Category / dbt

by krubesch

Hearts Keep Drumming

Hearts Keep Drumming

Oh life
Is just a game
No one ever tells you how to play
See different people
Go different ways
Some of them will leave you but
Some of them will stay
Well our hearts keep drumming
And the years keep coming
Quicker than they’ve ever been
You’re sick of the same thing
But it’s quicker than changing
It’s too late to begin
Well everybody’s running
But you don’t know where
Time is running thin
Everybody’s looking for somebody to love
But we’re scared to let them in
And I say oh oh oh
Are there any survivors?
Am I here alone?
I say oh oh oh
Are there any survivors?
Am I here alone?
Am I on my own?
Am I on my own?
Oh love
It comes and goes
But no one never tells you how to learn to let go
Different people, they walk different roads
Some of them will hurt you but
Some of them won’t
Well the bridge is burning
And the wheel keeps turning
Quicker than it did before
Your heart screams “yes”
Your head says “no”
And you’re never really sure
Well everybody’s running
But you don’t know why
Time is running short
Everybody’s looking for a place to hide
So there’s no one left at all
Survivors
By Passenger

It’s been almost a year since I have posted on my blog. It’s not that I have not written, I just did not feel like sharing what I wrote, as it has been a difficult year and I have felt guarded. Everything I wrote just seemed so dark and depressing. I judge myself a lot harsher than I would anyone else and feel like what I have written is utter crap. This past year has felt like being on the biggest and craziest roller coaster at six flags. Not only have I had some of my lowest moments, I have also had some really good experiences, in which I have pushed myself out of my comfort zone. These experiences seem to have changed me in substantial ways and pushed me to grow in ways I don’t think I otherwise would have.

In February after years of hearing about it, I took part in Ladies Rock Camp. Thanks to my friend, Emily (!) and all my awesome friends who donated towards my tuition. This is basically a 3 day music camp for adults that includes music lessons, we are split into bands, and then tasked to write an original song and then perform it at a venue. I was so excited and nervous before participating and had a lot of self doubt about taking part in this. I am so glad I did it! I played the drums (my first choice of the 3 instruments I put on my paperwork) at Ladies Rock Camp and this was the first time I had seriously played since I was 17 years old. I had a bad experience with a band director in high school and was picked on for being one of the only girls (and good) who played the drums in middle school and thought that I would never play again. This experience was amazing and really boosted my self confidence. I feel like I was able to reconnect with this part of my 17 year old self and it felt really healing. It was nice to prove to myself that I could do something that felt really scary and out of my comfort zone and actually excel at it. I didn’t even get mad at myself when I goofed up during our performance (big deal for me!). This is something I try to hold on to when I am having difficult moments and I am slowly starting to add the drums back into my life as a fun activity. This was definitely one of the heights of the rollercoaster of the past year.

Part of the reason why I am writing about all of this now because not only do I need to sort out the thoughts in my head, but I think I need to reach out for help from my friends and family. Writing seems to be the only way in which I am able to articulate my thoughts and needs in an effective way.

I was diagnosed with stage 4 endometriosis after having surgery on 08/01/2018. The doctor who diagnosed me was the 7th doctor I had seen for the chronic pain I had been experiencing at that point for two years. Although that surgery relieved a lot of my pain, I started having chronic back pain again in October of 2018. Since then my pain has increased and is now affecting different parts of my body. Currently, and in the past 6 months, my pain levels radiate between 6 out of 10 to as bad as 10 out of 10 on the pain scale. My wife tells me I am not an effusive or demonstrative person (What?! who is surprised by that other than me?!) and that she has not been aware that I have been in that much pain since I don’t go into detail when I tell her I am hurting. To me, saying that, “I am hurting” means that I am in a lot of pain because I don’t usually complain. I think that I am conveying to people how I feel when apparently I am not getting my point across. That has been a big source of frustration in general for me, as I think I am communicating to people when I am actually not. I need to keep this in mind and try to be more descriptive with my words.

After almost 8 months of physical therapy ($$$ because hardly any pelvic floor therapists in Georgia are in network with insurance), an MRI, a back x-ray, appointments with my primary care physician, my surgeon and a rheumatologist, I still did not really have any answers about why I was continuing to have chronic back, hip, glute, thigh and heel pain. In early April, I became a little desperate about my increased pain and decided to get a 2nd or 8th (depending on how you look at it) opinion from a doctor in Chattanooga who was in network with my insurance and really seemed to know his stuff. When I called the earliest appointment he had available was 08/06/2019, so I went ahead and scheduled it.

On my birthday, 4/30/2019, the surgeon who originally diagnosed me, called me to let me know I had some concerning cysts and “fluffy” tissue that her radiologist noticed on the MRI I had in February (after Emory told me it was normal- the 2nd MRI they have misread). She let me know that she would need to do multiple procedures along with a biopsy as soon as possible to determine if that was causing my recurrence of pain and to rule “other things out.” Of course I immediately went into panic mode and consulted Dr. Google! Bad idea… My immediate concern became that I might have cancer. I continued to pretty much obsess about this until we finally got the results of my biopsy. Almost two months after that phone call and the procedures, I found out that I did not have cancer and that the “fluffy” tissue was likely due to the excess estrogen that is caused by endometriosis.  Not a definitive answer as to if this is causing my pain. My doctor seemed pretty unconcerned with my pain levels, especially since my test results all came back “normal.” I decided to keep that appointment with the other doctor in Chattanooga in hopes that he might have some insight.

