The Post-Appointment Dip

The Post-Appointment Dip

It’s Super Bowl Sunday! I don’t actually know anything about football, but I’m here for the chips and drinks.

Wednesday was my first DBT session. DBT, or Dialectical Behavior Therapy, is a year-long treatment specifically designed to treat Borderline Personality Disorder. It focuses on learning how to change behaviors, emotions, and thoughts that are causing distress. Specific goals include decreasing emptiness, interpersonal stress, loneliness, and mood-dependent behavior. I’ll also be working on increasing mindfulness skills, emotion regulation skills, and distress tolerance skills. Part of the DBT treatment agreement includes a commitment to living life. No, I’m not talking about work/life balance, I’m talking about continuing to breathe every day. I’m committing to seeking additional resources if I feel physically unsafe- which for me, is important.

While this session was mostly introductory, I did learn one new thing that I wish to share with you all. Part of biosocial theory says that some people are born more sensitive to emotional stimuli. People like myself are more cognizant of the subtle emotions of ourselves and others. What I learned, however, is that some people are more vulnerable to changes in their physical environment. I have moments when I feel like I’ve hit sensory overload. The lights are too bright, there’s too many people talking, I’m surrounded by too many people- there’s just too much happening and I can’t process it all. I’ve felt some shame in not being able to handle these types of situations, so knowing that it’s connected to my BPD is validating.

I expect DBT to be a place where I gather information and skills, and learn how to apply the respective skills in my everyday life. This, of course is different from the traditional talk-therapy that we all think of as a staple of mental health treatment. Every time I go in for an appointment, whether it’s with my normal therapist or the psychiatrist, I get pretty anxious. I’m not sure why, really. Maybe it’s because I realize I’m about to spill difficult details of my life and answer tough questions. Or maybe it’s because I can’t shake the underlying feeling of not being worthy of help.

Talk-therapy is interesting because it’s designed as a one-way conversation. When’s the last time you sat with a friend and only talked about yourself? My therapist will ask me questions, I’ll answer them to the best of my ability, and then sometimes she’ll just stare at me. It makes me wonder if I’m supposed to share more. Am I being resistant? I’m sharing as much as I can, yet there she is staring into my soul trying to pull more out of me. It’s all a part of the process, I suppose.

I have noticed a dip in my mental health following my individual appointments, and I’m curious if this happens to other people. I almost always have a panic attack in the day or so following an appointment, and my emotions are all over the place. It makes sense, though, that after spending an hour talking about difficult life situations that I’d feel a little raw. I had an appointment with my psychiatrist about a month ago where I basically word-vomited. He broached the topic of sexual assault, and I was talking about how when random people touch me throughout the day, it makes me feel like I need a shower. Even a simple squeeze of my shoulder or brush of my arm can leave me with flashbacks and the need to crawl out of my skin. If I don’t even have control over who can put their hands on me, then I don’t really have control over everything.

The point is, all these thoughts and feelings spilled out of me during an appointment with my psychiatrist. When I left the appointment, I couldn’t just turn off these feelings. However, now that I know that I am more vulnerable after appointments, I can make changes in my environment to help me get through these dips. I have an appointment on Tuesday, so here are some of the things I plan to do in the 24 hours before and after the appointment.

  1. Treat myself to a Starbs
  2. Take a bath
  3. Light candles
  4. Avoid after-work commitments

Talk-therapy, along with DBT, are going to be essential to my recovery and future well-being. If treating myself and creating a calmer environment for myself is going to help me along this process, then so be it.

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