Mental Illness: Emotional Dysregulation

This post is meant to provide a brief overview on symptoms of mental illness and then insight into living with the symptom. It should not be used as a diagnostic tool, but if you relate to what you read, it may be time to have a conversation with a mental health professional. 

Emotional dysregulation is the inability to regulate emotional reactions. There are four main aspects to this issue according to Psychology Today.

• A lack of awareness, understanding, and acceptance of emotions
• A lack of adaptive strategies for regulating emotions (the intensity and/or duration)
• An unwillingness to experience emotional distress whilst pursuing desired goals
• An inability to engage in goal-directed  behaviors when experiencing distress

These are mental and behavioral strategies that ultimately make negative emotions worse.

What does emotional dysregulation look like?

• Experiencing intense emotions
• Crying in response to a variety of feelings, even happiness
• Struggling to take your focus away from your emotions
• Having mood swings and unpredictable emotions
• Having a low tolerance for frustrating situations
• Being unaware of the feelings of other people
• Becoming overly excited

Emotional dysregulation can be aspects of multiple mental illnesses such as depression, anxiety, panic disorders, and borderline personality disorder. They may involve dysregulated behaviors such as self harm, substance abuse, etc. which are unhealth coping mechanisms.

It can also be a side effect of neurodivergence such as ADHD or autism which may result in a meltdown for some if the triggers are strong enough.

Emotional dysregulation can negatively impact multiple areas of your life resulting in workplace difficulties, issues studying or in school, relationship conflicts, worsening mental health struggles, and increasing a tendency for risky behaviors (i.e. substance abuse, dangerous driving, etc.)

What can you do to have healthy emotional regulation?

Practice good mental and physical health as outlined in our sections on self care.

• Exercise
• Deep Breathing
• Yoga
• Acceptance
• Awareness
• Learn your tirggers
• Try the F.O.U.L. Method
• Try the R.A.I.N. Method
• Reframe self talk
• Therapy & Medication may help depending on the reason for dysregulation
• CBT and DBT therapies are often used for emotional regulation

Helpful Links:

Article: Emotional Dysregulation in Children and Adolescents with Psychiatric Disorders (NIH)

Understanding ADHD (by ADDA)

What is Emotional Dysregulation? (Psychology Today)

"Emotional dysregulation is most often something I hear talked about in regards to ADHD these days. I live with three adults with ADHD so its a common conversation in our house. It is interesting to talk about how I have the same symptom as part of my PTSD/PMDD while my bestie has it because of ADHD. The way it works in our heads is different but the end result is the same.

Sometimes the world is just really overwhelming and the ability to regulate or function "normally" is shot. I am pretty good at recognizing when I have reached my limit and shutting myself away until I can regulate again.

I think most often for me it feels like standing still and quiet when the emotions inside me are begging me to just scream and throw things. Its like my emotions are too big for my body and they need to get out somehow, but some rational part of me knows we can't behave that way. It can come from a place of rage or pain or frustration. It takes an enormous amount of self control to just hold my tongue and walk away. I know this is healthy management but it feels like absolute garbage in the moment.

I tried to describe it before so I am going to share my prose "Scream" which I think captures the feeling quite well.

SCREAM

Somedays I just want to scream. I don't want to censor or silence myself. It's beyond longing to simply release the feral beast trapped within. She is not a quiet, passive person. She rages, slamming against the walls of her prison while snarling and clawing any happiness nearby. She need not be provoked for simply being awake is enough to draw forth a mighty anger bore from the darkest reaches of my own soul. Today, I want to scream. I don't want to reason with those I love or hope for their acceptance. Somehow today I want to scream to the overcast skies that there are still unhealed wounds, that I can not bear the saline words ground into them. The silent denial of truths that rock my world, the blissful ignorance of the black abyss monster always poised to drag me under the churning waves. The endless nights laying awake because I can feel the shadows settle as my demons hover over me waiting to lead a legion of nightmares into my slumbering mind. It's the conflict of the primal being as she struggles with her rational form. It's the cramped box of expectation as the air runs out.

- D.M.

