M A G A Z I N E FEB/MAR 2019 ISSUE 15
NATHALY AGUILERA JACKIE LYNN PHOTOGRAPHY
DERMA & TRICHOTILLOMANIAÂ
ANXIETY DISORDERS
LMFT KIMBERLY QUINLAN SPEAKS IN-DEPTH ON DIFFERENT ANXIETY BASED DISORDERS
WWW.BOUTIQUEOFTOI.COM
TABLE OF CONTENTS Collages of Appreciation Connecting the Dots with Dr. Shawn Horn Anxiety Disorders Testimonials
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Therefore we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day. Â 2 Corinthians 4:16
WE are supporters of mental health. FROM LEFT TO RIGHT: @anxiety_recovery_com GAD @passionatedirection PTSD @silver_stream_system DID @wild.fighter.girl Anorexia Nervosa @schizo_celia Schizoaffective Disorder @amberhess2019 Anxiety
@xiannewman Health Anxiety @coralieundead PTSD, Anxiety, Depression @breakingstigma333 Major Depressive Disorder @frgmntdpsyche Dissociative Identity Disorder (DID) @becoming_courtney OCD & Anxiety @francescaeldridgehealth OCD
@passionatedirection
@vic_carnevale
@georgina_brights
@becomingkeanna
we stand for body positivity. @girlwithredshoes
@heather_fit_tips
@andrea_giromondo
@@postpartumweightlossjourney
CONNECTING THE
DOTS
with Dr.Shawn Horn LICENSED
CLINICAL
PSYCHOLOGIST
@drshawnhorn Host of "The Rock Your Awesome Show w/Dr.Shawn" Podcast
Shawn Horn, PsyD is a Licensed Clinical Psychologist, in private practice, with 27 years’ experience in the mental health field. You can hear her podcast, “The Rock Your Awesome Show with Dr. Shawn Horn” on iTunes and google play and find her on social media @drshawnhorn. This column is for educational purposes and is not intended as direct medical advice nor constitutes a professional relationship with Dr. Shawn. If needed, please seek support in your community.
F
First Session begins, I say, “Welcome….so today we are going to do an intake where I gather information on what brings you here and get my thoughts together on the best course of action….” Client-“Well, I think I’m Depressed. I’m home a lot, I really don’t like being around people. I become so agitated with them, I’m not really motivated to do
social things…Someone told me I was depressed and needed help.” The client begins to describe how she has always been that way. How she prefers to be home alone with a book, likes solitude, will be around others, but happy to get back home. This preference hasn’t really interfered with her work nor is it distressing. She doesn’t have a lot of relationships…but she really prefers it that way. Although others thought it was odd, she was content. However, their alarm, alarmed her! So she came to seek help. “What would you like to get out of your therapy experience?” Well, Dr. Shawn, I would like to be social, it would be great if I wanted to be around others, be outgoing, do all the things others are doing. I think I should be doing that right? I mean, shouldn’t I want too?” After a few sessions I gave her my feedback. “We have had a few sessions now and I think I have a clear idea what the diagnosis is.” “REALLY!?! WHAT?” “Well, I don’t want to alarm you…but you have a serious case of….Introversion.” “What?” she smiles. Let me explain. I began to share with her how introversion is not a disorder or a problem. It is a preference given the persons disposition. They are pretty much born this way. Many introverts will say, if they have free time, they would prefer to spend it alone, with a good book, perhaps with a warm cup of tea and yummy blanket. Even this extrovert (me) thinks that sounds AMAZING! You see, Introverts get “refueled” with alone time, and fatigued with social interaction. The opposite is true for Extroverts. If they have free time they want to organize a get together, have friends over and spend time with others. They are fueled by social engagement and fatigued by isolation. This isn’t a hard rule, but it is a notable difference. The above scenario is a typical experience I have had treating thousands of individuals over the course of my career as a Licensed Clinical Psychologist in private practice. There is one common trait I see in most of them. I have named it, “Connect the Dot Disorder.” This is when individuals will jump to a conclusion about their experience, feelings, and behavior. They are not aware of contributing factors nor have appropriate expectations for themselves, others or life in general. They then believe they are experiencing some “phenomenon” or have something permanently wrong with them and catastrophize their current state. They begin thinking they will ALWAYS be this way! Unfortunately, some have even been told they will always have……(fill in the blank). Once we work together I discover some of the contributing factors and educate them on why their body is experiencing what it is, or what’s going on with their emotions. Some of the contributing factors involve lifestyle: not eating, too much soda, too much sugar, alcohol, coffee, lack of sleep, too much stress etc. Some are physical: hormone problems, diabetes, thyroid issues, gluten intolerances, vitamin D deficiencies, genetic mutations and more. Some are circumstantial: loss of job, loss of a love one, financial concerns, relationship concerns, etc. Some involve mindsets and beliefs: I shouldn’t, life shouldn’t, it’s not ok…basically unrealistic expectations for themselves and life. They don’t have a sense on what is ‘normal.’ After I “connect the dots” for them, they begin to understand, we then know how to help and they begin their journey. At the end, they say, “Thank you so much Dr. Shawn, I didn’t think there was hope, but now I know there is!” This is why I have decided to name this column, “Connecting the Dots.” We will begin to discuss some of these factors and help you, the reader, connect the dots. To understand what is really means to be human, learn appropriate expectations for our lives/experiences and become equip with information which will assist you in breaking down the stigma of mental health and support your own healing journey. I can’t wait to begin this journey with YOU!
Jumping to Conclusions
panic dis order nia a m illo t a m der
rt i c toh i l l mo a ain
anxiety
ptsd
GAD
ocd
anxietywithdisorders kimberly quinlan
CALIFORNIA LICENSED MARRIAGE AND FAMILY THERAPIST, FOUNDER OF CBT.SCHOOL.COM, & HOST OF THE YOUR ANXIETY TOOLKIT PODCAST @cbtschool @KimberleyQuinlan CBT School
cbtschool.com kimberleyquinlan-lmft.com
Kimberley, originally from Australia, has a private practice, specializing in Anxiety Disorders, Body Focused Repetitive Behaviors and Eating Disorders in the city of Calabasas, CA. She is the founder of CBTSchool.com, an online psycho-education platform that provides online e-courses for those with OCD, OCD Related Disorders and Body Focused Repetitive Behaviors (BFRB’S). Kimberley is also the host of Your Anxiety Toolkit Podcast, a podcast aimed at providing mindfulness-based tools for OCD, anxiety, depression and BFRB’s. The goal of the podcast is to not only provide listeners to helpful resources, but also to provide them with a great big virtual hug and make them feel less alone.
I
I have always found myself incredibly interested in mental health and psychology. When I left to go to college, I became overwhelmed with significant anxiety, and this quickly developed into disordered eating, and then an Eating
Disorder. I would spend hours of each day mentally and physically calculating calories, planning meals, compulsively exercising and obsessing over how people perceived my body. Over time, I came to realize that my world was getting smaller and smaller and I finally reached out to a mental health professional for help. I quickly learned that I needed to change a lot of behaviors in my life and as I did this, I decided to quit my job as a personal trainer and nutrition coach (both in which reinforced my eating disorder) and decided to go back to school to be a psychotherapist. After I graduated, I was fortunate to get an intern position at an OCD Center and I was trained to specialize in Obsessive Compulsive Disorder and Obsessive Compulsive Spectrum Disorders. I immediately resonated with my clients with OCD, as it felt so similar to the cycle or obsessions and compulsions I experienced with my Eating Disorder. I now adore the work I do and I am so fulfilled by empowered by helping people in my community. What mental health disorders are connected to anxiety? Everyone has anxiety. The important thing to remember is that anxiety runs on a spectrum. On one end, people might have occasional anxiety about life, life stressors and common dangers that occur in life such as earthquakes, storms, terrorism etc. On the other end of the spectrum is where anxiety takes the form of a disorder. In this case, the presence of anxiety can severely reduce functioning, damage and impair relationships and cause significant distress to a person. Common Anxiety disorders are Generalized Anxiety Disorder, Panic Disorder, Social Anxiety, Obsessive Compulsive Disorder, Health Anxiety, Specific Phobias and Post Traumatic Stress Disorder. In General Anxiety Disorder, you may find yourself worrying about life stressors for large portions of the day. It is common for those with Generalized Anxiety Disorder to engage in a lot of cognitive distortions, which are errors in thinking such as catastrophizing, magical thinking and black and while thinking. With Panic Disorder, one will experience intense levels of anxiety to the degree that they are unable function in daily activities. The panic attacks often manifest
