Thursday, November 29, 2012

Do's and Don'ts for the Holiday Season

I enjoy Christmas lights and eggnog as much as the next gal, but let’s face it most of us experience more stress than good tidings during the holidays.

Over the years I’ve found ways to make the holidays, not just bearable, but actually enjoyable. I know this is is shocking, right? Unless is not shocking and you are one of those lucky people with fond memories of your childhood Christmases. If that’s the case you can go ahead and skip this blog and get back to browsing Pintrest for homemade Christmas decorations.

Here are some Do’s and Don’t’s for the holiday season for those of you who, like me, may experience anxiety during this time of holiday cheer.

Do set healthy boundaries. Remember you can’t be everything to everyone. And if you come from a split family and/or are in a relationship you likely have at least four places to attend each holiday. Find what works best for you and your household and stick to it. This may mean saying no to some invites, but remember your sanity is just as important as the feelings of your Great Aunt and third-cousin twice removed.

Don’t allow guilt trips from your family or in-laws to get to you. I’m not a mother yet, but it seems that somewhere during the labor and delivery process mothers receive these superpowers that allow them to give guilt trips like no other. I’m very lucky that my mother doesn’t use these during the holidays. But if I didn’t set healthy boundaries she might be tempted to. She is, after all, a mother.

Do reach out to your doctor if your anxiety and depression starts to get worse this time of year. An antidepressant or anti-anxiety medication can help regulate your moods in a safe and healthy way.

Don’t self medicate. There is a difference between having a glass or two (or three!) of wine at a Christmas party and turning to alcohol to drown your sorrows and numb your pain. The former is fun and festive the later is dysfunctional and self destructive.

Do create traditions that are meaningful for you. My husband and I try to go to the Christmas Eve service every year as our “tradition.” I say try because we’ve only actually went once. One year there was a blizzard so bad that churches actually cancelled their Christmas Eve services. Every other year he has worked and this year he’s on-call. So, maybe that tradition was a bad example, but you get what I mean.

Don’t set your expectations too high. Things happen and the holidays are never as picture-perfect as they are on TV. Unless they are for you, in which case why are you still reading this blog? Shouldn’t you be on Pintrest?

Do give yourself lots of grace. So you didn’t pick out the perfect gift for your mother-in-law? No biggie. So you burned the pre-made sugar cookies? Who cares. You forgot the date and time of your extended family gathering? Don’t worry, there’s always next year.

Don’t completely shut down. It’s not healthy to isolate yourself from your loved ones when feel depressed or anxious, but it’s what we tend to do. If you feel yourself shutting down, take a minute and reach out to your “safe” person. It could be your best friend, or your spouse, or you sister. Whoever it is for you, reach out. Don’t keep yourself in isolation.

Do feel free to leave comments if you found this blog helpful.

Don’t stop reading this blog if you are one of those people who have great holidays. I forgive you for continuing to read even after you were instructed to go to Pintrest.

Tuesday, November 13, 2012

Erring on the side of happiness

I generally try to put on a good face wherever I go, but especially when I have to go to my psychiatrists office.

I say “my psychiatrists office” as if I have I psychiatrists I see regularly. For now I go to KU Med and see which ever resident fits with my schedule.

In reality, I haven’t been able to find an attending psychiatrist who sees outpatients who is not a complete quack, but I’ll save my adventures in doctor hunting for another post.

This blog, is about saving face, a skill that I have mastered over the years. During my quarterly psychiatry visits my goal is to be the ideal patients. I have had doctors hug me at the end of my appointments before. Why? You might ask. Because I’m an extremely compliant patient. I take my lithium as directed (minus my the little experiment I had earlier this year), I get my labs checked, I exercise, eat healthy, and stay connected to my support systems.

I strive to be the perfect patient. If there is ever a hint of hypo-mania in my head, I call in. That’s what good patients do.

