National PTSD (Post Traumatic Stress Disorder) Awareness Day

It’s National PTSD (Post Traumatic Stress Disorder) Awareness Day! Please don’t tell someone just to get over it that it’s in the past or they can’t allow it to define them! Do you honestly think they haven’t tried that? So what does that mean, what are the symptoms…

—> Intrusive memories

~ Recurrent, unwanted distressing memories of the traumatic event
~ Reliving the traumatic event as if it were happening again (flashbacks)
~ Upsetting dreams or nightmares about the traumatic event
~ Severe emotional distress or physical reactions to something that reminds you of the traumatic event

—> Avoidance

~ Trying to avoid thinking or talking about the traumatic event
~ Avoiding places, activities or people that remind you of the traumatic event

—> Negative changes in thinking and mood

~ Negative thoughts about yourself, other people or the world
~ Hopelessness about the future
~ Memory problems, including not remembering important aspects of the traumatic event
~ Difficulty maintaining close relationships
~ Feeling detached from family and friends
~ Lack of interest in activities you once enjoyed
~ Difficulty experiencing positive emotions
~ Feeling emotionally numb

—> Changes in physical and emotional reactions

~ Being easily startled or frightened
~ Always being on guard for danger
~ Self-destructive behavior, such as drinking too much or driving too fast
~ Trouble sleeping
~ Trouble concentrating
~ Irritability, angry outbursts or aggressive behavior
~ Overwhelming guilt or shame

Exercise as a Coping Strategy

Exercise is, of course, a natural antidepressant. It leads to the release of endorphins, those chemicals in the brain that help us relax and feel happy. Exercise also simply helps people feel good about themselves because they know they’re acting effectively and doing something that’s good for them. Some studies suggest that exercise is as effective as antidepressant medications at reducing symptoms of depression among adults diagnosed with major depression. Both the biological effects and the psychological effects (increasing self-efficacy and self-esteem and reducing negative thinking) of exercise are thought to be responsible for its positive influence on mood.

In addition, there is abundant evidence that exercise has positive effects on blood pressure and cardiovascular disorders, improves learning and memory, delays age-related cognitive decline, reduces risk for dementia, and improves medical conditions such as diabetes, osteoporosis, and Alzheimer’s disease.

While there are guidelines about how much exercise people should get, anything more than what you’re currently doing is a great start. This perspective helps take the pressure off and makes it more likely that you’ll actually increase your exercise, whereas telling yourself you need to exercise for twenty minutes three times a week could overwhelm you and result in not exercising at all. Of course, if you are working to reform an eating disorder, you may need do the opposite and reduce compulsive or excessive exercise.

Source: DBT Made Simple, by Sheri Van Dijk

Serious Mental Illness By The Numbers

Serious Mental Illness By The Numbers:

Prevalence and Treatment Rates*:

~ 8.3 million adults with schizophrenia or bipolar disorder mental illness (3.3% of the population)+

~ 5.5 million – approximate number with severe bipolar disorder (2.2% of the population), 51% untreated+

~ 2.8 million – approximate number with schizophrenia (1.1% of the population), 40% untreated+

~3.9 million – approximate number untreated in any given year (1.6% of the population)+

Consequences of Non-treatment*:

~ 169,000 homeless people with serious mental illness**

~ 383,000 inmates with mental illness in jails and prisons

~ 50% – estimated percentage of individuals with schizophrenia or bipolar who attempt suicide during their lifetimes

~ 44,193 suicide deaths in 2015

~ 10% – estimated percentage of homicides involving an offender with serious mental illness (approximately 1,425 per year at 2014 homicide rates)

~ 29% – estimated percentage of family homicides associated with serious mental illness

~ 50% – estimated percentage of mass killings associated with serious mental illness

  • Numbers and percentages of US adults
    +National Institute of Mental Health, 2016
    **2015 Annual Homeless Assessment Report


What is grounding?

Grounding is a set of simple strategies to detach from emotional pain (for example, drug cravings, self-harm Impulses, anger, sadness). Distraction works by focusing outward on the external world– rather than Inward toward the self. You can also think of it as “distraction,” “centering,” “a safe place,” “looking outward,” or “healthy detachment.”

Why do grounding?

When you are overwhelmed with emotional pain, you need a way to detach so that you can gain control over your feelings and stay safe. As long as you are grounding, you cannot possibly use substances or hurt yourself! Grounding “anchors” you to the present and to reality.