Mental Illness: Nightmares & Insomnia

This post is meant to provide a brief overview on symptoms of mental illness and then insight into living with the symptom. It should not be used as a diagnostic tool, but if you relate to what you read, it may be time to have a conversation with a mental health professional. 

Nightmares and Insomnia are part of the human experience. Almost everyone will experience these at some point in their life but people with mental illness may experience chronic nightmares or insomnia, meaning it is a long standing continuous symptom. 

Sleep is an important part of your overall health and disruptions to it can generate their own sets of issues as well as making other mental illness symptoms worse.

Insomnia can be a symptom (secondary insomnia) or a sleep disorder on its own (primary insomnia) that makes it hard to fall asleep or stay asleep. Most adults need seven to nine hours of sleep a night and will experience short term insomnia at some point in their life- typically due to stress or illness. Natural changes during aging may also results in insomnia. Chronic insomnia is insomnia that lasts for three months or more typically due to another illness or disorder.

What Causes Insomnia?

Insomnia can have many causes. 

• Genetics
• Stress
• Irregular person schedule due to work, school, or travel
• Poor Sleep habits
• Heart burn
• Mental Illness
• Nightmares
• Medication
• Sleep Disorders
• Sleep Apnea
• Caffeine
• Nicotine
• Alcohol
• Aging
• Changes in activity level

How many people have insomnia?

According to the Cleveland clinic - roughly 1 in 3 adults

When do I get help for insomnia?

• Sleepiness during waking hours that is hard to resist
• Microsleeping during the day, especially if during work or while driving

How is Insomnia treated?

• Developing good sleep habits
• Setting a sleep schedule
• Having wind down time
• Being comfortable
• Limiting device usage
• Being mindful of eating/drinking before bed
• Exercise
• Medication
• Sedative Drugs
• Hypnotic Drugs
• Antidepressants
• Melatonin
• Some herbal supplements
• Mental Healthcare

Nightmares are not just "bad dreams", they are dreams that can lead to emotionally disturbing feelings such as fear, anxiety, or terror. They can generate physical symptoms like a racing heart, sweating, or rapid breathing. Chronic nightmares can be a symptom of different types of mental illness or a disorder of their own. Nightmares can be the cause of insomnia.

Nightmares are not the same as night terrors. Night terrors mainly affect children who may physically act out with screaming, shouting, thrashing about early in their sleep cycle. Typically the child will not recall they had a night terror.

Nightmares affect adults and children but lead to strong feelings which will be recalled later. They tend to happen later in the night during REM sleep.

How often do people "normally" have nightmares? (Source: www.psychologytoday.com/us/conditions/nightmares )

• Women tend to have nightmares more often than men
• 6% of adults report nightmares at least once a month
• Between 1% and 2% of adults have nightmares more often than once a month
• Less than 1% report frequent nightmares that disrupt daily function

How are Nightmares treated?

• Creating a healthy sleep routine with good sleep hygiene 
• Creating a safe, healthy sleep routine that includes practices such as relaxing, reducing screen time, and sleep journaling may help
• Treating any underlying issues (i.e. substance abuse, physical health concerns, etc.)
• Certain health conditions are comorbid with nightmares such as cancer, Parkinson's disease, and coronary heart disease
• Substance abuse may also result in nightmares
• Therapy
• Therapy to address trauma, stressors, or anxiety that is reoccurring in nightmares may reduce the frequency of nightmares
• Medication (used for persons with PTSD, anxiety or depression) 
• Some medications can cause nightmares so adjusting those may reduce the nightmares
• Medication can be prescribed to treat nightmares

Note: There is a documented link between nightmares and suicide risk. You can read more here: https://www.apa.org/monitor/2024/10/science-of-nightmares

"Nightmares are one of my longest standing PTSD symptoms. The first truly awful one I can remember happened the night of my fifteenth birthday. I can still remember it vividly twenty years later.

I have chronic nightmares. The vast majority of my dreams that I can recall are nightmares and I have had multiple a night for as long as I can remember. The severity ranges from almost comical (still scary while dreaming) to horrific gore that makes me wake up and vomit. I have been too scared to fall asleep at times because I knew I hit a trigger and the nightmares were coming for me.

