Anhedonia 101

One of the more common symptoms of depression is what is known in psychology circles as “anhedonia”. Most people see this word and go “huh?” then continue their lives. However for those people who experience anhedonia, it’s an incredibly debilitating aspect of depression and is one that more people need to understand. Without that understanding, others can make suggestions that seem like impossibilities, or simply say things that are cruel without realizing it.

You can read the rest of this post at Aut of Spoons.


Building Mastery

There’s a skill that we’ve been working on in DBT called “building mastery”. This is the process of doing something new/difficult/fulfilling in some way and feeling a sense of accomplishment after you do it. You don’t have to complete the entire project (get in shape or graduate from college), but rather every time you take steps towards getting something done you are building mastery. Building mastery also doesn’t have to be anything huge, it simply has to result in that special feeling that can be describe in no way except “I did a Thing”. This is about building a self-identity through feeling accomplished. Generally these things should be guided by your values, so that they contribute to feeling as if you’ve done something worthwhile.


I’ve been struggling with this skill lately, and it’s something that I think many people misunderstand and could use some work on. So we’re going to do some building mastery of building mastery today.


I’ve noticed among many of my friends, particularly the accomplishment minded of us, we discount all of the work or effort that we put into something until we have reached the end point, and then we simply nod and move on to doing something else. Rarely do we take the time to look at our accomplishment and accept it as something we’ve done and done well. This is a serious problem, especially as we’re part of a culture that expects us to be endless wheels of perfect accomplishment. Particularly for the women among us, perfection is apparently a prerequisite of acceptability, and the number of things we need to be perfect at just keeps on growing.


So how can we fight back against a culture that tells us we should always be getting more done? How do we retrain our minds to accept the things we’ve accomplished and praise ourselves for them? This is something I’m struggling with myself, but here are my suggestions so far:


1.When you finish something, do more than cross it off the to-do list. Give yourself a reward, take a break, or spend some time thinking about what you just did. Let it sink in that you got something done.


2.Make sure you check the facts at the end of the day. It’s so easy to discount all the things you did when looking at the endless list of things that still need to be done. Sit down and honestly think to yourself about what you did today. It’s probably a lot more than you think.


3.When doing 1 or 2, try to honestly compliment yourself about some element of what you did, or at the very least think about the effort it took and the impact of your success. This doesn’t have to be big. I’m sick today, so if I manage to get clothes on and leave the house that will be a huge success because of the effort it took to get there. It’s incredibly easy to just assume you should have been able to do everything you did, so it doesn’t count. That’s not true. Everything you do is a victory for you. Let it sink in, don’t brush past it.


4.It’s especially easy to ignore your progress across time. If you’re working on something like getting in shape, it can be a good idea to keep a record of how you’re doing so that you can look back and see how things have changed. This is especially true for things like depression and anxiety. Often we don’t notice when we’re getting better. Keeping a diary card like this one of how you’re feeling each day is a good way to notice when you improve. Pay attention to that! Even if you don’t write down how things have changed, spend some time thinking about how far you’ve come in the last year, what changes you’ve made, what you’ve done. I’ll bet if you think about all of it you’ll feel pretty darn accomplished.


5.Avoid the comparison game. Your accomplishments are yours, and they don’t lose importance because someone else did more or better or different.


I’ve been trying to keep these things in mind when I get things done each day. While it still doesn’t make me feel like master of the universe, I have felt less of that anxious bug that tells me do more, do more, do more! When you stop feeling as if every second of the day needs to be spent accomplishing something, anxiety and exhaustion really disappear. So today I’m patting myself on the back for writing this post, for getting up and taking care of all the animals, for finishing my Lumosity workout, for reading all my regular bogs, for writing a blog for work, and for checking all of my work email even though I am sick. And it’s not even noon! I think I should reward myself with a nap.