Many people with ptsd and substance abuse struggle with either feeling too much (overwhelming emotions and memories) or too little (numbing and dissociation). In grounding, you attain balance between the two– conscious of reality and able to tolerate it.


  • grounding can be done any time, any place, anywhere and no one has to know.
  • use grounding when you are: faced with a trigger, having a flashback, dissociating, having a substance craving, or when your emotional pain goes above 6 (on a 0-10 scale). Grounding puts healthy distance between you and these negative feelings.
  • keep your eyes open, scan the room, and turn the light on to stay in touch with the present.
  • rate your mood before and after to test whether it worked.before grounding, rate your level of emotional pain (0-10, where means “extreme pain”). Then re-rate it afterwards. Has it gone down?
  • no talking about negative feelings or journal writing. You want to distract away from negative feelings, not get in touch with them.
  • stay neutral– no judgments of “good” and “bad”. For example, “the walls are blue; i dislike blue because it reminds me of depression.” Simply say “the walls are blue” and move on.
  • focus on the present, not the past or future.
  • note that grounding is not the same as relaxation training.grounding is much more active, focuses on distraction strategies, and is intended to help extreme negative feelings. It is believed to be more effective for Ptsd than relaxation training.

Mental grounding

  • Describe your environment in detail using all your senses. For example, “the walls are white, there are five pink chairs, there is a wooden bookshelf against the wall…” Describe objects, sounds, textures, colors, smells, shapes, numbers, and temperature. You can do this anywhere. For example, on the subway: “i’m on the subway. I’ll see the river soon. Those are the windows. This is the bench. The metal bar is silver. The subway map has four colors…”
  • play a “categories” game with yourself. Try to think of “types of dogs”, “jazz musicians”, “states that begin with ‘a’”, “cars”, “tv shows”, “writers”, “sports”, “songs”, “european cities.”
  • do an age progression. If you have regressed to a younger age (e.g., 8 years old), you can slowly work your way back up (e.g., “i’m now 9”; “i’m now 10”; “i’m now 11”…) until you are back to your current age.
  • describe an everyday activity in great detail. For example, describe a meal that you cook (e.g., “first i peel the potatoes and cut them into quarters, then i boil the water, i make an herb marinade of oregano, basil, garlic, and olive oil…”).
  • imagine. Use an image: glide along on skates away from your pain; change the tv channel to get to a better show; think of a wall as a buffer between you and your pain.
  • say a safety statement. “my name is ____; i am safe right now. I am in the present, not the past. I am located in _____; the date is _____.”
  • read something, saying each word to yourself. Or read each letter backwards so that you focus on the letters and not on the meaning of words.
  • use humor. Think of something funny to jolt yourself out of your mood.
  • count to 10 or say the alphabet, very s..l..o..w..l..y.
  • repeat a favorite saying to yourself over and over (e.g., the serenity prayer).

Physical grounding

  • run cool or warm water over your hands.
  • grab tightly onto your chair as hard as you can.
  • touch various objects around you: a pen, keys, your clothing, the table, the walls. Notice textures, colors, materials, weight, temperature. Compare objects you touch: is one colder? Lighter?
  • dig your heels into the floor– literally “grounding” them! Notice the tension centered in your heels as you do this. Remind yourself that you are connected to the ground.
  • carry a grounding object in your pocket– a small object (a small rock, clay, ring, piece of cloth or yarn) that you can touch whenever you feel triggered.
  • jump up and down.
  • notice your body: the weight of your body in the chair; wiggling your toes in your socks; the feel of your back against the chair. You are connected to the world.
  • stretch. Extend your fingers, arms or legs as far as you can; roll your head around.
  • walk slowly, noticing each footstep, saying “left”,”right” with each step.
  • eat something, describing the flavors in detail to yourself.
  • focus on your breathing, noticing each inhale and exhale. Repeat a pleasant word to yourself on each inhale (for example, a favorite color or a soothing word such as “safe,” or “easy”).