They are consistently so violent that my long time therapist told me I should never take prescription sleep aids because she was concerned I would be a danger to myself or others if it caused me to sleep walk while having nightmares. She did suggest I try melatonin or Unisom to help me fall asleep to see if I couldn't manage more sleep around the nightmares.

Over the years I have tried several different ways of managing my nightmares, some more successful than others. I spent most of my late teens and early twenties working myself into exhaustion then sleeping with headphones on. I spent my mid twenties working a lot and then using exercise or sleep to push myself into a deep sleep that went past dreaming. 

Sleeping in sunlight seems to consistently result in dream free sleep so I often nap in my car on my lunch break or sleep in a hammock in the sun when the weather is nice.

Part of my medication journey as an adult in my thirties is trying out prazosin for the nightmares. It helps in that while I still have nightmares they don't seem to "stick" very well. I can wake up from them and fall back asleep without it triggering anxiety or insomnia. It is easily the best and most sleep I have gotten since the nightmares started when I was a teen. I still have them and I still have insomnia but that is once or twice a week instead of every night. I am starting to have and remember regular dreams now which is novel to me still. Its still not the normal amount of sleep that most people get and I still have a lot of nightmares but it is still an improvement.

To be completely honest, the sleep deprivation between insomnia and nightmares amplifying some of my other symptoms was one of the primary reasons I decided I should not go through with a pregnancy or care for a newborn. I just couldn't see a world where I could be trusted if my already fractured sleep was even more scarce. I realize that may seem like an extreme choice to some people and many of my loved ones still don't understand, but luckily my therapist and OBGYN both took my concerns seriously and helped me get the sterilization procedure I wanted. The older I get, the happier I am with my choice. I will dedicate a whole other post to that decision but if you know you aren't able to function then seek medical professionals that take you seriously."

- D.M.

Mental Illness: Flashbacks

This post is meant to provide a brief overview on symptoms of mental illness and then insight into living with the symptom. It should not be used as a diagnostic tool, but if you relate to what you read, it may be time to have a conversation with a mental health professional.  

A flashback is a vivid memory experienced as if it is happening currently. Flashbacks can take different forms. They can be emotional, visual, auditory, olfactory, tactile or a combination of senses. Someone who experiences flashbacks may experience different types of flashbacks depending on their mental state or the trigger for the flashback.

Flashbacks are primarily a symptom of PTSD or C-PTSD as result of the memory processing issues created by trauma. Basically, your brain does not properly make a complete memory of the trauma and is trying to recall the memory by associating it with current stimuli. As a result, any stimuli that reminds a person of their trauma can become a trigger for flashbacks. These can be internal stimuli such as thoughts or emotions OR external stimuli such as a smell, taste, or physical sensation. 

Reactions to flashbacks can be emotional (i.e. shames, fear, anger, etc) or physical (i.e. racing heart, feeling disconnected from your body, etc) as your brain tries to process the trauma in real time. Some people find flashbacks more distressing than others and tolerance for flashbacks can change over your healing journey.

There is not a way to prevent flashbacks but there are ways to manage them.

1. Create a safe space to go to when having a flashback 

2. Practice calming breathing exercises

3. Use ground techniques ( I like my EMDR app or using the CALM app. Doing a mindfulness exercise that focuses all five senses can also help a lot. - D.M.)

4. Ask for support from family, friends, or mental health professionals

*Mental Health Care may include medications or therapy. EMDR therapy is often used for people with PTSD and CPTSD to help process traumatic experiences. 

5. Create a self-care plan ( See our posts on maintaining physical and mental health)

Helpful Links

Post-traumatic stress disorder (PTSD) - USA

PTSD: National Center for PTSD (USA)

Understanding PTSD flashbacks and triggers (UK)

Scientific Article: The neural basis of flashback formation: the impact of viewing trauma

What are Flashbacks? (Rape Crisis UK)

"I had PTSD for a number of years before I started having flashbacks. I often track the beginning of my PTSD experience to chronic nightmares I clearly remember starting when I was fourteen/fifteen years old. I did not start having flashbacks until after I was with an abusive romantic partner.

