Recovering from mental illness while on (likely limited) disability
February 6, 2015 11:00 AM Subscribe
I have a relatively short amount of time to get out of my dark, scary, and dysfunctional places and "rejoin society". I keep going through cycles of pushing too hard and then not pushing at all (while feeling shitty and guilty about it). How can I develop more patience with myself? And at the same time, are there ways to use the freedom I have right now to ensure I end up making adequate progress?
The relevant conditions are major depressive disorder and social phobia. ~5 months ago, after a two-year battle by my treatment team, I was awarded monthly SSDI and SSI payments, up for review in what is now a year and 7 months. The administrative law judge in charge of my case has an unusually low award rate and a poor opinion of disability applicants in general, and I was very lucky he considered my appeal the first time.
The only real improvements in my level of functioning in the last five months can be attributed to two things: having that no-strings-attached (sort of) income, and moving in with my boyfriend, who does things like keep the apartment clean and make sure I remember to take my medications. Neither of those changes are internal.
Things I'm trying to do right:
I have a daily checklist I'm trying to adhere to that covers the basics other people take for granted, e.g., showering, getting out of bed, making food when I'm hungry, and things that will help with my mental health, like taking my meds and going for a walk in the sunshine each day. It helps a little, but I most often fail at it. I see my psych nurse/prescriber once a month for med adjustments and a licensed therapist every two weeks, and I have a case manager who, according to the treatment plan we worked up together, is supposed to call me the next day if I don't email and let her know how I'm doing on my checklist, but doesn't. I study computer science through massively open online courses, both for the straight-up fulfillment of learning something new (one of the few things that still gives me a thrill), and because I hope to eventually make programming my profession. In a fit of enthusiasm, I signed up for too many of these and other classes, and I've had to cut my workload in half twice, and I'm still not meeting all my deadlines. I also sometimes try to make myself do things I used to find fun, like writing fiction or playing video games.
I'm not sure, at most any given time, if I'm pushing too hard or not hard enough. My friends and significant others tend to come down on the side of "too hard", and want me to treat this time less like a countdown and more like a needed vacation. My family, on the other hand, wants me to sign up for more real-world commitments, like driver's ed and watching my sister's kids. The state is pushing their Ticket to Work program pretty hard, with a very specific timeline-- working 3 months of the first year, then 6 months of the second, and so forth. I worked part-time for 4 or 5 months this summer, and it was, see this AskMe, difficult and distressing enough for me that it would not be wise to do it again anytime soon.
In addition to learning to be more patient with and/or optimizing the process, I need to wrap my head around some kind of consistent model of what being on disability really means. I feel like I'm a worthless drain on society right now-- even though I believe other people should be housed and fed regardless of what they are or are not doing with their lives. I know, legally, that what it means is I've been found medically unable to perform "substantial gainful activity", but beyond that, I haven't a clue.
I feel like I'm leaving something important out, here, but I can't think of what. Feel free to ask for clarification.
The relevant conditions are major depressive disorder and social phobia. ~5 months ago, after a two-year battle by my treatment team, I was awarded monthly SSDI and SSI payments, up for review in what is now a year and 7 months. The administrative law judge in charge of my case has an unusually low award rate and a poor opinion of disability applicants in general, and I was very lucky he considered my appeal the first time.
The only real improvements in my level of functioning in the last five months can be attributed to two things: having that no-strings-attached (sort of) income, and moving in with my boyfriend, who does things like keep the apartment clean and make sure I remember to take my medications. Neither of those changes are internal.
Things I'm trying to do right:
I have a daily checklist I'm trying to adhere to that covers the basics other people take for granted, e.g., showering, getting out of bed, making food when I'm hungry, and things that will help with my mental health, like taking my meds and going for a walk in the sunshine each day. It helps a little, but I most often fail at it. I see my psych nurse/prescriber once a month for med adjustments and a licensed therapist every two weeks, and I have a case manager who, according to the treatment plan we worked up together, is supposed to call me the next day if I don't email and let her know how I'm doing on my checklist, but doesn't. I study computer science through massively open online courses, both for the straight-up fulfillment of learning something new (one of the few things that still gives me a thrill), and because I hope to eventually make programming my profession. In a fit of enthusiasm, I signed up for too many of these and other classes, and I've had to cut my workload in half twice, and I'm still not meeting all my deadlines. I also sometimes try to make myself do things I used to find fun, like writing fiction or playing video games.
