How do I survive surviving?
January 7, 2011 10:52 AM   Subscribe

I'm a childhood sexual abuse survivor who is not really surviving right now. I need help with a whole bunch of things, and after reading this, I decided I'd query AskMe to see what resources are available.

I'm in pretty bad shape right now. I haven't worked in several years, am on disability, and have been in treatment, on and off, for more than 15 years.

Right now, I'm at a point where I can't do most things for myself. If I have to get to therapy, I call a taxi -- which costs about $50 of my $900 monthly stipend. I don't eat regularly, because fixing a meal takes too much energy. I don't go out of the house except to go to therapy and buy cigarettes.

I don't open my mail. This is a huge problem because I've got crazy financial problems -- as a result of not opening my mail. The thing is, I'm afraid. Every piece of mail bears bad news, and so I just avoid, even though I know avoidance only makes things worse in the long run.

My apartment is a disaster. I don't have the energy to clean. There are too many things to be done, too many obstacles, and I just can't handle it right now.

I don't know what to do. I've been in this holding pattern for years. My hips have started to hurt when I walk -- though I'm young yet -- because I'm sedentary all day.

Starting in March, my monthly stipend will be reduced significantly because of my student debt.

There are so many little paperwork things that I NEED to deal with, like getting my psychiatrist paid by the agency that pays him. But even getting on the phone with someone -- which used to be a delight -- is terrifying for me.

I do have a supportive SO who does the dishes and makes sure I eat dinner and pays the rent. He tries very hard to help me, but there's only so much one person can do. He's also pretty avoidant himself, so he's not really a person I can turn to for help with my financial situation or my Giant Life Obstacles. I think they terrify him almost as much as they terrify me. And he is exhausted from being my sole caretaker for so long. Really exhausted.

Since I lost my last job in 2007 or so, my whole world has shrunk down to about three people. My boyfriend, my therapist, and sometimes my mother -- though that last relationship is dicey at best.

My extended family wrote me off years ago, when it became clear that I wouldn't just "move on" from the abuse and that I would have problems for many years to come.

My friends used to try to call me and lure me out of the house, but they eventually gave up. I pushed them away over and over again until most of them figured I didn't want them around.

There's a lot of good advice I imagine you can give me, like "open your damn mail," but I ask that you try to be gentle. It's very hard for me to take criticism right now, and very hard for me to even get up the nerve to ask for even more help.

My therapist is great, but she's not a social worker, which I think is what I need. I've called a few places that offer that sort of help, but when no one returns my calls I don't bother calling back. I want to, but I'm just ... so tired of being treated like I should be okay because the abuse is over.

Honestly, I feel like I need a personal assistant to help me clean up all the piles of crap in my apartment and help me get my life under control. Or maybe a life coach. Or a psychic. Or a knight in shining armor. But I don't know. I don't know what will help.

The abuse was severe, and it lasted a long time. I've been hospitalized three times in the last five or six years, and the hospitalizations have been more traumatic than helpful. Without fail, the doctors have released me back into the world without even attempting to help me find the kind of resources I need to get my life under control. I've done CBT, DBT, plain old dynamic therapy. I've been, at times, highly functional and even over-achieving. Right now I am not. I feel like an infant being asked to solve a quantum physics problem.

Information that might help you help me: I live in NYC. I don't have good insurance, so there is sort of a limit on who will see me.

I think that, if a personal assistant is really what I need, my SO would be happy to help out with the financial aspect. If it's a social worker I need ... well, how do I find one who won't tell me I'm an idiot for not having recovered by now? Actually, how do I find one who will return my phone calls in the first place?

It's a new year, and I'm determined to get back into the real world in 2011. But I'm afraid, and I'm very isolated, and I don't even know how to begin. What would you advise?

throwaway e-mail:
posted by anonymous to Health & Fitness (45 answers total) 19 users marked this as a favorite
I'm glad you are reaching out to us here and I'm sure a lot of people will offer great suggestions.

One thing you mentioned is student debt. Do you mean student loans? If you're on disability you should not have to pay them at all. If you're on Social Security disability they should write them off.

It would help to know which borough you're in so that we can recommend programs, agencies, etc.
posted by mareli at 11:03 AM on January 7, 2011

RAINN is a great resource that can help point you to people in your local area that can help you. You can call them at 1-800-656-HOPE.

Thank you for reaching out.
posted by inturnaround at 11:12 AM on January 7, 2011

I don't have specific experience with the type of trauma you've suffered, but I have dealt with severe depression in some family members, so I'm going to approach your situation from that perspective.