My flashbacks are often visual or emotional. I find scents to be a particularly strong trigger for me and have a small list of scents I now avoid. 

The most common time for me to have flashbacks is in the shower. I don't have any specific trauma that relates to being in the shower but I have a habit of seeking a hot shower to calm down and ground myself. Its also considered reasonable to lock a bathroom door even when things are spiraling. Sometimes when I am particularly uneven it feels like I close my eyes to rinse my hair as an adult and I open them to find I am back to being a teenager trapped in an abusive relationship. Same bathroom, strawberry shampoo, dim light... its all the same. It can be very disorienting and the desperate panicking that sets in can ruin my whole day. 

A couple years ago, I had a day where I woke up and looked in the mirror to see my ex's blood splattered on my face again. I knew it wasn't real and tried to just ignore it as I did my normal make up before I went about my day. It was the first time I had a flashback like that and to say I was unsettled would be an understatement. I felt so sad, like I would never ever find normal again. 

Interestingly, I got a tattoo on my shoulder a couple years back and its really helpful for grounding me for flashbacks in the shower or when I am getting ready because if I look down and don't see the tattoo... it isn't real. If I have the tattoo, then I know I am safe at home as an adult. I find it helps me a lot when I am struggling to keep myself in the current time.

That being said, I have also had extended visual flashbacks with no emotional reaction that lasted days. I continued through my normal day, working and even training staff, while doing my best to ignore the involuntary video reel in my head. It was a very strange experience because I objectively knew I was watching some of my worst memories but I had no emotions about them. I was complete apathetic to them and they were mostly annoying me because I couldn't focus. It lasted about three days and hasn't happened again. I never sorted our what triggered that one.

My final thoughts are ... time is hard when you C-PTSD between the flashbacks and dissociation. Time is slippery and my grounding in it is not as concrete as other people's seems to be. I often cant tell you how old I was when something happened and I am missing whole chunks of time because the stress was so bad that my brain just... didn't save the memories properly. There have been years of my life where I kept notebooks so I could jot down my days, more so when I am around people who make me question my reality. I am finally at a place in my life where a planner for work is all I really need. Home is safe and I don't need to stress everything so much."

- D.M.

Mental Illness: Addiction

This post is meant to provide a brief overview on symptoms of mental illness and then insight into living with the symptom. It should not be used as a diagnostic tool, but if you relate to what you read, it may be time to have a conversation with a mental health professional. 

Need help with addiction?  SAMSA National Helpline Call 1-800-662-HELP

Addiction can be an issue someone struggles with separate from any trauma but it is not uncommon for people who have trauma to struggle with some form or substance abuse or addiction when attempting to self medicate. This disorder is complex and can have multiple factors that contribute to an addiction which includes genetics.

Addiction is considered a chronic condition meaning it is life long. It is a disease. People with addiction issues compulsively seek and take a substance (or perform an activity) despite negative consequences. These can be consequences that impact your health, relationship, work, and/or overall quality of life.

There are two main categories for addictions.

• Substance (alcohol, drugs, medications, etc.)
• Non-substance (behavioral addictions such as sex, porn use or gambling)

Alcoholism is the most common addiction that comes up and as a result there are a variety of resources available to assist. We have included links to resources in the USA, UK, and Canada below. Nicotine and marijuana use are the next most common substance abuse addictions.

What is the signs of an addiction?

• Inability to stop
• Increased tolerance
• Intense focus on the substance or activity
• Lack of control
• Personal problems
• Health issues
• Withdrawal

How is Addiction Treated?

• Therapy
• Support Groups
• Medication
• Rehabilitation
• Hospital Management (especially important for withdrawal from substances that can create serious health concerns.)

Personal Experiences

"I personally do not struggle with addiction issues. A portion of my abuse was by someone who was struggling with abusing medication and as a result I have been very weary of substance use to the point of being extremely reserved in my alcohol consumption and medication use.

A friend of mine who does struggle with alcoholism and addiction as part of their journey has kindly offered to provide some insight. I will be adding them to our collaborators page as they plan to contribute to multiple subjects moving forward." - D.M.