I am really glad I kept the appointment with the surgeon in Chattanooga. He listened and asked questions in a way no other doctors had up until that point. He knew from looking at my previous surgery pictures that I still had endometriosis on my intestines and most likely in other areas in my abdominal area. He told Leah and I that I would need another surgery and explained that I would need to have my appendix removed because it can be a pelvic pain generator and excise any endometriosis that he finds when he goes in. He also highly recommended that I get a hysterectomy and he will leave it up to me as to whether I keep my ovaries or not. He did extensive blood work at that appointment, ordered a lumbar MRI (in hopes to see if he could tell what was causing my back pain, although he is pretty sure it is endometriosis). I left that appointment in tears- partly because the drive to Chattanooga felt amazing compared to Orlando (my other surgeon’s office is there) and really because, once again I know my body best and I am not crazy. He validated the fact that I knew and still know that there is something wrong with my body and my surgery was scheduled by the time I left his office. His office is so much more efficient than my previous surgeon. He answered all of my and Leah’s questions in detail and spent over an hour with us at my appointment.

I thought that waiting 4 months for my appointment with him would probably be the most difficult thing out of this process, well I was wrong. Our insurance changed in July of 2019 and I have been trying to get the MRI that my doctor ordered approved by our insurance company for two months at this point. My doctor’s office and I have spent hours on the phone with them, he did a peer to peer review (where your doctor tries to convince one of the insurance company’s doctors that you need whatever procedure they’re denying), and I wrote an appeal letter- including my eight months of physical therapy notes, my x-ray results, and a note from my therapist (basically saying that chronic pain and constant self-advocacy and battles with insurance is affecting my mental health). I am still in limbo as of today as to whether they will cover my MRI and my surgery date is 20 days away. I thought that having three months in between my appointment and my surgery date would give me plenty of time to get everything in order. As of today, I still don’t know if they are going to approve my surgery that is scheduled out of state in less than 3 weeks.

Everything came to a head last night and I had an epic meltdown. I started crying while I was cooking because we were out of avocado and that was supposed to go into the meal that I was cooking. I am on a crazy anti inflammatory/endometriosis/ interstitial cystitis diet to try to manage my pain and inflammations and it was the avocado that tipped me over the edge! All the feelings that I have been keeping at bay by remaining constantly busy, productive, researching and planning, all came rushing to the surface and finally I let myself stay with my feelings and allow them to move through me. I am so so tired. Being in constant pain and remaining a productive member of my household, job, and society in general is so draining. I am very careful as to how much we have scheduled outside of work because even a fun and easy dinner with friends is exhausting. I know that I have been isolating myself for this reason and also having a chronic illness that involves my lady parts is not necessarily the easiest thing to talk about, nor the most acceptable in our society. I am aware that I am not reaching out to people when I need to and I am going to work on this.

It’s very hard to try to process losing my uterus when I don’t even know if or when it is actually going to happen. It feels hopeless to have to fight with my insurance company when I am in so much pain and the dark thoughts I try to keep at bay come bubbling up to the surface. These suicidal thoughts make me feel riddled with shame along with the shame that comes with having endometriosis in the first place. Not to mention having to prove to doctors and insurance companies that there is something wrong with my body. This is something that needs to be discussed. 1 in 10 women have endometriosis and so many women have hysterectomies and don’t talk about it. I would love any input from those who have had one, as to what to expect, tips and anything else I might need to know.

I am scared about my surgery. I am scared that the surgery won’t help and that I will feel this way the rest of my life. I am scared of not knowing how long I will be out of work (it will depend on exactly what is done in surgery and we won’t know until it happens). I am terrified that we will have to go into debt or that I will have to delay this surgery even longer. I am scared that permanent damage is being done to my body while I am in this limbo. I worry about Leah having to take on most of the household responsibilities while I am recovering, and the toll her worry over me takes on her. I worry that I made the wrong decision in not having kids now that it is almost too late. I worry about possible complications from my upcoming surgery. I am so anxious about our insurance and whether we will have surprise bills IF they even approve my surgery.

 

Did you know?

  • Endometriosis is one of the top three causes of female infertility
  • An estimated 8.5-10 million women in the US and 200 million (that’s 200,000,000) worldwide are believed to be affected
  • Extremely painful menstruation, endometriosis’ most commonly known symptom, is the leading cause of missed work and school in young girls and women, according to one NIH study
  • Endometriosis commonly goes undiagnosed or misdiagnosed, with women experiencing about 6-10 years delay before being correctly diagnosed
  • Endometriosis is also frequently undiagnosed in teenage girls, due to persistent medical myths, like the false belief that pain with periods is normal or that teenagers rarely get endometriosis
    Taken from http://nezhat.org/endometriosis-treatment/endometriosis/
by krubesch

Real Talk

“Write hard and clear about what hurts.”
Ernest Hemingway

Due to the recent celebrity suicides, I have been thinking a lot about what my depression looks like on the outside and how people I am close to would know when I am struggling to keep my footing in this world. I know I have written about my depression and suicidal thoughts before (as this blog is mostly written about these subjects), but each time I put my most vulnerable thoughts on paper and create a permanent record letting everyone know my struggles- it feels like coming out all over again. Let’s be honest, it’s pretty taboo to admit that your brain is fucked up and that is one of the reasons why it’s important to talk about it. A few years ago I had to take a FMLA leave from a job that was very stressful and I was struggling with increased PTSD symptoms along with high blood pressure. I remember being completely distraught when my FMLA paperwork was sent to the wrong fax and a coworker looked through my paperwork and started rumors that I was having a nervous breakdown. I was so ashamed that I had to take a break from work and that my PTSD was a part of the reason why I had to. It felt taboo to show any weakness, especially since I was in management and I was terrified of what people thought of me.

People resort to suicide, or at least I struggle with suicidal thoughts when I am overwhelmed with my feelings and emotions along with the shame and stigma of having these thoughts in the first place. The silence of keeping these thoughts to myself is often deafening and although all of this is embarrassing to admit, we need to talk about it or we will keep losing people we care about. I cannot speak for Anthony Bourdain or Kate Spade, but I can speak for myself.

