Thursday, December 24, 2015

Counselors & Doctors & Stuff

Original image by mondspeer
Guys, do you like my Microsoft Paint skills or what?




You don't have to answer that.

Anyways, I'd like to start off this post by addressing a popular misconception: you don't have to have a mental illness to go to a counselor. For myself, and a lot of people I know, one of the biggest barriers to deciding to see a counselor was feeling like your problems weren't big enough to see a counselor about, or like you probably didn't really have depression, anxiety, OCD, etc., so wouldn't you feel really dumb if you went to a therapist and they were all like, why are you even here? Just suck it up and deal with it like a normal person!

The thing is, there is no sign saying "Your mental or emotional problems must be at least this crazy to see a psychologist." There's not, I checked. Trust me. In fact, people go to psychologists for a number of reasons. You may be really stressed, or have difficulty coping with something that happened in your life, or you might be experiencing problems with your attention span or motivation. Counselors are trained to teach people practical, practice-able skills to deal with almost any problem. Mental disorders are what happens when some of these problems go way beyond what most people experience, but even people who are experiencing these same issues to a lesser extent can benefit from the same kind of therapy. 

So if you're worried about your problem "not being real enough," or getting diagnosed with some sort of scary problem, don't be. Honestly, going to a counselor before your problems become big issues makes them easier to treat, and ideally, you can practice what you learn and stop them from getting any bigger. It's kind of like going to the doctor and getting antibiotics within the first few days of strep throat, instead of waiting a few months and risking getting scarlet fever or getting so sick that you have to miss a month of classes.


Making the Appointment

College is a great time to go to counseling, because your university usually has a free counseling center. For BYU, it's the Counseling Center in the Wilk. If you're not at college, I would probably start by seeing your primary care doctor and asking for any referrals to psychologists in the area.

Guys, it took me SO LONG to see a counselor at BYU, because it's behind these doors and shuttered windows and opening those doors just felt like stepping into the unknown and it felt way more scary than they probably intended it to be. They keep it like that to protect the privacy of anyone hanging out in the waiting room, but it was still intimidating. I tried to find a picture of the waiting room for everyone, but I couldn't. It looks kind of like this, except with a detached reception desk instead of one built into the wall and a BYU blue color scheme:

(Image source)

It literally just looks like every waiting room ever on the inside, trust me. At the front, there are usually two students manning the reception, and behind them is an older lady. You can talk to any of them.

Before you make an appointment, you have to do some paperwork. It's easier if you do it before you come; just follow the instructions here. The first few questions are pretty open-ended, kind of along the lines of "why do you want to see a counselor," and it can be hard to think of what to write. It's not really a big deal though, because the rest of the form is checking a bunch of very detailed boxes with a multitude of symptoms. They just want a brief overview in your own words — it can be as simple as "I feel disproportionately stressed a lot of the time," "I'm having trouble concentrating on anything," or "I feel down/blue/unmotivated frequently." Seriously, feel free to put that exact phrase in there if you can't think of anything. It's fine.

After that, you can either call them at 801-422-3035 to schedule an appointment, or you can walk in and talk to anyone at the desk. If both of those feel intimidating, recruit a friend, family member, or roommate to come with you or help you call. In either case, all you have to say is "I'd like to schedule an intake appointment." They'll ask you if you completed the paperwork, to which the answer is yes, and you'll set up a time!

Again, the procedure will obviously be slightly different at other universities, but the general idea may be the same. You might have to talk to someone at the desk to get the paperwork, depending on how they have things set up.

Your First Appointment

At your first appointment, just go up to the desk and say, "Hey I have an intake appointment scheduled for [time]." They'll probably ask for your student ID number or your initials, and then you sit there and wait until your therapist calls your name. You'll go back into a little office and usually there's a couch and a few chairs. You can sit anywhere you want. Modern therapy doesn't actually look like the whole "lying down on a couch" trope; you just sit face-to-face and talk.