"A Reflection on Addiction

Being an addict colors my thoughts, and actions in many ways. There’s the obvious desire thoughts like I want a drink, a joint, or to get laid. It's deeper than that as well, when I reflect or ruminate it’s from the perspective of an addict.  Anything I do or say serves the purpose of getting relief.  This doesn’t mean I'm ingenuine or only self-serving like addicts are often portrayed.  It means in addition to anything I do there is an underlying need for more. Accepting and not demonizing that fact has been important.

 My mental health is such that I'm riddled with insecurity, self recrimination, and anger. I don’t feel or accept love in the way other people seem to.  I’m constantly overwhelmed with emotion and thought.  I need it to stop if only for a while.  Drugs help the thoughts mellow, sex keeps the insecurities at bay, cutting provides control over my emotions.   It's not about good or bad coping, healthy or unhealthy behavior.  It's about function.  

  Over the years of self work and therapy I’ve learned to accept certain aspects of myself and learned to expand my coping.  I quit drinking, but still smoke weed, and do shrooms. I don't cut as often, but use rubber bands for small doses of pain.  Sex and touch still are the only ways I can process affection and love.  I’m working on it, but it still persists.  Mostly I’m working to unlearn the need to catastrophize or vilify my feelings.  It’s ok to be angry, sad, and insecure. It's the actions we do that matters, a simple enough concept, but it took me a while to really understand it.

  My goal isn’t to beat addiction, any more than it is to beat ADHD, depression, or trauma.  My goal is to live in such a way that I'm not destroyed by anything.  I want to be someone that can be depended on, and manage the requirements of living.  It’s not easy, but most days it seems doable. I have more hope and love for myself than I ever have.  Hopefully my experiences can help others.

Addiction is tough to talk about, because there is a zeitgeist around it being sad, but unsympathetic.  It's hard for people to understand why someone would choose to harm themselves in such a way.  I’d like to reframe how people see addiction.  There is a component to it that is like hunger. A need that can't be easily satisfied. A chemical imbalance, a trauma, or coping mechanism.  The reasons matter when trying to understand. " - R

Resources you may find helpful

National Institute on Alcohol Abuse and Alcoholism - USA

NHS Webpage on Addiction with support links - UK

Addiction resources - Canada

For Loved Ones

What is Substance Abuse Treatment? A booklet for Families (USA)

NHS - Advice for families of people who use drugs (UK)

CAMH - Information for Families (Canada)

Mental Illness : Hallucinations

 This post is meant to provide a brief overview on symptoms of mental illness and then insight into living with the symptom. It should not be used as a diagnostic tool, but if you relate to what you read, it may be time to have a conversation with a mental health professional. 

Hallucinations are false perceptions of sensory experiences that feel real - sight, sound, taste, smell, and touch. Most people will experience hallucinations in their lifetime. It is considered normal to have them when falling asleep or waking up. They can be a symptom of a physical illness such as a fever, dehydration, or migraines in addition to being caused by drug and/or alcohol use. Certain medications can cause hallucinations as a side effect. 

There are neurological conditions that may cause hallucinations such as Parkinson's Disease, Alzheimer's Disease, Lewy body dementia, Narcolepsy, and some forms of Epilepsy.

Multiple mental illnesses can also cause hallucinations with schizophrenia being the one most people immediately have come to mind. Severe PTSD, bipolar disorder, different personality disorders, Major Depression Disorder and delusion disorders can also cause hallucinations as a symptom. 

The treatment for hallucinations will depend on the cause. Chronic hallucinations as part of a mental illness are typically treated with medications such as antipsychotics. It is considered a manageable symptom.

Types of Hallucinations

• Auditory - Sounds
• Visual - Sights
• Tactile - Touch
• Olfactory - Smells
• Gustatory - Taste
• Presence - Feeling as if someone if in the room or standing behind you
• Propioceptive - Feeling as though your body is moving when it is not

How do you know you are hallucinating?

You may not realize it all, but it is possible to be aware you are hallucinating due to context clues in your environment (i.e. hearing someone who has passed away talking to you, being in a room alone, etc.)

Can you do anything to prevent hallucinations?

There are some things you can do to reduce the frequency, but they will not prevent hallucinations if you have an underlying medical issue.