physically, with severe physical symptoms that can occur at any time and cause significant distress for the sufferer. With Social Anxiety, one will be preoccupied with the being judged by others. Someone with Social Anxiety often engage in a lot of social avoidance and this can cause them to struggle socially, academically, and professionally. With Obsessive Compulsive Disorder, one will experience intense, intrusive thoughts, feelings, sensations and urges, which are called Obsessions. These Obsessions lead to compulsive behaviors that are done in effort to reduce very high levels of anxiety, uncertainty, disgust and discomfort. There are many sub-types of OCD, so please got to IOCDF.org for more information on these subtypes. Health Anxiety is an anxiety disorder that involves significant fears about ones physical health. It is common for those with Health Anxiety to be fearful (or certain) that they have severe medical symptoms that result in multiple doctor visits, excessive checking for medical symptoms and large degrees of reassurance seeking via google searches and second and third opinions by doctors. Specific Phobias can show up in many forms. Phobias can be related to pretty much any object, sensation, or event, however, the most common forms of phobias are to needles, vomit, dark rooms, hospitals, death, airplanes and water. Post Traumatic Stress Disorder (PTSD) is an anxiety related to a previous traumatic event. Those who struggle with PTSD commonly experience flashbacks of the traumatic event, nightmares, dissociation, and panic attacks. The wonderful news is that Anxiety Disorders are highly treatable and people can learn helpful tools to help them manage, reduce their symptoms and live a full and thriving life. Advice on Panic Disorder The most difficult thing about Panic Disorder is that instinctually, we assume the best way to manage high levels of anxiety is to run and hide. This is what we call avoidance. While instinctually this might make sense, this often makes the panic worse. The best tools for managing a panic attack is to gently allow yourself to just feel the panic as it rises and falls and use tools (such as mindfulness etc) as you do this. Often after someone has a panic attack, they commit to avoiding the trigger for that panic attack. This also can reinforce the panic symptoms. The goal with anxiety and panic is to always work on facing your fears every day. One of the most common things I tell my clients and social media followers is, “It is a beautiful day to do hard things."
"anxiety runs on a spectrum."
What this means is that we have to take each day and use it as an opportunity to stare our fear right in the face. While this may feel scary, it will help retrain our brain and teach it that we can, in fact, handle our anxiety and that anxiety cannot take anything from us.
Throughout your journey of teaching & helping other with anxiety disorders & BFRB disorders, what have you noticed helps each person the most?
It is also super important to remember that panic attacks cannot hurt us. If we don’t fight them, they will rise and fall on their own and we can go back to our day.
The first thing is a community. When we know we are not alone, we tend to thrive. Knowing that others are out there struggling with the same issues can be incredibly helpful and can reduce shame, guilt and embarrassment.
Advice on OCD The gold-standard treatment for OCD is Cognitive Behavioral Therapy, specifically focusing on Exposure & Response Prevention (ERP), which is a component of Behavioral Therapy used to help a client learn to face their fears and refrain from doing compulsive behavior (both Overt and Covert). By using a hierarchy (created by the therapist and the client), the client will slowly expose themselves to their specific obsession and fear and learn mindfulness tools to manage their anxiety and other emotions that they experience, instead of doing compulsive behaviors Advice on Dermatillomania & Trichotillomania Overcoming Hair Pulling and Skin Picking is not as easy as “just stopping” and is not just a matter of willpower. The gold-standard for BFRB’s is Cognitive Behavioral Therapy (CBT), with an emphasis on Habit Reversal Training. Treatment involves Cognitive Therapy, which teaches people with Trichotillomania to identifying binge urges and triggers and how to restructure their distorted thoughts into more reasonable and rational thoughts. Behavioral Therapy involves making small, but significant behavioral changes to reduce the chances of hair pulling and to manage life stressors. Habit Reversal Training (HRT) is a behavioral tool used to reduce urges and strategically plan for triggers and events that can increase the likelihood of hair pulling. We don’t quite know why BFRB’s are developed yet. There is still not enough research to help us understand it entirely. What we do know is that it is commonly a combination of nature (genetics) and nurture (our environment). Sometimes people pick their skin and pull their hair to avoid anxiety, but other times they might engage in BFRB’s to escape boredom, stress, anger and other psychological emotions. Other people with BFRB’s might not even know they are picking or pulling and get stuck in what we call a “trance”. This is a deep almost meditative state where they lose track of time and their location and become so fixated on the skin or hair that they are unaware that they are engaging in a BFRB.
