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Friday, September 30, 2016

My purple journal

When my therapy session last week was about to end, I handed my personal journal to Dr. G. It was the journal that I kept when I was still under the care of Dr. B (my former psychiatrist) and was still not undergoing Cognitive Behavioral Therapy (CBT). I was just under medications back then. Writing on my journal was my way of releasing...whatever it was that I needed to release. My anger, anxiety, things that make me upset, things that make me sad, Z whom I'm so insecure of, how Z (or should I say, thoughts of Z) has the power to pull me into a deep, dark, downward spiral--all these are on the pages of my journal which, coincidentally, is purple and has a metal elephant ornament in front. "Oh it's an elephant, and it's purple," Dr. G said when I handed her the journal. My purple elephant. My symbolic purple elephant, which I wrote about here.

I stopped writing on that journal when Dr. G told me to keep a thought journal wherein I would write situations, my moods, and emotions and images that came to mind in those situations. This is the CBT format. My purple journal doesn't follow any format. It's all me. I'll resume writing on my purple journal when I'm done with CBT.

I decided to lend my purple journal because I wanted to let Dr. G see how I was before I started seeing her. I wanted her to see what plagued me when I was still not undergoing CBT. I wanted to give her a peek into my chaotic mind so she can help me deal with my present troubles, which are a continuation of my past troubles. I wanted her to get to know me better so she will know the story behind every tear I shed during therapy.

My purple journal is my private, personal journal. The journal itself is a gift from PM (my boyfriend), which he got for me during his trip to Thailand. He told me that when he saw that journal, he knew he had to get it from me. And the moment I saw that journal being handed to me, I knew I was meant to have that journal. It's now my purple journal, and written on its pages are my purple elephants.

I let PM read my entries once in a while. I'm not sure if I've allowed him to read everything, but every time I want him to read an entry or two, he would gladly oblige. He is the only person who has access to that journal, and even then, he doesn't touch it unless I ask him to. Now, it's with Dr. G. I'm practically letting her dig deep into my soul. I'm practically introducing her to my demons. This is difficult. No wonder a psychiatrist's professional fee is steep. It's because he or she helps the patient fight demons that the patient cannot fight alone. And these demons cannot be seen, but they are there.

I've been seeing a psychiatrist for a year and five months already. It has been a long journey but the road ahead is still long. Dr. G and I are processing everything one at a time. Every negative thought, every emotion, every trigger--we're dealing with them one at a time. CBT is usually finished after ten sessions, but I think I would have to extend. I don't think everything that plagues me can be resolved in my remaining three or four sessions.

On a more positive note, I always look forward to my CBT sessions with Dr. G. I get upset when I have to skip a session because of work or other matters. I feel safe in her clinic. For me, it is a place where I am free to talk and cry and then talk again. It is a place where I am away from all my demons and ghosts, from all my triggers. It's a place where I am away from Z, where Z cannot hurt me.

Every time I sit on that sofa at Dr. G's clinic, I do not want to leave. I do not want to be back to the "real world." But of course, the next patient is waiting, someone who maybe has the same demons as mine.

I hope Dr. G has the time to read everything in my purple journal. But she's busy. Maybe she would scan them and maybe read the entries that stand out. I don't know. I don't know what her reaction would be. Maybe I'll find out on my next session.

Monday, September 26, 2016

Cognitive Distortion No. 1: Catastrophizing

Last Wednesday, after my therapy session, I didn't come out of Dr. G's clinic a disaster. And that, I think, is an achievement, so I treated myself to a glass of chocolate cream frappuccino and a sausage roll from Starbucks. I deserved the treat.

I now feel that everything that Dr. G has been telling me in our therapy sessions is starting to make sense. In my mind, they're no longer theories. Dr. G has been telling me that one of our goals in doing CBT (Cognitive Behavioral Therapy) is to deal with my destructive thinking patterns and "fix" them. My session last Wednesday couldn't have come at a better time.

Last Tuesday, I made a REALLY BIG mistake at work. It was really a big deal. It was a stupid and avoidable mistake. Of course, I got flak for it. I was so embarrassed that I felt I couldn't face anyone at work anymore. I slept last Tuesday night hating myself--as in REALLY hating myself--and telling myself repeatedly that I was so stupid. Stupid, stupid, stupid. And irresponsible. Irresponsible, irresponsible, irresponsible.

And when Wednesday came, it was still fresh in my mind, so I told Dr. G about it, aside from all the things that happened to me the past month. Dr. G told me that the incident at work is a perfect example of why we're doing CBT. We focused on this thought: I am stupid and irresponsible. From that thought, she asked me what is my basis for saying that I'm stupid and irresponsible. And so I told her. She then asked me how many times I've made this mistake in the past seven years (I've been working in this publishing company for seven years). I said one, followed up by, "But I also made other mistakes in the past." She then asked me to share them, and I obliged, and she wrote them down.