My initial thought was you really sound like you could benefit from some inpatient treatment, but since you've said that has not been helpful in the past my next thought would be to attempt to find a support group. Online help is nice, but finding a group of people who have suffered a similar trauma who live in your area can be invaluable because they will have tried different resources themselves. ASCA (adult survivors of child abuse) has 2 meetings listed for NYC as well as a list of other resources for you to consider.

You need to know that you can do this, you can rebuild from this and you can get better. I read Bill's letter too, it is scary and very sad to learn that he didn't think he could recover. You can, you're still trying and there are still resources you haven't explored. Keep trying.
posted by dadici at 11:19 AM on January 7, 2011

I don't know anything about social workers and so forth, but here's one tiny idea: in the past, I have helped friends who have been in similarly dire financial and paperwork situations and avoidant because it's too stressful. When it's MY paperwork I'm not such a fan, but when it's someone else's paperwork, that's not stressful for ME, and I feel good feeling like I can actually help someone solve an actual problem. So if you have an organized, competent friend who's good at things like finances and paperwork, don't be afraid to reach out to that person. Even just having someone open envelopes, make piles, and start a list would be helpful. But I've sat down and helped a friend make a budget, called banks and things for her, sorted out problems, and organized a payment system.

I imagine the difficult part for you will be keeping the system going once established ... you'll probably need some time to get the good habits going and to start defeating the avoidance. I'd be upfront with any friends about this. I'd certainly be willing to spend one day a month helping my friend be sure she got her bills out the door and wasn't missing anything, at least for a while, after the initial "paperwork cleanup."
posted by Eyebrows McGee at 11:26 AM on January 7, 2011 [5 favorites]

FWIW, I believe that as a direct result of that moving thread about Bill Zeller, people are working on strengthening and adding to the Resources section of the Metafilter FAQ, specifically the section about depression.
posted by Melismata at 11:31 AM on January 7, 2011

Seconding RAINN. In my city, long term counseling with therapists who specialize in trauma survival (this is critical) is provided free of charge to all abuse/assault survivors free of charge. Your SO would also have access to their services. The hotline also provides the ability to process through the times you feel overwhelmed and in crisis.
posted by hecho de la basura at 11:32 AM on January 7, 2011

If you're on disability you should not have to pay them at all. If you're on Social Security disability they should write them off.

If you are receiving disability benefits, you automatically qualify for an economic hardship deferment on your student loans, which unfortunately has a maximum time limit of three years. You can only get your loans written off if you are totally and permanently disabled and have a doctor that will certify this is true.

There are tons of options on student loans that will either lower or defer your payment; all you need to do is call your loan servicer to discuss them.
posted by Lobster Garden at 11:34 AM on January 7, 2011

Yeah I love organizing other peoples lives for them so its very possible you already have a friend who can help you. Who would love to help you. Who do you know that organizes their DVDs alphabetically? Ask that person.

As far as your depression goes have you ever seen a psychiatrist outside of a hospital setting? You are experiencing symptoms (depression, mood swings, insomnia, anorexia, anxiety) that they can treat with medication. Sometimes treating the symptoms helps a lot by allowing you some relief to deal with the causes.
posted by fshgrl at 11:35 AM on January 7, 2011

Creditors who are not US government agencies can not garnish SSDI benefits. The federal government can, up to 15% a month, for student loans that have defaulted.

Can My Social Security Check Be Garnished to Collect on a Student Loan Debt?

Here is a link from the Social Security Administration that says you can request a review of the garnishment and for it to be reduced because of financial hardship:

Rights if subjected to Administrative Wage Garnishment

Contact form for the Social Security Administration to request that the garnishment be reduced.
posted by mlis at 11:38 AM on January 7, 2011

I regret that I don't have any specific, constructive advice for you right now, but please believe me when I say that I'm very, very happy that you've come forward to ask for help.
posted by Faint of Butt at 11:41 AM on January 7, 2011 [2 favorites]

I also have no experience or advice for you but I'm so glad that you reached out and I know that you will find some ideas here. Big hug to you from Georgia!! You CAN do this and it DOES get better!!
posted by pearlybob at 11:43 AM on January 7, 2011

Seconding the suggestion Eyebrows McGee had.