• Ensuring you have good lighting
• Checking for sounds that may be misinterpreted (i.e. sounds from an appliance)
• Correcting lighting that can cause shadows, reflections or distortions
• Covering mirrors

If you are medication for hallucinations, taking it consistently as instructed.

How do I help my loved one having a hallucination?

It depends on the type of hallucination they are having but a good starting point is to stay calm and assess the situation. Listen to the person having the hallucination and then decide on a course of action.

• If asked, calmly confirm if you are experiencing the same thing. 
• If they are adamant that the hallucination is real, you may be crossing over into delusion territory, in which case playing along may be more comforting.
• Understand that you may not be able to do anything but be a calming presence until the hallucination has passed.
• If this is a new development, encourage them to see a medical professional.

The information for this section was pulled from the Cleveland Clinic's website

My Experiences with Hallucinations - D.M.

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Mental Illness : Depression & Anxiety

This post is meant to provide a brief overview on symptoms of mental illness and then insight into living with the symptom. It should not be used as a diagnostic tool, but if you relate to what you read, it may be time to have a conversation with a mental health professional. 

Mental Illness comes with a constellation of symptoms and can vary from person to person even with the same diagnosis. Depression and Anxiety are common symptoms as well as being a diagnosis on their own.

Anxiety is an intense, excessive, and persistent worry and fear about everyday situations. There are many types of anxiety disorders such as Agoraphobia, Generalized Anxiety Disorder, Panic Disorder, Social Anxiety Disorder, etc.

According to the Mayo Clinic common symptoms include:

• Feeling nervous, restless or tense.
• Having a sense of impending danger, panic or doom.
• Having an increased heart rate.
• Breathing rapidly (hyperventilation).
• Sweating.
• Trembling.
• Feeling weak or tired.
• Trouble concentrating or thinking about anything other than the present worry
• .Having trouble sleeping.
• Having an upset stomach or other problems with digestion.
• Having difficulty controlling worry.
• Having the urge to avoid things that trigger anxiety.

Anxiety is more common than depression with a third of adults in the U.S. experiencing it within their life time. It can interfere with daily life and routine activities such as holding down a job, managing schoolwork, and relationships.

Treatment for anxiety typically involves therapy and/or medication. There are many types of medications that may be used to treat anxiety with SSRIs, SNRIs, benzodiazepines, buspirone, and beta-blockers being common choices depending on the type of anxiety.

More Information Here: National Institute of Mental Health

Depression is more than just being sad or having a bad day. It is a persistent feeling of sadness and loss of interest. Depression can be a symptom of many mental illnesses or a diagnosis on its own such as Major Depressive Disorder. It may also be part of a cycle of mood changes for those with Bipolar Disorder.

Hormones can also play a role in depression symptoms as part of Postpartum Depression and Premenstrual Dysphoric Disorder (PMDD).

According to the CDC* symptoms of depression include:

• Feeling sad or anxious often or all the time
• Not wanting to do activities that used to be fun
• Feeling irritable‚ easily frustrated‚ or restless
• Having trouble falling asleep or staying asleep
• Waking up too early or sleeping too much
• Eating more or less than usual or having no appetite
• Experiencing aches, pains, headaches, or stomach problems that do not improve with treatment
• Having trouble concentrating, remembering details, or making decisions
• Feeling tired‚ even after sleeping well
• Feeling guilty, worthless, or helpless
• Thinking about suicide or hurting yourself

Depression is extremely common with 1 out of 6 adults experiencing it sometime in their lifetime. The most common treatments for depression are therapy and medications (typically SSRI or SNRI varieties). Those with Postpartum Depression or Premenstrual Dysphoric Disorder may also be treated to balance hormones.

More Information Here: National Institute of Mental Health

" Depression and Anxiety are the primary symptoms I am being treated for as part of my PTSD. 

The anxiety impacts my daily life the most because I am borderline agoraphobic without medication. I get physical symptoms of anxiety even if I feel calm mentally. Its so frequent that I stopped wearing a smart watch because it was logging my racing heart as workouts when I was just sitting at my desk at work answering emails. I will mix liquid holy basil with tea to sip at work to help maintain that anxiety symptoms at a lower level so that I can work more efficiently.(Note: Holy Basil is a supplement that some people find helps with anxiety but you should absolutely tell your doctor if you are taking it because it can impact blood clotting.)

