Is there help for people who suck at helping themselves?

October 3, 2008 10:13 AM

Angst and melancholy aside, I persistently fear that I will never be able to happily integrate into society. I know I need help, but I can’t figure out how to overcome my negative emotions and in succumbing to them I only feed into my cycle of avoidance and disappointment.

I live in a state of persistent flight response. The depressive lethargy that accompanies this anxiety only worsens the problem. It has taken a long time for me to understand the avoidant urges I experience as anxiety. Basic functional tasks have become drawn out, painful exercises in will. Mustering the energy to overcome an irrational fear of showering can take half the day. Yet I know that I feel energized and happy when I am clean and comfortable. I’m not afraid of the shower – I think I subconsciously fear being rejected or negatively judged in spite of my efforts to adhere to social norms. I experience the same process whether I want to buy groceries or do my class work. It is hard to describe, but I am regularly overtaken by an intense “scrunched up” feeling, as if there were a black hole in my chest about to implode my limbs and body. I have had a very moderate amount of success overcoming this by telling myself that the worst case scenario is better than the outcome of avoiding the situation/activity that stimulated the fear. How can I approach this subconscious mechanism so that I may understand the reasons I respond the way I do and effectively change my behavior?

At the same time, I consciously reject many of the principles that direct modern society. I am not religious, I believe in the spirit of capitalism but am appalled by the excess and irresponsibility of our consumption oriented culture, I would rather make someone happy than make a profit. To be concise, I love humanity but am overwhelmed by society. I fear that even if I successfully finish my studies and find a productive role within society that any good I am able to accomplish will be outweighed by my taking of a functional role within a civilization that values punishment over forgiveness, wealth over health, and violence before understanding. I’m not okay with that on a deeply existential level. It’s hard for me to accept that in order to meet the expectations of society I must condone some level of morally reprehensible actions.

I also need grief counseling. My mom was diagnosed three years ago with terminal cancer, and while she’s alive and doing well I cannot avoid the ticking time-bomb of reality. I spent a long time helping my mom through her initial treatment and have grown closer to her. But the topics of death or cancer are usually enough to set me off. I can’t handle it now – what can I do to maintain some dignity and respect when things finally go pear shaped? In truth, I am writing this because I encountered the topic of death in my studies and couldn’t bring myself to do the related work. Though I have experienced anxiety throughout my life, I suspect my response to my mother’s illness has exacerbated the problem. If I were to rate my emotional stability, I would say that I am less stable today -- more prone to outbursts of anger, fear or sadness – but the actual presence of negative emotions is not significantly greater than my historical baseline.

Understanding that I hardly qualify as a functional human, how can I overcome my subconscious perceptions and become a productive member of society? I need friends and social support, but I am very isolated. I am going to give pharmaceuticals a chance, but I haven’t come to terms with the fact that I may need to pay for a magic substance to “fix” the way my brain functions. There is something sick and twisted about paying to pharmacologically manipulate my neurochemistry so that I can functionally exist within a consumption oriented society so I can have enough money to pay for my pills so I can maintain a job so I can buy more crap ad infinitum.

Is there a support group or some form of social assistance for people like me? I just want to be happy and productive. I want to have the energy to read a book, keep my house clean, and maintain friendships. I am sick of this miasmatic angst that clouds my perception and prevents me from achieving a functional existence. Your thoughts and suggestions will be appreciated. I've set up a throwaway email account if you wish to contact me.

posted by anonymous to health & fitness (14 answers total)

I'll keep this short: talk therapy. You're depressed. (IANAD, psychologist, LICSW, etc.) Talk therapy and meds.

but I haven’t come to terms with the fact that I may need to pay for a magic substance to “fix” the way my brain functions.