If you don't feel like you can prevail upon a friend, though, it's very, very, VERY common for people to get behind on their paperwork for ANY number of reasons, so you may want to consider hiring a college student or someone like that to just come help you go through paperwork just for a day or two. I know it may sound counter-intuitive to hire a stranger for this, but this may give the whole thing a sort of impartiality -- they're a stranger that's not going to care, they're just there to open all the mail and help you sort it and throw crap out once you know you don't need it any more. You don't even have to get into WHY your mail got backed up; you can tell them any story you want ("I just got back after a year in Antarctica saving arthritic pengiuns and found my mail was all piled up....")

It sounds like the paperwork is one worrying hurdle, but it's one that can be tackled if you just got some help to get on top of it, and once that was tackled you may feel better just from the mere fact that it's done,and will have a good shot at maintaining it.

And getting that level of organization can help you emotionally as well. I can't say I've had the same misfortune you've had, but I can definitely say that sorting through things and organizing them and bringing order to the things around me can feel very, very grounding sometimes. It can be a good, positive coping strategy; I coped with the death of a pet by doing a hard-core cleaning and organizing of three whole closets. It was my own little way of exerting control when I felt I had none; "I may not have been able to stave off Zach's mortality, but I can create order HERE, dammit!" I know that sounds a little ridiculous, but emotionally, it absolutely helped.

At the very least, it will be one thing you won't have to worry about, so you can focus on healing yourself instead of trying to focus on healing yourself AND paying the gas bill. And that's also a good thing.

Good luck.
posted by EmpressCallipygos at 11:44 AM on January 7, 2011 [2 favorites]

I pushed them away over and over again until most of them figured I didn't want them around.

It sounds to me like you're maybe trying to do the same with your SO. Are you trying to give yourself permission to completely give up on life by eliminating the people who care about you?

Also, DO NOT see a psychic. I'm saying this as a professional tarot card reader -- people in situations like yours often turn to psychics and healers and so forth in hopes that someone will be able to look right into the heart of their problem and explain it away magically, and there are many charlatans out there who are quite good at keeping you on the hook while making it seem like they're doing exactly this. Truly well-meaning professionals would rather you get actual help, even if it means .

I have been approached MANY times over the years by people who are in a deep depression or an out-of-control spiral, looking for clues and answers. As soon as I see that they need real help, and I demur from offering any services (usually that's right away, but sometimes it takes me a while to discover it).

I would start with cleaning your house. Not your whole house, but just one room. Not the whole room, but just one area of it. Your house is symbolic of so many things, such as your mind and/or body. Sure, we dream of just leaving it and starting over somewhere else. Sure, we wish it would just magically cleanse itself. But in the short term, at least, it is ours to deal with however we can.

Spend 15 minutes cleaning. If you feel like it, spend 15 more minutes cleaning. If certain tasks are too stressful or intimidating or require too much preparation, pick something else. Spending 15 minutes cleaning every day might sound like a pitifully small ambition. Or it might seem dreadfully large. Fortunately, it's not either.

I recommend you go do 15 minutes now and then come back to reading this thread.
posted by hermitosis at 11:47 AM on January 7, 2011 [4 favorites]

You have so much on your plate right now. I think it might help for the time being to ignore some of your problems in order to focus what energy you have on your other problems. For example, can you forget about opening your mail for now (just put it aside someplace safe) and just make an effort to go outside every day and walk around the block? Then move up to taking the subway just one stop and turning around and going back home? Can you get up from the couch to clean for 5 minutes and then go sit back down? One step at a time, and you will get there.

Also, have you tried medication for depression? I've had a lot of success taking anti-depressants on a short term (several month) basis in order to help me over the really rough spots and give me the energy to take back control of my life (abuse survivor here, too).

Add me to the list of those saying they're really glad you've reached out. Best of luck.
posted by hazyjane at 11:49 AM on January 7, 2011 [1 favorite]

If it's a social worker I need ... well, how do I find one who won't tell me I'm an idiot for not having recovered by now?

None of them will tell you this. I promise.

Actually, how do I find one who will return my phone calls in the first place?

This is harder, because everyone is swamped. Let me ask around and find some folks in NY for you to call. If you could let a mod know which borough you're in, that will help me find someone closer to you.

It's okay to find this tough to deal with. It really is. You're asking for help--that's good. Please keep asking.

