My mental health toolkit
Maybe you can do in months what took me years
I hope that you or someone you care about can flourish again sooner with some of the tools and ideas I share here.
One month ago I published an article on one of my most uncomfortable secrets.
At the same time, with the help of an old friend Ashley Brittenden and many, many wonderful friends who had chipped away at the stigma, I realised I needed to try something new to overcome the depression that kept destroying great connections in my life.
I went to see a doctor and got onto anti depressant medication.
I found a psychotherapist.
I posted about it on facebook:
I was suprised and overwhelmed by the response. I felt so so much support.
On facebook: 240 likes, 40 thoughtful comments, about a dozen private messages of support, thanks, and sharing of similar challenges.
In real life: Many people have said thanks, expressed their support, and most people now know me better.
Overall: It has deepened my connections with everyone I know — some a little, many a lot.
The two photos above are actually a good example of the kind of love and support I continually have as I open to be more honest and real with the people around me. It is incredible.
Before I shared, I felt often alone.
Now I see that there was this safety net there all along — so many people wanting to support and help me on my journey! And this makes sense, because I also really want to support and help all my friends on their journeys!
My Toolkit
This is a huge brain-dump of things I think might be really valuable — to everyone, but particularly those with mental health challenges and the people around them.
Someone I care about has/may have mental health challenges. What can I do?
Good question. I’ve not come across many answers or resources. I think there need to be more plentiful, accessible and quality resources for those wanting to/needing to support people with mental health challenges.
The main thing I can think of is asking good questions, giving kind and honest feedback, and being open, honest and vulnerable yourself. Also to remember that at the essence you are both beautiful living creatures:
“I now give you my word of honor,” he went on, “that the picture your city owns shows everything about life which truly matters, with nothing left out. It is a picture of the awareness of every animal. It is the immaterial core of every animal — the ‘I am’ to which all messages are sent. It is all that is alive in any of us — in a mouse, in a deer, in a cocktail waitress. It is unwavering and pure, no matter what preposterous adventure may befall us. A sacred picture of Saint Anthony alone is one vertical, unwavering band of light. If a cockroach were near him, or a cocktail waitress, the picture would show two such bands of light. Our awareness is all that is alive and maybe sacred in any of us. Everything else about us is dead machinery.” — Kurt Vonnegut, Breakfast of Champions
Even really really wonderful people use therapy
Lots of therapy. When at the Open Source // Open Society 2015 conference, Audrey Tang, Taiwanese Digital Minister, was asked “What is the most effective way to develop empathy?”. She replied: “there are many paths; personally I practice psychoanalysis”. She said she does an hour a day, four days a week. She is playing a big part in evolving democracy while being really lovely, genuine and writing beautiful poetry.
Psychowhat?
I still don’t really know the difference between psychologists, psychotherapists and counsellors. I suspect seeing any one of them is great. If someone wants to clarify this in the comments below I’ll update it here.
Choosing to make therapy work
I tried seeing a counsellor BEFORE I accepted I needed help. It didn’t work that well, due largely I think to not committing. Also I saw a woman. I suspect I have some man stuff to work through sooner or later, and decided I’d prefer to go through this process with a man. I have found a good guy, and it is going really well.
Making therapy more effective
After I accepted help, and decided to REALLY commit to exploring therapy, I had great results from even my first therapy session. I’ve heard that normally it can take 4–5 sessions for the therapist to get to know you well enough to help. I think that by getting to know myself with questions and friends, and being radically open my therapist was able to immediately help me.
About half way through the session, I decided that he was good enough (and by deciding that, I made him a great counsellor). I decided to trust him completely, and put energy in to opening myself up to our connection.
In my first session I openly explained where I was from, what I’ve been struggling with, and that I knew there was some darkness and suppressed feelings I needed to explore but I didn’t know what they were, let alone how to access/explore them.
He used his question super powers, and we launched straight into new territory that gave me new insights and lifted old and new burdens.
After each session, on the same day, I made some time to reflect, and either found a question to sit with, or decided to take an action, for example a difficult conversation with a friend about feeling inferior to them. These have worked out wonderfully and have deepened our connections and my connection with myself and the world around me.