Today was one of the hardest days I have had in awhile. I had a particularly difficult and draining therapy session last night and being in constant physical pain is starting to wear on me. I feel like I have been hit by a bus, which is how I usually feel the day after I’ve done a lot of work in therapy. I pressed the snooze button for over an hour and fell asleep in the shower. I contemplated staying home from work, but knew that might make things worse. On my drive into work I thought about what my outward signs of depression look like and I came up with this list:

  • I completely stop wearing makeup because I usually end up crying on the days I actually wear mascara and I look like a racoon (it’s harder to hide that I’ve been crying). I also sleep too late in order to have time to put it on.
  • I stop exercising and want to spend most of my time watching tv or laying in bed.
  • I push people away and cancel plans- even though I desperately want to connect.
  • I become forgetful and have a hard time paying attention.
  • My posture is different- it feels like I am moving through my day with a heavy, wet blanket on my shoulders. Every daily task feels difficult.
  • I am way more quiet than normal (crazy, I know!).
  • I have sleepless nights or I sleep for over 10 hours at a time.
  • I avoid eye contact and shut down
  • I use humor in order to avoid serious conversations or in a self deprecating way before anyone else can criticize me

Words I have heard to describe people who have committed or attempted suicide are lazy and selfish. I personally know that this is not true. Suicide may look selfish to the people who are left behind or those who don’t struggle with this particular demon, but as someone who has contemplated suicide, I have convinced myself that it is the least selfish thing I could do. Depression tells me that I am a burden and that people are tired of dealing with me. It convinces me that everyone would be better off without me and that I would really be doing the world a favor. As someone who has worked really hard and spent thousands and thousands of dollars in order to try to combat (or at least alleviate it, since it appears to not be going anywhere) my depression, I would argue that I am the opposite of lazy, even though American society and I tell myself that I am. Sometimes that is the worst part, working so hard to feel better and it never (my wise mind knows that it is occasionally and not always) feeling like it is enough or that I am trying hard enough. Sometimes I get really mad and feel like it is selfish of people to make me promise that I won’t hurt myself, when I know that they just care. I feel like they don’t understand, but I know deep down that this is not necessarily true. I get mad at them because if they cared so much, then why don’t they do more to make me feel better? Don’t they know that if I am contemplating suicide, it feels unbearable to be inside my body and in my mind? But I know, that it’s really not up to them to make me feel better, it’s all on me.

What do you do when a friend is struggling? It helps me when people check in with me, even though I might have stopped reaching out to them. Talking to or just sitting with someone who I know will just hold space for me helps. I clam up if people tell me how I have it better than others (of course I know that, it does not negate that I still feel this way) or if they freak out about hearing that I have had suicidal thoughts. Please do not tell me to do self-affirmations. Please do not tell me that this too shall pass, because in the moment it feels like it won’t. Something as simple as a text can help me when I am in a funk. Asking me to reach out when I am struggling is complicated. That is the last thing I want to do when I am down in it. I recognize that it is my responsibility to get help when I need it, but I tend to only reach out for help when things are pretty bad.

I can say that the severity of my suicidal thoughts has diminished over the past year and that it does appear my hard work and money spent is helping in that regard. I am too practical to hope that one day I won’t have these thoughts or urges, as they have been a part of my life for a very long time. If you also struggle with suicidal ideation, I can say that is gets better (or maybe more manageable) even as cliché as that sounds.

 

For crisis text line- Text CONNECT to 741741 in the United States.

 National Suicide Prevention Lifeline: tel:1-800-273-8255

 

by krubesch

The Journey

The Journey

By Mary Oliver

One day you finally knew
What you had to do, and began,
Though the voices around you
Kept shouting
Their bad advice‚
Though the whole house
Began to tremble
And you felt the old tug
At your ankles.
“Mend my life!”
Each voice cried.
But you didn’t stop.
You knew what you had to do,
Though the wind pried
With its stiff fingers
At the very foundations‚
Though their melancholy
Was terrible.
It was already late
Enough, and a wild night,
And the road full of fallen
Branches and stones.
But little by little,
As you left their voices behind,
The stars began to burn
Through the sheets of clouds,
And there was a new voice,
Which you slowly
Recognized as your own,
That kept you company
As you strode deeper and deeper
Into the world,
Determined to do
The only thing you could do‚
Determined to save
The only life you could save

I have not felt suicidal for what feels like a long time (and probably has been a long time for my brain when I have not conquered a bout of depression).  For the past 2 weeks or so these dark thoughts have re-entered my mind with a fervor and this concerns me. I have been on the same cocktail of medicine for a year now, which is the first time in over four years that my medications have not been changed every 3-4 months.  This feels like a victory because it means I am stable (with the occasional trigger or bad week) and I have also gotten used to whatever side effects that come with this cocktail and have learned to live with them. Almost a year ago I started TMS (Transcranial Magnetic Stimulation), which along with this medication cocktail I am currently on, I credit with saving me from the depths of depression and probably my life.  Overall, I think the past year has been one of my best (of the past four) in terms of my mood and energy and this recent return of suicidal thoughts makes me worried. My wise mind reminds my emotional mind that thoughts come and go and most likely the reason why they have returned is due to the chronic pain and the increase in the severity of pain that I have been dealing with for about a year and 7 months.

