Letting People In…

A trauma brain is a brain that is reactive and vigilant all of the time, affecting the way we regulate our emotions, heightening our sense of anxiety and making it hard to trust anyone. Scientific data shows that traumatic stress can reduce the functioning of the prefrontal cortex that is responsible to assist us to analyse and think logically, regulate and interpret emotions, control impulses and solve complex problems.

I’ve been unable to write anything the past 4 to 5 months because my mental health has been deteriorating. There has been so much going on at work, mostly interpersonal relationships with my colleagues, that has been very challenging because I find it very difficult to set boundaries and be assertive, thus, to avoid conflict, I bend over backwards to avoid it at all cost, making me a people pleaser. My therapy sessions the past months have all been about interpersonal struggles at work, feelings of utter helplessness in my inability to set boundaries and be assertive.

I started this blog entry with an ambition that I was going to write a long one this time around since my long hiatus, but, I don’t think I can manage it, so, I am going to cut to the chase. What I really want to say is that I now have insight that all my interpersonal struggles the past couple of months, validating as it is, was exacerbated by my trauma brain. Everything gets amplified, and thrown out of proportion. I know now because today is my farewell with my colleagues as I have made a very difficult decision of resigning from my work as a mental health nurse to focus on myself… to pause and focus on my recovery. It still feels like I have given up at this point, but I am certain that I’ve made the necessary decision because I am in a really, really bad place. My colleagues gave me a bouquet of flowers and a hand made card, which was painted in watercolour by my associate charge nurse! (the profile picture of this post is the handmade card) and lots of hugs and encouragement. One of my colleague reminded me this: “You are walking the talk as how we always tell our clients. You’re not giving up because you know, that you will never say this to your client. I am so glad you have made this decision to focus on yourself to heal.”

What I’ve realised from this is, “I need to let people in… I need to learn to trust again… it’s time to stop keeping people at bay.”

5 fun things to do

I came across a new app developed in locally in New Zealand called Groov. It’s an extension from their parent app, Mentemia. It’s been helpful to keep me grounded. I’m going to see if I can try these activities that they recommended.

sharing.mentemia.com/shared/linkid-5-fun-things-to-do-by-yourself

How Work is Like Currently

The last post I wrote about how I am coping with work was on January 17, 2021. I know that it has not been too long ago for an update about how I am coping at work, so, I thought I share some thoughts on what’s going on.

The past 2 to 3 months, work has been exhausting. I find myself dragging myself out of bed when the alarm goes off and forcing my brain to stop the anxiety thought loop that would start the moment I open my eyes. The level of stress I feel on each work day is all consuming and difficult to describe in words. Recovery is long and difficult and the days when I feel that things might finally start to look up, these days never seem to last long enough for me to sustain some respite from the constant struggle day-in-day-out. At work, it seems that my eyes and mind are focused on the task at hand but my soul was somewhere far away, like a distant observer watching me carry out work tasks, one after the other.

Since the start of last week, I have taken some time off work. I have 4 more days remaining for some respite before I need to go back to work at the start of next week. I am not looking forward to it as I know what it entails. But, life goes on, and I need to continue pushing forwards, even when I feel I’m dragging myself through mud. My relationship with my colleagues have been difficult because I still don’t have the language I need to create boundaries and to be assertive. My opinions and ideas doesn’t get heard or it just gets disregarded during meetings. Decisions have been made on my behalf while I am away from work, assuming that whatever this decision might be, would be ok with me. I don’t have a voice yet. Maybe, one day, this would change. I need to start learning to find the words to create boundaries and to be assertive.

Exhausted

Everything I am doing is towards mt recovery. Every decision I make on a daily basis is rooted on ‘doing the work’. The constant juggling of emotions, thoughts, exercise, work, studies and self care is exhausting. My therapist reminded me that I have come a long way from where I was at 13 months ago. My rational brain knows that what he said holds true in my recovery journey, but, I haven’t reached a point where I feel totally comfortable in acknowledging that just yet.

Going back to Therapy

I have just re-engaged with therapy last week on Friday after taking a break from it to focus on psychological work with a clinical psychology for the past 11 weeks. I am still on a temporary schedule for the next three sessions while waiting for a more permanent slot when it comes up.

When I requested for a session with the therapist, I wasn’t in a good space. I could feel the depression descending and as it always does, it filled me with dread and hopelessness, that this is what the rest of my life is going to be like. I went to bed restless, with my mind, having a field trip of tormenting me. I did eventually fall asleep, albeit a restless one. Somehow, I managed through the next four days at work, with only moments of despair and dread. Only during therapy did I realise that I have fallen back into the habit of coping through numbing and busyness. I wouldn’t have realised this if I did not have a therapy session. Therapy was a good reminder that I need to be mindful to move towards switching to helpful coping styles when I am falling back to old habits of numbing, ambivalence and busyness.

On a good note though, I am starting to enjoy work much more. Anticipatory anxiety every night before bed time is still in the fore, making sleep quite restless. There is a lot of psychological preparation that I need to make to calm myself down and not go into a panic every time I need to facilitate a group. I am not sure when this is going to be less prominent, but, I am hopeful that with time, and lots of practice with grounding skills, it will get easier.

