Moving On.

I will wake up tomorrow at 7:20 and, within the hour, be on the road to my last day of intensive outpatient therapy. I am nervous.

Okay, fine, scared.

The IOP was the price of discharge from the psych ward this summer. I was afraid, then, too.

It’s a different kind of fear, this. I have new tools, thanks to my program, which is based in dialectical behavioral therapy. These skills are taking hold in my psyche and approach to life, people, and situations. I know now the importance of living in the moment: I simply cannot let myself hurt myself, through old behavior patterns and my previous (unsuccessful) approaches to conflict and stress.

They didn’t work then and won’t work now.

I have found that, thanks to the IOP, I am now able to examine my thoughts without judgement, something that has hurt me in the past.

Try it sometime: If you’re having a stressful thought, look at it. Examine it without labeling or judging it. Simply recognize that thought for what it is. That will help you understand that there is quite often no black or white, no “all good” or “all bad,” but rather, it just is.

And that’s ok.

This is wise mind, in DBT-speak. That zen-like place that is neither all emotional mind, nor all analytical mind. It is the marriage of both; the melding of your cognitive intellect with your emotional IQ.

Wise mind allows me to observe, describe, and participate in the moment: non-judgmentally, one-mindfully, and effectively. It is the epitome of mindfulness.

Wise mind allows me, when I am in it, to tolerate distress in ways that are healthy and helpful, rather than self-harming (such as using alcohol) or becoming stuck in old behavior patterns and responses that keep me stuck in my depression and anxiety. It allows me to recognize when I am mind-reading: scripting the response that I imagine I will receive when I ask for something that I need, or voice a concern. It also allows me to see when I am predicting the future (yeah, I don’t actually have that ability) and am about to hurt myself emotionally because I’m not living in the moment.

I have learned new skills that encourage me to tolerate distress. Those include using my senses effectively to curb my racing thoughts and to bring myself back to center.

For me, even being of my center is a major development: I think I’ve been living so much of my life in a state of internal conflict and chaos, because it’s what I was raised in, it’s what I knew.

Even if you’re not battling anxiety or depression, these are helpful tips for living in the moment and centering yourself.

One way is to use 5,4,3,2,1, as illustrated here in a note a fellow patient gave me before she left the hospital:

You can mix those up any way you’d like: 5 things you smell, 4 you taste, 3 you see, 2 you hear, 1 you hear, etc., as you wish. Do it 50 times if you have to, to center yourself and bring you back to the moment that you’re in — not the one you’re imagining.

Other soothing skills? Hold an ice cube: feel the cold and the texture as it changed under the heat of your hand. Keep a mesh sachet of lavender or buckwheat: rub it between your fingers, smell the earthy odor, listen to the crunchy texture.

I have also begun the process of emotion regulation.

That one is a little tougher for me. This involves skills like using opposite actions. For example: feeling terribly sad? Watch a comedy. Racing thoughts? Try coloring, deliberately.

I did buy a coloring book over the weekend, with some cool pencils, but I haven’t exactly been in the mood to color.

The final DBT skill I’ve been working on is interpersonal effectiveness. This involves balancing my needs with those of others, and getting and giving in ways that strengthen my self-respect. In program, we work on identifying triggers and prompting events; what problem behaviors erupt as a result; and what results from the problem behavior. This is the part of DBT that, for me, is about helping me expect better from people, and receive better from people, through effectively explaining what I need, and expecting that I’m entitled to be treated a certain way.

So. Recovery from clinical depression, from anxiety. It’s a process.

Three months ago I was leaving the safe confines of the acute psychiatric care unit that I had committed myself to in a desperate attempt to keep from suiciding. Tomorrow I leave the cocoon of the IOP, no longer suicidal, my medications under control, my life a whole lot more ‘even.’

In these three months I have grown in ways I didn’t know I could. I have been challenged by myself, and I have faced painful questions in therapy, in a love relationship, from my fellow patients. And I have shared the deepest parts of myself with those folks, trusting them to care and yes, to love and accept me if, for nothing else, my honesty.

I took that leap of faith, in others and myself, because I want to live a loving and fulfilling life in the time I have left. I want my life to mean something. But: If to no one else? To me. Because I matter.

To those struggling with severe depression, bipolar, or anxiety, I wish you inner peace and help in finding what works to help you see that life is worth living, and the knowledge that life can be so much better than you imagine.

To those of you who love people who live with depression, bipolar, or anxiety, I wish you the ability to understand that some days are going to be tougher than others. Please know that getting help — be it therapy, meds, ECT, or a combo — is critical to the person who is suffering, and know, too, that your love and support are key to recovery.

To all: I wish you self-love, and the knowledge that Life Is Beautiful. Even when it’s not? Life is beautiful.

Namaste.

Heather