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Dr. K
Dr. K, Psychologist
Category: Mental Health
Satisfied Customers: 31
Experience:  Associate Professor at Southern Illinois University
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What can i do to make myself get out of bed and create a

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What can i do to make myself get out of bed and create a resume and find work? I feel fine when I am working. I am in a house filled with my clutter all day and feel imprisoned. I am treated daily with bupropion xl 300mg, lamotrigene 200mg, atomoxetine 80mg, and lisinopril 10mg. I am female, 64, have master's degrees and crippling student loan debt. I need to do what I need to be doing, but I am controlled by my emotionalphysical reactions. When i am working i can afford to visit my therapist, when not working need help the most but can't access it. What can i say to myself to snap into action when something in me refuses to face things? I wake up worrying at night and waste many day hours on phone games. Once I get started I feel better. Dx ADHD and BP2.
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Customer: replied 3 years ago.
Was the question beyond the scope of JustAnswer questions?
Hello,
We will continue to look for a Professional to assist you. Your question wasn't beyond the scope of JustAnswer questions.
Thank you for your patience,
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Hi there. Thanks for your question. I'm sorry you've had to wait for a response but I'm happy to try to help. It sounds like our question is about what strategies you can try to get out of bed in the morning and get started working, have I got that right?

Customer: replied 3 years ago.
Thank you for answering. After asking the question, i thought about what answers i remembered that i could use to fight the Black Dog.So I washed my face with Noxcema, a mentholated cold cream, got dressed for housework, took my meds. Back in bed feeling sad, went to 7 Cups app to see if reflecting might help. It just asks simple questions about 3 things for gratitude, 2 good things you did yesterday (none), and you post answers and read answers from other users, so it gives perspective and helps the loneliness.Next I spent time looking at Android apps about mental health and depression, and found Youper, which is a pretty good chatbot that uses Cognitive Behavior Therapy (maybe even Dialectical Behavior Therapy) techniques. Leads you to examine your feelings and underlying factors, giving simple choices for suggestions. I began to feel better because it brought me into thinking specifically and logically.I got up to feed my pets and was soon right back under the covers. I put on headphones and listened to a guided hypnosis session on depression on my phone. I have them on self-esteem, self-confidence, motivation, etc. One is a series by SurfCity, one by a German named Kim Fleckenstein. In a half hour it woke me and I did feel a little better.
I can't say i got anything done that day, but at least i was doing Something.The next morning my mood was a little better and i didn't accomplish much, but i watched a humorous drama i enjoy, and i did get on my exercise machine for a while. I kept up with the helps from the android apps and watched a couple of college lectures on CBT on Great Courses Plus. I knew that bipolar 2 means the heaviness of unhappiness would lift in a few days.The next morning I felt my bad period had passed. The bed still called me but i was busy doing things around the house. I have been making some progress filling my recycling bin and Giveaway basket.Yesterday i spent the day on the phone with doctors and insurance companies about my husband's health care. Paperwork is my nemesis but I faced the financial situation and worked to get the medical bills paid and delay all the other payments i could. Whenever I am able to revise my resume and get work, i can help with my earnings and catching up will become possible. I got a lot done and pray i can continue on Monday.Since being on the lamotrigene, i have been feeling flat. It may be from the unemployment though. While i have learned to recognize the buildup of anxiety before a blowup, and am very happy my episodes of "losing it" emotionally are now rare, it seems i am always sad underneath and i miss my energetic days that the manic side or ADHD provided.Being diagnosed with ADHD at age 50, i had already suffered a huge amount of destruction to my self-esteem because of the constant failures to measure up in spite of a genius level IQ measurement. My only success has been in college, where i thrived in spite of the ADHD. I come alive on a college campus.Which is a long way to say i feel better now, but it feels like there is a strong underground river of hopelessness.
Having someone just respond to my question, and let me talk about it, has been tremendously helpful this morning. It's different than meeting with my therapist because i don't jump from topic to topic. In writing i can organize my thoughts like magic.And finally, yes, any strategies you can offer for repelling the Bed Magnet would be appreciated and put to good use.Thank you for choosing to respond to me. It was a good surprise this morning. I am going to get up and do the dishes and see where that leads, because it will give me a shot of happy with myself.