After this, she asked me what my basis is for saying that an employee is responsible, and in my seven years of working, what are the things that I've done that make me responsible. And so I told her all that I could remember--all the good things that I did, articles that I wrote beautifully, positive feedback from some of the people whom I've interviewed for my articles, writing for other magazines published by the company once in a while, and representing our team during events. She wrote everything down.

Then, when I was done talking, she told me to look at the things she wrote. I made a mistake, yes, but in my seven years of working, I've done good things, too. One mistake doesn't make me irresponsible. And that, I felt, is how CBT helps.

One of the cognitive distortions I am guilty of having is the tendency to catastrophize things. One mistake, and I feel that I've summoned a catastrophe. One mistake, and I already feel that I'm stupid and irresponsible. One mistake, and I feel as if I've committed a crime against humanity. One mistake, and I can't forgive myself for it.

This isn't my first time to catastrophize. Last February, I've done this, and I think that was my worst case of catastrophizing so far. It was when I tried to reach out to Z to make sure everything is okay between us. But then, she said that it only made things awkward, and I didn't take it well. I beat myself for it, attempted to overdose on tranquilizers (Alprazolam) not to die but to fall into a deep sleep, and I made cuts on my left arm. I wrote about it here and here.

Now, cognitive distortions and CBT are starting to make sense to me. Catastrophizing isn't the only cognitive distortion I'm guilty of having. I'll write about them in my succeeding entries. For now, Dr. G's homework for me is to do at least one pleasurable activity per day. Activities that make me happy, which she had me list down during our session. I listed down fifteen activities, but she told me that I am free to add more. That is my homework. And I'm going to do it, being the good student that I was (some XX years ago) and being the good patient that I am.

Tuesday, September 13, 2016

My never-ending battle with insecurity

Nothing could trigger my depressive episodes really hard than bouts of insecurity. And there's this particular girl that I am so, so, so insecure of. In my previous entry, I called her Z. From then on, let's call her Z in all my related entries.

I'm not the type who's insecure about looks; modesty aside, I think I'm not lacking in that department. What I'm insecure about Z are her brains and her talent. She's incredibly smart. She's a doctor. And she can sing--not very well though, but still, she can sing. Ever since I got to know these things about her, I felt so down and inadequate, even if we're not being pitted against each other.

The fact that she can sing is probably the biggest and heaviest boulder thrown at me. She's incredibly smart and she's a doctor, and I'm neither. Sure, people say I'm smart, and I'm happy about that. But the thing is, I sing, too. I love to sing. And it pulls me down knowing that she can do this, too. It's as if she can do everything that I do, but I can't do what she does.

I've never considered science, math, medicine, and law to be superior fields, reigning over the arts, languages, and communication. That's why we have multiple intelligences, right? But when I got to know Z and the things that she can do, I felt so small. I felt that being a writer "doesn't count." I felt that I'm in a "lesser" industry. What's writing compared with saving lives? It's as if she's doing something great for humanity, while I'm just here, typing my articles.

Months passed but this feeling didn't go away. And as the day that I'd get to meet her drew near, my anxiety level shot up, one level at a time, every single day. When I was already at the venue (it was a dinner party), I couldn't eat because I knew she would arrive at any moment. My stomach was in knots. I felt like throwing up. My pasta tasted bland--either it was really bland or I couldn't taste anything anymore. I wasn't able to eat. And when she arrived, I didn't know what to do. I managed to smile and shake her hand when we got introduced, but I knew I wasn't in a "safe place." I managed to interact with the other people at that dinner party, and somehow, those interactions helped calm my panicking self. But those interactions didn't change the fact that I wasn't feeling well. Seeing her around made my heart beat faster and pound in my chest really hard.

After that dinner, I broke down and cried. I couldn't take it anymore. I couldn't pull myself together anymore. I just cried, even if I knew I wasn't making sense, nor was I being rational.

A couple of months after that dinner, I thought I was already feeling better. I thought I was ready to put everything behind. I thought that if, by some reason, we bump into each other, I wouldn't be awkward with her, and I didn't want her to be awkward with me. And so with all these good intentions, I tried to get in touch with her to tell her how I felt. But it didn't turn out well. She said it made things awkward. I felt that wow, there I was, trying to rectify the situation. But I made things worse. Even with good intentions, I made things worse. I failed.

Because of this, the more I got pulled into this downward spiral. I got even more insecure of her. And the worst part? SHE HAS NO FREAKIN' IDEA about all these. She doesn't know that she has this effect on me. And why should she care anyway? It's not her fault that I am insecure.

I am insecure. I wish I wasn't. But it's not something you just get over with. It's not something you put in a box and stash in your storage room (we call it bodega here in the Philippines). It's not something you throw in the wastebasket. It's not something you wash off. It's part of you. It's part of me. I wish it wasn't.

And so I'm here, dealing with my insecurity. I'm already on my seventh session of Cognitive Behavioral Therapy (CBT). My psychiatrist Dr. G has really been so nice and patient. Throughout those seven sessions, we always touch on my insecurity. And what happens next is always the same: I break down and cry. My makeup gets ruined. My eyes get red. My nose gets clogged. And all these because I'm insecure of Z. Because I feel so small. Because I feel inadequate.