I’m like a teacher’s pet, only with my doctors. I don’t want to let them down, so much so that when I’m feeling depressed I don’t like to mention it. I mean really, an ideal patient shouldn’t get depressed, right?

This obsessive people pleasing may sound strange to you. Unless you are related to me or a part my inner-inner circle, in which case you already know this is the neurosis we call Arley.

A few weeks ago I had an appointment with a new resident. I scheduled the appointment with a female resident who came highly recommended from my therapist.

That morning I put on a super cute dress I just bought from White House Black Market, scrunched my curls in place and prepared for what I thought would be an awesome doctor’s visit. I planned to discuss the possibility of tapering off my medication so I can maybe, possibly, fingers-crossed, try to get pregnant next year. I was ready for the appointment. I was ready.

Before my doctor’s appointment I had a slightly stressful meeting at work, but I didn’t let that get me down. I listed to Fresh Air on KCUR on the way to KU Med and thought about all the questions I wanted to ask the doctor about bipolar pregnancy.

But when I arrived at the sixth-floor outpatient psych unit, the receptionists put glitch in my plans.

“Your appointment isn’t until tomorrow Miss Arkenberg,” she said politely.

“What?” I’m sure my voice was obnoxiously high. “My appointment is today. It says so on my phone.”

I held up my iPhone as proof.

She just gave me a look that said, “Seriously?”

Clearly I had typed the appointment into my phone wrong, but I knew there was no way I could take off two afternoons of work in a row. And I couldn’t let anyone at the office know that I had written down my doctor’s appointment wrong. I mean really, getting confused about when your psychiatry appointment is, how embarrassing is that?

“Well, what if Dr. Smith’s 2 o’clock doesn’t show up?” I asked. “Could you squeeze me in then?”

It was already 2 p.m . so I thought their might be a good chance that she wouldn’t show up.

I was wrong. Two minutes after I asked the questions the woman showed up, prompting me to call her swear words in her head. It wasn’t this woman’s fault that I entered the wrong day in my calendar but I needed someone who I could project my anger towards.

I sat down in the waiting area to collect my thoughts. As I did so tears began to fall down my cheeks.

“Come on Arley,” I thought to myself. “Be strong. Think of a plan. What’s your next move going to be?”

I decided to reschedule my appointment with Dr. Smith. I couldn’t come back tomorrow, but I would be able to come back in a couple of weeks. That seemed like the reasonable, responsible thing to do. That seemed like the thing a “good patient” would do.

But when I went up the receptionists desk to reschedule my appointment she wasn’t there.

I sat back down in the waiting room and succumbed to my tears.

Ten minutes later the receptionist came up to me to let me know that there was another doctor available to see me.

I wiped the tears from my eyes and followed the doctor into his office. Instead of giving him my pre-scripted overview about how well I was doing and how my husband and I would like to start having children, I broke down and told him how I really felt.

I felt overwhelmed.

I felt tired.

I felt paranoid.

I felt anxious.

I felt embarrassed.

I felt isolated.

I felt confused.

I felt depressed.

I realized that I hadn’t planned to tell the doctor and of these things when I left the house this morning. I’m always hesitant to tell anyone when I feel depressed. In some ways I’m still ashamed of my depression. As if I should know better. As if the chemicals in my brain should cooperate better.

The doctor asked me if their was a reason that I kept my SSRI (anti-depressant) at such a low dose.

“I’m scared of getting manic,” I confessed.

“It’s okay to err on the side of hypo-mania,” he said. “We can catch that and make adjustments. We want you to be happy. We want you to err on the side of being happy.”

His words, “err on the side of being happy,” struck me. I had never thought of it that way.

Part of me has always viewed happiness as frivolous or even reckless if there was any risk involved at all.

This doctor was telling me to go ahead and take the risk. My happiness was worth it. I was worth it.

When I left the doctor’s office that day, I didn’t feel like the ideal patient. But I did leave with a new outlook on life and a script for a higher dosage of Zoloft.