Tag Archives: mental health

it’s time to be honest

I’ve been struggling with my eating disorder. I’m ashamed to say that but it’s time to be honest. Not to be taken care of, not to be attention seeking but because lying and hiding does me no good. Also, it’s past time to get on track and in my case transparency has been the best motivator for that.

I’ve been in recovery from my eating disorder for almost three full years. I’ve been extremely proud of that. Extremely. In fact, out of everything I’ve done in my life I can say that this was the one thing I have been proudest of because it is the thing I have had to work the hardest for. And now? Well I can see it slowly slipping through my fingers. It’s a scary feeling for me and I know it’s a scary feeling for those around me.

What happened? I don’t exactly know. I suppose it’s been a combination of factors. Med adjustments, depression which caused loss of appetite, stressors, a lingering dissatisfaction with my body which never really went away, change and the biggest one of all – a significant trauma anniversary (which at one point I plan to write about). All of that collided and I let down my guard and the disorder slipped in.

I owe some apologies. At this point in my recovery I can’t slide back into my disorder without some awareness of my actions. There was some familiarity in the behaviors and feelings. They brought relief I was seeking but even that is no excuse. I owe apologies to my friends who fight everyday for stepping away from the battle and for leaving you to fight alone. It invalidates your struggle and for that I am sorry. And it goes without saying that I owe many apologies to those who love me.

So where do  I go from here? Well, I try. I try to get back on track. I pray that I haven’t gone too far down the rabbit hole and that I can still yet pull myself out. I try with every fiber of my being even with my brain screams that this is wrong. I fight the biology of the disorder with everything I have and everything I have learned. And believe that I can regain the reground I have lost and come the end of February I can celebrate my third year in recovery.

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Filed under body image, coping skills, depression, eating disorder, eating disorders, friends, life events, Recovery, survivor, trauma

my experience with mental health coverage

If you’re living in the United States you had to have been living under a rock not to have heard at least a little of the health care debate over these past few weeks and the ensuing shut down of the government. I’ve stayed out of the facebook comments, the name-calling, the blaming etc. I really dislike those posts. I hate the hate that they breed. I don’t understand it. But what I do understand is how insurance has effected my life. And this is what I want to share with you.

Currently I am on my parent’s insurance, which I will remain on until 26 years of age. This extended age period is due to Obama-Care and is one of the few points both political parties agree on. Without this extended age I would be off my parents insurance which would be terrifying and leave me with little to no coverage (at least before the Insurance marketplace opened up this month). Even with my parents insurance I have experienced first hand the problems with our health system.

Mental health is misunderstood. I think that is clear to anyone who has been in the mental health system.  In 2008, The Health Parity and  Addiction Equality Act added onto the Mental Health Parity Act of 1996. The 2008 act:

 mandates that insurers define and make available specific criteria for medical necessity when it comes to mental health and substance abuse disorder benefits. In addition, MHPAEA also requires that insurers provide specific information and reasons in the event that reimbursement or payment for treatment is denied.

Okay, so this gave some required coverage to mental health. For me it came none too soon. I was hospitalized in September 2009. Less than a year from when this act was passed. Without it I never would have been able to have received treatment including outpatient therapy visits. However, even with this coverage what I needed was still not given to me. The insurance is still in control and even when my doctors advocated for me till they were blue in the face my insurance always cut out before I was ready or stable. Yes, they provided their specific reasons they denied but quite honestly they were bullshit. How can an insurance company claim to know more than my doctors? How can they who have never met me rule that I was in no danger of suicide, self-harm or relapse? How can an insurance claim to know my ideal weight or know what vitals are stable for me? And how can they know what exactly how my PTSD effects on a daily basis? They can’t. Yet every time I have been in some sort of treatment the insurance company does claim to know these things. And according to the law that’s quite alright as long as they provide proper documentation of why they are denying me further coverage.

In addition, my insurance doesn’t over me complete benefits. I have inpatient benefits meaning I can be hospitalized till I am medically stable but have no residential benefits. Residential is a level of care that provides a transition from inpatient to daily life. It is imperative in eating disorder treatment. It allows time for more therapy instead of just nutrition and weight gain. Residential allows the real “meat of therapy” to begin which can’t until nutrition is stabilized. By just leaving me hospitalized until I have gained some arbitrary number of pounds does nothing to aid in my recovery.