Roller Coaster Ride

Last Thursday, I felt the best I have felt in a very long time. Why did I feel good about myself last Thursday? The reason is simple enough: I had enough mental reserve to provide a distressed client the mental and emotional support that she needed at the time. I can’t say more about the encounter due to confidentiality, but, what I can say is that it felt good to be able to support someone else and direct my focus away from my own mental health struggles to give another some reprieve from theirs. This warm, fuzzy feeling lasted for the rest of Thursday evening. It was short lived though…Come Friday, my mental health started to take a dive and at this very moment of writing this, I can feel myself plunging into the depths of darkness, the darkness that pulls you in, deeper and deeper, until there is nothing left to feel, apart from the emptiness and vast open void that you feel inside.

I am getting hooked with so many thoughts and feelings and I know what I need to do to diffuse and unhook myself from these unhelpful thoughts and feelings. Believe me, all I have been doing since Friday morning was that every chance I get an ounce of strength… to ground, re-centre and bring myself back to my present self… damn it! I even have a worksheet that my psychologist have given me to jot down how it went each time I used diffusing and unhooking strategies… it isn’t working. I think the reason why I am writing this post is because I need to try and quiet my thoughts, quiet my feelings … suppressing and numbing is not really working for me anymore. Supressing and numbing was all I used all these years to cope, and it isn’t working anymore. What do I do? What do I do?!

Here We Go Again… An Endless Cycle

For the past month, I have slowly found my mental health deteriorating. I could feel that slow, dread and despair, just lurking around the corner. From my work as a mental health nurse, I know the theory and concepts behind ‘unhooking‘, a term used in ACT (Acceptance Commitment Therapy), where you ‘unhook’ from difficult thoughts and feelings by acknowledging that they are there, but instead of focusing on them, you let them buzz in the background. The idea is to focus on the present moment, and not be dominated by these difficult thoughts and feelings, in order to live the life we want. It does work, when it works. As with many other coping strategies, unhooking is another skill that requires us to repeatedly practice and use and make it so automatic, that our brain automatically uses it as a positive coping mechanism when our thoughts and feelings becomes unhelpful. It’s great when it works, but for me, at this point, it’s a hit and miss at most times. So, what I am trying to say is that I am not quite there yet!

The irony of it all is that I teach my clients these skills. From various grounding strategies, such as physical grounding, object grounding, safe space visualisation and unhooking, to name a few. I understand the concepts behind them and the reasons why they work for some and not others, but, I find it difficult to use and practice them for myself.

My psychologist has given me a task to practice ‘unhooking’ on a daily basis. I have been trying, but, it hasn’t really worked out the way I thought it would. I am quite frustrated with myself. Maybe it’s the stress of work and the stress of an assignment that I am currently racking my brains to try and complete…Maybe my concentration is so bad that I can’t focus on any of the tasks I have in hand at the moment… Maybe it’s just the simple fact that I am slipping into a depressive episode again. The thing is, I have not even surfaced to the light from the episode 8 months ago. It’s just an endless cycle of ‘I’m ok’ and ‘I’m not ok’ and this is just so f***king exhausting!

Focusing on the Present Moment

Firstly, I just want to say that this is going to be a short post. I have not have time to really sit and write; to just ponder and write. Juggling part time study and full time work is much more of a challenge now then a year ago when I was in a better headspace.

Today is my last day of the Easter weekend holiday. I am glad that I have some time off work, but the anticipatory anxiety of going back to work tomorrow, has started bubbling up since Sunday morning. I do like my days off, but at the same time, it is like a double-edged sword because I feel at edge, almost untethered, knowing that I have to function and face work until the weekend arrives again.

Saturday morning was supposed to be a relaxing and calm day, because I finally convinced myself that going for a short hike nearby would do me good. Unfortunately, I was not able to enjoy the hike at all, my mind would not quiet down. I tried grounding myself to the sounds of the birds and the feel of the breeze on my face, but it did not work. What was supposed to be a calming and mindful outing, turned out to be a stressful one.

Since then, I keep berating myself for not being able to just enjoy the present moment. Little things would bring my thoughts back to my past and my mind would start to feed into the self-loathing and feeling unloved.

Focusing on the present moment sounds simple enough. But, really, it does take a lot of effort to make it work. Sometimes, it doesn’t not work at all. I guess I just have to keep practicing.

Note: the photo was taken during the hike at Taeri Mouth.

Spiralling

I took time off work today and yesterday. Firstly, it was mostly because I am physically and mentally exhausted. Work has been extremely stressful the past 3 weeks, due to shortage of staff. Shortage of staff is a norm more than an exception in my department, due to a multitude of reasons that I won’t talk about here. Essentially, I have been the only nurse at the moment, juggling between clinical work, supervision of student nurses and a new graduate nurse, facilitating groups and administrative tasks. I have fallen back into my coping strategy of just pushing through and numbing myself, and it is starting to unravel me.

Since Monday this week, I can feel myself slipping back into a depressive state. My mood has been low and I feel flat. Concentration is bad and all I can do is distract myself with watching Netflix and vaping. This is not a good sign.

I have a follow up consult with my psychiatrist tomorrow and I am considering to discuss the possibility of her signing me off for a 3 day work week for the next 3-4 weeks. I think I need to slow things down. But, I am not sure if this is going to help.