I'm not sure, at most any given time, if I'm pushing too hard or not hard enough. My friends and significant others tend to come down on the side of "too hard", and want me to treat this time less like a countdown and more like a needed vacation. My family, on the other hand, wants me to sign up for more real-world commitments, like driver's ed and watching my sister's kids. The state is pushing their Ticket to Work program pretty hard, with a very specific timeline-- working 3 months of the first year, then 6 months of the second, and so forth. I worked part-time for 4 or 5 months this summer, and it was, see this AskMe, difficult and distressing enough for me that it would not be wise to do it again anytime soon.
In addition to learning to be more patient with and/or optimizing the process, I need to wrap my head around some kind of consistent model of what being on disability really means. I feel like I'm a worthless drain on society right now-- even though I believe other people should be housed and fed regardless of what they are or are not doing with their lives. I know, legally, that what it means is I've been found medically unable to perform "substantial gainful activity", but beyond that, I haven't a clue.
I feel like I'm leaving something important out, here, but I can't think of what. Feel free to ask for clarification.
I absolutely understand what you're going through.
Guilt is a big problem I have. It's part of my mental illness. The thing I try to say to myself is "If someone you really loved was going through this exact same thing, how would you feel about them and how would you treat them?". You're doing your best, you have a lot of things to contend with and your brain can be your worst enemy. Try to give yourself a break, be patient and remember there's always going to be ups and downs. Make sure you appreciate how well you're doing.
posted by shesbenevolent at 12:11 PM on February 6, 2015 [1 favorite]
Guilt is a big problem I have. It's part of my mental illness. The thing I try to say to myself is "If someone you really loved was going through this exact same thing, how would you feel about them and how would you treat them?". You're doing your best, you have a lot of things to contend with and your brain can be your worst enemy. Try to give yourself a break, be patient and remember there's always going to be ups and downs. Make sure you appreciate how well you're doing.
posted by shesbenevolent at 12:11 PM on February 6, 2015 [1 favorite]
In a fit of enthusiasm, I signed up for too many of these and other classes, and I've had to cut my workload in half twice, and I'm still not meeting all my deadlines.
Get it down to one class if you can. You need something achievable. You need to account for the fact that you cannot perform consistently.
I also sometimes try to make myself do things I used to find fun, like writing fiction or playing video games.
Stop FORCING yourself to try to have fun. Fun grows out of enthusiasm for a thing. You are killing what little enthusiasm you have left.
Depression can have physiological roots. Deal with it like it is a physical ailment. Walking in sunshine is good. But you also need recovery time for anything that is actually productive. Think of it like this: If you had major surgery, would you go back to work the next day? The answer is Nope. So accept that any time you do something that is at all good for your condition, it will be followed by a need to rest and recuperate.
I think the goal to learn to program is a good one. It might make it possible for you to earn money without "getting over" some of your issues, like social anxiety. But you need to push less hard on making it happen NOW. Instead, you need to find a path forward that actually works and ignore the imaginary deadlines in your mind concerning "getting well." You need to work on a basis of milestones. You need to find goals that are a good fit for making your life work and find ways to make progress towards them and accept that you will get there when you get there. The ONLY thing that matters is finding a path forward that actually works.
It also helps to find some means to track your progress. When I was very ill, I would go to sleep at 7am and sleep all day and get up in the evening and it would take eight hours to get showered and fed and so on so that I could go get a few groceries at 2am. That was the only thing I accomplished that day. As I got better, I began sleeping at night and getting groceries in the evening and it took, say, six hours to get my act together to go get groceries. It was hugely frustrating, but my sons were good about pointing out that it constituted measurable progress and that helped me stay on track. That helped me see that, yes, I really am getting better, even though it is frustratingly slow.
