[acb-hsp] Socializing, multiple disabilities, etc.

[Carmella D Broome]

As is often the case, several comments Jessie has made lately  lead me to additional thoughts on this issue.

I'm sure that hearing loss  or other  additional  physical disabilities  makes  a lot of things, including socialization, much more difficult for someone who is blind.  Blind people rely  so much on  what they take in through  hearing in social settings,  and in many other settings, as well, so I can't imagine  how frustrating that must be at times.  I know that the blindness stuff often means needing to  be more aware and attentive  to  other sensory data and it takes a lot of energy to   do that.  Compromise another primary sense and  its even more to adapt to,  try and work around, and all those  words.  

Sometimes, I think it can be easy to say that the extra effort is not worth the  energy and planning  and possible problems that may come up.  I suspect this is   particularly true for introverts who have to push themselves more to be   social anyway.  If you're around  people, but feel unable to fully participate in conversations or activities,  that can feel more isolating than being  physically by yourself.  None of us like that  "left out" sort of feeling.  It can  remind us way too painfully of other times we've  experienced the same emotions and   those reminders are not pleasant ones.  

I think another aspect of this worth bringing up is  the reality that some of us also deal with emotional, mental health, psychiatric, etc. sorts of things.  There are certainly plenty of blind people with these additional issues to deal with.  I am one of those people.   I've  experienced several major depressive episodes since my late teens and seem to deal with that low grade dysthimic  stuff on an ongoing basis.  I  began having severe anxiety in my mid teens and have had several major episodes of GAD that   were extreme enough to interfere with  daily functioning. GAD, like the depression I experience, doesn't ever go away entirely either.  These two seem to feed off each other  and I'm constantly having to manage them   and their biopsychosocial impact on my life. 

For both of these "conditions" or whatever you want to call them, they're like white noise.  Sometimes, I can barely hear them  or don't notice them much. Other times, they are painfully loud and I need help turning the volume down, as it were.   I struggle with motivation, focus, low energy, procrastination, insomnia, irritability or  easily becoming tearful, being withdrawn, catastrophizing and worry,  and other symptoms. Depending on how all that is going, it may be all I can do to   try and accomplish what has to be done for work.  Forget finding the extra energy or  emotional reserve for social stuff. I just want to be alone  and read a good book in the safety of an environment I have control over as much as is ever possible. 

I didn't go into this work  because of these issues.  I don't think I  fully recognized their existence within myself when I decided to become a counselor. I  just knew I wanted to help people dealing with  relationship and family concerns to have someone safe and  knowledgeable to talk with.  It  wasn't until later that I began learning more about   diagnoses and   the DSM and all that.  By the time I did, I  already knew counseling was what I wanted to do.  My own personal  stuff became more  apparent  once I was actually  licensed and employed, I think, because I realized that  what I experienced wasn't just reaction to  stressful  life circumstances and for other reasons.      

Anyway,  point being, I know it is important to "push back" against symptoms such as being withdrawn or avoiding   responsibilities. Its important and helpful to  choose social activities that I think I'll enjoy, which usually involves me being with at least one  person I know already and am  comfortable with.  I prefer activities where I can be  in a small group, even if  that small group is part of a larger group.  I don't like noisy places or  lots of crowds but I don't mind  talking with people I dont' know as long as  the small talk doesn't last too long.  I find chit chat kind of exhausting after a  point. I  know it builds bridges between the "Hello" and a possible deeper connection and I'm okay wit it   if its   interesting and  comfortable.  I hope to get beyond it when I meet people I'd like to get to know better, obviously. 

Unless it just seems like something I  would not  be able to enjoy for a specific good reason, I have to remind myself that, affterwards, I'm usually glad I did whatever social thing  I  did but wasn't sure I wanted to do. I  have to remind myself of that fact and the importance of maintaining those connections and not base my decisions  strictly on  feelings. Sometimes, I'm very good at doing that "pushing back" thing and sometimes not.  

The better we're  coping in general, the more able we are to    want to  do social things, I think.  That's true for me anyway, as an introvert. I take appropriate medications, see a  counselor, and  do  what I can in terms of self care.  I  monitor my self talk, use distress tolerance and emotion regulation skills when necessary,  and draw on spirituality, sense of humor, and other resources.  Blah, blah, blah. Each of those things help in their own way, but there's no magic  solution, or even combination of things, that makes this stuff  get down to a totaly nonclinical level for me for any length of time.  Its frustrating, but  all I can do is try and manage it and not let it manage  me.     

