Happy New Year! I hope all of you enjoyed time spent with family and friends over the holidays. I know I did 🙂 My 2023 New Year’s Resolution… well, I don’t have one. In my experience, New Year’s resolutions are a set-up for failure. Historically, I have established extremely difficult, practically unattainable, goals, typically around diet and exercise, which I eventually flop on. So, this year, I’m going to continue working hard towards my recovery, sharing my story to advocate for others, enjoying the company of family and friends and finding new adventures! Nothing new, nothing unachievable, and NOTHING diet related. Just me being me!
So, I know it has been a while since I last wrote. The reason… avoidance. 100% avoidance! Avoidance is my OCD’s “bread and butter” compulsion. If feel uncomfortable… avoid, avoid, AVOID! Whether that be physical avoidance or mental avoidance, I’m a master of it all. To share my experiences and feelings with readers is challenging, but to process and accept these myself, is damn near impossible. So… I avoid.
Now, don’t get me wrong. I experienced many moments of joy and happiness, throughout the holiday season, but, unfortunately, I also experienced depression, anxiety, fear and panic. In the middle of December, I fell into a “low”. In session that week, my therapist recognized something was off. To each of his inquiries, I denied, deflected… avoided. I was suppressing the feelings, hoping that they would pass quickly. I woke up the following morning with an overwhelming sense of hopelessness and worthlessness. The urges to self-harm were relentless. Getting out of bed was a chore and every step after that a challenge. The apathy set in, I wasn’t hungry and I had no interest in taking my meds. I felt broken… again. I was scared, and finding it difficult to express my feelings to both my therapist and myself, so I wrote…
December 7, 2022
I want to run.
I want to hide.
Nothing but noise.
My brain is on fire.
Why is this happening?
I’ve worked so hard.
Stuck my finger down.
this is what I deserve.
I need more.
But, I can’t.
So, I sit
As Damon so finely puts it, I was at “battle stations”. With every ounce of my being, I had to dig down deep and find the strength to get through the next few days. If there is a hell on Earth, this was it.
Historically, my mood begins to shift in a positive direction after ~3-4 days. The plan, no self-harm (cutting, starving, purging, excessive exercise, burning and withholding medications), follow my base meal plan, keep an open, honest dialogue with Damon, lean on my support system, and take one step at a time. It was grueling, but I did it. I followed the plan and therefore took a significant leap forward in my recovery. So, what caused all of this? Was it the difficult content of my obsessions and exposures? Was it just par for the course for a Bipolar diagnosis? Was it the stress of the holidays? Who knows?
In the following weeks, my mood trended towards baseline, as I prepared to face-off against my new opponent… panic disorder. It was time for Interoceptive Exposures! Interoceptive exposure is a cognitive behavioral therapy (CBT) technique that refers to carrying out exercises that bring about the physical sensations of a panic attack, and in the process remove the person’s conditioned response that the physical sensations will cause an attack to happen. First step, develop my Interoceptive Exposure Hierarchy:
(Exercise) – (Duration) – (Panic Attack Similarity Rating)
All Over Muscle Tension – 60 seconds – 1
Head Between Legs – 30 seconds – 3
Step Ups – 60 seconds – 3
Hold Breath – 30 seconds – 4
Spinning – 60 seconds – 5
Straw Breathing – 60 seconds – 8
Rapid Breathing – 60 seconds – 8
Head Shaking – 30 seconds – 9
Now, it was time to get to work!
– Start with the first exposure.
-Do one exercise per day; repeat the exercise five times.
-After each repetition, rate your fear or dislike of the symptoms produced from 0-10.
-If the fifth fear or dislike rating is 2 or less, move to the next exercise the following day.
-If the fifth fear or dislike rating is 3 or more, repeat the exercise the following day.
-When you complete the list, repeat it.
THIS is what I have been up to the last week, or so. Today, I finally completed Interoceptive Exposure #4: Hold Breath – 30 seconds. That was a tough one. It took several days to adjust to the symptoms, chest tightness, dizziness and lightheadedness, of not breathing for 30 seconds. Tomorrow, I continue on this journey and begin Interoceptive Exposure #5: Spinning – 60 seconds. Wish me luck…
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