There are several things that I find helps them the most.
The second thing is self-compassion. Too often I see people with these disorders beat themselves up so much for what they have been through and are going through. My heart hurts so much when I hear them tell themselves that they are faulty human beings because of these disorders. I really hope that my message can help people understand that it is not their fault that they are going through this and that their worth has nothing to do with these disorders. They are still wonderful, smart, beautiful, funny and worthy human beings. The last things is this. YOU CAN TAKE YOUR LIFE BACK FROM THESE DISORDERS. These disorders often cause havoc on peoples lives and take away the things they love most, like friendships, careers, hobbies, and much more. But I my mission is to help people see that they can live a full life with or without these struggles. I see people every day take their life back and tell anxiety that it isn’t in control anymore. They tell anxiety to take a back seat, because they are taking the steering wheel from now on and this is so wonderful to see.
how i battled OCD & ANXIETY
@becoming_courtney
HOLISTIC COACH AND SURVIVOR OF OCD/SEVERE ANXIETY
In February of 2004, I had a stomach virus. I threw up a few times, it wasn’t fun, but it was life, and within 24 hours it had passed. I survived and moved on. Fast forward one month later to March of 2004, my sister had gotten that same stomach virus and for some reason, it triggered this intense fear, anxiety, and panic that would consume the next 14 years of my life. I specifically remember hearing that my sister was inside getting sick, and I was hysterically crying, pacing back and forth on my driveway, terrified at the thought of her, me, or anyone throwing up. This was the first panic attack I had ever had in my life, and it was paralyzing. I had no explanation for this phobia I had developed, or this anxiety that was taking over me. Within 24 hours, my sister was completely back to normal, but my life had completely changed. As days went on, my anxiety got progressively worse. I started to form these habits, where I felt like if I didn’t do something a certain way, I would get sick. It took me so long to do the simplest tasks, such as leave a room or turn the light off. I had to switch the light switch on and off 4 times, or else I would get sick. I had to say a ritual in my head everytime I left the room, or else I would get sick. As frustrated with myself as I was, I was more confused than anything. I was always a very happy kid, and within one day I went from living a carefree, joyful life to living this life consumed by negative thoughts and fear. After seeing their daughter transform into this completely different kid filled with worry, my parents made the decision to take me to go see a psychiatrist and a psychologist, to try to get to the bottom of this, and get me the relief I so badly desired. After multiple screenings and evaluations, I was diagnosed with severe Anxiety, Obsessive Compulsive Disorder, and Emetophobia (the phobia of vomiting). I was also placed on my first antidepressant. Although it felt good to get some answers, I remember feeling so ashamed with myself. I still didn’t understand why I had to struggle this badly. The medication I was first put on started to give me a little relief, but it took time, and many adjustments. My anxiety and OCD would fluctuate very frequently, leading to psychiatrist appointments every six weeks to adjust the medication I was on, and therapy twice a week to try to help everyone understand what was going on. Eventually, the medication I was on and the therapy I was doing started to work, and I would feel like I was gaining control of my life again, until a few months would go by, and more flare ups would occur. These flare ups led to more adjustments in my medication, which sometimes would help, but other times they would make me feel worse, and the cycle continued. This was my life, and I had learned to accept it. I think one of the worst parts about all of this was the unknown. Going about my normal day, when a panic attack would come on out of nowhere was one of the scariest parts. I would be left shaking, crying, and beyond nauseous. When I had these panic attacks, my biggest fear was that I would throw up, but these panic attacks would leave me so nauseated that I would just worry more, making the nausea worse, making the anxiety worse, etc. It was a vicious cycle. Over the years, I had seen more psychologists and psychiatrists than I could keep track of. They all were trying to give me the right tools and medications to get me back to normal, when in reality, normal was the last thing I ever felt. Even when medications would work, I still had this fear in the back of my mind that I would spiral again. Eventually, I felt like I had gotten to a pretty good place. I was going long periods of time without panic attacks, and I went over a year without the need to adjust my medications. I got towards the end of my sophomore year of high