They'll probably ask you a couple of open-ended questions about why you're here and what you'd like to get out of therapy, so come prepared to describe what's bothering you. I had trouble answering "Why I'm here" because it was kind of like, " make all of these feelings not be the way that they are? Duh?" If you're struggling with that question, a good thing to say might be something along the lines of, "[Symptoms] are impacting [school, relationships, etc.] really negatively, and I'd like to reduce them to the point where they're not interfering with [the things] as much."

At this point, you'll probably talk about future treatment options. The two big options, at least at BYU, are individual vs. group therapy. Your experience will vary depending on who your counselor is and/or who is in your group therapy, but this is my experience with the two:

It's totally okay to choose one, the other, or both. When I first started going to therapy, the idea of talking to a group of people about everything was really intimidating, so I went to individual therapy only for a while and then eventually added group therapy. They're both great in their own way.

Continuing Therapy

BYU has you complete a 40-question survey before each appointment. (If you have trouble accessing it or forget, the people at the front desk have iPads you can take it on before your appointment). Some therapists make more use of it than others. Both therapists I had primarily looked at your overall "score" to get a rough idea of how you were doing from week-to-week. This also helps them evaluate how treatment is going; once your scores fall below a certain range, they'll typically bring up tapering off the therapy. BYU's therapy model is short-term, which means they have the goal to help you learn skills that will allow you to manage your mental health independently in the long term.

Sometimes, the first therapist you get may not be right for you. A friend of mine explained it this way: expecting your first therapist to be the right one for you is kind of like expecting to marry the first person you go on a blind date with. If your therapist doesn't seem to get you, it's perfectly fine to transfer to another one. I did, although mine was going on maternity leave anyways. You don't have to worry about offending them — it happens all the time. Just say something like, "I've really appreciated having therapy with you, but I don't feel like we're clicking. I was wondering if I could transfer to a different therapist?" They'll probably ask you a few questions about why you feel that way, but don't worry; they're just trying to get a better sense of who would be a good fit for you. Alternatively, they might realize that the things you're describing are easy for them to do differently, and they'll change their approach slightly. Either way, it's a good idea to bring things up so that you can get the best experience possible.

Doctors & Medication

Most counselors, therapists, and psychologists can't prescribe medication. For that, you need someone who's been to med school. You don't need a referral from a counselor or anything to see a doctor about medication. You can just book an appointment with your primary care provider. On the BYU Health website, you can even schedule the appointment online and select the "mental health" category.

You'll go in, check in like any other appointment, and the nurse will call you back. He or she will probably weigh you and take your blood pressure, and ask you what you're here for. You can describe your symptoms, or if you've already seen a counselor and been diagnosed with something, you can say, "I have [disorder] and wanted to see about trying medication for it." They'll probably give you a form to fill out to rate the severity of your symptoms while you wait for the doctor to come in. He or she will come in, look at the form, and prescribe you something.

I only have experience with antidepressants, but typically, medications aren't a life-long thing. With antidepressants, for example, they'll typically start you on Prozac or another common one, and wait a few months to see if it works. If it works, they'll keep you on it for 6 to 9 months, at which point, you can choose to go off it or continue. If you go off it and relapse, they'll put you back on for twice as long, at which point you can again choose to discontinue. If you relapse again, that's when they'd recommend you take them permanently. Sometimes, the first medication they try for you won't work, or will even make things worse in rare cases (Prozac definitely exacerbated both my depression and anxiety), and they'll try a different medication. Once they find one that works, they'll follow the same procedure.

Typically, the doctor will make a followup appointment about a month from your first appointment to see how the drug is working. Depending on how well you're doing, they'll give you a refill for a longer or shorter amount of time, or switch you. If your condition proves resistant to most common medications for your condition, they'll give you the option to consult with a doctor who specializes in psychiatric medication to help you find something, if you want to keep trying.

The generics of both Prozac and Zoloft cost less than $0.80/month on the BYU Health Plan, so you don't have to worry about breaking the bank.

So, Which One Do I Choose?