I love you and I want you to get through this. Yes, I don't know you, so what is that worth? Perhaps not much, but everyone who has experienced childhood sexual abuse is precious to me, because I've been there too. So please know that there's a cranky 46-year-old lady in Cambridge thinking of you with nothing but love right now.
posted by Sidhedevil at 12:00 PM on January 7, 2011 [7 favorites]

From the OP:
I live in Brooklyn.
I have a pyschiatrist.
I have a therapist.
I am on medications for depression and anxiety.
I have called RAINN, who referred me to someone who tried to refer me to someone else, only they weren't taking calls, so RAINN was a wash.
I am not anorexic. Actually, I've gained about sixty pounds over the last two years from medications and lack of exercise. If I don't eat, it's not because I'm trying to starve myself but because I literally do not have the energy to prepare food.
I am on Social Security disability. They are the ones who sent me the letter informing me that my monthly stipend would be reduced to pay my student loans.
I don't have friends who would come over to help me clean my house, because as I've said, I've pretty much cut all my friends off.
posted by jessamyn (staff) at 12:09 PM on January 7, 2011

You have not chosen to be disabled; you clearly want to be able to cope. If someone shames you for not recovering in a specific timeframe, or for allowing your finances to go all to hell because you were overwhelmed, please tell that person to go straight to hell.

You are reaching out and looking for a path to resolving your psychological, physical and financial troubles. This is a difficult and courageous act and you deserve credit.

See if you can find an exercise program for people recovering from being bedbound. Physical exercise will help a lot. There may be a tv exercise show, or Wii games might help. Sunshine helps; even if you can't go for a walk, even 5 minutes outdoors helps.

Tell your therapist you need active coaching towards resuming your life. You may be eligible for Vocational Rehabilitation funding.

Let me say it again. This is a big step; you have nothing to be ashamed about; you are working hard to overcome something that is not your fault. I wish you the best.
posted by theora55 at 12:14 PM on January 7, 2011

I'm rooting for you from Wisconsin. You've already taken many huge steps, even if it feels like you're tripping through the dark. If I were in New York for any amount of time, I would come over and help.

There are good people in the world. The fact that you care means that you're one of them.
posted by Madamina at 12:16 PM on January 7, 2011

OP, I'm in NYC and would be more than happy to help you out with your place and/or with meals. I love to cook. My e-mail is in my profile.
posted by roomthreeseventeen at 12:17 PM on January 7, 2011 [14 favorites]

OP, thanks for following up with us.

That decision by the Social Security Administration can be appealed; I know that dealing with government paperwork probably feels overwhelming right now, but that's something to think about.

I will be asking around about Brooklyn-specific resources for you, and like others I wish I could come and help in person. Don't hesitate to contact me by MeMail before you hear from me at your gMail account, though.
posted by Sidhedevil at 12:21 PM on January 7, 2011

First of all, I am so glad you are reaching out for help. I don't know you personally, but it sounds like you've been through a lot, and the fact that you're still surviving is testament to your incredible strength and resilience.

It would be helpful to know whether you did DBT/CBT only in the context of your hospitalization. DBT's really meant to be a years-long process where skills training and individual therapy are paired to give you the life skills you need to survive a history of trauma. If it didn't continue after your hospitalization, it may not have been effective for you.

I have a friend who works in human services in Brooklyn; he's looking into resources for me. He has heard of a good resource in downtown Brooklyn, so I should at least be able to give you that.

Please feel free to memail me if you need someone to talk to. I can send you my email or Gchat if you'd like. I was sexual assault victim advocate for years, I facilitate a DBT group, and I am working on a degree with a research focus in sexual assault/child sexual abuse.

I have a great amount of hope for you. I know it's probably hard to feel that hope too, but there are a lot of Mefites here who will hold it for you until you're ready to feel it yourself.
posted by emilyd22222 at 12:23 PM on January 7, 2011 [1 favorite]

I too am glad you are reaching out. I know how difficult a step this can be.

The NAMI-NYC Metro helpline might be helpful for referrals. NAMI has lots of services you might find useful.

Best of luck. I'm pulling for you.
posted by keever at 12:24 PM on January 7, 2011

First, follow the advice upthread about getting up to date on your paperwork. Because...

Second, you probably need to file for bankruptcy. IAAL, but though IANYL (and not licensed in New York), I know enough to know that you need help here. Contact The Legal Aid Society. It will probably take a series of phone calls, but they're more-or-less the clearinghouse for legal aid in the city.

I know your debt is student loans, but student loans are, in fact, dischargeable in bankruptcy if you can demonstrate undue hardship. Given your circumstances, it's entirely possible that you can, but that's something you and your lawyer are going to have to figure out.

Good luck.
posted by valkyryn at 12:32 PM on January 7, 2011 [2 favorites]

Just wanted to chime in to cheer for you because you have already done so much to reach out for help.