The pain I am writing about began in September of 2016.  All of you who are squeamish about the reproductive system need not read any further!  It started with a UTI that lasted for about a month and a half. Although the UTI had been medically resolved with two rounds of antibiotics, my body felt like it was still there.  My symptoms were intermittent dull and stabbing pelvic pain and a feeling of pressure on my lower abdomen. Because I was and still am doing trauma work in therapy, my therapist, psychiatrist, and I thought I was experiencing body memories, which I had not heard of until then.  (For more information on body memories click here http://help4trauma.org/bodymemories.html).  After a couple of months of this pain and an increase in the frequency, I became worried and scheduled an appointment with my primary care physician’s office with a doctor I had seen once (my regular doctor was not available).  At this appointment it was very apparent to me that this doctor was in a rush and I was in the way of her lunch break. I explained to her what was going on, along with the information about my PTSD and working through that in therapy (which is hard for me just to tell random strangers and to talk about in general).  She basically dismissed my pain, told me it was probably in my head and ordered a strep test because I mentioned that I had a sore throat, but that was not the reason for my visit. She acted like the strep test was my consolation prize and that they would call me with the results. As I knew, the strep test was negative and my pelvic pain remained along with shame and embarrassment.

In the past year and 7 months I have been to 2 visits with primary care physician’s, 2 Minute Clinic appointments, 3 visits to a urologist who specializes in female issues (including one invasive procedure), 6 visits at my gynecologist office with two different doctors, countless dry needling visits and conversations with my boss and coworker (physical therapy office), and 1 visit to a gynecologist who specializes in endometriosis. I have been to the gynecologist more in the past year than in my entire life (seriously,one of the things I hate most in the world). The visits with the urologist and gynecologists left me feeling triggered for several hours to a couple of days.  I think I dissociate somewhat during these procedures and later on in the day my mind finally catches up to what my body felt and I end up feeling dirty, disgusting, and humiliated. Any other body part would be so much easier to deal with it really makes me angry that it’s my pelvic region.

What has been extremely frustrating is that in this whole process I don’t have someone overlooking everything.  My psychiatrist has told me to speak to my pcp, my pcp has told me to speak to my gyno, the gyno has referred me to the urologist and so on.  Even though I would think that my psychiatrist would want to speak to anyone messing with my hormone levels, as any change could affect my mental health symbiosis.  Everyone seems to be passing the buck to the next medical health professional. Honestly, my therapist and my boss have been the most helpful through this whole process and they are not medical doctors.  

In May 2017 I decided to try the Mirena IUD with the hopes that regulating my menstrual cycle would help resolve my pain and the hemorrhaging that occurs along with it.   I was pretty much pain free for 4-5 months with the Mirena (and period free, yay!) and then I started having back and hip pain along with the return of the pelvic pain. In February of 2018 I went back to the gynecologist, and she saw that I had a 3mm cyst of my right ovary and that this was probably causing my pain and could have been brought on by the IUD (a side effect is an increased risk of cysts along with a bunch of other unpleasant other side effects).  She did say that it looked like the cyst was resolving on its own and that I should follow-up in a month. A few days after this appointment I called her because my pain had not decreased and Tylenol and Motrin were not helping. For the record, it’s very hard for me to advocate for myself and I dislike calling physicians to ask questions. I hate asking for things in general. When she called me back, she basically insinuated that the amount of pain I was having seemed to be more (meaning that I was exaggerating or drug seeking) than what someone should have with a cyst of this size that was resolving on its own.  She called in a stronger type of Ibuprofen to the pharmacy and said that should help. It did not. When I went to my follow-up with her a month later, I still had the cyst, but it reduced in size to 1.5mm. Because I was still having the back, pelvic, and hip pain, we decided to remove the IUD at that appointment to see if that was the issue (as I had done extensive research about the side effects of the Mirena) and had never had back pain before getting the IUD.

Since having the Mirena removed in March of this year, I have had right eye twitching every day, pain in the palm of my hands, increased back, pelvic, and hip pain, bloating and have been unable to wear any pants that put pressure on my middle and lower abdomen.  I have had to buy 5 pairs of leggings and long cardigans and shirts so that I have clothing to wear to work! Although the Mirena was not the answer to my pain, it does appear to have helped some with my symptoms because now I am much worse now without it.

I am thankful that I have an awesome job and I heard a patient telling my boss about the doctor who had changed her life.  He was the 9th doctor that she had seen and she was so happy to share his information with me. I had to wait a month to get an appointment with him and saw him 10 days ago.  At this appointment he validated my pain and basically acted like it was a no brainer that I have endometriosis. He was surprised that no one else connected my symptoms with an endometriosis diagnosis. He gave me three surgical options to choose from and sent me on my way. The appointment and his conclusion happened so fast that I had to verify with him that he was sure and that I had heard him correctly. I don’t think I have ever happy cried like I did that day when I called Leah from my car.  I cried because I finally had an answer that made sense, that I was not crazy or making things up, and that hopefully my symptoms will be alleviated soon.

I feel like I have been on a roller coaster of emotions since then.  It is disappointing that there is not a cure for endometriosis, especially since it apparently is very common (almost as common as diabetes).  I go from being hopeful that treatment will alleviate my symptoms to wondering if I will be in pain until I go through menopause. I have scheduled a laparoscopic procedure for July 11th and I think the hardest part is going to be waiting until then when it feels like my pain is increasing and my comfort levels are decreasing.  All the doctors that I have seen are hesitant/ resistant to prescribing me anything for pain, which is frustrating. I have been researching what I can do on my own in order to be able to function on a daily basis. Getting out of bed in the morning has been particularly difficult. I am extremely tired and usually in a lot of pain. I have noticed that I am not enjoying activities and end up leaving early in order to be able to alleviate my pain and get comfortable at home.   This morning I felt especially hopeless and I wondered how I am going to be able to wait until July. The dark thoughts clouded my sunny drive to work and as usual lately, I felt on the verge of tears. I am reminding myself to try to take it one day at a time and to allow myself to be aware of my needs without beating myself up.