If you broke your arm you'd have it set. Your brain needs help, and there's no shame or dishonor in seeking it, and it's not a sign of weakness to do so. It's a sign of strength.
posted by rtha at 10:28 AM on October 3, 2008 [2 favorites]

There is something sick and twisted about paying to pharmacologically manipulate my neurochemistry

No, there's not. If something is mechanically wrong with your car, there's nothing sick and twisted about fixing the parts that aren't working correctly. Nor is there any failure in admitting that you can't fix it yourself. I sure as hell can't change out an oil filter; that doesn't make me a failure.

Your brain is an enormously complex electrochemical machine. Antidepressants don't erase your personality or swallow your soul: they help your brain keep those chemical balances in line. There's no shame in this, and it doesn't mean you've failed in any way, shape or form.

Step one: get thee to a therapist. Pronto. When you get your feet back under you (and you will), you will look back and wonder why you didn't do it sooner.

I wish you the best of luck, and I'll keep you in my prayers.
posted by DWRoelands at 11:08 AM on October 3, 2008

I am not anything close to a psychologist, but based upon the experiences of those close to me, and after reading your post, this sounds like far more than depression/anxiety. I strongly urge you to go see a professional soon before this gets any worse. Are you in your early/mid 20's by any chance?
posted by The Light Fantastic at 11:19 AM on October 3, 2008 [1 favorite]

I remember what it's like to want to write a post like yours, and how incredibly hard it can be to ask for help.

You may find it helpful to learn how antidepressants work. Here's a brief overview of SSRIs. Try thinking about it from this point of view: Is taking insulin sick and twisted? Is thyroid medication a tool of capitalism? Doesn't it stand to reason that if people must do things to keep other parts of the body in good health so that they can function properly, the brain is no different?

The overwhelming majority of people who have depression have treatable depression. Successful treatment doesn't make people into something they are not. It fixes precisely the problems you seek to fix. That's why I'm echoing what was said before me, and will likely be said after me.
posted by gnomeloaf at 11:27 AM on October 3, 2008

Notbullshitfilter: While pursuing traditional therapy as recommended above with an open mind, look at internal martial arts like Tai Chi, Chi Gung, Aikido, and Ba Gua with a similarly open mind.

It's entirely possible that there are no good teachers in your area, or that it would be too much of an exertion to go to a class or study right now, but I would highly recommend looking into it. I have some very practical, non-hippy reasons for suggesting this.

First, you: 1) You seem to have a load of physical anxiety in addition to more complex issues. 2) You want non-pharmaceutical treatment if at all possible.

Second, me: 1) When I was a teenager, I successfully broke my own depressive cycle by secretly quitting my (massive amount) of medication, ignoring everything I was told during two lengthy hospitilizations and taking a long-term attitude almost exactly as described by ZeFrank nearly a decade later.

2) One of my closest, oldest friends has a wide range of serious problems so intertwined that the obviously-diagnosable ones can't really be separated from the stuff that could be beaten with better coping skills. I've seen how drugs, programs, and even ECT have either given her the chance to take control of her problems or enabled the problems further.

So I've seen a lot of treatment up close, and I know how some things just work for some people, some things don't, and how powerful "setting your mind to it" can be if you find a way to do it.

so, finally, Tai Chi: 1) What most people think of when they think of Tai Chi (people doing a slow series of exercises by themselves) does some basic things for you without any hippy-dippy stuff -- it's something to concentrate on, it gets your blood moving, it increases your sense of balance, and it gives you a way to spend time with your body in a pretty unstressful way, all of which might be good for you.

2) If you want to get into it more -- especially where Chi Gung is concerned -- you can learn to observe and control a lot of your own physical sensations and states. Again, this isn't mysticism. It's a structured way of connecting your conscious mind with your body in ways that don't exceed anything proven by placebo or biofeedback studies. If you're overwhelmed by physical anxiety at times, it might prove very empowering to learn ways to control that. It's a good way to learn about your psychosomatic reactions.