school, and the time finally came...I threw up. It was the first time since second grade, and guess what? I didn’t die, it wasn’t pleasant, but I survived. However, my mind thought otherwise. Immediately after I got sick, I had one of the worst panic attacks I had ever had in my life, terrified that it would happen again. I felt like everything I had worked past had come rushing back in, and I was right back to my 8 year old self. I ended up spending the next 8 months convinced I had a stomach virus. I was constantly nauseous because of how worked up I always was, my habits were back and worse than they had ever been in my life, and the worst part about it all was that I was oblivious to the fact that this was all anxiety based. I truly believed I was sick. For 8 months. I was living off of plain pasta, crackers, applesauce, and bananas. You would not see me leave the house without a stack of saltines and a Ginger Ale. I was missing school, missing out on time with my friends, I was in a relationship at the time that was falling apart because the person he started dating no longer existed, and I was down 20 pounds. I was seeing a new therapist who I loved, but I felt so sick at our sessions that I could barely pay attention to what she was saying to me. Aside from feeling anxious and frustrated, I started feeling depressed. This was not the life I wanted to be living, and I truly believed that unless the medication I was on was helping, this would be my life as I knew it. Just like every other time I had spiraled downhill, I eventually got myself back to “normal”. The new medication kicked in, the anxiety and OCD faded out a bit, and I was back to living my life. I graduated from high school, I went off to college, and I lived my life. My habits and anxiety never fully disappeared. It was always something that was there, I was just so used to these tendencies that I had a better handle on it, and knew how to keep it to myself. Now, fast forward to the summer before my senior year of college. I noticed that I was starting to feel my anxiety flare up a little, and I wanted to get one step ahead of it before it got any worse, so I went back to my psychiatrist (because at this point in time, medication was the only known answer to my problems). I was already on 200 mg of Zoloft, which is the highest possible legal dosage of this medication. After sitting in the same chair I had been sitting in for years, talking to the same doctor about my same problems, I remember her exact words. “Technically you are on the highest dose that I can legally prescribe you, but you have been on this medication for long enough, that I am confident to push you up to 225 mg of Zoloft. You can start today”. I walked out of that office that day, and something just clicked. I called my mom, and I told her I didn’t want to be on medication anymore. She was taken back to here this, because medication was always the answer to my problems. In my heart I just knew there had to be some other option. I went home that day, and I started doing my research. I talked to my one friend who was very into holistic health, and she showed me specific essential oils that could help with anxiety. I went home and I bought the oils. That gave me some relief, but I knew there was way more to it. I went back to her, and we did my very first meditation together. I felt relaxed afterwards, but I knew there was more to it. As I did more research, I read something completely new, that no doctor had ever told me before. I learned that roughly 90% of serotonin (what regulates feelings of wellbeing and happiness, and what the antidepressants were trying adjust) comes from the gut. I was blown away by this. Could what I was eating really be the root cause of all of this suffering? From that moment on, I became aware of the
ffoods I was putting into my body, and how I felt after. Before I go on to talk about how food helped changed my life, let me just mention that my diet up leading up until this moment consisted of bagels, pizza, pasta, bread, cookies, cupcakes, candy, soda, and juice. Every. Single. Day. I was quite possibly one of the most unhealthy eaters, but I never thought it mattered because I naturally have a fast metabolism, and I thought that the only reason you had to eat healthy was to get in shape. After doing more research and some experimenting, I was blown away by how certain foods were affecting me. I started by experimenting with dairy. I was noticing that I was feeling more nauseous, anxious, and tired when I had dairy, so I cut it out. It wasn’t easy, but I wasn’t messing around at this point. Once I cut dairy out, the amount of anxiety and frequent upset stomachs had decreased, but I knew there was more I needed to do. Having a father with severe Celiac disease, and a sister and mother with gluten sensitivity, I wasn’t surprised