In Defense of Self-Isolation "Laziness"

     Since we've been self-isolating because of this global health crisis, I've seen a lot of things going around on social media telling people that they're lazy if they don't take this time to learn that new skill they've been thinking about or if they don't (visibly) accomplish something while we're all at home doing "nothing".
     I completely understand that some people cope with stress by staying busy so they don't have to think about the stress. I used to be one of those people. It's actually how I survived four years of college with untreated OCD. (This is not the way I cope now.) I also completely understand the oh-so-American idea that we have to be (visibly) productive for every possible moment that we aren't trying to get, like, five hours of sleep at night.
     Here's the thing, though. This isn't really "down time" in which we have nothing to do. This is a high stress situation. Our routines, and for those of us with mental health conditions, the routine that helps us manage our mental health condition (including access to mental health treatement) has been disrupted. That stress alone is enough for in increase in symptoms associated with anxiety, depression, PTSD, bipolar disorder, and every other chronic condition that is exacerbated by stress. Add to that stress the worrying whether or not someone we love is going to become ill or that we might fall ill, and Survival Mode is activated for many people right now. That means (visible, socially-accepted) productivity might be taking a backseat to just making it through the day.
     Sure, many people have been talking about learning something new or accomplishing something big when they had the time, but just because they aren't leaving the house to go to work every day and they're stuck at home doesn't mean they have the time. It can mean the opposite, actually. It can mean that a lot of us are working overtime just to make sure we aren't living in a constant state of panic and/or hopelessness. Also, our brains may not be processing as much as they normally would due to stress and the increase in mental and physical symptoms associated with our mental health conditions, so learning the new skill is going to have to wait for non-pandemic downtime. Just getting out of bed, eating something, trying to connect with friends and family, and watching things that make us laugh might be the only things we accomplish THIS ENTIRE TIME because it's about surviving right now. We can get back to thriving and being "productive" after we've survived.
     I know this might sound un-American, but, mental health aside, people are allowed to rest. Stress is exhausting for everyone. Working, even from home, is exhausting. Life, in general, even when we aren't in the middle of a global health crisis, is stressful and exhausting. It doesn't mean that anyone is lazy for taking this time to rest even if that means sleeping late, taking a nap, soaking in the tub like it's spa day, re-reading favorite books, or watching all of their favorite movies. Rest is good. It's good for your mind, body, and soul.
     I'll end with this: Just because other people use this time to be visibly productive doesn't mean that those who use this time to simply survive are lazy. Taking time to rest and refresh is also not lazy. Rest is crucial to our overall well-being. So, please, be mindful of the way you speak to and about others. Also, please be kind to yourself if you didn't get to accomplish all the things you wanted to do during self-isolation because of how the changes and the stress impacted your mental health. Surviving, practicing self-care, and maintaining mental health are just as productive as learning the new skill or, say, redecorating your entire house. 

The Boiling Frog

     This week, I've been thinking about this analogy for people in bad situations that I heard in one of my college psychology classes. If you put a frog in boiling water, it'll jump out immediately, but if you put a frog in tepid water and gradually increase the heat, that frog will stay there until it dies. It turns out I am that frog, and the water is my anxiety.
     Let me explain. If my anxiety has a spike in which it goes up very high very quickly, I will take medication to help me bring it down. However, if I start out with low to moderate anxiety that slowly starts to feel more and more out of control, I am more likely to sit there and quietly suffer until I spiral or have a panic attack.
     I don't do this to intentionally cause myself suffering or because I don't want to take the anti-anxiety supplements that my therapist suggested. I end up doing this to myself because I know a piece of the treatment for OCD is to learn to sit with my anxiety and to learn that I don't have to do, or in my case think, the things to appease the anxiety so that it drops off for a short time. I'm also one of those people that thinks that as long as I'm "functional" that I'm fine. (Note: "functional" does not mean not suffering. I can be suffering and still be functional. I did it for years.)
     After four years of regular therapy, it's STILL difficult for me to find the line between sitting with my anxiety and causing myself unnecessary suffering. My therapist is forever pointing this out and gently nudging me to be kinder to myself instead of constantly fighting so hard. She also points out that letting my anxiety keep creeping up and up as I try to sit with it, isn't good for my body or my brain.
     In an effort to be kind to myself, I started giving myself limits for how long I was going to allow moderate anxiety to scream inside my brain or how high I was going to let low anxiety climb before I took something to bring it down. I'll say something like, "Okay. if my anxiety is still high after I make dinner, I'll take something." Or, "If I wake up with anxiety first thing tomorrow, I'll go ahead and take something." Or, "If my anxiety gets up to a 5 out of 10 (we started using the scale during ERP), then I'll take something." Or, "Okay, if the meditation with deep breathing doesn't work, I'll go ahead and take something." I admit, it's hard for me to stick with setting my limits sometimes, but it's a work in progress.
     Strength and suffering can look so similar, especially when it comes to mental health. Here's the thing, though. Saying to yourself, "I don't have to feel like this, and I have the power to help myself not feel like this by taking some (recommended) supplements or (prescribed) medication," shows just as much strength as sitting with the feelings or functioning through the suffering because you were able to recognize a boundary you set with yourself and you didn't budge on it. Setting boundaries, even with yourself and your mental health, is a sign of strength and recovery because it's a little piece of not allowing your mental health condition to control you.
     I'll end with this: Although strength and suffering can look like the same thing, they are not the same. There is a fine line between them, especially in the area of mental health, and we all deserve to find that line and set that boundary. It's okay to take the supplements and/or medications to avoid unnecessary suffering. You don't have to fight so hard on your own because that can actually do more harm than good to your brain and the rest of your body. We all deserve kindness and compassion, most of all from ourselves.