3) Instructors who aren't too interested in money, admiration, and wearing silk pyjamas can teach you -- or try to teach you -- excellent coping skills through physical means. If you're undergoing talk therapy or if you've found some drugs that work for you, something like push-hands (Tai Chi "fighting") or Ba Gua training could be an excellent counterpoint -- or maybe it could save you if nothing else is working. The training basically consists of physically training yourself, in various ways:

not to freak out when something messes with you
how to stand up straight (figuratively and literally)
to understand how you react to things
&
that stuff changes, sometimes it sucks, and you can deal with it.
posted by nímwunnan at 12:23 PM on October 3, 2008 [5 favorites]

I concur with several people above who suggest you are likely suffering from a chemical disorder of the brain, in which you are not being provided certain chemicals necessary to neuropsychiatric health. Correct medical treatment of physical disorders is paramount to health. I'm not sure why physical malfunctions in the brain are called Psychiatric and the idea of treating them medically evokes the response you and the majority of us have. Every other body organ is acceptable to treat with medication suitable to the disorder. When my thyroid went south I became irritable, anxious, slow and fat. However, I didn't feel guilty about taking medication for the problem and although it took about 3 months, all of my symptoms vanished and I was back to my pre-thyroid-disordered self.

When at another time, I became seriously depressed at I felt guilty, a failure, conspicuous in my inability to "be like everyone else and cope with life". After 18 months of therapy, and working hard a employing all I was learning...I was still very depressed. Six weeks after beginning anti-depressants, I became the person I REALLY was, rather than one lacking the correct chemicals to regulate my emotions as others people were fortunate enough to have supplied to them naturally. I hope you take your issues not as signs of a lack of character, personal qualities, or natural abilities, and see them as a result of a malfunction of a physical organ. And get medical treatment, first...

Blessings and peace to you.
posted by mumstheword at 3:12 PM on October 3, 2008

There is no shame whatsoever in going to therapy or taking antidepressants, as others have already said.
posted by Nattie at 3:51 PM on October 3, 2008 [1 favorite]

You definitely sound depressed, and you're dealing with grief on top of it. Those are serious things that people generally find difficult, if not impossible, to dig out of on their own. So, get help, yes. If you can't muster up the momentum to jump through all the hoops necessary to get help, confide in someone who can be your advocate and help with telephone calls and appointments and insurance paperwork. Tell a family member or close friend that you need them to actively help you get what you need. And make no mistake -- you do, indeed, need help. This is not a want or a luxury. For you, in this state, it is a necessity. This stuff can rob years of your life, precious time with your mom. It can even kill you. Don't let it.

The help you get doesn't have to be medication-based if you really don't want it to be. I have chronic depression, since I was a kid, and the many different kinds of medications I tried over the years never helped a bit. YMMV, of course. But some people geuinely just don't respond to those things, even if the underlying problem is chemical in origin.

Now -- and I only type all this because I have experienced a lot of what you describe, the grief, the battles to get myself to do even the simplest daily tasks -- people on Metafilter are going to suggest you try cognitive behavioural therapy, and they're going to tell you to read Feeling Good by David Burns. Which is a fairly good book, all told, especially if you're new to CBT. But since I've practiced CBT since 1996, I'm totally sick of it. I recently found a better book called Self Esteem by Matthew McKay. It has helped me; maybe it will help you. I experience paralysis and anxiety quite a lot.

The CBT may help you stop thinking so negatively, and help with the paralysis of motivation you experience. Maybe that paralysis has something to do with deep-seated resentment about your life, about things that have happened to you; I don't know. But CBT will help you become aware of what you term the "subconscious mechanism" that's keeping you locked in to feeling bad -- which are, for most people, a constant, running commentary of self-defeating thoughts that you don't even realize are running through your head. And it's something you can start practicing on your own, while you seek other help. But it's not magic.

You're definitely going to need more help than a book can provide. You're going to need to talk to someone. If not a psychologist/psychiatrist, maybe someone at the place where your mom goes for treatment (if it's a hospital, there should be a chaplaincy/spiritual care dept. who is there to help families in exactly your situation. Check their website or call their switchboard and ask.) There are also counselors available at most universities -- check out what your school has. They are generally free, self-referred. They can also help you out with the process if it turns out you need to take time off school. And you may need to. This is an exceptional circumstance.