Before I get to the actual pros and cons of both kinds of treatments, let me note that a lot of the things that will help you deal with mental illness in college require documentation. Getting accommodations is almost impossible without a letter from a counselor or doctor to verify your condition. In my experience, counselors write better letters, plus you see them on a regular basis, which makes them easier to request as part of a normal visit. For that reason alone, it can be useful to meet with a counselor at least occasionally. However, if you really don't want to try therapy, a doctor can also provide medical documentation. Additionally, neither counselors nor doctors are allowed to ever tell anyone else about your treatment without your consent; your privacy is equally safe with either.

As far as effectiveness goes, the thing about mental health is that it's very individual, with a lot of different causes. Some people may do better with therapy, some with medication, and some with both. For mild to moderate depression, for example, medication isn't more effective than therapy; however, severe depression often can't be fully treated with therapy alone. ADHD, anxiety, OCD, bipolar disorder, schizophrenia, and other disorders all have their own unique needs, as does every individual person.

Neither therapy nor medication needs to be long term. To a certain extent, it depends on what you feel the most comfortable with. In my personal opinion, therapy is always a good idea to at least try. If your disorder is being heavily influenced by certain ingrained patterns of thinking or reacting to situations, medication may not provide a long-term solution. However, if your disorder is more biological in nature, therapy may not provide a permanent solution.

The thing about therapy is a lot of the things you learn are little "rope ladders" of their own. Therapy requires effort, and if your mental state is really severe, you may not be capable of climbing those ladders right away. For instance, a lot of things that help with depression are getting enough sleep, maintaining a regular schedule, eating enough nutritious food, staying as on top of your responsibilities as you can, keeping your apartment clean, and exercising. A lot of the effects of depression are insomnia, an inability to get out of bed in the mornings, loss of appetite or eating too much, and not having the motivation to shower, let alone complete responsibilities or exercise.

You can see where this can run into problems. If you have mild or moderate depression, your therapist can help you find strategies to start doing at least some of these things, which can improve your mood and help you build up to doing all the things. However, if you can't even start doing any of the things, medication can provide a jump start to help you work on the things you learn in therapy. Think of it as a prosthetic arm that helps you climb the ladder. Except in this case, the more ladders you climb, the more likely your arms are to grow back and help you eventually climb out of the hole entirely, and you may not need that prosthetic arm anymore. Or, I guess, maybe your arms don't grow back but the prosthetic arm helps you climb out of the hole. Everyone's arms are different.

Analogies are hard, you guys.

Now if you'll excuse me, my prosthetic arm is giving me a weird compiler error and I need to do some troubleshooting.

Stay tuned for more posts about mental health in college, or read the series introduction to start from the beginning.

Wednesday, December 23, 2015

Mental Health & University Series: Introduction

Some of you may be aware that I've been having a really fun time with depression and anxiety over the past year or so. Some of you may not have been aware of that. It's been fun, though, trust me.

The good news is, college is full of useful resources and accommodations for people with physical or mental health conditions. The bad news is, nobody seems to know about them, or if they do, they're not entirely capable of accessing them.

Here's an analogy:


You have no arms. (This may seem weird, just go with it. It's relevant later.)


So you have no arms, and somehow you fall into a hole. Or are pushed into a hole. Or you're just walking along and the hole opens up underneath you. Or maybe you run and jump into the hole on purpose. The thing is — and this is crucial — it doesn't really matter why you ended up in a hole. A lot of people seem to miss this point, including the people (professors, petitions committee members, etc.) who are supposed to help you. Yeah, there's a time and place for examining how you got into the hole, and maybe you could have prevented it, and it might help the university to figure out how to put up fences around the holes or prevent them from spontaneously appearing in the first place. However, the time and place for that isn't while you're still in the hole. If you're still in the hole, the first priority should be to get you out.

The point is, you're in this hole, and somehow you've managed to convince the people standing outside the hole to stop interrogating you about how you got into it and they're willing to try to get you out. You need to get out, because you can't really do your homework in the hole, or go to the testing center, or shower, or really do anything. The hole is pretty boring, not to mention unproductive. It doesn't even have WiFi.