I am so blessed that my parents were able to pay out of pocket for residential treatment at CFC. But it came at a high cost to my family. Without this extra time I would not be able to be in recovery today. However, the insurance did not see it that way. They gave me two weeks. The center said I needed five and a half months. And over those five and half months I was placed on suicide watch multiple times. What would have happened to me if insurance had had to control my care? I truly do not know.

It doesn’t stop there. But to go further would get more into the politics than I want to and I’ve probably already delved far enough into that. Simply put – my experience with insurance has been one that teaches me that they care little for my health and more for their own profit. They skirt the laws and do the bare minimum. I’ve managed to survive in the system because I have a family that can help me with and that has some resources.   And honestly, I have one of the good policies. My mother has become a pro at navigating the insurance system and I’m lucky my first treatment center  did everything in their power to get me covered for as long as possible.

I don’t know what the answer to the problem of insurance is but to say there is no problem is not correct and is closing your eyes to the experiences of others. Without adequate (actually more than average, I need good mental health coverage) I will have no quality of life. I survive now because of a somewhat decent policies that I can benefit from until I’m 26 but after that? I face a future that before October 1st of this year was very scary. Now it seems somewhat less so.

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Filed under depression, Independence, PTSD, Recovery, social change, society

i am kate. i go to therapy. i am not ashamed.

I’ve gotten some questions/suggestions lately that perhaps I should pursue therapy. I’m not offended in the slightest. I think most of the comments came from a fairly good place and therapy ceased to embarrass me a long time ago. Because the truth is that I do see a therapist. Twice a week right now but this is actually the least amount of treatment I’ve had in four years.

In January 2009, after ending an abusive relationship I began seeing a therapist (a really crappy one but that’s another story). I was humiliated and embarrassed that my anxiety had become such that I couldn’t function in everyday life and that I had to seek professional help. The whole idea that I was seeing a “shrink” embarrassed me beyond belief to the point I went at great lengths to hide the fact from my college classmates that I was driving an hour once a week to seek help. I truly believed that it was “just anxiety” that was causing my obvious decline in my mental health but instead of getting better from treatment I felt downhill. Fast.

In September of 2009 I entered treatment for anorexia at Laureate’s eating disorder program. I stayed for ten months going through inpatient, residential, transitional living and back to inpatient for another short stint. I left OK (where Laureate is located). This was in July 2010. By September 2010 I was hospitalized again this time at The Center for Change in Orem Utah. This treatment stay was focused on my eating disorder and my PTSD. I left in February 2011 (after five and a half months) in a much better place, stable mentally for the first time in many years and armed with coping skills.

The next two years were rough. I was in and out of the psychiatric hospital. For a stretch of time I was in every month. In December of 2011 I went to Washington DC to The Psychiatric Institute of Washington’s Center for Post-Traumatic Stress Disorder. I learned a lot here but it also opened a lot of wounds and closed memories and so my cycle in and out of the hospital continued until July of 2012. This is when my service  dog Ben entered my life.

Since Ben arrived I have been stable. I have not had to be hospitalized for my eating disorder, self-harm, depression, anxiety or PTSD. I receive the least treatment I have in four years, simply seeing my wonderful therapist twice a week.

I tell you all of this because like I mentioned at one time I was so filled with shame that I was in therapy. I saw it as a weakness, an embarrassment, a sign of failure and something that made me somehow “less than” everyone else in my life. I went so far as to tell professors when leaving college to go to treatment that it was due to heart problems (not a lie at that point my heart was severely compromised due to my eating disorder) instead of due to my anorexia (however they probably guessed anyways).

Therapy is so stigmatized. Especially by young people. I believe that this is due to a number of factors but a primarily one being the lack of information regarding mental health. This not only harms those who struggle with diagnosed mental illnesses but also those who need help but refuse to seek it out of shame. The media does not help. Crimes (such as the recent Naval Yard shooting) are blamed on mental illness. Yes, this may be the cause however the media fails to mention that the majority of people who suffer from mental illness are in no ways violent or dangerous. How can someone feel unashamed of their mental struggles when they unintentionally compare themselves to a deranged man who killed many people?