 

by krubesch

Out of Control

I’m getting fat and I feel completely out of control.  Things are still heavy in therapy, which is bleeding into every facet of my life at the moment.  It was extremely difficult to get out of bed this morning and I can’t figure out if this is the new normal for me or if there was a specific reason that I pressed snooze for two hours today.   Maybe it’s the weather change, the up in my medication, having therapy last night, missing Patrick, or the current antics of the republican nominee for president.  I don’t think I’ve realized until today how the election has had an impact on me.  There are news articles everyday about the minimization of sexual assault by various men, especially judges and Donald Trump and I guess I have a lot of feelings about it.

As a woman, I know that sexual assault is viewed differently than any other crime.  If Donald trump had been stealing jewelry or money instead of kisses, gropes, or God knows what else we would not even be having any of these discussions because he would be sentenced and that would be that.  To me it is plain and simple he took something that did not belong to him and that is wrong.  But then we want to know what she was wearing, if she was drinking, if she was even pretty enough, or what behavior she demonstrated that made him think that it was ok.  If you were at someone’s house and they stole your wallet- none of these questions would be asked.

Then you have the Brock Turners of our society where we excuse their behavior because they somehow can contribute to society in a way we deem worthy of looking the other way.  What is not considered is that the woman who was violated by Brock Turner has to find a way to get out of bed every morning and that her life has been forever changed.  Who gives a shit about what she can contribute!  This event will just be one day out of Brock’s life and will be something she will have to “overcome” and something she will be responsible for taking care of even though she did not have a choice.  She may spend thousands and thousands of dollars on mental health professionals in an effort to just to be able to make through each day or she may just decide it’s not worth it and end her life.  Obviously I am not specifically speaking about Turner and his victim.  This happens everyday in the US, we just know about this case because he was caught and the judge gave him such a light sentence.

Then there is the guy who was convicted of raping his 12 year old daughter repeatedly in Montana and gets 60 days in jail. This is our judicial system at it’s finest, folks.  This is what happens IF there is enough evidence to convict and if the victim even comes forward.  No wonder many survivors do not make police reports or even try that route. They end up feeling worse in most cases and he gets a slap on the wrist, literally.   Man, I am so angry right now I am shaking.

Everyday I have an experience where I get a creepy feeling or a loud noise freaks me out and my brain immediately thinks that this would be the perfect moment for someone to attack me or that maybe there is someone behind me.  I know that statistically I am more likely to be attacked because I have been sexually assaulted.  What’s funny is that I knew the guy who assaulted me and I still worry more about the guy who I don’t know that may be lurking around.  I constantly try to be aware of my surroundings when I am alone and do whatever I can to protect myself.  The house is always locked when I am home, my car doors get locked before I put on my seatbelt, I don’t walk alone at night if I can help it, and I made us get an alarm system for our house.  I tried to explain rape culture to a guy I went to high school with a couple of weeks ago on Facebook, but I don’t think he gets it at all- and why would he?  It’s not something you understand until you experience it.  Every woman I know does some of these things, even women who have never been raped or molested.  This is what I mean by rape culture.  If Donald Trump is elected (and I don’t think he will) he will be President of the United States- think about that.  The highest role model of role models for kids (and adults) in the US.  Little boys will be looking up to him and think his behavior is acceptable.  Little girls will think that his behavior is normal and will either have to tolerate the same behavior from other males or be constantly looking over their shoulders. Is this what we want for our children?

It’s hard for me to have hope lately because this is the reality.  I’m trying to hold out hope that someday (hopefully I will make it to that someday) I will have less days filled with anxiety and depression.  I will be able to look in the mirror and like the person staring back at me.  Suicidal thoughts will be a rarity instead of a frequency.  I won’t have to turn towards something (food, alcohol, perfectionism ect) to cope.  Hopefully we will look back on this time in history as that time the US lost it’s shit and did not elect a sociopath as our leader.

 

by krubesch

Triggers

“Ongoing experience convinces me that some children respond to pervasive emotional neglect and abandonment by over-identifying or even merging their identity with the inner critic and adopting an intense form of perfectionism that triggers them into painful abandonment flashbacks every time they are less than perfect or perfectly pleasing.”

Pete Walker

The only time I am in touch with my anger/rage is when I’m driving.  It always shocks me when I venomously yell out curse words or hurl insults at crazy drivers around me.  I don’t recognize my own voice. I have to stop myself from flipping people off.   It’s interesting to me that this is the one situation where I express anger. I guess it’s safe? Because I am in my car and it’s socially acceptable to have some road rage.  No one can hear me and I am in my own space.  Quiet  and calm Katie disappears when I buckle my seatbelt and put my car in drive. I’m becoming more aware of my habits, traits, and actions.

I mentioned in the my last post that I have started EMDR with my therapist and it’s been pretty intense.  I have also been attending DBT (Dialectical Behavior Therapy) class every other week.  Since I’ve begun processing events of my childhood I’ve gone from one regular therapy session and one DBT session to as many as three therapy sessions and one DBT session a week.  I’ve been gauging how I am doing by how many sessions I’ve had to go to in a week.  A four session week means that I am  not doing well and having to take each day an hour at a time.  The good thing is that I’ve been reaching out and asking for more appointments when I need them instead of “toughing” it out.

Since we started doing EMDR I am more aware of my anger and a greater presence of PTSD symptoms.  I’ve been extremely jumpy in my everyday life.  The other day Leah was driving and I literally jumped out of my seat because of brake lights ahead of us. I scared the crap out of both of us!   Today I’ve jumped when the office phone rings, when I hear a loud noise from the restaurant above our office, and when the bank teller surprised me.  I had forgotten what this feels like- always being on edge. I’m also not paying as close attention to tasks and everyday things as I normally do. I went flying over a speed bump that I did not see and took my car and myself by surprise.  Laundry, grocery shopping, and meal planning have been incomplete to my wife’s alarm.  She’s used to me being the one who gets most of this done. Sorry honey!   My therapist says that this is normal and that things are going to get worse before they can get better.  I’m just afraid of what worse means.  I’ve also been way more emotional and triggered by things that I would normally just let roll off my back.