Hi there. I'm glad to hear from you. Wow, it sounds like you have already used a lot of great strategies and are starting to feel a little better. I'm impressed to see you dusting off and using skills. Well done! Now let's see what we can do about the bed magnet. It's so funny that you said that because that's the exact analogy I use with my therapy clients!

It sounds like you are already familiar with CBT. Are you familiar with the Behavioral Activation skill from CBT? Or the Opposite Action skill from DBT?

Customer: replied 3 years ago.
no, what are the behavioral activation skill and opposite action skill? i will look them up

I'm happy to provide some of that information for you and I'll also send some links.

I’d like to do two things for you today, if that’s ok. The first is to give you some short-term self-help strategies to deal with the symptoms right away. The second is to help you get set up with a good cognitive behavioral therapist or another app or online service that can offer you support and help you with your symptoms in the long term. How does that sound?

So first I'll share some information about opposite action, which is actually something you've already started. Sadness comes with an action urge to withdraw, isolate, and avoid. We know from research and you probably know from your experience that these behaviors actually make depression and sadness worse, even though that's what we feel like doing. Opposite action encourages us to be active when we feel down, to sort of "fake it till you make it" until the sadness lifts. It sounds like you were able to do some of this yesterday, so keep up those good behaviors. I've attached a handout with some more information. Next I'd like to work on a plan to get you out of bed and stay out of bed in the morning. What are three ways to keep yourself out of bed once you're up? For example, do you make your bed right away?

Customer: replied 3 years ago.
Dr. K., your suggested ways of helping me get up sound great!I just found a site called TherapistAid.com and printed some worksheets about Behavioral Activation.Through financial aid at a mental health clinic, i have a trusted counselor I have been seeing. I will take her the materials I am working with and ask her to help me. I think she will enjoy learning more about CBT and DBT. The Catch 22 is: until I get better I can't afford a trained DBT therapist. I go on Medicare in December but won't have doctor coverage until i can pay $356 a month. Not sure what therapy is covered; i will find out. In the meantime, i will use whatever online resources you think will be helpful. I appreciate your advice very much and will do my homework!Thanks for the handout on opposite action. The “urge” for isolation, avoidance and withdrawal explains why i no longer have friend relationships. I thought it was because all the pop psychology about the wisdom of rejecting negative people. Therefore my not wanting to inflict my presence on friends. I have felt I had nothing to give them.I have a great app for routines from the University of Virginia (i think) called Fabulous, designed to use behavioral change, brief reflection responses, and mindfulness to change thinking, thus influencing behavioral change … it is based on recent neurological science findings.I think i have put so many steps in my routine on that app that i resist the pleasant reminders. Even reading the steps daily helps me remember to do many of them, but i am lacking essential structure in my day, especially when not working. I will reduce my steps for the morning routine to focus on getting out of bed steps, and will try to be consistent doing those few steps in order.How I usually start my day is: I try to take my meds with water while waiting for my coffee. Often I forget the meds until much later. That is a problem because I really can’t watch how the meds are working unless I can correlate my mood changes with the medications’ effect. Compliance is not my strong point on time, although I almost never miss any daily meds.I make sure I eat, usually oatmeal for digestion. (Lately I get indigestion every time I eat, I suspect GERD.) Then I feed my pets and put the clean dishes away.It would be a good idea to make my bed -- as long as I don’t crawl back into it. Maybe if I get dressed before making it I might be less likely to get back into bed. Not getting dressed is another way to feel bad about myself.That’s about all my morning routine that is actually a routine so far.It makes me feel good to wear makeup and do my hair, but I usually skip it since I am at home almost all the time. I have calendared some events I would like to attend, even registered for them, but then don’t want to go when the time comes.Three ideas to keep myself up: hmmm.
Take my coffee to my comfy chair instead of my bed.
Listen to something that contradicts my thoughts of “I feel so down. I just want to crawl under the covers. When I sleep I don’t feel depressed.”
Use my android apps requiring responses, to lift my spirits and keep recovery on my mind so I can have more determination.
Those are fairly vague. Possibly I can set an alarm with a recording that fights those depressed thoughts. I think it would have to be automatically triggered. I have tried using my hypnosis sessions, but that is still in bed and doesn’t really wake me up.But I do LOVE research and WRITING so the mental health apps would be something I could let myself do even if in bed, until I feel a desire to get up and accomplish something. Once I do something, I get a boost that lets me move to the next thing easily. Then I’m up.Obviously writing is my best way to process info and plan. I had to switch to my computer to make sure I answered each of your questions.Thanks for helping me. I hope JustAnswer recompenses you fairly.
Customer: replied 3 years ago.
Here is a link to Fabulous. It's from Duke University's Behavioral Economics Lab.
https://thefabulous.co/