The anxiety seems to mix heavily with the hypervigilance for me, so being in places with lots of people or without clear lines of sight can push me into panic attack territory. Most of the time I can still function through a panic attack enough to walk out of a place or get somewhere "safe", usually my car. My heart will be racing and its hard to focus and breath but I just make myself practice box breathing and try to stay focused on the next simple task.

Sometimes I am otherwise having a good calm day at home and I can feel the anxiety in my chest, so I will be sitting watching youtube videos with my husband and just be like... man this really sucks and I don't want to feel like something is going to attack me. Usually my husband will just rub my shoulders until my heart rate comes down. It makes it hard to sleep or even stay asleep after waking up.

I have rescue meds I can take for panic attacks. Its a type of antihistamine that can act as a sedative. It works pretty well but also makes me very very sleepy so I don't like having to take it at work.

Interestingly, I don't have social anxiety. I am confident with interpersonal interactions and don't seem to struggle there.

My experience with depression as an adult is mostly that it makes me tired and gives me brain fog. I struggled a lot with it becoming more of an issue when I used hormonal contraceptives, so much that I had to be taken off multiple types because I was getting the severe side effects for it that you are supposed to immediately tell your doctor about. There was also some issue with suicidal ideation increasing with both hormonal birth control and some SNRI medications.

The depression symptoms were definitely more of an issue when I was in my teens, but it is hard for me to gauge how much of that was caused by my hormonal birth control use throughout those years."

-D.M.

* I have included a link to the CDC's website in this post because at the time of writing it is still functional. The current changes happening in the USA may result in this no longer working, at which point we will begin looking for alternate sources to reference.

Personal Growth: Healthy Expression of Negative Emotions

 Personal growth, like healing, is not a linear process. 

Learning how to express negative emotions in a healthy way can be one of the most challenging parts of your healing journey. It takes conscious thought and intention to build new healthy patterns of behavior. It means having to deal with situations you wish you could avoid and making a commitment to doing better. Sometimes you will "get it right" and other times you will fall back into old patterns.

Where do you start?

To break a pattern of behavior, you first have to recognize it and decide you want to change it.

"I got out of my relationship with my abusive ex and sort of stumbled into the relationship I had with J. It wasn't really something we planned on and I hadn't put any thought into what behaviors I needed to work on at all. A couple years in, we got into an argument and I threw a wooden spoon at him. He caught it and set it on the floor telling me that was unacceptable. 

It was the first time I had to really consider that how I handled my anger was not appropriate. I had grown up watching my mom throw things when she was angry and I had only really been in a relationship where violence was always a possibility. 

I decided then and there that I didn't want to be that kind of angry. I wanted to be the sort of person that my partner felt safe talking to or arguing with. I didn't want to be like my ex. It was not a good feeling but it motivated me. I still had to work on yelling and learning how to communicate my anger but it was where the change started." - D.M.

Once you have noticed the pattern and decided to change, you need to decide how you DO want to handle things moving forward. This is now your goal and it is going to take practice.

Also weird is not necessarily bad if it works and doesn't create an unhealthy pattern. (i.e. coloring on yourself instead of self harming)

"Anger is hard. Learning to sit still and be quiet and measure my own voice when I feel the rage rolling off me has been a huge part of my journey. There have definitely been occasions where I was just too tired or stressed to manage myself and ended up screaming at people I love. I then had to own that action, apologize and make amends.

Likewise, I have had to learn to rationalize out feelings of guilt and shame rather than resorting to self harm. The impulse is still there but this year I celebrate twenty years since I last cut myself. Its easier these days because they have more awareness and they even have apps for it like Calm Harm. " - D.M.

What if I mess up?

You own it. Apologize and make amends if necessary. Forgive yourself and try to do better next time. 

What if I can't do it by myself?

That's okay too. 

Therapy and Anger Management Classes are tools you can utilize to help you on this journey.