As far as It’s hard for me to accept that in order to meet the expectations of society I must condone some level of morally reprehensible actions goes, it's categorically untrue, and even if it were true, your dropping out of society would do nothing to help fix the problems in the world. People choose career paths all the time that provide both a decent living, and make them of service to other people and improve society at large. And actually, that's probably the most rewarding path a person can take. But you're not going to really believe that until you start feeling better. This is a problem to wrestle with after you take care of the immediate, dangerous health problem you're experiencing.

I know it's hard, it might even feel impossible, but you must stare this thing in the face and take direct action against it. Even if that action is just asking someone to help you. Do whatever you can, in any way you can. You've already started by posting here. Keep it going.
posted by peggynature at 5:28 PM on October 3, 2008

We all put things in our bodies to keep going - food, water, and for some pills. It's no thing. Get help.

And look, if there are people around you putting something on you - pressure to be the good soldier and do right by the family and whatever else for your mom - fine, they can want that and you can pay lip service to that, but you need to talk to someone about your values and your feellings.

You may have emails on this already, if not, if you could tell us more we can suggest ways to get help - through school, public health, research on public health at the library, etc.
posted by Lesser Shrew at 6:13 PM on October 3, 2008

I have the same problem, what you describe as depressive lethargy -- well, not precisely the same, but very similar, and with me it is also connected to unprocessed grief. Its severity fluctuates but I'm never entirely free of it. At times I'm hard pressed not to just call myself hopelessly lazy and give up altogether. I'm 44, to give you an idea of how intractable this can be if you don't find a way to combat it early and often.

For me, depressive lethargy is ameliorated to an extent by medication; some of it I've found workarounds for; and some of it I just live with. Change seems mostly a function of forming different habits through repetition, as simplistic as that sounds.

Mustering the energy to overcome an irrational fear of showering can take half the day.

Take baths instead of showering. Read in the tub, if you like to read. You don't have to make it a long-drawn-out luxury bath -- spend maybe half an hour in there tops -- but you'll get clean, and it'll have been more relaxing than a shower, and it's worth the time.
posted by FrauMaschine at 5:04 AM on October 4, 2008

Also, the absolute best thing in the world for depressive lethargy is vigorous exercise, in any form whatsoever. Any day I can drag my carcass to work out for an hour or two is a good day, or at least way better than it would have been otherwise.
posted by FrauMaschine at 5:06 AM on October 4, 2008

Therapy, therapy, therapy. You are why therapy exists. It can help you drastically.
posted by callmejay at 10:25 AM on October 4, 2008

Just another voice chiming in to say that talk therapy, possibly medication (prescribed by a psychiatrist, not your primary care) would probably do you a world of good. I understand your negative feelings about these types of medication. I felt this way once, but have long moved past that with more education and personal experience. You would be surprised by how many people take medication. You wouldn't think it was sick to take insulin to treat diabetes, right? Anti-depressants and similar medications are just like that. Often there is an underlying biological issue that a person can't control by sheer force of will. In those cases, medication becomes a life changing help. Of course, I'm not a doctor, just a person who suffers from clinical depression and has been helped immensely by therapy and the right medication (which finding can be a process). wants to help When I hear others going through similar things, I just want to help. it may be hard to believe, but it can get better and it is not a defect of character to seek help from a variety of sources. Good luck!
posted by katemcd at 6:09 PM on October 4, 2008

Dear Anonymous..Try and find someone else to help..get involved in something you care about..get out there and go walking..and remember--you'd be surprised how many other people walking around out here apparently "normal and happy" feel exactly the same way you do. They're just better at acting like they feel okay And a lot of them take medication to appear that way.
If there are any organizations around you that have special people...Down's Syndrome. and such you can learn alot from them about unconditional love and acceptance.

It's something we are all supposed to be trying to do but they do it better than the rest of us.
posted by AuntieRuth at 12:40 PM on October 5, 2008