I’ve found myself unable to cry when I feel like I need to.  I don’t know if this is because of the anti depressants or because I’m somehow not in tune enough with myself to let the tears fall.  I’ve recently started getting sad books from the library because when I really get into a book I am able to let the tears flow. I was not sure if this was going to work because I had not tried it with this round of drugs, but last night it did still work. Is this self-care? I’m not sure.   I am able to identify more with a book than with my own life. I’m not quite sure what this says about me.

Sorry if this is TMI, but my entire blog is pretty much “too much information.” I was diagnosed with a urinary tract infection yesterday and boy has this been the biggest trigger so far.  It’s all I can do to stay awake and present with the pain from my lady parts. I’d love to just retreat by going to bed and pop a trazadone to fall asleep until the pain goes away.   I’m really glad my therapist and I did not do EMDR last night during our session because I don’t think I could have handled having flashbacks along with this intense pressure in my pelvic area. It was nice to be able to go home and be with Leah and lose myself in a book after therapy last night.  I think reading has always been a welcome escape for me even as a child. I remember loving how reading could take me away from the present moment and into the lives of other people.  I felt like I had a relationship with others through stepping into their lives.  I’m still learning which of my coping skills are “effective and kosher” and which are not.  I know that in a way reading lets me dissociate from the present, but it also serves as a great distraction.  It’s a lot better than drinking, self-harming, or eating.

More info about DBT http://behavioraltech.org/resources/whatisdbt.cfm

by krubesch

Full Circle

“Courage doesn’t happen when you have all the answers. It happens when you are ready to face the questions you have been avoiding your whole life.”
Shannon L. Alder

I broke up with therapist number two.  It just didn’t feel right and I had a sense of dread before therapy sessions, which is not normally the case.  The good news is that I have found someone I really like.  Under different circumstances I think we would be friends.  I feel that familiar pull with her of wanting to open Pandora’s box and wondering if it’s worth it or if that’s even necessary.  I spend so much time minimizing my feelings that I don’t think I know what’s even there.  I’m afraid that we are probably going to be able to do some serious work together. I’m afraid because I know its going to be arduous and difficult.  It feels like a looming probability that I know needs to happen, but I’m not sure if it’s going to be manageable.

We’ve come full circle back to my favorite skills: Nonjudgementally, One-Mindfully, and Effectively in my DBT class.  This week I’ve tried to be very aware when I’m using my skills.  I think these are my favorite because they are so familiar.  I definitely have become intimate with Nonjudgementally.  I direct judgement at myself everyday and I’m becoming increasingly aware of how often.  The first time I ever practiced this skill it was devastating to realize how little self compassion I have.  Now I’m realizing that I’m starting to be able to notice that inner critic and side step the judgement.  For instance, on Tuesday I was taking my dog Penny for her second walk of the day and I really wanted to do interval training with her, but my stomach hurt.  Instead of pushing through it or berating myself because I wasn’t running I noticed that I could either be an asshole to myself or just be glad that I’m able to take Penny for a walk.  This is pretty huge because I’m a grin and bear it kind of girl.

I didn’t have many choices growing up.  Things were decided for me: what I could watch, eat, listen to, say ect.  I think this made me seem easy-going to a lot of people later on in my teenage years and twenties.  What may have looked like a laid back personality was really me just going with the flow because I didn’t think my opinions mattered or were important. Or that I even had any.  I’m realizing now that I have choices and my voice deserves to be heard.  This may be bad news for my wife!

To be intentional about the skill One-Mindfully, I’ve been driving to work without music, talking on the phone, or eating.  Just focusing on my driving. That’s 15-30 minutes a day.  It feels so un-natural and difficult.  I guess I never realized how much I use music as a distraction.  When I first started therapy a year ago my therapist told me that I should practice mindfulness so that we could determine what thoughts keep popping up for me and those are the things we would need to work on.  Well it’s taken a year for me to be able to even entertain that possibility. This week I’ve gotten a lot of clarity on the thoughts I keep at bay.  I’m not surprised by the thoughts that have come up and I know why I keep so busy and distracted from myself.  The thing is that they are painful and I’m not sure if thinking about them and processing them will be helpful or just make me spiral back into my dark hole.  They also involve people who are either dead or who I’m estranged from.

For the Effectively skill, it’s shown up way less intentionally.  My new therapist asked me my goals yesterday and one of them is to develop self compassion.  I’ve been effective in identifying a goal, but I have no clue on how to achieve that goal. I guess I’ve completed the first step in breaking up with a therapist that was not a good fit and continuing to find the right one.  I’m doing my homework and attending my sessions. I guess that’s a step in the right direction.  I wish things would just move faster.  I tend to approach my mental health like I do everything else: get ir done. unfortunately that attitude isn’t going to speed things along or resolve why I don’t have self compassion.  Unfortunately I’m going to have to be willing to dig through a lot of shit and be okay with things taking time.

by krubesch

Adrenaline Junkie

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“If your mind is always moving
It’s hard to get your heart up off the ground
Yeah, your mind was always moving
But your thoughts never made a sound”

Lyrics from Say Anything

Tristan Prettyman

Writer(s): David Hodges
Copyright: Emi Blackwood Music Inc., 1206 Publishing

Recently I’ve come to the conclusion that I am an adrenaline junkie.  It dawned on me during my weekly DBT class that the “One Mindfully” skill is extremely difficult for me.  Marsha Linehan describes One Mindfully as:

-“DO ONE THING AT A TIME. When you are eating, eat. When you are walking, walk. When you are bathing, bathe. Focus your attention on the very moment you are in with the other person. Do each thing with all your attention.