This isn't something that my medicines can fix. That's why I'm going through therapy, hoping to get equipped with the right skills to cope with it. I can't go through life feeling like this, feeling small, feeling like my achievements don't count because someone out there is saving lives or whatever. I'm tired of all these. I'm so tired of being insecure.

Don't compare yourself with others. It's easy to say that. I've told myself the same thing countless times. And yet, here I am, still insecure.

I can't wait for the time when all these--my insecurity, my depressive episodes, my unpredictable moods--will be over. I can't wait. But like my psychiatrist who's patient with me, I need to be patient with myself, too. And I should stop punishing myself for feeling this way. I didn't want to be like this. I'm sure no one wants to be like this. But what can I do? These are the cards I am dealt with. I have no other choice but to play this right and recover.

Sunday, September 4, 2016

The case of the purple elephant

I've been wanting to write about my therapy session two weeks ago, but I've been really busy. Anyway, here I am, writing about it and giving you an update of what I've been going through.

As I've mentioned in my previous entry, my psychiatrist put me back on antidepressants (Escitalopram). So now, I'm back to taking three medicines: Escitalopram, Quetiapine (antipsychotic), and Lamotrigine (anticonvulsant). The cost has really hit my wallet so hard. Thank God I got extra money last payday for extra work I did before.

Last August 24, my psychiatrist and I touched on my insecurity once more. This, I think, is my biggest depression trigger. I've been really insecure of (and frankly, annoyed at) this person. Let's call her Z. And last February, when I sort of had a close encounter with Z (through Facebook), I really spiraled down. Down, down, down. I wrote about it here and here.

Ever since that February encounter with Z, I never go out without makeup. Before, I could go out with just moisturizer and powder on my face, especially if I wouldn't be out for long. But now, since February, I always wear makeup when I go out. When I'm with my boyfriend to watch a movie or just stroll at the mall around the area where he lives in, I make sure I wear makeup. First, it's because when I see that I look good, I feel good. And second, we might bump into Z (she lives in the same area), and I don't want to look plain when that happens. I want to look good, to be pretty when I bump into her. So far, it hasn't happened. Yet.

This insecurity of mine is spiraling out of control. It's one of the reasons why my psychiatrist (Dr. G) put me back on Escitalopram. I'm now taking 15mg of Escitalopram in addition to 300mg of Quetiapine and 150mg of Lamotrigine. This combination is making me very, very sleepy.

In my last session with Dr. G, she gave me the elephant exercise. She asked me what my favorite color is (it's purple), then she told me to close my eyes and think of a purple elephant. She asked if what I'm seeing is an adult or baby elephant; what's going on with its ears, trunk, and tail; and where I am seeing it, was it in a jungle, zoo, or somewhere else. When she told me to open my eyes, she asked me if I've seen a purple elephant in real life. I said no. She then went on to say that that is the power of our thoughts.

After her explanation, I asked, "Does it mean that I'm making it (my depressive episodes) all up?" She assured me that I'm not making anything up. The point of cognitive behavioral therapy (CBT) is not to put blame on me. It's to change my negative thought patterns. She then went on to say that our thoughts are influenced by our past experiences, like the way were brought up. These experiences affect how we think about and see things. None of these are imagined or made up. They're all products of our past.

My depressive episodes and panic attacks and my restless and noisy mind--from now on, I will see these things as one purple elephant. My purple elephant. It's not something I made up, of course, but something I saw because of my past experiences.

Dr. G also gave me a list of cognitive distortions (with explanations for each) and asked me to encircle what applies to me. Out of ten, I encircled eight. It's from David Burns's book Feeling Good Handbook (which I have yet to get my hands on). My destructive thinking patterns are destroying me and the way I see myself.

My latest destructive thought is that I'm afraid of getting fat (just to make it clear, I don't have anything against plump people). I've never been the type who's conscious about her weight or figure. I eat anything I want. I have a fairly fast metabolism, but I don't overeat. But lately, seeing a flat tummy when I look in the mirror makes me feel good even if it means I'm hungry because I haven't eaten breakfast yet. Then I will just have light snacks then eat lunch late. When I get to the office, I just want to work, with sugary food like cookies sustaining me before I eat a proper meal. It's not healthy. I shouldn't rely on sugar for energy--I must eat regular meals. But lately, my appetite is messed up. Z triggered my latest panic attack (and my subsequent plunge, as if my current depressive episode isn't drowning me enough) when I saw a photo of her on my Facebook timeline (FYI, I'm not friends with her on FB but some of my friends are). I got insecure for the nth time, hence this latest destructive thought: I don't want to gain weight because Z leans on the chubby side.

I'll see Dr. G again in two weeks (I'm supposed to see her this Wednesday but something came up at work so I had to reschedule). I'll bring all these up--my fear of gaining weight, my fear of being seen barefaced, my neverending depressive episodes. Maybe we'll have another exercise that could help me see things from a better perspective.