You might try keeping a private journal. Journals can be very valuable in tracking what is really going on in your life. It is easy to forget the details or downplay things. Having some kind of written record, no matter how stream of consciousness, can be extremely useful, especially if you don't have other people reliably giving you feedback on what is really happening in your life, the way my sons did for me.
Best of luck.
posted by Michele in California at 12:45 PM on February 6, 2015
Get it down to one class if you can. You need something achievable. You need to account for the fact that you cannot perform consistently.
I also sometimes try to make myself do things I used to find fun, like writing fiction or playing video games.
Stop FORCING yourself to try to have fun. Fun grows out of enthusiasm for a thing. You are killing what little enthusiasm you have left.
Depression can have physiological roots. Deal with it like it is a physical ailment. Walking in sunshine is good. But you also need recovery time for anything that is actually productive. Think of it like this: If you had major surgery, would you go back to work the next day? The answer is Nope. So accept that any time you do something that is at all good for your condition, it will be followed by a need to rest and recuperate.
I think the goal to learn to program is a good one. It might make it possible for you to earn money without "getting over" some of your issues, like social anxiety. But you need to push less hard on making it happen NOW. Instead, you need to find a path forward that actually works and ignore the imaginary deadlines in your mind concerning "getting well." You need to work on a basis of milestones. You need to find goals that are a good fit for making your life work and find ways to make progress towards them and accept that you will get there when you get there. The ONLY thing that matters is finding a path forward that actually works.
It also helps to find some means to track your progress. When I was very ill, I would go to sleep at 7am and sleep all day and get up in the evening and it would take eight hours to get showered and fed and so on so that I could go get a few groceries at 2am. That was the only thing I accomplished that day. As I got better, I began sleeping at night and getting groceries in the evening and it took, say, six hours to get my act together to go get groceries. It was hugely frustrating, but my sons were good about pointing out that it constituted measurable progress and that helped me stay on track. That helped me see that, yes, I really am getting better, even though it is frustratingly slow.
You might try keeping a private journal. Journals can be very valuable in tracking what is really going on in your life. It is easy to forget the details or downplay things. Having some kind of written record, no matter how stream of consciousness, can be extremely useful, especially if you don't have other people reliably giving you feedback on what is really happening in your life, the way my sons did for me.
Best of luck.
posted by Michele in California at 12:45 PM on February 6, 2015
cbt is great, just google it
posted by sistertips at 4:08 PM on February 6, 2015
posted by sistertips at 4:08 PM on February 6, 2015
I have same diagnosis plus ADD. Recovery from alchohol and drugs was helpful as well as any other self destructive, self defeating behaviors and thought life.Try looking at the types of goals you choose, mostly relatioships with self, others, creation and the most valuable.. Creator. When I could dance with joy again, much negativity fell away. Worship is just a superlative form of gratitude. Knowing inner peace, and values lasts.
posted by weaverd53 at 12:52 PM on July 24, 2015
posted by weaverd53 at 12:52 PM on July 24, 2015
This thread is closed to new comments.
Hmm. You want to evaluate your goals. Here's a management-speak way to do so: S.M.A.R.T.: Goals should be Specific, Measurable, Achievable, Realistic, and Time-bound.
Realistic is defined as: "what results can realistically be achieved, given available resources". Of course, when your resources are internal, it's hard to evaluate them directly. So you have to evaluate them indirectly, using other measurements.
I've had to cut my workload in half twice, and I'm still not meeting all my deadlines.
I have a daily checklist I'm trying to adhere to that covers the basics other people take for granted, e.g., showering, getting out of bed, making food when I'm hungry, and things that will help with my mental health, like taking my meds and going for a walk in the sunshine each day. It helps a little, but I most often fail at it.
Data suggests you are either (a) pushing yourself too hard, and/or (b) setting the 'success' bar too high.
I'd suggest you re-evaluate your criteria for success: what percentage of your daily checklist are you checking off? Measure that. Measuring things automatically increases odds of improvement. Compare it from day to day. Graph paper is your friend. Satisfaction in achieving small-but-vital goals boosts morale for the hard stuff.
posted by feral_goldfish at 12:11 PM on February 6, 2015