The Right Questions

     All of us that live with a mental health condition have probably been asked why at some point. As in, "Why are you anxious?" Or, "Why are you having a panic attack right now?" Or, "Why are you depressed?" Basically, the question always means, "Why are you experiencing symptoms of your mental health condition?"

     I know the question is almost always meant in a kind way. I know the person asking only wants to understand the condition and the cause for the unpleasantness we're experiencing. I know they're only asking because they think it's helpful. When I woke up the other morning with intense anxiety literally as soon as I opened my eyes, my mom, when I mentioned that I was anxious, asked, "Why are you anxious?" I know she only wanted to help, but I was frustrated by the question, like I am every time she asks me why. My automatic response wanted to be *squints* "If I knew why I was anxious, then I'd be working to resolve the issue." I didn't say that, though, because I understood that she was coming from a helpful place. I only shrugged, but I was frustrated nonetheless. 

     The reason I find the question so frustrating is because I don't always know what causes me to feel anxious. Sure, sometimes I can pinpoint a triggering event for both my OCD and panic disorder, but a lot of times, like the other morning, I don't know the trigger. As a person that always feels like I need answers and like I need to get to the root of the issue, so to speak, the days when I wake up with anxiety without being able to find the reason for it are the hardest days for me. So, of course it's frustrating to be asked why I'm experiencing anxiety because I've already asked myself that question, and I couldn't find the answer. Someone else asking the same question only serves to drive home the point that I don't know what's going on in my own mind at that particular moment.

     Most of us with a mental health condition don't actually know or understand why we have that mental health condition or why we're experiencing symptoms at any particular moment. We know the broad, scientific answer, which is an imbalance in brain chemicals. However, we also know it would be rude to say, "Well, I'm experiencing symptoms because of my brain chemicals," because that's not helpful even if it is the literal answer to the question someone asked. That also isn't the answer family and other loved ones are looking for when they ask.

    Sometimes symptoms just...happen, as they do with any chronic health condition. That doesn't mean we caused the symptoms in some way, like by thinking of something that brought on the depression or anxiety. It just means the anxiety or the depression decided to show up and hang out at that moment, even when things seemed fine. It also doesn't mean we're not answering the question because we don't want to. Sometimes, we really just don't know how to respond to that question except with "I don't know" or a shrug.

     You can still try to understand and help a loved one as they experience symptoms of their mental health condition. There are questions that we CAN answer and that can help provide insight that are much more helpful than just asking us why something is happening with our brain chemicals. You could ask something like, "Was there a trigger that you can think of?" Or, "What do you need and/or want from me right now, while you're anxious/panicking/depressed?" Or, "How can I help?" Or even, "What do you do to manage these feelings?" (This last one can be particularly helpful during a spiral or panic attack to help with grounding, at least for me, because it jogs my memory for coping techniques and brings me back to reality.)
     I'll end with this: Asking someone with a mental health condition why they're experiencing symptoms at any particular moment isn't the most helpful question, even though it comes from a helpful place. We may not be able to answer the question because we honestly might not know why we're anxious, panicking, or depressed. Changing the why questions to something we actually know how to answer is a great way to try to gain understanding and help us when we're trying not to drown in our own minds.