Soothing grounding

  • say kind statements, as if you were talking to a small child. E.g., “you are a good person going through a hard time. You’ll get through this.”
  • think of favorites. Think of your favorite color, animal, season, food, time of day, tv show.
  • picture people you care about (e.g., your children; and look at photographs of them).
  • remember the words to an inspiring song, quotation, or poem that makes you feel better (e.g., the serenity prayer).
  • remember a safe place. Describe a place that you find very soothing (perhaps the beach or mountains, or a favorite room); focus on everything about that place– the sounds, colors, shapes, objects, textures.
  • say a coping statement. “i can handle this”, “this feeling will pass.”
  • plan out a safe treat for yourself, such as a piece of candy, a nice dinner, or a warm bath.
  • think of things you are looking forward to in the next week, perhaps time with a friend or going to a movie.

What if grounding does not work?

  • practice as often as possible, even when you don’t “need” it, so that you’ll know it by heart.
  • practice faster. Speeding up the pace gets you focused on the outside world quickly.
  • try grounding for a looooooonnnnngggg time (20-30 minutes).and, repeat, repeat, repeat.
  • try to notice whether you do better with “physical” or “mental” grounding.
  • create your own methods of grounding. Any method you make up may be worth much more than those you read here because it is yours.
  • start grounding early in a negative mood cycle. Start when the substance craving just starts or when you have just started having a flashback.

Schizophrenia and Breakthrough Symptoms

This seems like a good time to discuss breakthrough symptoms of schizophrenia. This is not easy for me to admit, but important if I want people to understand what it’s like to have a psychotic disorder.

“People can be on the best psychotropic medication targeting a mental health disorder and still experience disruptive and paralysing symptoms. These breakthrough symptoms can be voices, delusions, paranoia, anxiety, or perhaps even depressive features that go unchallenged and uncontrolled by medication. Breakthrough symptoms can be very disturbing, and demoralising, due to the chronic, sporadic, and their seemingly unpredictable nature. This type of symptom activation can be triggered by something external.”


I’ve been feeling numb for a few weeks now and hoping to control it through positive coping strategies such as increased meditation as I did not want to go through a med change of increasing my antipsychotic medication.

It didn’t work and this past week breakthrough symptoms of thought broadcasting and thought insertion which drives my paranoia continued rising to the level of needing a change. After consultation with my psychiatrist I’ve increased my antipsychotics, anti-anxiety medications and one on my antidepressants which is a noradrenergic and specific serotonergic antidepressant (NaSSA) and encourages sleep, i.e. drowsiness is one of it’s side effects.

My breakthrough symptoms can best be summed up as more invasive auditory hallucinations, paranoia and delusions that people can read my mind and insert thoughts into my head against my will. At this time I realize it is just a delusion and not real. If I didn’t make the med change it wouldn’t be long before I believed my delusions despite all evidence to the contrary which would probably require hospitalization. The med change will probably take a couple of weeks until I am completely back at my baseline. It’ll be an interesting couple of weeks, but this is part of the reality of living with a severe mental illness.

#MySchizLife #BreakthroughSymptoms #PsychoticDisorders

Will Tonight Be The Night

July 22nd, 2009

It had been one of those weeks. I was on a bender. I was always on a bender averaging around eight drinks a day, but this one was significant, was impressive even by my standards. I was drinking more than usual during the day and then when I got off work I headed direct to the Bar. I wasn’t eating, hardly sleeping, just drinking heavily. It was a mere two and a half blocks to the Bar, I could stumble to and from there in my sleep.

I slapped my copy of Anna Karenina on the bar. I read it once every year and it was that time of year again. The days of me actually ordering a drink here had long since passed. A moment later I had my well vodka tonic and a rocks glass of Jameson. The perks of being a regular. Work had been slow and I was eager to put it behind me. Tomorrow would be better, it could hardly be worse. I glanced around the oval shaped bar, most of the usual regulars were there. The professor was talking with his latest girl. He wasn’t a full fledged professor, but a lecturer at Montana State University. He read genre fiction in his spare time. He would bring in about five books a month to trade in at my used bookstore. I almost always sold his books online within a day or two. We’d talk a bit of philosophy and the current events at the university.

P was sitting across from me drinking her coke. N her boyfriend and father of their unborn child was bartending. She had her laptop in front of her going through possible baby names. She was a photography student with a penchant for going to the strip club outside of town. N would stop by her every few minutes and they’d exchange a glance or a joke. She was talking to the girl next to her I didn’t know. We would probably talk later as we usually did. She stopped in the store from time to time, but just to say hello and see if I’d be at the Bar later.

