Overwhelmed and drowning
February 25, 2015 9:52 AM   Subscribe

I am a disaster, I've always been a disaster. I want to not be a disaster any more--please help me make a plan to get better.

Big problems: I've struggled with eating disorders, addiction, and severe self-harm all my life. Extreme depression alternating with manic periods. Smaller problems: extreme anxiety, procrastination, risk-taking, a complete inability to keep up with the little details of life. I lie a lot. I seem like a really smart, very high-potential person on the outside at first but jobs, relationships, everything blows up eventually because I can't keep things together for longer than a few months or years at a time. To others it seems like frustrating self-sabotage, to me it seems inevitable.

I'm sick of having a major breakdown and starting over again every couple of years--I want a career, a family, other things that take stability and reliability. I am taking a 4 week leave of absence from work; I see that all the little mental health things that have been falling apart here and there for the last year actually add up to IN CRISIS NOW--I feel paralyzed and like I can't see any way to get better. I've created some huge work problems, which is bad, but I guess it's better than other crisis periods where I only realized I was melting down from a hospital bed or on the brink of eviction.

I feel so hopeless and sad and tired when I realize that I will never "fix" this stuff and will have to work on it forever. And I am trying to accept that I might never live the life I thought I eventually would--high-functioning, successful, happy--and maybe I'll just always be struggling to not drown. I've tried to work on issues with therapy etc. in the past but I think I was always trying to bandage specific issues and have never tackled the full picture, so I want to at least make a plan for those four weeks. Obviously I need to find a therapist but should it be a psychiatrist? How am I supposed to find someone when I can barely bring myself to get out of bed much less go to a bunch of appointments? Are there other resources I should be thinking about? What is a realistic place to try to get to, in four weeks and also in life overall? Have you gone through something similar and come out on the other side?
posted by anonymous to Health & Fitness (18 answers total) 17 users marked this as a favorite
Obviously I need to find a therapist but should it be a psychiatrist?

If it's not too overwhelming a task, I would suggest both: a therapist for therapy appointments, and a psychiatrist for a medication evaluation if you're open to exploring that route.

If you can update us via the mod contact form with your location and (if relevant) health insurance status, MeFi can generally provide more useful information on a short term plan to access mental health care. That said, the mental health page on the MeFi Wiki is actually a great compilation of resources and advice for folks struggling on where to start in accessing different types of support.
posted by deludingmyself at 9:59 AM on February 25, 2015 [2 favorites]

This is kind of a left field answer, but your question reminds me of this article. (It's not really about toast.)

As someone who also seems smart and high-achieving on the outside but who is frequently crippled by anxiety and depression, I found her story inspiring and thought-provoking. Personally, I'm unlikely to open a toast-and-coffee shop, but the idea of setting up my life in a way that accommodates my vulnerabilities was a powerful one to me.
posted by missrachael at 10:06 AM on February 25, 2015 [12 favorites]

Did you grow up abused?

Because if you did, by this stage there are biological components behind your (re)actions and you'll need to find a health professional that can address the biology of the situation with you, as well as the mental health side.

Even if you did not grow up abused, there could be a physical component effecting your behavior. Don't neglect this angle of your recovery. Good luck.
posted by jbenben at 10:07 AM on February 25, 2015 [3 favorites]

Yes, it's time for therapy. And possibly medication (which can be useful in giving you the space and stability for therapy to be effective--sometimes I think of medication as like a cast for a broken limb).

In addition, and I am absolutely NOT a therapist of any sort, a lot of what you say--reckless behaviour, periodic implosions, etc--rings very very true for me, and can be but you need a competent professional to evaluate you symptoms of BPD. Which is difficult to treat, but not impossible, and often has a close relationship with depression.

I have to run (to a therapy appointment, coincidentally), but if you want my email/memail is in my profile; I'll try to give you a better answer later, I just wanted to say: you can have a better life. It seems impossible, but it is within your grasp, and there are a zillion lovely people around here who are ready to help support you and help you find the resources you need.
posted by feckless fecal fear mongering at 10:16 AM on February 25, 2015 [3 favorites]

I'm sorry you're struggling. I think I can give you some steps that can help you. Can you get a friend or family member to make the appointments and make sure you get to them?

1. Make an appointment for a full physical with your primary care physician. You can discuss your issues with him or her and this person can prescribe anti-depressants, or other appropriate medications. This person can also refer you to a psychiatrist, or another therapist. A full physical should be your first stop, mostly to be sure that your body is working appropriately.

2. A psychiatrist won't really do the talk therapy with you, these days they're more into dealing with your brain chemistry and the pharma part of it.