Most people I come into casual contact with  have no ideaabout any of that, , though. They can see the visible disability but not the "invisible" stuff that's going on in addition to blindness. That's usually fine with me.  I don't  want or need most people to know about those things. The people who are close to me are aware and   supportive when I need them to be, for the most part. Other than my doctor and my  counselor, I don't talk about the emotional stuff unless I really need to usually, but there are times when I  really do have to. I'm still not as open about  these issues as I am about other things in my life, but I've become more honest out of necessity during the past few years.

I used to think that letting other people in  on  personal struggles, blindness or otherwise,  meant I was whining or    having a pity party.  I didn't want people  to feel sorry for me  because of blindness or anything else I  was dealing with.  Its hard for me to talk about the things that make me vulnerable. I know that  the challenges of blindness and the  mental health/psych   (pick your word) symptoms  feed off each other.  I think each makes the other more difficult to deal with.  That's my experience anyway. Throw in the range of life stressors that everyone, blind, sighted,  orange or green, has to deal with, and things can get pretty tough sometimes.  

I never want it to seem like I'm making excuses or trying to  label myself  for some kind of personal gain.   It doesn't  do any good to pretend problems don't exist or that they don't impact our lives either, though.   They aren't all of who we are, but they are things we  have to deal with. Additional  physical or emotional  problems are  another set of realities that can make  life as someone who is also blind somewhat more complicated. 

We all have to do what we feel is necessary to  find what helps us have  good quality of life, fulfillment, purpose,  and so on. I suspect many of us believe in that "handle each day"  idea and do a lot of the mindfulness stuff  to appreciate the good and to get through the not so good. Its up to us to do all we can to minimize the negative impact any physical or emotional problem has on our lives and we are all probably  better at doing that at some times and not so good at doing it  other times.  Reason being, we're human. Also, what successfully managing something means for one person may mean something very different for the next person.  Eachh person is unique and their approach to their challenges is unique.  That's why we expose our clients to a wide range of resources to help them cope with life, emotions, stress, and so on.  Same for ourselves.  The more resources we have to draw on, the better. Having social support is a crucial  resource, though, and  if we withdraw too much from others, we'll find ourselves without it. To me, that is loneliness, not  just being alone.    

I have no idea if rates of depression,  various types of anxiety disorders, or other mood disorders are  higher among people who are blind than in the sighted population. Or, if  they are higher among those with any type of physical disability than among those who don't have a physical  disability. I don't mean  adjustment disorders with  dep or anx because someone is in the process of grieving sight loss or the onset of another disability. I mean for people who  were born with a physical  disability or have had said disability since  chhildhood or adolescence.  

We'd be going back to the nature/nurture debate  to an extent, but we all know that additional life stressors can  lead to a person being more symptomatic in terms of  mental health/psychiatric symptoms whether they were there waiting to be  brought out or whether chronic stress or other environmental issues are the  cause.  I think we can  agree that, no matter how well we cope with it,  living in a world set up for people with all five senses when you   have one or more of those senses that does not  fully function day after day qualifies as a stressful life circumstance.  We're all different in terms of  how well we can tolerate chronic stress in general and then  you throw in  how supportive an environment we may have had emotionally and physically as kids, other life circumstances or possible traumas, and  the whole biopsychosocial range of  factors.  

Of course, those without disabilities would often assumed that  we  should be depressed or  traumatized. How could we not be, right?   How often are people with disabilities given mental health diagnoses based on someone else's  assumptions of how  they must feel or how severe  certain symptoms must be for someone who  has to live with a disability?  How often are  they  put on antidepressants even if they don't truly need them or without as thorough an evaluation?   

Maybe I just need to do a literature search about the   prevalence of  those with  physical disabilities being diagnosed with mental health  issues and what the research says about all this.  I'll add it to my  to research list. I am curious to an extent.  If any of you have already done that research, I'd like to know what you found. I think this could make for an interesting discussion topic.        



  
Carmella Broome EdS LPC LMFT
Crossroads Counseling Center, Lexington SC
http://CounselorCarmella.WordPress.com
Author of Carmella's Quest:  Taking On College Sight Unseen (Red Letter Press 2009)
http://CarmellasQuest.LiveJournal.com
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://www.acb.org/pipermail/acb-hsp/attachments/20120831/24aa119d/attachment-0001.html>