Your rescuer lowers a rope ladder, says "Here you go! Don't forget to hand in your paper on European portraiture on Tuesday!", and walks away.

"Wait! I can't climb this ladder! I have no arms!" you yell as they leave. They keep walking.

Several days later, they come back. You have a couple of bruises from trying to climb a rope ladder without arms, and you're pretty hungry and greasy. "Why didn't you finish your paper?" they demand. "You can't stay in this hole forever. I even gave you a way to get out!"

"Being stuck in a hole isn't an excuse to blow off your assignments."

"But," you protest, "I couldn't get out of the hole. I can't climb a rope ladder with no arms."

"Look. You shouldn't have fallen into this hole in the first place, but we've given you all the resources you needed to get out. Just because you have no arms doesn't mean you get to be self-pitying and take no responsibility for yourself. Rope ladders have helped plenty of people climb out of holes before. You have everything you need — you're just not using it."

They walk away and leave you in the hole.

Somehow, being stuck in a dirt hole for days on end is less upsetting to you than the fact that you're failing Art History.


That's the thing about mental health. Just because various resources are made available doesn't mean you're capable of taking advantage of them on your own, or that they're designed in a way that's actually helpful. And that's assuming you even know about the resources! If you don't, it's more like being told, "If you dig around in the bottom of this hole for a while, you'll find a set of directions to find some rope. If you follow those directions, you'll find another note, which tells you that the rope is back in the first place you dug. Dig around a little longer, and you might stumble upon a length of rope and a couple of stakes. Tie the rope into a ladder, attach it to the top of the hole with the stakes, and you can climb out!"

Then, if you don't manage to follow all those steps and get out of the hole, you have to convince someone to lower a ramp into a hole, and whether or not you get the ramp is dependent upon your ability to justify why you couldn't just use the resources they already provided, or why you need a ramp instead of another ladder. Somehow, I don't have any freaking arms isn't an acceptable answer.

Fortunately for me, between the stars aligning and the support of my husband, I actually managed to climb the ladder somehow. However, between my experience and talking to friends of mine who have had similar experiences, it's come to my attention that most students don't know what resources are available to them, or if they do, they face significant challenges in using them. As an attempt to help with this, I'll be writing a multi-part series that addresses as many relevant topics as I can think of, namely:

These posts will lay out the basic process for completing these tasks, explain how to know when you need to make use of these resources, and provide examples of emails, petitions statements, and hypothetical conversations for anyone you need to talk with. While these posts focus on BYU, most of the ideas within them should hopefully be applicable across a range of institutions. As the posts are written, links will be added to this page.

If you're experiencing a mental illness in college, or if you know someone who is, please share this information so that people can get the help they need.

Wednesday, November 25, 2015

The Completely True, Doctrinally Accurate Story of How I Inadvertently Created Donald Trump

Archangel, holding a clipboard: "All right, everyone, for today's brainstorming session Michael has assigned our group the topic of 'Minor Inconveniences of a Fallen World.' He would like them to be as ironic as possible, so let's start throwing out ideas!"

Angel 1: "Not getting enough sleep makes you tired, but sleeping too much also makes you tired!"

Angel 2: "All the tasty foods are unhealthy, and all the healthy foods are especially hard to get children to eat."

Archangel: "Good, good, keep them coming."

Angel 3: "Spiders control the population of all the other gross bugs, but they are the most disgusting and fear-inducing of them all."

Me: "Wait...guys..."

Angel 2: "Avocados and bananas are healthy and delicious, but they stay unripe for two weeks, are ripe for half a day, and promptly become disgusting."

Angel 3: "The more often you clean your hair, the faster your hair gets dirty."

Angel 2: "Actually, let's just make that true for the entire body."

Me: "Guys..."

Angel 1: "How about a disease that makes you need to pee more frequently, but also makes peeing really painful?"

Archangel: "I don't know, that seems like it would fall under the 'Illnesses and Afflictions' group. Is there any way you can tone it down a little?"

Angel 1: "What if it mainly affected women?"