3. Start taking care of yourself. Exercise, eat well, speak of yourself kindly.

You may never live a life without mental health issues, but it can be hundreds of percent better than where it is now.
posted by Ruthless Bunny at 10:17 AM on February 25, 2015 [4 favorites]

I'm sorry you're feeling so overwhelmed - this stuff is so, so hard and you're moving in the right direction asking these questions even if it doesn't feel like you're getting anywhere.

You probably want to be talking to both a therapist and a psychiatrist, but at least in my city/insurance network, a psychiatrist appointment can take a long time to set up. You can probably get in to see a therapist sooner, and start doing some work with that person while you're waiting for a psychiatrist appointment. The therapist might even be able to help you see a psychiatrist faster. I would suggest you start by finding a therapist who takes your insurance if you have insurance, and let that person help you come up with the bigger-picture plan for how you're going to move ahead. Part of that person's job is to be on your side and help you figure out how to make the kinds of progress you want to make.

A couple of thoughts for how you might take that first step when getting out of bed is awful - is there a friend who might be willing to do the legwork of finding someone and making an appointment for you? Failing that, do you by any chance have an Employee Assistance Program at work? (Check your employee benefits website/handbook to find out.) Those often provide a few free therapy sessions, usually there aren't a ton of choices but that might not be a bad thing when you're not sure where to get started anyway.

With four weeks I think you could start seeing a therapist, be at least on a waitlist for a psychiatrist, see your family practitioner for a workup and maybe get started on medications if you want to do that. Just as important, you could use this time to be making other steps toward self-care - I would try to use that time to build better sleep/eating/exercise habits, shore up your social support network by trying to find a trusted friend or two you can talk to, see if there's maybe a support group you can go to, read up on things like CBT / DBT /mindfulness to see if any of those coping strategies might be helpful for you and if so start trying out some of the exercises/practices you'll read about.

You have some time here in which you can practice being gentle with yourself and taking good care of yourself, as you start working to get a good medical support team in place. That's not going to fix all your problems but it can get you into a much better place from which to proceed.
posted by Stacey at 10:48 AM on February 25, 2015

I concur that while you may always have to deal with mental health issues as a chronic ongoing medical problem, it can get hundreds of percents better.

And I concur also that now while you're feeling really crappy the best thing to do is go talk to your PCP, get a full workup, and then there's a good chance the most helpful thing would be medication.

For me, medication, which I don't take now and haven't for years, was a life changer. Because it let me experience what it felt like to have the brain chemistry/stable emotional state that I wanted. And when I was there, I paid attention to what that felt like and assigned that state as "me". This is my baseline.

And then over the years I tried to pay attention to fluctuations in my trend from that baseline and what influenced them. And I made a list of things that trended towards stable baseline and whenever I notice I'm trending back away from it, I go down that list in my head and do those things. And through that method I've managed to stay, for many years now, successfully very close to the baseline of the "me" I like and enjoy being instead of the "me" that was out of control and unhappy.

If you do elect for medication, one very important thing I want to add is to stay on it for at least five months, because in many people antidepressants don't noticeably work for 3 months or so. I know that seems discouraging, but life is a long game. And in the short term all you have to do is survive while you wait to feel better. For me, I actually find that kind of freeing, that if I get to the point where I feel really really terrible, all I have to do during those periods is not die until I feel better again.

And even if you don't elect for medication, this is still true; most mental health issues are somewhat cyclic, and when you're feeling on the extreme end of crappy, merely surviving and being kind to yourself is often enough. Then when you're feeling a little better, don't just forget the whole thing. Notice you feel better and work on making it an upward spiral.
posted by shiawase at 10:52 AM on February 25, 2015 [3 favorites]

Lots of good advice here that I won't re-cover. But one thing you should do is stop characterizing yourself as a disaster. Your life may, up to now, have been a disaster. You may be capable of behaving disastrously. But none of this is wired into you, and by seeing yourself as a disaster you create a feedback loop. Try not to label yourself with fixed attributes, but instead try to see yourself as a human being capable of change. Then you'll be better positioned to take advantage of the other strategies presented here.
posted by ubiquity at 10:57 AM on February 25, 2015 [4 favorites]

I think that if you're someone whose life's work turns out to be struggling to fix yourself and your self can never be fixed, as long as you don't drown, you're succeeding in your life's work and it is possible to consider that evidence that it is fixed. I speak as a fellow disaster who has every one of the smaller problems you list and a few of the big and who fails this way all the time. Having killed off all the other threads I was ranting in, I was looking for another distracter (because that's all I do all day), and I dived onto this question as if it were a floating mattress in a flood. I'm preparing to resume the struggle after an insanely and terrifyingly extended "coast." I've been so preparing for weeks and weeks. Preparing = avoiding, dodging doom by tiny increments the whole time. I am terrified. I am a disaster. I am a disaster, but ubiquity is right. It's not helpful to keep saying that. I am not a disaster. Right. I am not a disaster and you are not a disaster. You are not a disaster because you have just saved me. I am jumping off this wonderful mattress that I came across just in time. (Truly: thank you so much for asking this just now.) Farewell. I wish you all the luck in the world.
posted by Don Pepino at 11:05 AM on February 25, 2015 [4 favorites]

You don't mention diagnoses, but as has been mentioned in other askme threads lately, there are very successful treatments out there, some of them emerging. As an example, a friend who'd been partly treated all their life (meds, therapy) recently had a mental health crisis, got a new diagnosis, and has changed meds, upped therapy, and received ECT... and is doing much better for these changes.