The reality is that seeking help is a sign of strength. I never would have believed this four years ago but working through treatment and recovery has been the hardest thing I’ve ever done. Much harder than making straight A’s in high-school, much harder than transitioning to college and much much harder than staying stuck in my illnesses.

So yes, I see a therapist and no I am not ashamed. Not anymore and I can say this:

I am Kate. I have PTSD, depression, anxiety and an eating disorder. I see a therapist. I have been hospitalized for my mental illness. I have a psychiatric service dog who without I would not be able to function. But I am no less a person because of these things.

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2009 – 2013 – happier and healthier thanks to therapy and treatment

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Filed under coping skills, culture, depression, eating disorder, eating disorders, Hope, Identity, Life Story, New Life, psychiatric service dog, PTSD, Recovery, service dog, society, survivor, trauma

invisible disabilities

This last week was Invisible Disability Awareness Week as well as Suicide Awareness Week. Perhaps it’s a coincidence that they fall on the same week but it is fitting that they do so. Suicidal ideation like all mental health conditions is an invisible illness that seeps into the conciseness and can be as deliberating as many other “visible” illnesses.

I remember the soul crushing weariness and hopelessness I felt for many years before receiving treatment of any kind and not having any kind of validation for this feeling caused even more hopelessness. At this point in my life I had no voice with which to speak. I did not know how to share my pain or advocate for myself. As I spiraled further down into anorexia and my weight loss began to mimic the sickness inside me there was some relief. Now someone knew I was not ok. Now it showed. However, as my weight climbed into the normal range again I was left once again with all of the challenges that come with an invisible illness. (important thing to note: you cannot tell if a person has an eating disorder based on their shape or weight. In fact, an eating disorder can be one of the most deadly forms of an invisible illness and I was in fact very sick at an acceptable weight).

And these challenges that come with an invisible illness are many. As I began to inch my way towards recovery my activities were limited. I did not attend school nor did I work. However, I often got the question ‘where do you go to school?’ and when I said I wasn’t in school it was followed by ‘okay so where do you work?’. I was often considered to be lazy because I didn’t do something productive. I didn’t look sick or ill therefore in society’s eyes I wasn’t.  This extended to friendships. Some friends didn’t understand that I didn’t turn down invitations because I didn’t like them but because mentally I had limited resources and reserves for what I could and couldn’t do. I lost some of these friends who didn’t try to learn. And then there were my long absences from life which was the time I spent in the hospital. This was also hard to explain to those who would see me one day looking fine and the next I would be hospitalized for up to a week at a time. As hard as many people tried to understand many couldn’t and some wouldn’t try.

Now I face new challenges – having a service dog while while not looking disabled. Benny sometimes wears a patch that says not all disabilities are visible as a reminder that just because I don’t look disabled doesn’t mean I am not. Most people assume I am training Benny and Shona for someone else and when asked and I say that yes, they are service dogs and yes they are mine. I get probing questions that quite frankly sometimes I struggle to answer politely.

Mental illnesses are not the only invisible illnesses. There are many others. Wonder into a service dog group and you’ll find at least ten other handlers that have a service dog for an invisible disability and each has a different illness.

And from these handlers I have learned that it is impossible to know someone’s story just as it is impossible to know my story. I hope you’ll join me in dropping judgement about mental health, the use of accommodations and other disabilities.

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Filed under Ben, depression, eating disorder, eating disorders, friends, psychiatric service dog, service dog, Shona

i’m stable…

I had a psychiatrist appointment this past Wednesday. Since seeing this psychiatrist shortly after retuning from CFC I have seen him consistently every other week. My meds were being adjusted yes, but it was more of a “just in case Kate needs to be hospitalized” kind of thing. For the first time at the end of the appointment he announced that he didn’t think he needed to see me for a whole month.

This doesn’t seem like much I suppose to the outsider looking in but it’s huge to me. I couldn’t quite put it into words until someone in our CFC alumni group said “doesn’t it feel great to be STABLE”. And that’s what I am. I’m stable.

Whoa, I’m stable.