Archangel: "Sounds good to me."

Me: "Wait, how does making it mainly affect women suddenly downgrade it to a 'minor inconvenience'?"

Archangel: ", if you're not going to contribute any of your own ideas, you can't criticize ours. Do you have a better idea?"

Me: "Gee, I don't about 'people thinking they're right when they're clearly wrong'?"

Angel 1: "Hey, great idea, how'd you come up with that?"

Me: "I have no clue..."

Archangel: "All right, let's put it down. Our next topic..."

Me: "Wait, I wasn't serious!"

*no response*

Me: "I have a bad feeling about this."

Donald Trump: "I'm here to make America great again!"

Friday, November 6, 2015

I Didn't Think This Would Be My First Post

So I've had this blog hiding on the Interwebs for the past few weeks, trying to come up with a good blog post and the motivation to write it. I started this blog because I wanted somewhere I could talk about ideas and interesting stuff in addition to my personal life (which is often less interesting), but the first post felt like a lot of pressure because I didn't want people to pigeonhole my blog into one category or another based on what I talked about first.

I guess the fact that I wasn't planning on blogging about this freed me from that self-imposed problem.

(Spoiler alert: I'm not having a crisis of faith or making any big drastic changes in my life, so all of my relatives who are already getting nervous can start breathing again.)

But you see, I am bisexual.

(Cue heart attacks starting again.)

That's not the point of this post; I just wanted to get it out of the way. (If you want to know the point, scroll down to the bolded phrase "the point is this".) While it's a big struggle for a lot of people, for me personally, it hasn't affected my life a lot. This is partly because I was in denial about it until well after I'd decided I wanted to marry my husband, so the most difficult part has been answering his question about whether Anna Kendrick or Emma Watson is more attractive. 

And that wasn't very difficult, because the answer is obviously Anna Kendrick. 

In fact, I probably would have been comfortable telling almost any of you in the right moment; I just wanted it to be relevant to something, because I didn't feel it warranted a big "coming out" moment all on its own for me.

I just didn't expect it to become relevant to something quite so soon.

Unless your Internet has been down, you've probably heard about the Church's new policies regarding same-sex marriage by now; namely, that same-sex marriage is considered to be a form of apostasy, and that children of same-sex couples must wait until they've turned 18 and moved out of their parents' house before being baptized, and must denounce the practice of same-sex marriage and obtain First Presidency permission before doing so.

I was surprised by the news, as a lot of people were. Well, the first policy wasn't too surprising – "apostasy" is a really strong word, which I think hurt a lot of people, but the idea that participating in a same-sex marriage is grounds for excommunication wasn't exactly new. In fact, I'd been expecting a clarification of this sort ever since the Supreme Court decision, since I had heard some people express the idea that perhaps a legally wed same-sex couple wouldn't be breaking the law of chastity. I expected the Church to eventually comment one way or the other, and again, while "apostasy" is a strong way to say it, the policy hasn't actually changed and if that was all it is, I feel like it would blow over.

The policy about children was a little different. I had a lot of questions about it immediately. At the same time, though, while I was surprised by the policy, I wasn't surprised that I had questions. There have been a lot of hard things in the Church that have caused people to question – persecution of the early Saints, starting polygamy, moving to Utah, ending polygamy, making the Word of Wisdom a requirement for a temple recommend, blacks not being able to hold the priesthood even after the civil rights movement, blacks being allowed to hold the priesthood in 1978, the Church's response to some aspects of second-wave feminism, the September Six, Proposition 8, the Ordain Women movement, and hundreds upon hundreds of issues that are more local in scope that I haven't even heard of before. 

People have questioned these things. Heck, even though I have a lot of potential answers to some of these issues, I don't know if those answers are the right ones and how to explain it in some sort of conclusive, all-encompassing way that would defy any objection or criticism. What I do know is that I've had enough spiritual witnesses of the Church and enough glimmerings of possible answers for these issues that I have faith that someday in the eternities, I'll be able to look at God and say, "So...what was that about?" and He'll be able to provide me with an explanation that makes everything clear. As Paul says, "For now we see through a glass, darkly; but then face to face: now I know in part; but then shall I know even as also I am known." 