Statistics say use medication AND therapy together for best results
Apparently the statistics say:
- seeing a psychologist/counsellor/therapist has on average the same positive impact as taking medication
- Doing BOTH therapy AND medication have a much much more positive impact than either individually.
Can anyone back this up with a reference/discredit it? I don’t have time now…
Will I lose my identity taking medication — will it change me?
I’m on Citalopram hydrobromide. My basic understanding is that it’s like a slow release version of MDMA, the main ingredient of the recreational drug “Ecstasy”, in that it also acts on seratonin receptors in the brain.
I’ve taken MDMA recreationally (not in Aotearoa). The effect of MDMA for me was of a pure love and connection to the people around me. I just felt like a very loving version of myself.
I really enjoyed MDMA, and felt very connected to myself and my friends afterwards. It was a great reminder of how to love completely, openly and fearlessly.
MDMA itself is currently being trialled for use in therapy and for post traumatic stress disorder.
The effect of Citalopram is nearly unnoticeable, but even if it was, I don’t think it would change my personality except to possibly make me more loving and open. Which I want anyway. My doctor reckons it takes 2–4 weeks to fully kick in, and that it’s a good idea to be on it for 6–12 months before considering coming off them.
There are no noticeable specific effects (positive or negative) from taking Citalopram, but between Citalopram, therapy, the act of accepting help and getting a fairly stable job and falling in love, my life has started improving a lot. I’m just going to keep taking it another 8 months, then maybe test coming off it.
I’ve had friends who have had to try a few different medications to find one that works for them, but they’ve found it a worthwhile process to go through, and are doing better for the medication too.
Finding a good therapist for me
Aside from Stigma, one of the two big barriers to me seeing a therapist was fear of wasting time and $$ with a “bad” therapist.
I used this great website TalkingWorks.co.nz to look at different therapists profiles. I picked out about 10 that seemed the best for me.
I called each of them.
I told them: “I’ve been experiencing depression. I’ve tried exercise, meditation and now realise I need more help”
I asked them the following:
“Do you have capacity?”
“What is your approach?” — nice to hear their voices and the way they talk.
“I’ve just started looking for a therapist, is there anyone else you’d recommend” — This is great, I trust recommendations.
In the end most of the male therapists were full up (winter == high season), but one of the guys I liked most referred me to another therapist, who I called, decided to try him, and whom I have now been seeing for 5 weeks with great results.
It’s a great $$ investment
Counsellors, Psychotherapists and Psychologists cost anywhere from $70 — $180/hr. That seemed really expensive to me.
When I asked a GP Doctor about funding available for therapy, they said there was barely any in NZ unless you have a community services card. I think this is a problem. But they did say that there are independent organisations that subsidise therapy to as low as $10/hr. I don’t have time to find links to these now, but will try to later, or would really appreciate you posting any links to low-priced therapy in the comments below (I’ll add them to here). I have resources to pay $110/hr once a week, so I want to leave the somewhat limited therapy resources for those who don’t have so much resource. In saying that, I hear it is a common problem for people to say “Oh, I’m not that bad, other people will need it more”. Don’t fall into that trap. Take any support you need to get therapy ASAP — it is a great investment for society to make in you, to help you get to a place where you can contribute more to society.
If you have the resources, use them. Even if it takes two or three therapists before you find one you like. This is the best $550 I’ve ever spent so far. And I’ll spend more. I’m learning with my therapist and getting more out of life than I did when I flew one way to South America for $1000.
Therapists vs. Friends
Should friends and family be our therapists?
I’ve been thinking a lot about the role of therapists in our society.
Do we need therapists because our relationships with friends and families are lacking an important element?
How important is it that they are outside of your life?
Is it weird to pay for someone to listen, and have a connection/relationship with you?
Here’s my current thoughts…
I currently think that therapists DO play an important role:
- Skilled and experienced questioners — can ask the questions you need, a real craft/skill. I am happy to pay for this.
- Outside perspective
- Energy/time. I am happy to pay for this.
- If you have a lot to work through, it can be too much to ask it all of your friends and family to have the time/energy/experience/skills for it to be safe and sustainable for you and them.
- Safety — I know there can be some pretty heavy stuff that can come up, which if not well held can be damaging for both you and the people you’re working with. I am happy to pay for this.