Depression can indeed be truly paralyzing. I'd suggest that besides the steps you have taken (and pat yourself on the back for those!!) that you might make life a bit easier with the following:

1. Get super easy food in the house for breakfast/lunch/snacks, e.g. cereal and milk and fruit for breakfast, fruit and cheese/nuts for snacks, and lower sodium soups for lunch.

2. Take SHORT walks, maybe just 10 minutes (5 minutes to and from your house) a few times a day. Just to move a little and get some air.

3. Take the paperwork in very small bites. E.g. today I'm going to call about the psychiatrist payment and sort mail for 1 hour. That's it.

I.e., take some little steps, and don't forget to congratulate yourself for each thing you get done. Even small advances will get you there.
posted by bearwife at 12:35 PM on January 7, 2011 [1 favorite]

If you're in Brooklyn and want to consider the "hire some people for just a day or two to help me organize" route, I can recommend The Clean Actors' Guild. They're a married couple that are both working actors, and decided to start their own cleaning/moving/odd-jobs kind of business for their "day job". They're super-nice, very reasonably-priced, and helped me tremendously when I was packing for a move.
posted by EmpressCallipygos at 12:48 PM on January 7, 2011 [2 favorites]

A few suggestions:

Mindfulness may be very helpful in helping you heal. Mindfulness and buddhism focuses on living in the present moment and not being oppressed by the past or afraid for the future. By concentrating on the present moment it can help you free yourself from the agony of your past. If you are up to a bit of travel (in NY state), I would check out Blue Cliff Monastery, I would call as they may have a specific program for sexual abuse survivors (let the phone ring, they all stop and take deep breaths when the phone rings so you have to be patient), and they WILL call you back. They will ask only a nominal amount for your upkeep and will welcome you for a few days or week. When you get there ask them for a senior nun or monk who can practice compassionate listening with you. Its very transformative and they will teach you to achieve reconcilation within yourself as part of the mindfulness meditation practice.

If you can't face leaving the city, try to go to a day of mindfulness.

If you can't leave the house, try listening to Thich Nhat Hanh on the internet and ordering some of his books (which you can download as audio books or purchase on amazon). Here are some links:
Being Present (audio talk)
Breathing our feelings (you use these exercises to manage your anxiety/panic attacks etc)
Living in the present moment
posted by zia at 12:56 PM on January 7, 2011 [4 favorites]

I don't have experience from the original poster's side of things. I am, however, involved in a volunteer program that puts me in touch with people who have some of the original poster's struggles.

From that experience, I can tell you that none of the social workers I've talked with will tell you that you're "an idiot for not having recovered by now", but, amazingly, many psychiatrists and psychologists/therapists who haven't had experience with really traumatic upbringings will. This is a genuine concern on the part of the original poster, and one worth listening to.

And a suggestion born also of that experience: In my town we have a program called The Family Connection, administered by the organization that runs our local homeless shelters. It pairs up families who are moving out of the shelters into permanent housing with a team of volunteers who provide the extended family that those folks have likely never had.

I don't know what NYC or your area has, but a program like that would give you a cause in helping other people, and those other people would likely understand where you're coming from. You'd also be in touch with various social workers in a context that wasn't about you, so you could learn the scene a bit. But I think bringing your background, trauma and all, to that work could be extremely valuable, both for you and for them.
posted by straw at 12:58 PM on January 7, 2011

You said RAINN was a bust because the referral didn't work out. Call them again and tell them that. Keep calling, because you won't be the only one to benefit - if RAINN removes those referrals from their list it makes it easier for future people in need to get fast help too.

I gave up on my first therapist because he told me about his work with male prison inmates and I convinced myself that, in comparison, my problems were too trivial to bother him with. Don't let your brain trick you out of getting help. Keep trying. We're here rooting for you. Come back and tell us how these calls go, because we want you to be happy and healthy.
posted by tracicle at 1:00 PM on January 7, 2011 [4 favorites]

Oops, ach... a mistake and an elaboration

Here is the "Being Present" audio link:

Also, what I meant to say about Blue Cliff is that if they don't have a program/retreat for sexual abuse survivors tell them you need to come up there any way and that you need to talk to a senior nun or monk who can practice compassionate listening. Also you need to practice embracing suffering and walking meditation.
posted by zia at 1:02 PM on January 7, 2011

In this case a personal assistant would be put in a codependent situation. You are depressed and the system is failing you. You probably need meds, survivor group, and a really good therapist. A personal assistant would only clean up after you, be on top of things, etc. in short cope through a life that you should be coping with.