See if someone close to you can help you get to the first few appointments. You'll thank yourself for being the hero who decided to work on the whole picture.
posted by ldthomps at 11:09 AM on February 25, 2015

Have you gone through something similar and come out on the other side?

I just wanted to say that this was me, a high-functioning mess, and eventually diagnosed with BPD. I am now on the other side, after 5-6 years of therapy (2x per week for years), my life is simple and happy, I'm engaged and expecting. I never thought this would be me.

Recovery is 100% possible. Find a good therapist with whom you have rapport. Keep looking until you find a therapist who you *know* can take you deeper; someone you trust, someone who is also insightful and can keep you from avoiding your deeper self. Make the commitment to yourself. Get meds if that is what will help you.

I just want to promise you that your life can change.

How am I supposed to find someone when I can barely bring myself to get out of bed much less go to a bunch of appointments?

Envision the person you know you can be - stable, confident, loving, reliable, successful. It's not the pantomime of a stable person, but the feeling of stability. Envision feeling stable, consistent, reliable and living with deep relationships.

That person is within your reach. That person is right there. That person IS possible.

Every single step you take on this path will get you closer to being that person. Every tiny little step: picking up the phone, going to appointments, being brave, finding energy... every. single. step. brings that person into reality. Not one single step is ever inconsequential.

Know that in your heart and you will be able to find the energy for every little step. Keep remembering your stronger self. Keep taking steps, and that person will manifest bit by bit, and your life will change for the better.
posted by serenity soonish at 11:12 AM on February 25, 2015 [3 favorites]

How am I supposed to find someone when I can barely bring myself to get out of bed much less go to a bunch of appointments?

The same way you found it in you to write this very articulate and important letter. There is a drive in you that can do this, you have done it today. You got out of bed and did something, something big. Call around and find a Dr. who will see you ASAP, keep calling, don't give up. Definitely both therapist and psychologist.

And while you're waiting for the appointments, in fact, today, why don't you go find an AA meeting? You absolutely do not have to be an alcoholic but you have to have a desire to stop drinking. If you don't have that desire or if you don't drink, it's still OK. Go and listen to other people's stories. It's an immediate support group of people who are working to improve themselves and discover a new way of handling their problems. There are meetings in every city every day and night of the week. The strength of AA is that it provides you with support, a family of people who have been through hell and back. BTW, people generally don't even talk about drinking but they talk about behaviors that lead them to drinking. You can talk about behaviors that have lead you to zone out, check out of life for a while in a bewildering place. You are not alone and this is something you can do right now.

Knowing you have the power to do something right now, along with a plan will do wonders for your peace of mind.
posted by waving at 11:18 AM on February 25, 2015 [1 favorite]

In the same vein as waving's answer above, you mention eating disorders. You could find a NEDA (Nat'l Eating Disorders Assn) support group in your area and go to a meeting - or just call their helpline. You don't have to know what to say. Just be as honest as you possibly can be.
posted by Sophie1 at 12:37 PM on February 25, 2015

I suspect you really, really need medication. It sounds like you have something going on chemically, and that needs to be addressed with drugs. Drugs can make a huge difference. Even if you've tried drugs before and weren't pleased with the results, you should try a new drug.

A lot of your problems sounded all too familiar to me. I take meds and they haven't solved everything, but they have made things a hell of a lot better than they would have been. I can still have a big despair crash, but now it's because my life is in the shitter that day and not because the bad chemicals in my brain are making me hate myself. Now when I mope, it's because I've earned that mope.

If you are truly willing to make changes to get out of this mess, it's time to try medication. Trying to get through a crisis like this without meds is like building a house without using any tools. Yes, maybe you can put something together that's house-shaped, and maybe you can even live in it for a while. But the building process will be so much harder than it needs to be, and that house is probably going to be a wobbly, fragile thing.
posted by Ursula Hitler at 4:29 PM on February 25, 2015 [1 favorite]

I've know some people who are similar to the way you describe yourself, and they all had one thing in common: (relatively) wealthy and successful parents who raised them to have very high standards for themselves concerning what it means to live well and who also bailed them out after each crisis.

