night at home to have some distance.

Today, I spoke to the patient liaison person again. She was not happy at the fact that my psychologist had failed to cooperate with me in getting me a second opinion. This essentially means we’re back at where we started and I’m probably going to ask my psychologist to get me a second opinion again soon.

https://bloggingastrid.wordpress.com/2016/11/22/diagnonsense-oh-diagnonsense/