I’ve been medically and eating disordered stable for awhile now. In fact, since returning from CFC. But psychologically? Not so much. In the year I spent waiting for Ben I was hospitalized for sucidial ideation, self-harm thoughts/behaviors or other psychiatric problems probably around eleven times. That’s a lot of time spent in hospitals and psych. wards.

Since receiving Ben I’ve been pretty stable psychologically. I struggle with the effects of my trauma and my therapist would probably say that I’m not quite stable in that area in the terms of dissociation and related behaviors  But self-destructive behaviors and thoughts? By and large those are gone or well managed. In fact, it has confused me lately because I have been having trouble sleeping due to some trauma stuff and I haven’t felt like doing anything (meaning hurting myself). I shuffle around my apartment crafting, messing around on the internet, watching netflix, lying in bed, talking to Benny or just generally doing stuff to pass the time but self-destructing I am not. I’ve never done this. I’ve never felt the fear, experienced the trauma without everything going to hell in a handbasket.

It feels really, really, really weird to say the least. Foreign. Wrong but yet very right at the same time. Is this what living is like? Is this what moving on feels like? Is this what I have to look forward to?

I know I face struggles ahead. I know I probably still face some times when I won’t be as stable and may have a few short stays in the lovely PV resort as AL fondly (or not so much) call it but right now I am stable and I’m getting a taste of how life can be managed without self-destructing, wasting way or wondering around in a fog. And it feels pretty good.

 

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Filed under Ben, coping skills, depression, eating disorder, eating disorders, Hope, Independence, life events, New Life, PTSD, Recovery, survivor, trauma

i don’t understand

I’m struck tonight by how much sadness and suffering there is in the world. For once I’ve been able to look outside myself and peek into the lives of friends and observe the world from the perceptive of a bystander (as much as anyone can be). My heart breaks for several friends who have experienced loss in their lives this week or have come to a place that I believe is the scariest position a person can ever be in.

Images flashed through my mind and flooded my dreams last night. So much sorrow. So much hurt. And all of it undeserved. It occurs to me that I have learned how to love. I have opened my heart to hurting people. I do not regret it. I do not regret the friendships I have made and continue to nurture but part of the cost of friendship is feeling the other’s pain.

And today it strikes me that there is so much of it. So much pain. I wonder why this has to be? Why is our world so full of things that can and do cause suffering? Why are there people who inflict so much harm on others? How can people reach such deep depths of depression? Why do memories continue to resurface when all an individual wants to do is forget?

I don’t understand.

 

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Filed under depression, eating disorder, eating disorders, friends, PTSD, Recovery, survivor, trauma

i’m in a rut

I hate to admit it but I’m feeling stuck. Stuck in one place. Not moving forward. Not moving anywhere.

I don’t honestly know if I’m moving backwards. Beth and I have differing opinions on this. I can’t seem to explain myself completely to her but I can when I talk to P. or L. I feel like right now my friends have a better picture of where I’m at than my therapist. She thinks that I am beginning a slow backslide and I think I am trying different things that at this point in my recovery I am equipped to handle.

But I do agree with her I’m stuck. It’s been hard waiting for an apartment to open up. I’ve gotten into the habit of staying in the house all day alternating between staying on the computer, talking on the phone, reading or sleeping. Actually scratch the reading. I need to do more of that.

Needless to say, this doesn’t help my body image. It seems like a large effort to take steps to get out of the house. I feel heavy and awkward. Both physically (i.e. body image) and emotionally. I can’t seem to move my body effectively through space. I seem to have to drag it around. Exercise is a challenge. Odd because it is something that while I have not been compulsive about for several years I still find important because of yes, my fear of gaining weight. I want to exercise but again it takes effort that I can’t seem to find. I suppose this is depression manifesting itself in ways that it hasn’t before. I don’t like it. I don’t like the feeling of being unproductive but unable to find anything that resembles the energy to do something. It’s a catch 22. My brain can’t summon the energy to do something and instead tells me to sleep but the other part of my brain screams that I’m lazy and need to move so I won’t get fat. It seems right now like I can’t win. 