Support Is a Two Way Street

Over the weekend I was on a panel for FtBCON about supporting individuals with mental illness. It was really fun to participate in, and I feel like I got some good insight from others, as well as solidified some of my own feelings about what’s helpful and what’s not, but there’s one thing that I feel is extremely important about supporting someone with mental illness that we didn’t touch on at all (it was a one hour panel, there’s only so much we can do). But I think that this topic is something that we need to talk about because it will make life easier for support people, it will reduce some of the guilt and shame for people with MI, and generally it will strengthen and solidify relationships to last beyond the end of an MI.


Support is a two way street.


Ok, obvious thing is obvious, but many people, particularly support people, forget this. Any relationship you’re in requires a give and take of support and being supported. This is true EVEN if the person you’re in a relationship with has a mental or physical illness and needs more support than the average bear. A lot of the time support people think that they can’t burden their friend/family member/lover with any more troubles, and so they keep all their own difficulties to themselves. They want to protect their loved one. They think it’s showing that they care: they will take care of you through anything, but they won’t ask anything in return.


Unfortunately this tactic will make both parties feel like shit. First and foremost, a relationship with someone with an MI is a relationship, and any time you have massive inequalities in a relationship, that relationship is likely to not work or to lead to unhappiness. In very few other circumstances would it be considered acceptable to treat one party like a child and expect to be able to have an adult relationship.


If you try to protect the other person and you don’t allow them to offer support, both people will end up hurt in some fashion. It will make the support person resentful, afraid, and give them feelings of complete responsibility for the other person. It leads to lots of burnout and means that in the long run your relationship is likely to fall apart because the only thing sustaining it is sympathy or “fixing”. And from the perspective of the person with the disease, it feels incredibly condescending, isolating, and lonely. You never really get to hear about the other person. You don’t get to feel useful. You feel like you’re less than the other person or a drain on them. You feel like you’re ruining their life, or like they don’t actually want to be around you but they feel obligated. You feel like they don’t trust you to be adult or helpful or positive. It’s horrible.


Support people: you are allowed to make requests, set boundaries, and ask for support with someone who has a mental illness. Not only are you allowed, but you should. Being a support person is HARD work and if you aren’t willing to take care of yourself and be open and communicative about how you need to take care of yourself, it will not work. If the other person repeatedly makes demands that are too much for you or that you feel are enabling them, you are allowed to say no. If you’re having a horrible day, you’re allowed to call them and ask if you can vent or hang out or go to the movies. However just like any other relationship, you need to remember that when you do these things you should be gentle and validating of the other person.


People with mental illness: your mental illness is not a get out of jail free card. I know that sometimes it feels like you can’t add any more onto your plate. That’s ok. That’s when you get to set your own boundaries. But you have to step up for your friends and family when you can and how you can. All of us have something that we can give to others. All of you have something about you that draws your loved ones to you. Remember that and remember that if you want to maintain a strong and healthy relationship with someone then you owe honesty, support, and respect to them.


One good example of this is something that is really hard for everyone: opening a dialogue and asking for more information. Support people often find themselves a little lost and confused about what’s going on in the mind of the person they love. In this case, they need something. They need more information to feel some certainty, some understanding, and to be able to help more effectively. Lots of people are afraid of doing this because they feel it might set something off. However just like the person with the MI, the support person needs to listen to their own emotion of confusion and plan out strategies for how to ask for something. In this case, they should probably alert the other person ahead of time, ask without accusation, and try to maintain a curiosity about what’s happening with the other person.


Oftentimes we forget that the person with the MI is learning a great deal through therapy or skills training or simply dealing with their day to day life. They pick up on lots of skills and coping mechanisms. These often involve ways to take care of themselves, particularly in a relationship. However these are skills that are generally good for everyone. Learning how to be kind and giving, learning how to hold to your values, learning how to request something, learning how to set a boundary: these are all things that we should be taught clearly as children but most of us aren’t. And so just like the individual with the illness has to learn new things, so do the support people so that they can be more effective both for themselves and for the person they’re in a relationship with. People with MI want to be able to support and help others. It helps us remember we’re not useless. Giving us clear ways to give back does a lot for us, and it will do a lot for you.

Why Is Pain a Badge of Pride?