to learn that gluten was something I needed to eliminate too. Needless to say, I noticed even more of a difference, but I still wasn’t where I wanted to be. I kept repeating this process of noting how I would feel after eating certain foods, and eliminating them if need be. I ended up cutting out dairy, gluten, eggs, meat, and all processed/artificial foods, and it made all the difference in the world. Throughout the process of learning about healing my gut and feeding my body the proper nutrients it was so badly craving these past 14 years, I managed to wean myself off of my Zoloft entirely. I stopped seeing my psychiatrist and therapist, I began a practice of daily meditation, I developed a passion for lifting, and I fell in love with taking care of my body. I graduated from college this past May, and within that same week, I enrolled in the Institute for Integrative Nutrition, which is an online school that will allow me to pursue my dream in becoming a certified health coach. My journey was far from easy, but it was an experience that I will be forever grateful for. It taught me resilience, it taught me strength, and it taught me how to treat my body properly. I’m not expecting to never have any anxiety ever again, but I now have the tools to power through any obstacles that come my way. To this day, my phobia still briefly exists, and I do feel anxious from time to time, but I’m still a work in progress, and I’m proud of the person I grew up to be.
I’m proud of the person I grew up to be.
I’m still a work in progress, and...
TRICHO
Body-Focused Repetitive Behavior disorders are not spoken about as much as other disorders are, yet many people do indeed experience them. The following stories are of brave individuals who have decided to share their story, so you may become aware (if you neever knew about these disorders) and no longer feel alone (if you too suffer from one or both of these disorders).
TILLO
DERMA
MANIA
A
N
D
Lucine's Story The name Lucine means "moon". 19 y/0 from Germany @lucinebae
Around the time before high school, I remember noticing, when I tie my hair up, the shorter parts of the hair. They somehow bothered me so much. At first I think I might have cut them a little bit so I don't feel them anymore but after a while I started pulling them. About a year, it didn't effect me and i stopped. The second year of high school, was when a lot of struggles started for me. A lot of ups and downs, a lot of new and old things coming in and out of my life and that's when i began pulling my hair. I never understood why I started pulling, I'm afraid I will never know why I started it. I remember getting compliments for my hair the first year of high school, I also remember loving my hair and always wanting to make it look good. But after the second year, I really started not caring about my hair, my hair has began feeling like a relieve to me I never thought about it becoming such a huge problem for me in the future. All I wanted to do with it was to do what I did and hide it later so nobody can see any bald spots. But later that turned to the length change as well, that's when i started feeling more insecure and more aware but still didn't try to stop it. The urge to pull has always been there, sadly it still is there. It was like something raises my hand up to my head, finds a spot and forces it to start pulling. After a while it became more noticeable and harder to stop. One day, I was on YouTube again, watching random videos and this video came up on my recommended list. I was curious as to what that was, cause it involved someone I watched before and I wanted to see, as the title said “What you don't know about ...” I clicked it, she was talking about her struggles in life and having this one secret that she revealed in the video. She explained her life that she shows on social media a bit, and she said there was one thing no one knew about her. She stopped, the moment she said “I have Trichotillomania” within seconds, an explanation comes up in the screen and i remember pausing the video to read, the moment i read it, my heart just broke. The more i kept on watching, the more i related to her, the more i understood what i was doing. The next day, i told my mom about what i saw and learned and everything kind of hit us. I suddenly got an answer, an explanation to something i never thought i on your hair. Once you are more aware, when you notice more of your hair pulling, would. I thought i was the only one to do this, i thought it was only me doing this. that can maybe be the time that it gets easier to find the triggers as a short term. For The more i become aware, the more i try to stop but also the more i got hurt, the long term, you can identify easier as to why you have more anxiety in your life because you realise how much pressure you put in yourself for things happening and what effects your life at that moment. Then that can be what triggers the hair around you. pulling.