-If other actions, or other thoughts, or strong feelings distract you, LET GO OF DISTRACTIONS and go back to what you are doing- again, and again, and again.

-CONCENTRATE YOUR MIND. If you are finding you are doing two things at once, stop and go back to one thing at a time.”

Linehan pg. 113

I’ve noticed lately that I am often doing more than one thing at a time.  It’s very rare for me to be in the moment and focusing only on the task at hand.  I’m listening to music and consumed in my thoughts when I’m driving, I play on my phone when I’m watching tv, I’m either listening to music or watching tv when I work out, and even when I’m trying to sleep I’m consumed by all the thoughts that I avoid during the daytime.  Apparently this phenomena of keeping myself busy and jumping from thing to thing means that I’m keeping myself hopped up on adrenaline.

I love extreme sports.  I do triathlons- it’s not enough for me to pick one thing, I have to do all three! I am a goalkeeper because I love the thrill of diving to catch that ball.  I have eight tattoos. I love tattoos- the noise, the sensation, and the picture I’m left with for the rest of my life on my body.  My love/addiction? with tattooing started when I was in high school.  I got my first tattoo when I was a high schooler (17 years old) on a band trip to Victoria Canada.  I was going through a particularly difficult time in my life and also had the urge to be a rebellious teenager, so why not get a tattoo on a band trip?!  My first taste into the tattoo world was delightful.  I got the tattoo on my butt, so it didn’t hurt that much but I also liked feeling that pain.  I was aware of how freeing it was to get that tattoo and how the pain was somewhat socially acceptable.  Up until that time I had not dabbled into the world of self-harm, but this feeling of adrenaline felt so much better than my anxiety and depression.  It was a welcome vacation from what was going on in my life.

That was 16 years ago.  Looking at my tattoos I only have two that I planned years in advance and was in a good head space.  That means that six of them were done when I wanted to feel that familiar pain and cover up parts of my body.  I like my right arm better than my left because its covered with a few of my favorite things: flowers, berries, and birds.  It’s almost like my armour and I feel more comfortable in my skin when it’s decorated.

It’s so funny how I feel like I am meeting parts of myself for the first time.  I had not realized that a lot of the things I do on sometimes a daily basis cause me to have an adrenaline rush.   I remember jumping off rocks into a watefall and going bridge jumping when I was in high school.  It reminded me that I was still alive.

I am going to share a bit more information about myself- I am a survivor of childhood sexual assault. I feel like it’s necessary to share this because apparently being an adrenaline junkie correlates strongly with PTSD, especially those who’ve had trauma in their childhood.  I’ve been reading different sources about trauma and I’m finding it fascinating.

mentalhealthdaily.com states that adrenaline addiction starts from:

1. “Traumatic event or high stress – War, life changing diagnosis (i.e. cancer), rape, hard drug withdrawal, anxiety disorders, etc. There are plenty of things that could trigger the start of an adrenaline addiction – even a bunch of less severe, minor stressors.

2. Body sensitized to adrenaline – After a good 6 to 8 months of excessive adrenaline build up, it changes your physiology. You become sensitized to the epinephrine and used to what it does for you. Initially it may be difficult to cope with, but after awhile, you become so accustomed to it that you can function.

3. Brain in overdrive – It sends your brain into full throttle and your wit becomes majorly amplified. This is because your slower brainwaves in the alpha and theta ranges become severely diminished. Alpha rhythms are drowned out by high amounts of mid and high-range beta brainwaves. This leads to further production of dopamine, epinephrine, and cortisol.

4. Adrenaline floods the body – Your body will feel less relaxed and you may have the urge to move around. You will literally feel the adrenaline coursing throughout your entire body. Senses all become heightened – hearing, vision, taste, smells, and touch.

5. Brain and body conditioned to adrenaline – The sensitization of adrenaline is actually a heightened state of awareness. Your focus on soft sounds makes them seem like they may cause hearing loss; you panic. Bright lights may seem as though they are going to cause blindness. You become highly emotionally sensitive to minor issues and feel as though many things are a personal attack. After awhile though, you may become positive, outgoing, happy, and pleasure seeking. This is because your brains natural supply of chemicals becomes used up by the excess adrenaline and you are left to seek out external stimuli to keep the production going.”

The author also states that “If you are functioning well with high adrenaline, just keep in mind that it may lead to poorer physical health and problems such as: high blood pressure, heart attacks, physical pain, or excessive anxiety and hypochondria. Some people have a minor addiction to adrenaline and/or have it under control, but others cannot seem to cope well with the excess flood of epinephrine and cortisol throughout their nervous system.”

I think this need to keep active has contributed to my sleeping issues, my blood pressure, physical pain, weight gain, and also my gastro issues.  When I do slow down I get this heavy feeling…almost like impending doom.  I start to get a little depressed and then I get busy again.  I don’t ever just let myself spend time with my thoughts- unless I’m writing or in therapy.  This may sound shocking to you (note my sarcasm), but I’m not a huge talker. That’s why I married Leah- she’s my voice. I often find it difficult to come up with topics or even the right words when I’m with people, but I HATE SILENCE.  Silence makes me get really uncomfortable in any situation and It’s going to be a great feat if I can start being more mindful.

Caring for Patrick is helping me start to be okay with silence and to let myself feel the sadness without letting it consume me.

by krubesch

Clicking Forward

counter

“Shame needs three things to grow exponentially in our lives: secrecy, silence, and judgement” Brené Brown

It’s always weird and kind of awesome when my therapy homework matches up with everything else happening in my life.  It’s like an episode of Sesame Street – like my life seems to have a theme of the week.  This week my therapy homework and my DBT homework are to practice the skill Non- Judgementally.  “What the hell is DBT?”   Wikipedia defines Dialectical behavior therapy (DBT) as “a therapy designed to help people change patterns of behavior that are not effective, such as self-harm, suicidal thinking and substance abuse. This approach works towards helping people increase their emotional and cognitive regulation by learning about the triggers that lead to reactive states and helping to assess which coping skills to apply in the sequence of events, thoughts, feelings and behaviors that lead to the undesired behavior. DBT assumes that people are doing the best that they can, but either are lacking the skills or are influenced by positive or negative reinforcement that interfere with one’s functioning.”