So I’m sitting here at work trying to muscle through the last 4 hours while sick and somewhat miserable, my head hurting and my brain hurting, and I’m wondering why I don’t just go home and go to bed. Well partly it’s because I can’t afford to since I don’t have any PTO right now, but partly it’s more than that: it’s the idea that the more we suffer for something, the more it’s worth.

A while ago I was reading an article on (my usual haven of hilarity) when I ran across this choice quote about getting to the end of a Tough Mudder:

“And that’s exactly why I felt like an idiot by the end. I went in with the confused notion that any experience that is awful was also good for me. Suffering is always supposed to have rewards in the end, and even if those rewards are sometimes vague, I can at least chalk it up to a rounding of character. But Tough Mudder offers a window dressing version of personal betterment without much behind it. I don’t mean to insult anyone who loves the challenge of Tough Mudder because I will certainly admit that it kicked my ass. But it was painful like torture is painful. The simplest way I can describe it is that when I ran through the swamp portion of our course in the gloom and cold, I secretly wanted the experience to be like Luke training on Dagobah. But the most important challenge, the part where I fight myself in a cave and overcome my own weaknesses, wasn’t there. In its place were some greased monkey bars instead. I guess if I had one suggestion for the people who run Tough Mudder, it would be to include a Cave of Evil. That would be really nice.”

I think this sums up some of why I’m pushing myself to make it through work today. Part of me imagines a glorified image of me passing out in the hallway while I run to copy some highly important document so a little kid with developmental delays can get their testing done on time (ok not really but my Dayquil addled brain found that image funny). Unfortunately my job really isn’t that important, and I’m more in love with the idea of suffering than I am with the idea of sacrifice for a good cause. In many ways, we have falsely associated pain with success: we have phrases like “pain is weakness leaving the body” or “no pain no gain”. We assume that the things causing us pain are always there for a reason. If we’re working insanely hard at our job, it’s because we’re getting tons done and we’re going to get a huge promotion with lots of money. If we’re working really hard at our marriage, it’s because we’re so in love and everything will work out and become flowers and rainbows someday soon. If we’re working really hard at school then we’ll be a straight A student who will be rewarded with scholarships and acceptances to amazing colleges or grad schools.

Unfortunately all of that is bullshit. And it’s really privileged. In general, these things are only true if you’re coming from a very privileged position. People who are oppressed go through pain every damn day for no apparent reason. If pain really were a badge of overcoming and making something better, then we’d have a lot of really successful and awarded black single mothers, but unfortunately the reality is that pain often comes for no reason whatsoever and we have to just keep dealing with it. But even in privileged lives we seem to take it for granted that pain is a good thing, signalling progress.

I was watching a documentary last night on ballet dancers, and they talked about working through injuries, about continuing to dance no matter how much pain they were in, about not letting their feelings show when they were disappointed and simply working through any pain they had. In some perverse way, they wore it like a badge of honor: I will keep doing what I love no matter how much pain I’m in. I will even put myself in more pain to continue doing this. It will make my dancing worth more because I kept going through the pain.

I think that we often tell ourselves things like this to convince ourselves our pain is not useless. It’s similar to Miri’s post about depression, and how everyone wants to think that we can gain insight from every type of pain. We want to comfort ourselves into thinking there’s a reason for when things go poorly or that we can at least get something from every type of pain. And while I can understand this completely human dishonesty, and while I agree that many times pain does come with insight, I think that dishonesty almost always leads to bad consequences and this is no different. When we associate pain with improvement (either of self or situation), we unconsciously tell people that they should be in pain. I’ve felt this pressure often: I’ve felt as if I SHOULD be stressed out or I’m not getting enough done, I should be tired or I’m not working hard enough. And when people start to feel that they should improve their lives in some way, they might turn to pain instead of a positive method of life-improvement. This may be why self-harm is so damn popular: it feels like it means something because pain is always supposed to mean.

But it’s so important to remember that pain is not inherently important. When we earn something through pain we can be proud of ourselves, but the pain does not make the end result better or more worthwhile. The sour doesn’t sweeten the rest of life. We don’t need to glorify pain.