On NPR there’s a weekend show called “It’s Been a Minute,” and that’s how I’m feeling now as I write this first post in several months. Gosh has it ever been a minute. But I feel this need to apologize, like I’ve ghosted a friend (I swear I was doing something but I can’t remember what, but it was surely more important than talking to you, right? But SORRY!)
But it’s HARD to get started blogging again. Hard to get out there, when it’s easy to let the old status quo become the permanent status quo. It’s hard to get started with anything you once enjoyed and have let lapse, I think. And the guilt. I’ve learned a LOT about guilt in the past several months.
In fact, I’ve spent time learning about all kinds of emotions, and the role they play in both inner and outer life. After really struggling on and off through the fall, and feeling like I was making so little progress, and frankly feeling a little desperate, my therapist (PSA: I love therapy and you should go) said, maybe you should do an IOP. I think it would help you really get a jump-start in your life, and I think you need that. So then I said, “What is IOP?” And that’s when this began.
IOP: Intensive Outpatient Program for Mental Health
Turns out that on the spectrum between hospitalization & weekly therapy, there are a couple other options for those struggling with mental illness in a really active way.
PHP is Partial Hospitalization. This means that you go to the program every day, all day. Bring a lunch, the works. You spend time essentially like you would in a hospital, but you get to sleep in your bed at night.
IOP is Intensive Outpatient. This means that you go to the program every day for half a day. Same story, also get to sleep in your bed at night. :)
They’re offered, at least in my area, through larger psychiatry and behavioral health practices. They can be a month, 6 weeks, 8 weeks, and consist of psychiatric evaluation, individual & group therapy, CBT and DBT classes, meditation, music, art. Some programs do yoga.
My IOP Experience
Obviously I can’t speak for the experience of everyone, but I can say unequivocally that the month I spent in IOP was life-changing.
I had an initial assessment by a therapist, who was one of the group leaders. I filled out a bunch of papers, which included:
Things I like to do that help me relax or recharge or feel better
A specific safety plan, including people I can call if I’m feeling really desperate
Who I wanted at my family therapy session
My goals for IOP
The first 2 were really important, it turns out, because facing the darkness and talking about the pain is really, really painful. I had to enact the safety plan once, and admit to feeling suicidal, and referred to my “happy list” often. It was exhausting. I came home every day and fell asleep, many times with the salt of dried tears still on my cheeks.
The goal is to talk, and learn, and evaluate, and celebrate, and examine, and let go. To assess and be assessed (by professionals), and most of all, be supported by both professionals and fellow-travelers in a journey you’re on that’s lifelong, but that thankfully, blessedly, you don’t have to do alone.
I had an assessment by a psychiatrist, who changed my diagnosis and prescribed new meds, and who followed up every week for the 4 that I was there. That, coupled with the power that comes from actually going to a place every day, facing the darkness and the fear and the guilt, and learning skills for replacing those with positivity, for coping through the worst with hope, changed me forever.
The New(ly Diagnosed) Me
I’ve been seeing a psychiatrist for a really long time, and the same one for years, being treated for major uni-polar depression (“major drug-resistant depression”). With occasional tweaking, I’ve been on the same combination of meds for years. Part of what I was looking forward to with IOP was the psychiatric assessment (yep, I just said I was looking forward to a psych eval! ha!).
After the evaluation and a couple of computerized tests, he changed my diagnosis:
Bipolar type 2 and ADHD
I made those words big and bold, because I need for it to be known that mental illness is not a weakness. It’s ok to be out-loud about your anxiety, unipolar or bipolar depression, or your schizophrenia, or your PTSD, or your addiction. It’s courageous to be a survivor. It’s awesome to be conquering day by day.
The Dr. said the first thing I needed to do was come off of Effexor (venlafaxine). And start (re-start) taking a stimulant for ADHD, getting my blood pressure under control, and stop drinking Diet Mt. Dew like it came from the fountain of youth and I was dying in the desert. (He maybe just said, “you can’t drink caffeine while you’re taking Vyvanse.” But the message was there).
So I switched to Mio Energy drops on my way to caffeine-free. They are awesome (yep, I said are and not were and I don’t feel bad about it). And I was coming to IOP every day during the transition of meds, which made things infinitely easier. People who said, you showed up here yesterday to work on yourself, and you showed up here again today, and that is enough. You are enough, and even with setbacks you’ll always be enough.
The Good Stuff!
The clarity that has come from that combination - the extra resilience I feel, the skills I have, the mental clarity from the new meds (& off the old meds), and the month-or-so it has taken to basically re-integrate and I’m in a better place than I have been for as long as I can remember.
As a celebration, I “got my hair did” at a new stylist, who just by luck had specialized training in cutting curly hair and I posted my new hair on Insta:
End The Stigma Against Mental Illness
I am perfectly willing - eager, even - to put a face to mental illness. To put my face on it, if it helps end the stigma that the mentally ill are less worthy of love (or of hiring, or renting apartments to), or are walking time-bombs, or are somehow struggling in a way that is less than because it is less visible. I’ll be an advocate for the lonely and vulnerable, who maybe remain silent because they don’t know there’s another way.
If you and/or someone you love are out there today fighting the good fight, may God bless and shower you with Heaven’s love. May you know the kind of love and support that I’ve been given these past few months. May you feel how courageous you are, even if courage for day meant showing up to read this little post. It can get better. It WILL get better. You’re so much stronger than you know, even in your darkness.
In one of my IOP sessions we were asked to bring two songs - one that represented us today, and one that represented what we want in the future. This was my “today” song, and it has great significance for me. I hope it resonates, because I believe there ARE angels around us to walk us through this world.
I want to talk about the specifics in later posts. I really wish that everyone could learn specific skills taught in DBT (Dialectical Behavior Therapy), such as the function of emotions, emotion regulation, values-based goal setting, meditation, acknowledging both little successes and little failures, and always getting back up to try again. Look for those in the future. :)