For more information http://en.wikipedia.org/wiki/Dialectical_behavior_therapy

As usual, this post is going to make me come out of hiding even more.  DBT was developed by Marsha Linehan to treat people with Borderline Personality Disorder.  I do not have BPD, but this form of therapy also works really well with people who have PTSD.  I was very skeptical when my therapist suggested that I take this weekly DBT class, but it has changed my life.  Ask my wife…I sound like a therapy guru during our arguments now!

Anyways back to the skill of this week.  My therapist insisted that I buy a counter (featured picture of this week’s blog) and I use the clicker to keep track of how many times I am mean or judgemental towards myself.  It may or may not come as a surprise to you that I have an INTENSE inner critic.  Some of you may know that I am pretty judgemental (it’s getting so much better, so don’t think I’m judging you!) towards other people, but I am way more critical of myself.  I think I am my own worst enemy.  What I did not realize until recently, is that my inner voice comes from being verbally and emotionally abused by my father for most of my childhood and young adult life.  My father presented himself to friends and outsiders as a charming wine enthusiast foodie, but he was a very different man inside our home.

I’ve realized recently that it’s up to me to break the cycle.  It’s my job to figure out if I want to continue to act like an asshole to myself and occasionally my wife or if the cycle stops with me.  Practicing the non-judgementally skill involves the following:

• See, but don’t evaluate. Take a nonjudgmental stance. Just the facts. Focus on
the “what,” not the “good” or “bad,” the “terrible” or “wonderful,” the
“should” or “should not.”
• Unglue your opinions from the facts, from the “who, what, when, and where.”
• Accept each moment, each event as a blanket spread out on the lawn accepts
both the rain and the sun, each leaf that falls upon it.
• Acknowledge the helpful, the wholesome, but don’t judge it. Acknowledge the
harmful, the unwholesome, but don’t judge it.
• When you find yourself judging, don’t judge your judging.
Linehan, pg.113

The last bullet point resonates with me a great deal.  I often find myself judging my judging. It’s a no-win situation. It’s not enough that I call myself an idiot, but then I get mad at myself for calling myself an idiot!

When I went back to therapy last week with my counter in my hand, I excitedly pointed out to my therapist that the counter was only up to 25 clicks for the week.  She looked at me and told me that the goal is ZERO.  My comeback was at least it’s only 25 (during college it probably would have been 25 per day) and that at least now I am becoming aware that I berate myself on a daily basis.  Recognition seems to be the hardest part. Self awareness is not one of my strong suits and I’m amazed at what I’m finding out about myself these days.

The goal of my blog is not to invoke self-pity or to have others fawn over me.  I just wish I had access to anything growing up that would have initiated self kindness or even to know that I was not alone.  Some people have told me I should not air my dirty laundry, but if I don’t air it I contribute to the epidemic of depression, shame, and even to the number of suicidal teens.  I am fully aware that at some point in my life I may be interviewing for a job and they will inevitably google my name and find out that I have all these issues.  If they have a problem with my issues then I don’t want to work for them anyways.

judgement

by krubesch

Perfection is the Enemy of Good

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Webster’s Dictionary defines perfectionism as “a disposition to regard anything short of perfection as unacceptable; especially : the setting of unrealistically demanding goals accompanied by a disposition to regard failure to achieve them as unacceptable and a sign of personal worthlessness.”

I have realized this year that my expectations for myself have become unattainable and that I am the common denominator in finding myself in stressful situations.  For the first time in my life, or at least as far back as I can remember I am starting to silence the intense voice that tells me I have to do everything perfectly.  When I say everything, I mean EVERYTHING.  At this point in my life I am realizing that the expectations I put on myself are ridiculous and I am setting myself up for a life full of failure.

My self-worth has been tied to the things I accomplish for so long that I felt like I was worthless if i could not provide multiple services in my career.  It was not enough for me to translate for a Spanish-speaking person, but I also had to translate while putting on a cast while also managing two offices.

A co-worker once told me to just stop trying to be so perfect.  Well shit, I didn’t think of that!  I first had to recognize how my perfectionism has seeped into every aspect of my life in order to stop something I didn’t even know I was doing.

Surprisingly I think competing in triathlon’s has helped me to accept and realize my faults.    I finished a tri in May and I was distinctly aware that my primary goal was to finish.  I did not have finish by a certain time or be the best in my age group.  All I had to do was finish the damn thing.  What’s funny is that attitude helped me do better than I have previously.

I have started to apply this attitude in my everyday life and it’s amazing how much happier I am.  I think my wife will agree and say that I am much easier to be around as well.   My Perfectionism along with other unhealthy coping skills have  paved the way to and through some of the darkest times in my life.   I am only now realizing that these coping skills were helpful at the time, but are no longer useful in my life today.

I, Katie Rubesch, have become slightly artsy.  This is a shocking to me as it may be to you.  I have started working on a photography series where I’ve been taking selfies almost everyday.  This series of photographs demonstrates the complexities of depression and the ups and downs.

I have found that I don’t have to fight against my perfectionism when I’m working with Patrick.  I don’t know if this is because I am learning that there is no such thing as perfect or if it’s because it does not feel like work.   He is teaching me to be more in the moment and to appreciate the little things.   I don’t think I’ve ever stopped to appreciate the little things until now.

http://www.huffingtonpost.com/2013/11/06/why-perfectionism-is-ruin_n_4212069.html