Trust me, I get it. I get the utter chore to do simple things including opening mail because it's all bad news. I don't read the news anymore because of that. I put a lot of bills on autodraft because it was becoming overwhelming dealing with the manual payment method. I made a chart saying 'this bill on this date out of this check" which helps me understand that one check will be leaner than the other and I let it ride. I have piles and piles of paperwork to file but I don't because you know, I just don't give a rats ass. One day I will. For now, I don't. I do the bare minimum of what I can until these meds kick in. They worked for a while now they're tapering and I've noticed that I'm back like you--avoiding what needs to be done.

Bearwife has some very, very good self help methods at trying to tackle this. But trust me, I get it. Life is too friggen complicated sometimes. Try to do some things you enjoy.
posted by stormpooper at 1:06 PM on January 7, 2011 [1 favorite]

Hi. I'm so sorry you are feeling this way. I hope I can help a little bit. When I read the part of your post about not being able to open the mail it jumped out from the screen at me. I know exactly what you were talking about. I've done that, too - many times when I'm depressed. I still have boxes of unopened mail from a couple years ago. I do it out of fear/avoidance. This is how I broke it down (slowly) to get the mail part of my depression back under "control" (note - to help myself reduce anxiety - there might be another way to do this via "life hacking" /Real Simple - where emotions are not involved, but this isn't that):

I take the mail that is still relevant (less than two weeks old) and put it in one stack on my dining room table. I take all the rest of it and put that safely away somewhere else (in a box or a shopping bag - I don't simply toss or shred it because there might be something in there that's important - which I will either decide to deal with later or never again - but will definitely not decide that until I'm less overwhelmed in the immediate sense). You literally take all of that mail "off the table". Take it to a place out of the room you are keeping the now "relevant" mail.

I spend a few seconds taking out the junk mail and tossing that. Even this might make you anxious (it made me anxious). It's hard. But you will feel a tiny bit of relief and control over your life doing this first step.

Later, go back and sort envelopes into obvious categories by type of bill/etc.

Later, take everything out of the envelopes. that's it. toss the envelopes.

Later, read your mail. Much of it will be redundant/repeat messages - toss or shred those.

By now you might feel a little less anxious. You can look at each one and respond by phone or online - even if it's to tell them you can't pay right now. Write on the top of each letter what you did and the date you did it.

Now either file or keep these opened letters neatly in order somewhere where they won't "weigh" on you visually.

After this, try to open each piece of mail as it comes. Respond to things even if it's to say you can't pay right now. You might as other's have mentioned find someone who can do all of the above for you for a while - so that when you start to address these things yourself it will be after the "mess" you perceive it to be has already been tackled. This could be your SO. But it's best if it's you because you will feel stronger for every step you take to make your life manageable.

The idea of cleaning just one area of a room is key, as someone advised above. The momentum will happen on it's own - it taking really small steps that's important. You need the overwhelmed feeling to lessen. That might actually have less to do with what you do right now but how you do it.

Just take it slow - I mean the practical aspects of this (the mail, the house cleaning) and put the real emphasis on YOU getting better. Good luck to you.
posted by marimeko at 1:15 PM on January 7, 2011 [1 favorite]

Dear OP and all,
Perhaps this AskMe can be your Personal Assistant in a way.

To me, you sound completely and utterly overwhelmed, which is understandable. I think a bit of triage is in order, where tasks can be broken down and put in an order of priority. From there, you or this thread can help you further prioritize each task.

I would HIGHLY recommend starting small. You sound like you need a win, something you can look at say "I've done this step. There are other steps, but at least I've done this." Preferably something regular. How do you feel about at least making sure all the glasses in the sink are clean? If you have have to, try to limit it to a small number of glasses, say 4. Talk it over with the SO, see if he can get on board with that and understand what you're trying to do. You say he's exhausted, so maybe try to keep it small.

Or maybe you just need to start with a general list of some things you need to do. It doesn't have to be all, just a few like dealing with the paying the psyche dude or collecting information about contacting social workers.

You may feel stupid or small or worthless for having to start so small at first, but it's like that with everything. When I was getting in shape, I couldn't run a mile. So I ran for as long as I could on a treadmill, say 30 seconds. Then I did that for a week. Then I added 5 more seconds. Then 5 more. Then so on and so on, until I was able to add more 20 seconds at a time, then 30, then a minute, etc, etc. Looking back, I realize, I could have probably run for longer at first, but frankly I was so ashamed at being in bad shape, each step was like torture, it was like running through a thick fog of shame, hatred and self loathing that made me to always quit, so I wouldn't have to face those awful feeling. Taking it a little bit at a time allowed me to sort of deal with those feelings, come to terms with them and focus on doing a little bit more, being a bit better.