These ware wonderful ideas! So let's summarize a bit because you have listed a number of great ideas and we want to resist the bed magnet. What do you think about (1) getting out of bed and when your feet hit the floor, turn around and make the bed right away? Then when you leave your room to make coffee, (2) shut the door behind you so you don't see the bed (this is called stimulus control). Then (3) coffee, oatmeal and your medications--let's do the trinity together so you don't forget the meds. And yes, coffee in the chair rather than bed is a great idea. If you're having trouble sleeping, it could be due to other activities in bed. Try to limit bed for sex and sleeping only. (4) I like your idea of washing your face/shower/hair/make up, out of pajamas and dressed, even if you don't leave the house. From there you have a number of good ideas to stay busy.

You mentioned not having structured time and that can also be tricky. You mentioned pets--are you an animal lover? Maybe you could volunteer a few days a week for a few hours at a shelter. That could give you something to feel good about and motivate you to get out of the house and the day off to good start.

It sounds like you have a number of apps already that are working for you. I haven't heard of the Fabulous app and I'm glad you sent the link. I learned something today too! :)

I think your idea of taking DBT and CBT worksheets to the counselor you already have a relationship with is a great idea!

I hope this has been helpful. It really has been my pleasure to work with you today. I would love to receive a follow up message from you to see if these strategies are working.

Dr. K, Psychologist
Category: Mental Health
Satisfied Customers: 31
Experience: Associate Professor at Southern Illinois University
Dr. K and other Mental Health Specialists are ready to help you
Customer: replied 3 years ago.
Dr. K, thank you for the 123 and the Coffee Trinity! I will put those ideas into play tomorrow morning. Maybe I can even get myself out the door and to my church service.Yes, once I am out of the house I am not sleepy anymore. I am allergic to animals, so the shelter is out, but maybe I can work at a political office. (My president embarrasses me.)You have been EXTREMELY helpful to me. May I ask you other questions in the future? And if so, how do I contact you?I am in Dallas, Texas, by the way, and it seems my questions get posted on the UK site somehow, so you may be on a different day cycle than I am.You are a great psychiatrist and JustAnswer is so blessed to have you to help people. And I thought JustAnswer was for fixing my washer (which is still not fixed, LOL). You have a fantastic day (or night).Ruth McIntosh

Ruth, it's been wonderful working with you today. I would love to hear from you and answer your questions in the future. I will investigate how we can arrange that and get back to you here with an answer about that (it may not be until Monday when the support staff is back). I'm sorry I can't help with your washer. ;) I hope to hear that you make it to church tomorrow and have a nice weekend!

Hi Ruth. In the future you can reach me directly through this link: https://www.justanswer.com/mental-health/expert-drkertz/ Please be sure to put my name in the subject line. Thank you!