I'd reached the conclusion on my mission that it was virtually impossible for me to live my entire life in the Church without arriving at an issue of similar weight and importance. So when I heard the policy announcement, while part of me was confused, a part of me was like, well...there it is! (The first one, at least.)

As Mason and I talked about it, the conclusion we arrived at was that we can't see the eternal perspective. Because of this, our sense of what's right and wrong often depends on preventing people from hurt in the short-term. We don't always have the ability to judge whether or not something hurtful will be better for us in the long term. God does have that ability, and therefore, He is able to make different decisions than we can. (If you want an article by a non-LDS philosopher on that point, email me or use the contact link on the FAQ page.) We can try to look for possible answers (some can be found here, although there are definitely objections that could be raised to that article), but in the end, all we can know is the peace of God that passes all understanding (Phil. 4:7). 

As we talked together, as we prayed and read the scriptures, I felt that confirmation. I was reminded of times when I felt the Spirit witness to me that God and Jesus Christ appeared to Joseph Smith, restoring their Church upon the earth with a promise that it would never again be taken away from us. I felt a reminder of the love of God that He has for all His children, and a knowledge that He wants to give every single one of them the best possible opportunity to return to Him. He has a plan, and I don't know it, and I don't know exactly how or why this plays into it, but in the very least, I knew that it was going to be all right.

Despite how much time I've spent talking about that, though, that's not the point of my first post any more than me being bisexual is. The point is this:

Everyone has to arrive at this spiritual witness individually, and that doesn't always happen right away even when you want it to. So far on the Internet, I've seen a lot of people argue that it can't be right, and I've seen a lot of people argue that it is right and that anyone who disagrees isn't sustaining the prophets, or doesn't have enough faith, or isn't humble enough to accept the answer, or is too concerned about what the world thinks, or any number of things. Even when people don't necessarily mean to imply that about those who are troubled by this issue, that's often the message that people can hear.

The thing is, whether straight or gay or somewhere in between, a lot of people who are upset by this issue are responding from a place of hurt. It's tremendously difficult to be LGBT in the Church, or to be friends or family with someone who is LGBT. I've been lucky that my life and beliefs ended up dovetailing relatively easily with the Church's teachings, and I've avoided a lot of that difficulty as a result. Despite this, upon hearing the policy change, I felt hurt. I felt uncomfortable with a sexuality that I had come to terms with; I felt worried for people who were more affected by it than me; I felt ashamed of anything I had ever said about LGBT issues ever because suddenly I was doubting my ability to balance tolerance and doctrine. And I felt confused. This isn't because of a lack of faith in the prophets or humility or anything like that. I think it's a pretty normal response. 

I started seeing people post the number for the National Suicide Hotline on Facebook in connection with this, though, and on the other hand I started seeing people get all feisty about anyone who even questioned what was going on, and that probably made me the saddest of all – knowing that somewhere out there, people were feeling exactly that bad, and some people were responding by saying they didn't have enough faith. Elder Holland's recent talk and Elder Oaks' remark on Kim Davis were tremendously inclusive, and when you're facing a long and seemingly endless struggle, feeling hope only to have it crushed again sometimes feels worse than not feeling it at all.

So I guess what I'm saying is, right now I'm fine. Don't worry about me. Seriously – Heavenly Father and I have worked it out on a personal level. But when you talk about this issue, remember that questions are not a sign of sin. Remember that people are hurting. Remember that somewhere in the world, some child or teenager has already learned they can't be baptized for years to come and they feel crushed or angry. Remember that LGBT members who are anticipating a lifetime of loneliness are feeling discouraged and alienated. Remember not to judge people's reasons for struggling with this policy, or any other issue for that matter.

Remember to be kind.

Remember to pray.

Remember to hold to what you know to be true and not be ashamed to stand up for your beliefs.

And remember to extend compassion to others as you do so.