Therapy by Phone

     Four weeks have passed since the last time I saw my therapist face-to-face. We have, however, had two phone sessions since the last time I saw her in person. Things are...okay?
     When I got the texts from my therapist informing me that she would be doing phone sessions during the current health crisis, I was anxious about it. I'm a person who has anxiety about phone calls. If I have to call in a take-out order or call a store or office to ask a question, I'm more than likely going to break out in a sweat at the thought of making those phone calls. And, heaven forbid, if it's an "unscripted" phone call when I don't know what I'm calling about or what the other person is going to say when they call me, like when a new friend or family member outside my immediate comfort zone calls just to chat. (That doesn't mean I don't like phone calls or talking to them. It just means it makes me anxious.)
     It felt like therapy by phone fell into that "unscripted" category. What was she going to say? What was she going to ask? What was I going to say? How long were we actually going to be on the phone? Where and how was I going to sit for my session? (I don't live alone, and I have a tendency to wander around while I'm on the phone. Therapy needed to be private, so I was worried about that, too.)
     I have plenty to say during my face-to-face sessions, and I'm not awkward in person. Yet, I was worried I wouldn't have things to say on the phone and that I would appear awkward or like I had something better to do than my therapy session because she couldn't see me on the other side of the phone sitting in anxious silence, twisting my hair so that it turns into one big knot, and trying desperately to make my brain reconnect with my mouth so I could say things. In short, I was worried that my anxiety about phone calls and her inability to physically see that I needed my session and that I wasn't just biding my time until I could hang up was going to be a barrier to getting the help that I needed during this time.
     The phone sessions have actually gone okay. The first session was filled with some awkward lulls on my part because I was actually sitting there twisting my hair, scrabbling for words. She would usually see that during a face-to-face session and ask me something about what I'm thinking if I was quiet for that long. The second session went much better because I was more prepared for this one.
      After the first spike in anxiety because of the change, therapy by phone feels the same as face-to-face therapy. I'm not anxious about those phone calls anymore. She starts off with the same questions, and we go from there, just like we do face-to-face. I didn't run out of things to say or forget to mention anything that I needed to talk about. We end with a date for the next session, just like face-to-face sessions. I pick a spot in my area of the house, and I sit there the whole time, just like I would face-to-face. The session also still lasts for an hour, just like face-to-face therapy. Phone sessions are also just as helpful as face-to-face sessions.
     I'll end with this: If your therapist has offered phone sessions during this time in place of face-to-face sessions, but you felt like you couldn't do them because it would be too weird, that's understandable. I was worried about how it would go, too. I encourage you to definitely call and schedule the phone session, if you can and if you need it. Don't let the change make you think it'll be too weird or that it won't help. Phone session are just as helpful as face-to-face sessions.

Coping with Feeling Trapped and Alone

     We're all in a period of high stress at the moment, and so we're all carrying extra things right now. We're all extra-stressed. A lot of us are probably afraid, if not for ourselves then for loved ones that are vulnerable to illness or considered essential workers. A lot of us are feeling unsettled because of the sudden changes to our routines, like the sudden shift to learning and working from home or even being completely off work right now. On top of that, we're unable to do the things we might normally do to cope with or escape from that extra stress like going to a movie, going out to lunch with friends, or inviting friends over for a night in. 

     It's so easy for everyone, even those with completely healthy brains, to feel alone right now. Feeling alone and isolated with no way to escape it can be an even bigger concern for those of us with mental health conditions. I know that I use being around other people as a way to escape my OCD sometimes when my home environment feels "tainted" by my anxiety. There have been times when I've been home all week and dealing with particularly high anxiety, I find myself thinking, "If I can just hang in there until the weekend, then my mom and I will do something fun, and I'll be out of this tainted place. I know I'll be fine if I can just be somewhere else for a bit, with other people." 

     I even had to talk with my therapist about this at my last appointment. I was worried that being forced to stay at home with what felt like no escape would make it easier for me to get back to the period pre-therapy that I refer to as The Dark Time. (It happened before during a high stress period during Christmas break right after my first semester of college, when I wasn't busy, wasn't going a lot of places to fill up the time, and it was utterly terrifying.)

     My therapist suggested some things that could be helpful if the isolation felt like it was becoming too much. She asked me if I was able to get sunlight. Sunlight is not only important to physical health because of vitamin D, but it's also important to mental health because sunlight is thought to increase the release of serotonin, which can boost mood and help us feel calm and focused. We might not be allowed to go to public swimming pools and public outdoor places, but we can go out onto our porches, our yards (if you have on), and we can open a window to let sunlight in.

     My therapist also suggested that I could try to connect with people more during this time. So, I try to text with my friends more. I even try to be more active on social media to share fun things with those same friends to break up the negativity that seems to be overpowering everything else. My god-sister arranges Skype dates for herself and her girlfriend and they literally just Skype each other while they watch movies or TV. If you don't have access to internet or a cellphone, you can always call with a landline (yes, some people still have those). I've seen some people sitting in their own yards while their neighbor sits in their yard (with the recommended safe distance between them, of course), and they just drink tea or coffee or beer together or gossip across property lines.

     I know, given the state of emergency, mental health care from an emergency room might not be possible at the moment. I know many people, adults and children, are trapped at home with an abuser. I know members of the LGBT community are trapped at home with family that isn't supportive and may even be abusive. Crisis lines are still operating during this time. Please, if you're feeling too stressed or like your mental health condition might be spiraling, feel like you might harm yourself, or if you fear for your safety call a crisis line. US numbers are listed below.

1. The National Suicide Prevention Hotline: 1-800-273-8255

2. Crisis Text Line: text HELLO to 741741

3. Youthline (for kids ages 11 to 21): Call: 1-877-968-8491 or text Teen2Teen to 839863

4. The Trevor Project: call 1-866-488-7386 or text START to 678678

5. Trans Lifeline: 1-877-565-8860

6. The National Domestic Violence Hotline: 1-800-799-7233

7. RAINN (Rape, Abuse, and Incest National Network): 1-800-656-4673

     I'll end with this: It's so easy for all of us, particularly those of us that struggle with mental health conditions that use public places as a way to cope or escape, to feel alone and/or trapped right now. If getting some extra sunlight and reaching out more to friends and family to feel connected don't help, please call a crisis line. If you have a therapist, it's also okay to call them between sessions if you need to.