Designated Worry Time

In my last blog, I wrote that I had a mole removed to see it was melanoma. I got a call from my dermatologist that it had atypical cells, but wasn't skin cancer. I was relieved and had been trying to remain calm about the whole thing as best I could. I don't know if this is due to the bipolar disorder, but whenever I get stressed, it immediately effects my sleep. I have trouble falling asleep, and then I wake up several times throughout the night. I usually wake up early and can't go back to sleep. I try my best not to get stressed, but by my nature I'm a worrier.

So, it was interesting when the moderator of our bipolar support group, Alicia Brosse, handed out a sheet about worrying. It's called Designated Worry Time (DWT), and with this process, you set aside time one or two times each day to worry. Here's how it works.

In DWT, you "worry to death" one worry before moving on to the next, rather than jumping from one worry to another. This complete immersion into your worries generally leads to habituation - the anxiety you feel is likely to peak and then decline during your DWT, and after practicing DWT for several days, anxiety may even be replaced with boredom.This helps limit worry to one part of the day so that it doesn't interrupt other times such as at night when you are trying to fall asleep.

Part 1: Designate Worry Time

1. Pick 1-2 times a day and dedicate 10 minute to worrying.
2. Set a timer for 10 minutes. During your DWT, JUST worry. Do not problem-solve, plan or try to reassure yourself.
3. Ask yourself what you are worried about. Really worry about what comes to mind. Stick with it. Ask yourself  "what about this worries me most? What's the worst that can happen?" Imagine the worst possible outcome. Before moving on to the next worry, ask yourself if there are any other concerns related to this worry. If not, you can move on to another worry. Repeat this step until the end of your DWT.
4. If you run out of things about which to worry before the timer goes off, repeat the worries you already worried to death. It's important to keep at it for the entire 10 minute period.
5. At the end of your DWT, you may want to take a few ddep breaths, paying attention to each breath, and then shift your focus to an activity in the present moment (e.g., make dinner, engage in conversation, do some work.

I'll finish the DWT steps next blog, but this can get you started if you want to give Designated Worry Time a try.

Source: Alicia L. Brosse, PhD LLC (www.bouldercbt.com)

Melanoma and Fear

Over the past 30 years, I've had dozens of funky looking moles cut off of my body. Some have been atypical, but none were melanoma. I have so many moles, that I think I have a mole factory in my body that generates the little brown buggers; sometimes new ones show up daily. So, I went to my dermatologist, Dr. Isabell Zhu, this morning for a check-up. I had a mole that looked irregular and wanted her to look at it. It's been a few months since I saw her last, and I decided that going every six months instead of every year would be better for me. She did a full body scan, and the mole I thought was weird she said was fine, but another mole had irregular borders, so she shaved it off so that it could be biopsied.

According to the American Melanoma Foundation, the  ABCD's to look for signs of melanoma are:

A for Asymmetry
One half is different than the other half.

B for Border Irregularity
The edges are notched, uneven, or blurred.

C for Color
The color is uneven. Shades of brown, tan,
and black are present.

D for Diameter
Diameter is greater than 6 millimeters

As per the American Melanoma Foundation, melanoma is the fifth most common cancer in men, and the sixth most common in women. In 2005, at current rates, one in 34 Americans has a lifetime risk of developing melanoma. More than 73% of skin cancer deaths are from melanoma.

With these kinds of statistics, I usually get very uptight when she finds a mole that she thinks is suspicious and begin to engage in catastrophic thinking. I worry that I'll  die from melanoma. Once I start thinking fearful things, the ideas accelerate and like monkeys swinging vine to vine, the scary thoughts connect to one another and lead me in a downward spiral.  Fear rips through all levels of consciousness and my gut hurts so much that I don't want to eat. The antipsychotic meds I'm on don't seem to help keep me emotionally balanced when it comes to fear.

This time though, I'm trying to stay calm about it and not grab the "dread" thread of thinking bad thoughts. Instead, I'm trying to look at this rationally. I get regular check ups, so even if I do have melanoma, hopefully it will be caught early and then it is highly treatable. When melanoma spreads to other organs, that's when it can become deadly. In my bipolar support group, I mentioned yesterday my fears around this, and two of the women in the 8 person group had had melanoma and are fine. So, melanoma isn't a death sentence, and I need to remember that whenever I start down the path of fear.