So summing up, try to make a list, small list, one to triage your situation financial situation or cleaning situation and go from there. Get yourself a bit of a win and build on that.
posted by Brandon Blatcher at 1:35 PM on January 7, 2011 [2 favorites]

Oh, back to the crowd sharing/this thread is your personal assistant: Google has a number of tools, one is for creating groups. Perhaps a few people here would agree to be on that group and listen to questions you might have? That way you might get a few volunteers to help listen to your problems and offer advice. I'd be willing to sign up for that and my gmail address is

Or AskMe threads stay open for a whole year, so maybe just post questions or whatever here? It's great that you've taken a step to get help, now don't forget to use some of that help!
posted by Brandon Blatcher at 2:00 PM on January 7, 2011 [3 favorites]

I'm seconding Brandon Blatcher's idea.

OP, does this sound good to you?
posted by marimeko at 2:03 PM on January 7, 2011

Hi OP, I live in New York. Send me a MeFi mail with your info and I will come over and help you in whatever way you'd like: cleaning, opening your mail, making calls to figure out what your next steps could be. I have a lot of free time this week and some unstructured time over the next few months. Please take me up on this offer. I've been overwhelmed and needed help in the past and desperately wanted someone to come and really help me, not just give me advice. If I could give you that help now, that would make me very happy. Today you, tomorrow me. Seriously, you would be making my day.
posted by prefpara at 4:20 PM on January 7, 2011 [15 favorites]

I don't think a personal assistant would lead to codependency, if it is a short term situation. If I were you, I would think about hiring people to clean my house, open and sort my mail, maybe buy a whole heap of easy-to-cook groceries, etc. Just until everything is "back to normal" in terms of cleanliness around the house and not having piles of unopened mails/bills. Then try to use resources such as others have suggested above to get yourself to a place where you can keep on top of your newly organised life. College students would probably happily open and file mail, and cleaning services are not too expensive as a one-off deal, and won't judge - they have seen it all before.

Hugs and best of luck to you. I'm so happy you are reaching out.
posted by lollusc at 4:59 PM on January 7, 2011

OP, you are very brave to reach out here. Depression is overwhelming, and if you do not have a good support network in place, it crushes you.

I would suggest taking up the NY MeFites on their offers -- they really want to help, and having someone involved who cares (but who is not emotionally involved nor getting paid) makes all of the difference.

We're rooting for you.
posted by sdn at 5:26 PM on January 7, 2011 [1 favorite]

In this case a personal assistant would be put in a codependent situation.

I cannot disagree more. One-time or short-term help can be immensely valuable in helping someone jump-start a process of self-care. The only possible enabling would be if the help was open-ended and not part of a plan.

If someone was at the bottom of a ditch, helping them up a ladder would not be enabling or co-dependent. Once they're out of the ditch, they can make a plan to walk on their own, but forcing them to climb out isn't a salutary challenge, it's at best pointless and at worst cruelty.
posted by Sidhedevil at 5:47 PM on January 7, 2011 [3 favorites]

OP, I want to encourage the idea of getting a social worker. I have a social worker who comes to my house once a week and is invaluable for things like what you're struggling with and which I have struggled greatly with in the past (and still sometimes need help with). In nice weather, she encourages me to get out of my house; in bad weather, we do things like open my mail, fill out paperwork, and even just chat* sometimes.

*(which falls under the umbrella of "personal skills" development, e.g. how to talk to someone else.)

I would strongly recommend asking your therapist or psychiatrist, whichever one you're going to see soonest (or call them, even) for a referral to a "community living" agency.
(At least that's the term here--if they're not familiar with the term, tell them you found the description online: an agency comprised of social workers which help people with chronic mental illness, on an individual basis, with issues related to living in the community. [as opposed to being hospitalized repeatedly])
I suggest going through an agency because they would have more social workers than just one and so if one is totally booked, can go to the next one, etc.
posted by saveyoursanity at 6:10 PM on January 7, 2011

Have you asked your therapist and psychiatrist if they know how you can get a social worker or case manager? If they're in private practice, they probably don't know, but if they're affiliated with a hospital or community mental health clinic, they should know, or there should be someone on staff who does.