A
Stigmas I havent experienced anything myself but i always had this idea in my mind “Everyone is noticing your off hair style and they are judging you” Our society now sadly focuses on visuals and looks a lot so hair is probably something people focus on or at least look at. I also think that people are not really aware of our disorder unless they have it or getting introduced to it. Some doesnt even consider “hair pulling” as a disorder, or it being connected to stress or anxiety. Advice To You Do not pressure yourself and be patient with your recovery or willing to stop. It seems so easy to “stop” doing something for people that are not struggling with it. Its so easy to say “Stop doing it” but if it was easy, we would have been already stopped. Its not something we are happy or proud of, we also wanna stop but i feel like people really dont give time. They expect it to stop right away when they say “dont do it” Try to take your mind anywhere else, always have something on your hand that you can pick up to, play with, roll or squeeze. Try coloring, drawing, writing, knitting. Find new hobbies and keep your hand busy so that it wont reach to your hair. If there is something you wanna change about your hair, change it. Cut it, color it. That worked for me, maybe can work for you too. Try new things to your hair, so that you can love your hair back again. I also would like to say something for anybody that knows someone that is struggling with Trichotillomania ; please give them time, instead of complaining at the time they pull their hair, try to help and react nicer and remind them. Dont point out their bald spots, point out their recovery and hair growth. You will see how much it will help them. Triggers Short term, when im angry, nervous or just not feeling well, i pull more and seem to not take down my hand off my hair. But as long term, if a lot of things are happening in a short period of time, i can identify my triggers as in that time cause my bald spots to kind of increase. Try to find the triggers after or around the time you are more aware of your actions
Self-Reflection That i cared. That i cared way more than anybody has deserved or asked for. Also aimed more. I gave people so much love, care, attention and i wanted all back the same amount. I learned to stop expecting what i give back. I learned not to let peoples words and actions effect me as much and have a turn to judge my life. The words hurt, i still struggle to put them away and not care about them but i learned not to get my all down. Not everybody has to love me and agree with everything i say. I was so selfish to think that everything i think was right. It was not, and now i am aware of that.
TASHA
Note from Tasha: The photo above has been edited to not show scars & wounds. Hello Everyone! My name is Tasha and I am 21 years old, I am a full-time college student working on two degrees and have a part-time job as well as am a moderator for a group of ladies that send out birthday cards to an even larger facebook group of around 1,000+ young ladies of the creative arts! @iamtashaann
DermaAndMe
When I noticed I have an issue with skin picking (Dermatillomania I now know it to be) I was around 12 years old, however, I could have actually been older. This actually stemmed from after I stopped chewing my hair out of a nervous and compulsive habit and turned into skin picking. I've had acne since I was 12 and still battle it to this day almost ten years later, and that's where my picking originally started. I personally feel as though it was because I was going through a lot of stressful situations and struggling with a lot of anxiety as well due to my father having cancer (who also picked his skin, however that was a habit he admitted and not a disorder and would do it when he was bored). It became an even harder struggle when I turned 16. I was homeschooled, however, still went to classes some places and was around people. I get very anxious and nervous in crowds and around new people (introvert anyone?) and would pick to soothe myself as well as keep my hands doing something, little did I know that was the actual reasoning for my picking. Not only do I pick on my face, but it is also concentrated on my back as well mainly, however, I do pick in other areas. I went through a lot of emotions about my Dermatillomania due to people believing that it's a habit I need to stop and grow out of, if I just would clear up my acne it would go away (which is untrue since I also pick at blemishes and regular scabs), and also the looks I get from some people when they see me actively doing it, however, I do try to be discrete. I have been learning to accept it since I was around 18 and working through it daily. It is a battle from the time I wake up to the moment I fall
asleep, not actually just when I go to bed either, I actually have to be asleep. Somedays the compulsion is too much and I have to give into it, however a lot of self-care and love goes into myself for after-care, but I have to be very cautious in not scrubbing my skin raw due to also having OCD and the overwhelming desire to clean. Stigmas Oh yes, 100%. Again as I mentioned in regards to my journey, people think its a habit, and that you either need to just grow out of it, or stop it. It's not that simple, it is an anxiety disorder and compulsion, and just keeping my hands busy with something else sometimes just isn't enough, and believe me, I've tried lots of things- silly puddy, fidget spinners, drawing, writing, etc. It doesn't always work and does take a lot of will power as well. Triggers One severe trigger I have currently is school and shouting. So for example, if I am overwhelmed or anxious about an assignment I notice I tend to pick more, I notice this by one, stares, and two, being conscience about getting up to get tissues. Shouting is also something that triggers my anxiety and as I mentioned before with the OCD, if i have not cleaned a surface with wipes througholy or if someone is sick around me, I tend to pick way more than I normally would. Notice your habits- how often do you need to grab a tissue or go to the bathroom to deal with it? What is happening in that moment? What is the setting?