I obviously don't know if this describes you, but I think gaining some independence from one's parents (both in terms of their values and their money) can be helpful for people who swing from crisis to crisis.
posted by girl flaneur at 4:30 PM on February 25, 2015

Seconding AA: it's free and they're nice to you and you don't have to join the cult or do anything but sit there doing no harm. You don't have to believe in anything or say anything or do anything. I used to chant along with the lord's prayer even though I believe nothing of it just because it's pretty. I'd hold hands and move my jaw up and down while they said, "keep coming back! It works if you work it!" because that's not pretty so I wouldn't waste the air it takes to say it, but it was nice to hold hands. You don't HAVE to do that, though. You can do only as much of the meeting stuff as you can stand to do and just go to listen to people's stories. Some of them are good, and it helps shut up the little hater in your head and pull you out of the doom spiral. Also seconding meds. I tried and they didn't work for me, but the trying is good in itself. Plus it might work!

I mostly came back because I wanted to get back up on this comfy mattress for some relief from fear and pain and I wanted to say thank you. I worked, for the first time in ages, and if you're an accomplished procrastinator, you know how bad that can feel and how much you want to stop, but I did it because of your great question. I also went for a walk, and I thought about my disaster self. On my walk I looked at some clover that had dew on it and was pretty, and I thought, Okay, this is why I got up today. I went on this walk, I saw this clover, and it's pretty and that's better than being dead. Fine, good enough. Then I thought, you know: true, I dicked around all day. But if I hadn't been dicking around all day I wouldn't have read the great question. And here I am on a walk listening to myself think and not feeling anywhere near as terrible. So I'm really glad, not just chicken-soup-for-the-soul-glad, dew-on-clover-glad that I got up today. I did not waste this day, however it may look to somebody who can't see what happens inside my head.

Honestly: can we just admit this? When you're a disaster, or just really think you are, some days you look all day and never do find the reason you got up: it really would have been better not to get up. But lots of days you find the reason you got up. Today I did, and you are why.

I also figured this out, same walk: some things that you do all day every day you do because they feel good. And some things that you do you do because they feel good when you stop doing them. Ease is as good as pleasure to somebody as exertion-averse as I am. That's sometimes why to work: because if you do it long enough, stopping doing it is ecstasy. If you jump off a mattress into a scary mess and spend a few hours there, when you clamber back up there onto your mattress, it feels incredible.

Sometimes you work because working feels good in itself. Not when you're feeling like a disaster, though. Everything is still horrible, of course, because everything that makes me want to call myself a disaster is still all in play: I didn't fix it in two hours. It's going to be like this all my life probably, because I'm always going to be me, always going to be having to haul myself up out of the messes I make for myself. So tomorrow and the next day I'm going to jump back into the scary mess and be miserable and scared deliberately on purpose why? Because I'm going to fix this? I'm going to become at long last a competent person and never let this happen again? Hellnaw, fuckalottathat. I'm going to do it because it is going to feel so good to stop doing it--stopping work is going to feel better than not working in the first place. I can understand that. I can't understand how to not self-sabotage. I've tried 40+ years and I'm giving up on that, fuck it, it isn't me. What I can understand is the flux model: let it get all fucked up, then fix it, repeat until death. I'm going to keep going on walks and looking for why I got up, and if I can't figure it out that day, whatever: I'll just go back to bed and look again the next day. Thank you again. Thank you a million times.
posted by Don Pepino at 4:54 PM on February 25, 2015 [3 favorites]

I sympathize, and I understand your feelings all too well.

All I can offer is a couple practical items that helped me. I wish I could offer more.

Make sure you have someone, anyone, to help with getting you there, dealing with paperwork or insurance, etc. Those things were huge roadblocks for me when trying to get help. It makes it so easy to give up. Reach out to a couple friends immediately. Don't worry about how, or worry about being judged. If that's an issue, please let it go.

Regarding therapist, doctors, etc. You may not meet the therapist that's going to be best for you right away, the one where you feel comfortable and things start to really click. Try not to get discouraged, it's just part of the process. It may seem impossible, but it's not. Ask people you trust for recommendations. If a therapist isn't working, find another.

I wish you the best of luck. Please take care and be patient with yourself.
posted by -t at 7:36 AM on February 26, 2015 [1 favorite]

Sleep. The various big and smaller problems you mentioned frequently make it hard to sleep, but if you can, do, and when you wake up, remember what your dreaming mind said. The dreaming brain is kinder than the waking one, and has more sensible things to say than "I'madisaster" on endless loop. Speaking as usual from recent personal experience: a dream about walking knee-deep in fresh green and blooming stuff, right next to some pavement. Conspicuously not on the right path my waking brain would've hectored me to get on, conspicuously more pleasant, directly related to insight gained on walk two days ago that was in turn directly related to your question, which question is still helping me and I hope it's helping you.
posted by Don Pepino at 9:54 AM on February 27, 2015

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