I’m not using symptoms of any kind. An accomplishment for me since I have never just ‘sat’ with depression before. I’ve always made dramatic shifts in my actions and begun a huge slide into a danger zone ultimately landing me in some kind of long or short term treatment. Ben is defiantly a huge factor in this and while I should be proud of myself I find myself beating myself up for it instead. My head tells me “I’m letting myself go”, “I’m not being pro-active enough to make myself feel better (just so you know this means through very destructive ways)”, “I can’t just sit with emotions. I don’t EVER EVER do that”.

And so I sit here on the couch (my position for most of the day) sunk into some kind of rut. I’m stuck in a rut as they say. And I need to find some momentum to move out of it. I think I will. This is temporary I know that. But for now I guess I will try to make my rut as positive as possible and as non-destructive as I can.

 

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Filed under Ben, body image, coping skills, depression, eating disorder, eating disorders, Recovery

the missing puzzle piece (a service dog post)

Darcie, Ben and I

Team training is done. Ben and I are now officially a service dog team. We passed our Public Access Test and the Heeling Allies Team Training Test Review. One of the things that was so special about this past week was not only did I spend time with Ben but I spent time with one of his trainers and the director of Heeling Allies, Darcie. Heeling Allies is one of the only programs that travels with the service dog to their new handlers homes. Darcie met my family and extended family, saw my hometown, met my therapist, saw my parent’s home and my apartment and met Shona and Mandalay.

I had many conversations with Darcie ranging from dogs to all other subjects including the challenges in my life. I came to a new understanding and one that will probably continuously change about what impact Ben will have in my life. I knew Ben would not enter my life as a perfect dog. There is no such thing just as there is no such thing as a perfect person but I also had no idea of the skills he would have nor did I have any idea of the complexities that are that of a service-dog/handler relationship.

Ben and I are a team. I knew this from the beginning –  “Oh yes we will be a team. Yes, yes I know’ –  but honestly I had no idea what this could even begin to look like. I see a peek now. Ben is my comforter and in turn I am his. He helps me relieve my stress and I help relieve his stress. We nurture each other emotionally.  Each day I will rely on him to go to work and he will rely on me to give everyday a fighting chance. No easy way outs. No short cuts.

Perhaps this is what I had not fully grasped although I think I thought I had. Ben is more than just a commitment or a signature on a safety contract. He is mine. He relys on me. He needs me and I need him. I haven’t felt needed in many years. I have stayed alive (at times reluctantly) but failed to see how I was needed. And you know what I was completely fine with not being needed. Not being needed meant that I was exspendable and I found comfort in that thought as horrible as that may be. But now? I’m not expendenable. I  have a bond with this dog that I have never felt for anyone or anything else. I don’t know where that bond came from. From that moment in the airport when I saw Ben trotting beside Darcie’s side I felt like a piece of me was suddenly being fitted back together. And for me this is really big. I picture myself as one big puzzle that has strewn pieces about everywhere by my own carelessness, by other’s cruelty or some other cosmic reason. I knew (although I did not have the words) that Ben is one of those puzzle pieces. One that I have needed but never had nor even knew I needed.

And that puzzle piece? Well, he’s sleeping here beside me as I write this. Today we ventured out into the world without the knowledge that Darcie would be waiting for us later in the evening. I felt like I was learning how to walk again except it didn’t feel like something I had never done before but something that I had been waiting for. It’s hard make no mistake. Handling a service dog is no easy task and I am sure we will make many mistakes but I am letting Ben be my teacher. And I am trying to trust.

I haven’t trusted anyone completely 100% for many, many years but Ben is asking for that trust. He is asking me to rely on his training and trust that even through our mistakes he will continue to be at my side. How can I believe that? How can I take that leap to look at another being and say I know you aren’t going to leave me. You aren’t going to purposely hurt me. You love me with no conditions. I don’t know exactly how or when I will get fully there but I am determined to try and trust this dog completely.

You see my life depends on it. In order to keep living I must learn to trust those closet to me. Trust them to carry some of my emotions, fears, dreams and struggles. And it starts with this big, black sweetheart of a dog.

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Filed under Ben, coping skills, dogs, faith, family, Hope, Identity, life events, New Life, PTSD, Recovery, trauma