"Notice your habits-  how often do you need to grab a tissue or go to the bathroom to deal with it? What is happening in that moment? What is the setting?" Advice To You Give yourself some slack and grace. It is a struggle which you are always going uphill for, and some days it is worse than others. But just remember you aren't alone. Also, especially with Dermtillomania focused on the face, back and armsyou are still beautiful, and someone still wants you. Never believes those lies that say your ugly, disgusting, or worthless, because you are not. You're a lot stronger than most people by going through this on a daily basis. Self-Reflection I have learned that I am an amazing person and woman for dealing with this struggle every day, and to ignore people who stare or even mention it. I've learned to be open and explain to people in simple terms what exactly it is and not to comment on it because it makes it worse for me. Bringing awareness I see now is so important and should be spread near and far! Also, an extra tip- applying for a job, try your best the night before not to pick and that day, but if you do, bring alcohol pads, baby powder, and some makeup. After you get hired for the job, just take it in strides, and make sure to have those aftercare items with you in a little pouch just in case!
ISSUE 14
TESTIMONIALS
@UNICORNS_AND RAINBOWS _SYSTEM The Dec/Jan issue, I felt was instrumental in removing certain extreme stigma surrounding DID which can be attributed to the magazine outreach. It also carefully addressed anxiety and gave a reasoning behind it, allowing people afflicted with it to feel valid. I would 100% recommend this to other people to read. This is because it introduced us to examples of perfectly functional people with DID and proves to us that being diagnosed really isn't the end of the world. It feels unrealistically amazing to see people whom I had been following on YouTube and Instagram actually heard on a more formal platform. It gives us hope. I would like others to feel that hope as well. This issue is special to us for a very simple reason. It addresses all the issues we have been facing with the utmost care and concern. Especially a common side effect of DID in some alters: Anxiety. I was particularly moved by the articles by DissociaDID and Multiplicityandme. They were my first guides to dealing with and understanding DID and I cannot be more grateful that they exist. I find them exceedingly kind for having dedicated a generous portion of their lives to help others with the same mental health issue. However I do definitely wish they needn't have gone through so much trauma and pray for protected prosperous lives with great potential for all of the systems, not just the two systems I mentioned.
@SILVER_STREAM_SYSTEM We really enjoyed this issue because it explored some of the most stigmatized problems, such as body image and dissociative identity disorder, which we personally struggle with. I honestly think eveyone should read this because there is SO much stigma attached to struggles, and so many misconceptions about them especially DID. This issue made me feel so proud to be part of the mental health awareness movement and the dissociative identity movement. We were only diagnosed in September of 2018, and have found so much empowerment entering this community during a time where those with DID are using their voices and creating awareness. It is so beautiful that this magazine chose to be part of that. I must say we’re pretty partial to the the articles by the Kristin Chronicles and DissociaDID. DissociaDID is who we turned to right when we got diagnosed and really helped us feel less alone and helped address all our questions about DID. Kristin Chronicles are our friends, and literally we have learned more from them the past couple months than we’ve ever learned in our years of therapy. I was so proud of them for submitting to Toi and putting themselves out there.