How Are You Being Treated?

 B"H

As I recover from the freeze, I am thinking about other people I know with mental health challenges.  One thing that stands out to me is how many people I know who are inadequately treated for their mental health.  Why do I say they are inadequately treated?  Because for some people I know, waking up filled with dread or with quiet despair or with anger about being here another day is standard.  That feeling is the primary thing between them and a productive, fulfilling life.  

I certainly didn't know that these unpleasant feelings can be considered depression.  They were just so normal.  After having been treated intensively for depression, I am still building my way out of that dread of the day.  But I see movement, which is how I define the difference between depression that is being treated and depression that is being inadequately treated.

For myself, it was possible to have two therapy sessions per week, plus medication, and still be inadequately treated.  I needed some serious retooling of my thoughts to make better progress away from my depression.  This came in the form of a "PHP" (Partial Hospitalization Program): six hours per day onsite, doing group work in Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Narrative Therapy, Art Therapy, Self-Esteem classes, Family Therapy, Shame Resilience Theory, Goal-Setting, Behavioral Activation, and more and more.  We re-wired my brain with a combination of insight and persistence.  Of course I still need to check and tend the wires regularly.  But I consider myself adequately treated now, because when I do the things I know how to do for depression, they work.  At my best, I can characterize my days as reasonably happy.  Some days are not my best.  But all in all, I'm ready to take on other challenges, like living a meaningful and productive life.  Depression no longer takes up all of my energy.

So I'm putting out a call for everyone who deals with a mental illness to consider: am I being treated adequately for this challenge?  Can I tell that I am making progress?  Do I have times when my illness doesn't define my mood?  If the answers are no, please ask your providers what more you can be doing to heal.

Be warned, though: getting adequate treatment may very well involve going into the parts of your mind you dislike most.  For me, this has meant feeling and acknowledging a vast amount of shame.  Most recently I uncovered that shame is actually attached to taking productive action.  Not handy.  And ever so embarrassing, because it comes from the notion that I am to be so "good" that I don't have to do anything.  If I must engage with the world, I feel I have failed.  If you've ever wondered how people who have privileged identities get so funny about just doing normal stuff, this is part of it.  I squirm greatly at taking effective action, because it is, according to my old beliefs, an admission of being not good.

I would be failing you if I didn't provide some amount of hope for this dismal situation, so here is how I deal with my old beliefs about shamefulness.  Articulating the answers to the following questions begins to help change the feelings.  We think differently about the situation, and it produces different emotions than before.

1. What is an opposite to my old belief that action means I'm a bad person?  

    --It's good to participate in the improvement of our world.

2. Is there any evidence that my old belief is true?

    --One of my parents used to take pride in my accomplishments so personally that it felt like I was irrelevant.  That was an experience of feeling bad/dismissed for having acted.  I also felt like a thief for feeling any pride in my accomplishment, once it became clear that the credit belonged to my parent.

3. Is there any evidence that the opposite could be true?

    --My grandmother was part of the generation that came of age in the 1920s, and truly believed in working for progress.  I respect her lifetime accomplishments.  My religion also specifies that working toward a better world is each of our individual concern.  Finally, there have been times in my teaching career and my dance career when I found out that what I did influenced someone in a very positive way.  The fact and the feeling of making a difference are phenomenal gifts!

4. What belief will serve me best?

  --Opposite belief wins!  It makes much more sense, and is true in my experience, that it is good to participate in the improvement of the world.  The original belief's arguments are less compelling.

If you are at a point of wondering whether it's worthwhile to seek further assistance with your mental health, please try this exercise.  My counselors call it "putting your thoughts on trial."  What belief has kept you from trying to get adequate care?  What is an opposite to that belief?  What evidence is there for your current belief?  What evidence is there for the opposite belief?  Which belief serves you better?

No exercise is a silver bullet, though exercises can be powerful.  If you find it would be best to adopt a new belief, but you can't do it right away, give yourself time.  Look for evidence to support your preferred belief from day to day.  Consider what you might do if you held the preferred belief.  No strings, just become aware of your options and your choices.  May a consciously-chosen future become yours.