I also suggest calling 800-Lifenet, which is New York City's mental health line. They can give you referrals, but I don't know how good they are. Also call Baltic Street Peer Advocates at 718-875-7744. They know the system and do advocacy work. I don't know if they provide any sort of informal case management. Talking to a peer advocate could also help with your isolation. You might also benefit from connecting with a peer-run clubhouse. I imagine Baltic St can give you those referrals too.

Your primary issue is in needing additional support services, which is a mental health treatment issue. But if you want to talk to an attorney about your student loans and other debt, call MFY's Mental Health Law Project at 212-417-3830, Monday through Thursday. Leave a message and an attorney will call you back, usually within 24 hours. (MFY calls everyone back; I know not returning calls is a huge problem at a lot of social services places and immensely frustrating when you really need help. If you don't get a call back from someplace, try to call back. Making multiple calls can pay off.) MFY pretty much only offers advice on this sort of issue due to resources, but you will get accurate legal information (some of the statements here are well-meaning but wrong).

I don't know if it helps to hear this, but what you're going through is very normal. I see people all the time who need exactly what you need--help opening mail, calling places, following up, keeping up with all the stuff.
posted by Mavri at 6:14 PM on January 7, 2011

One powerful life change that really helps pull depressed brains back towards normal, is doing things that create positive expectation. In other words, finding and doing small mildly pleasurable and involving tasks, because they are pleasurable, and provide something to look forward to. I'm not talking about passive activities, either, like listening to music, or watching TV programs or movies; I'm talking about activities that engage you - talking, exercise, thinking, tasting, etc. In the beginning, even some simple activities like going for a 10 minute walk in the sunshine can be powerfully stimulative, but as you acclimate to such activities, you have to keep steadily, slightly raising the bar on your involvement and stimulation levels, to keep a growing sense of well being heading in the right direction. So after a few days of taking 10 minutes walks, you should make an effort to add some interactions with other people, like buying a paper, or a cup of coffee, during your walk. After some days of doing that, make a point of going into some other shops to look at merchandise, or ask some questions. These minor social interactions may be barely noticeable to the people with whom you chat, but their effects on a deeply depressed brain are powerful. Your walks needn't be outside either, if you're weather bound, and if you're in such bad physical shape that you can't walk for 10 minutes at a time, you can get much the same level of mental stimulation by taking a short bus ride.

The more of your brain that you can light up regularly with stimulation from the world, the more you drive the serotonin systems of your body. And that is enormously powerful bio-chemistry, that may, according to some studies, be as effective, or possibly even more effective in treating depression, than medication alone.
posted by paulsc at 6:14 PM on January 7, 2011 [3 favorites]

People have some wonderful suggestions here.

A tiny tip from someone who has weathered some very difficult times of depression: If you're able to get to a grocery store or drugstore (or can add this to your SO's list, etc.), pick up a box of the store's version of Ensure, or some other meal replacement shake. The ones that aren't specifically for weight loss are designed for people who aren't eating regularly or with deficient nutrition.

I found that having a box of those shakes in my fridge helped tremendously when I got caught in that low-energy loop; I'm hungry but I don't have the energy to move and make anything, so now I'm more hungry and have even LESS energy, etc. etc. Being able to just walk over to the fridge, crack open a shake and get some protein/carbs/vitamins really, really helped get me moving.
posted by sarahsynonymous at 8:49 PM on January 7, 2011 [1 favorite]

Definitely take baby steps. There's 1 room in my house that, the idea of cleaning, overwhelms me. I've been successful in taking baby steps. I vacuumed a little bit and felt better that at least I'd done SOMETHING towards cleaning it and not just ignored it yet again.
posted by IndigoRain at 9:00 PM on January 7, 2011

I billionth the baby steps. I'd start with one phone call, RAINN. Then tomorrow, sort some envelopes, the next day open a pile of them. Keep going. If you don't do it one day, that's okay (think of it as like your meds - don't double up if you forget one, but don't skip them for a week either). Eventually things do get better. Eventually. But trying to run a marathon right now will not help.

(you sound just like my best friend and I really really love her more than anything and lived with her for months in filth and boxes of unopened mail and she screwed up so bad when we had to move out but I still love her more than I can say)
posted by geek anachronism at 3:25 AM on January 8, 2011

One resource could be Fountainhouse, in NY City. The organization model has been copied around the US and is successful. In brief, the people suffering from any sort of mental illness band together to help one another toward survival and wellness.
posted by francesca too at 10:38 AM on January 8, 2011

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