The role of friends and family:
- They know you well, and can help you notice patterns and changes. For example, a friend to said to me: “I notice you’re making a lot of comparisons between yourself and others — is that helpful?”
- They can help keep you accountable for positive practices you do — My friends help me keep meditating, keep exercising.
- They can help you reflect, and understand you by asking you questions. You should both be mindful of safety, and both ready to say “Is this a safe place to go now?” “I don’t think so”.
- You can’t expect them to have the time and space to work though everything you need to work through. They are also busy, potentially stressed, and may have their own challenges, which may make some things unsafe for them to talk about.
- You need to be mindful of energy, yours and theirs.
Other roles:
- Mens/Womens group. I’ve found this hugely helpful.
- Talking with strangers
- Talking with people from different walks of life
Therapy for everyone
I really think that every single person in the world (except those enlightened folks) could get something really valuable from therapy, and could unlock more of their potential to be a positive contributor to society and a loving part of the world.
Three things I live by
- Live lightly
- Love fully
- Let go gracefully
Leting go gracefully is where therapy comes in for me. Therapy helps me find, sit with, and then let go of fears and shame and grief. This is something I realised I need to do to love fully, and also helps me live lightly (rather than avoiding my fears with shopping therapy).
These are an approximation of a version I heard of the Buddhist precepts. I don’t consider myself a Buddhist, but I hugely value many ideas and practices taught in Buddhism.
It’s as easy as changing mindset.
I’ve read numerous times that saying “I’m not good enough” or “I’m a failure” is pointless and egotistical. After 2 years I finally can see that truth in myself.
I originally included this as a side note in the “I feel like a failure for needing medicine to function” section.
I’ve since realised that this is a really core idea.
It comes down to applying the wrong mindset, asking questions that simply don’t make sense — there is no answer to them.
I was trying to share it with a friend who had similar self-worth challenges. I tried a couple of ways of explaining it, but the one that clicked was this question:
“Can you describe your feelings around your lack of self worth without using an ‘I’ statement?”
Initially she thought she could, easily. But when she tried, she said things like “The people around me are so amazing, I can’t keep up with them, I don’t have enough to offer”. This can be refactored to “I don’t feel I offer as much as other people”.
The point is, as soon as I move from “I” to “We”, all questions and troubles around self doubt and self love disappear. They become nonsense questions. you can’t even ask them.
“Our connection is… weak? one-sided?” — doesn’t really work.
Until recently I didn’t even know it was possible to think another way. What really helped me grasp it is a combination of meditation and reading the start of “The Way of Zen” by Alan Watts. “The Way of Zen” starts out as a general comparison of Eastern and Western mindsets, and shows the fundamental differences between them. Later on the book gets heavier as it gets into Zen specifically, but the first few chapters are really worth reading — he has a great understanding of both mindsets, and explains the differences well.
At work and in social situations, recognising these “I” statement thoughts as they come up — and knowing they are nonsense questions if I move to a collectivist mindset — allow me to shed those negative thoughts gracefully and maintain my connection to myself, those around me and my work.
Books
“The Prophet” — Kahlil Gibran
“Search Inside Yourself” — Chade-Meng Tan
Meditation
Meditation now feels like the keystone of my life — it hugely helps my relationships to myself, others and my work. It is my most important practice, that I think I will do for the rest of my life. Despite saying that, I still find it challenging to do and make time for. But I do keep coming back to it.
Here’s my journey into meditation, it was a good one, I recommend it:
“Search Inside Yourself” — Chade-Meng Tan, Book.
A westerners introduction to meditation and empathy— psychology of the mind and body, short two minute introductory practices, great content. Written for corporate America — I didn’t mind the language (I found the use of it interesting), though it irks some people. I think it is great, with great intention and execution.
This was a wonderful introduction to meditation, and I still use parts of it. Awesome animated videos clearly explain the ideas, and the first ten 10min guided meditations are amazing and free.
I’ve done 29 hours meditation with it so far. Really great.
Yoga
Mindfulness meditation showed me how I can use Yoga as a wonderful form of meditation to connect with my mind and body. I do sun salutations every other morning. Bonus: I can touch my toes now!