The Jameson and vodka was going to my head quickly tonight. It could be the alcohol I’d already consumed today or the blood I’d been passing lately. This was going to be an early night even if it was my thirty-seventh birthday. J walked in, a girl who had taken interest in me a couple of months ago as the guy who was always quiet and reading. She wishes me a happy birthday ordering us each a shot of scotch, Johnnie Walker Blue. We had polished off most of a bottle back on her birthday. It had cost a fortune. She sits down and we begin to chat. She runs a construction crew and has been by my store a few times.

I’ll miss my drinking buddies I casually think to myself when I’m gone. I wonder if it will be tonight or maybe tomorrow. This is what I’ve lovingly begun to refer to as my passive suicide attempt. I’m not leaving a note, just goodbye. The world will be better off without me. I’m sure it will hurt my family, but one large hurt is better than the endless small hurts I’ve been causing them these past few years. I wonder if I’ll have many people attend my funeral. I’d like a decent size crowd. I push my empty glass forward for a refill and return to my book. “If you look for perfection, you’ll never be content,” I mumble.

“What’s that,” J asks.

“Just something from the book,” I pat it tenderly, “if you look for perfection, you’ll never be content.”

“Do you believe that?”


“I think we need another shot.” Moments later I have my well vodka tonic, a rocks glass of Jameson, and a shot of Johnnie Walker Blue all in front of me. The shot goes down a little rough. I can feel the heat of it in my belly and my stomach churns in response. I take a large swallow of my vodka tonic to calm it down. “You alright tonight?”

“Just tired,” I reply.

“Well you’ve got a long night ahead of you the two of us,” she giggles.

“I’m in,” I lie.

“Be right back,” she gets up heading in the direction of the bathroom. I take it as a sign for me to escape. I quickly stand the alcohol hitting me. Grabbing the barstool I steady myself. This could be an interesting trip home. I can feel the heat of the shots in my belly as my nausea is returning. I have to get out of here quick before I’m ill. I’ve thrown up already twice today, all liquid. I haven’t eaten anything in a few days and the cheap vodka diet is playing havoc on my system.

“Will tonight be the night the sweet comfort of death closes my eyes forever and ends the unrelenting pain,” I mumble leaving the bar for home before J returns.

I’m Privileged

I’m privileged:

~ I live in a Western Country with well trained psychiatrists and therapists.

~ I’m white and middle class.

~ I have a college degree and a deeper understanding of my illness.

~ I have good health insurance.

~ I can afford my medications.

~ I have a family that has helped me pay my therapist out of pocket instead of one that my insurance would cover.

~ I have a roof over my head and food to eat.

~ I have a support system.

~ What if I had been poor with no insurance and lacking a support system? Would I be homeless and not medicated? Would I be the “crazy” person talking to himself on the street corner?

~ Having schizophrenia is difficult enough sometimes seemingly impossible, but I can’t imagine how hard and how different my life would be if I wasn’t privileged.

~ I’m no better than anyone else with schizophrenia, just privileged to be born into my social class and all the perks that come with it.

#MySchizLife #Privileged #Schizophrenia

Age 16, 1988

Age 16, 1988

For me my mental illness came crashing into my life in full force when I was sixteen.

That was the year I first started hearing voices,

started to believe people could read my mind and insert thoughts into my head,

was the first time I was truly suicidal,

was the year I started to self harm,

dragging a razor blade across my left arm and watching my blood flow,

the first time I was dissociative,

when the world became vague, dreamlike, less real,

as I observed events as if from outside my body like a movie in slow motion,

the year the panic attacks began.

This was also the year I suffered as a survivor of sexual assault,

the most difficult event of my life as a biker held a knife to my throat and raped me,

beating me severely.

From then on I carried a knife in case I am in a similar situation,

not so I could defend myself, but so I could slit my wrists.

To this day the sound of a Harley Davidson makes me physically cringe.

That was when the night terrors began reliving my trauma every time I closed my eyes.

That was the year the negative coping mechanisms developed: cutting, isolating, alcohol, drugs.

That was when the abyss of depression swallowed me up whole,

and I wanted to die or crawl in a hole forever,

because I was worthless, pathetic, weak, and most importantly,

I was to blame for being raped,

I should have been able to stop it as a sixteen year old boy.

This is not how it should be at sixteen.