I did an amazing course led by the wonderful Nick Laurence. A blend of Vipassana and Psychology, East & West. Amazing learnings, easy to fit around work, great accountability. There were some exercises in here about avoidance. At the time I was like “Bah, I don’t avoid anything! This is stupid”. Now therapy is helping me find the things I avoid, and the practices I learnt in MiCBT are really helping me confront these things safely and constructively.
Vipassana
International | Retreat in Aotearoa, 1 hour north of Auckland
Vipassana is awesome. It’s intense. I recommend thoroughly to anyone. I think this practice has a real essence of life in it. It is so simple. Non-secular. I didn’t do it for about 3 years because I was worried it was a cult or something weird. Now I know it’s not.
“That’s what you would say if you got converted into the cult!” I hear you say.
Fair call. I guess you’ll just have to trust me, and them. I think what swayed me in the end was the huge number of people I enormously respect who have been to one or many Vipassana retreats and recommend them.
It really is very simple, only about learning to feel and listen to yourself. But so wonderful too.
I really recommend to everyone.
Insight timer
I use this beautiful timer for my twice daily Vipassana style meditations. I try do at least 5 mins morning and night, with ideally one 30 min session each day. This is challenging to keep up, but brings me huge benefits. I’ve done 120 hours with it now.
If I’m very unfocused I’ll do a guided meditation, from headspace, the MiCBT course or sometimes from the insight timer database of guided meditations.
Exercise
With greater awareness of myself through meditation, I now really appreciate the positive effects exercise ALWAYS have on me. The more the better! It actually changes your brain chemistry. No time to find a reference now, comment if you know one/I’ll try add later.
How I see Depression
I think for me the opposite of Depression is Connection. Connection with myself, with people around me, and with the world. I think each different type of connection reinforced the other, but that the connection to self is essential.
How I talk about Depression
I dislike making it a part of my identity. I like to say “I’ve been experiencing Depression”, rather than “I have Depression”. This reminds me that it can change, and empowers me to take positive actions.
I can see how this approach can assist in avoidance of accepting that there is a problem, which can be a barrier to getting help.
Other people have told me they prefer saying “I have Depression”.
I reckon do what works best for you, but consider it and be intentional about it — words have power, our words shape our world.essential.
I feel like a failure if I need medication to live
I’ve felt this. My main thoughts on this one now: I just don’t care that much about this. What’s important to me is growing wonderful connections in the world and helping others. I don’t want to stuff around judging myself anymore anyway. I’ve read numerous times that saying “I’m not good enough” or “I’m a failure” is pointless and egotistical. After 2 years I finally can see that truth in myself. Though I often still need reminding (thanks Jan!).
Another minor point — this current dense, technology and advertising filled society is not the most natural place to live for recent apes. I’m working on carving out a more natural niche for myself, but until I do I’m going to take all the help I can get. And I’m super privileged to have time and energy to actively seek and carve a niche… How do other people do it???
Hmm, I’m feeling fine now. I don’t think I need help…
Depression seems to come to me in waves.
Every time life gets better I think “I’m fine now, I don’t need help!”.
Then I get disconnected and feel like shit again.
Then things get better, and I think “I’m fine now, I don’t need help!”.
Then I get disconnected and feel like shit again.
Then things get better, and I think “I’m fine now, I don’t need help!”.
Then I get disconnected and feel like shit again.
I didn’t get help for about 30 cycles of this over three years.
I didn’t get help when I felt like shit, because I didn’t have energy and courage or support.
I didn’t get help when I felt good, because… I didn’t think I needed it.
If you are in this cycle… maybe you need to get help?
Talk about it.
Opening up and talking about it has been hugely positive for me. I think I am surrounded by particularly supportive and open-minded people. I don’t know how safe this is in general. I think sharing on social media (facebook, twitter) is the very last step. Before I did, I discussed it with many close friends, a few strangers, then just sat on the idea for a month before publicly sharing.
There’s a bunch more stuff
Mental health is connected to all things in life — eating, friendships etc… so there are so many many many more things — opportunities for finding healthier ways. Media and advertising get to me. Coffee often takes me away from connection… play, and share what you find!
I’m interested to hear what is working well for you. Also I’d love to hear your feedback on this — what you took away from it, if there was something you found helpful, or things you didn’t agree with, things that I’ve got wrong, typos etc. ;)
Aroha nui, tihe mauri ora!
Pete
